From Antarctica to Haiti, to red zones in Cape Town, Dr Shaheem de Vries is accustomed to getting his hands dirty while saving lives. He tells Spotlight’s Biénne Huisman about the new challenges he faces as CEO of Groote Schuur Hospital.
In charge of the University of Cape Town-linked tertiary hospital since February, De Vries brings to the table a reputation for quick thinking and two decades on the emergency medicine beat, including 10 years as a “head cowboy”.
The cool kids, the cowboys
Before taking over at Groote Schuur, De Vries headed Western Cape Government Health Emergency Medical Services, instilling in its 2 000 staff the galvanising mantra of “we are the heroes, the cool kids, the cowboys” – a narrative intended to spark morale and respect as rescue workers risked their lives driving ambulances into violent Cape Flats suburbs, known as red zones.
“My emergency staff were targeted because that’s what happens in these communities. And so, you can’t go into that community and say: ‘you know, you must protect us’. They can’t even protect their own granny going to collect her pension, let alone an ambulance.”
Among other qualifications, De Vries attended medical school and completed an MBA degree, both at UCT.
In the executive corridors of Groote Schuur, a slew of complexity awaits his navigation. With 970 beds, the iconic hospital is a beacon of hope to many, with sick people travelling from around the province and country for specialised treatment.
Catastrophic budget cuts
But the historic hospital is under pressure. In February, senior Groote Schuur staff, including Professor Lydia Cairncross, head of surgery, and Professor Ntobeko Ntusi, head of the department of medicine, spearheaded a petition to national and provincial Treasury, decrying “catastrophic budget cuts” and “crippling austerity”; saying how distressed clinicians, with multiplying work hours, watch patients grow increasingly ill as waiting lists for lifesaving elective surgery grow longer.
De Vries concedes that last year R200m was shaved off the hospital’s budget. However, he responds to these challenges in level tones, placing focus on what is at hand instead of that which was taken away.
“So we’ve had budget cuts,” he says. “We’ve got frozen posts, and staff are really stretched at the moment. But we still have a R3bn budget. We still have 3 700 people; or 3 500 people now – recently less 200. So for me, the thing is not so much what we’ve lost, but what is still possible.”
To cut or not to cut
Notwithstanding widespread concerns about further cuts, he holds on to optimism. “I don’t think that my option is to cut or not to cut (elective services as it stands). The optimistic way of looking at things means I won’t easily accept a binary choice.”
He insists on “engaging with all the stakeholders in the ecosystem, to find ways to optimise what we have to offer…”
“The clinicians here (at Groote Schuur) believe they can save every life. But the question is, should they? We also have to ask, at what cost? And so I think those conversations about at what cost do we pursue saving a life become compelling, because it comes at an opportunity cost for another patient. It comes at a very real economic cost for the system.”
On to triage – the models for determining orders of priority for treating patients, so as to use limited resources for those who benefit from them the most.
Triage is a long-standing topic of interest for De Vries – he co-authored a paper titled The Cape Triage Score – A triage system for South Africa, published in the South African Medical Journal in 2006, outlining a triage model for use in emergency units countrywide.
Resilient health system
“Triage is applicable when demand outstrips the available resources, right? And in the health system in South Africa, that happens daily,” he says. “Our ambulance waiting times, our surgical backlogs; in many other systems or countries, these would be considered major incidents.
“So a health system like ours actually is a very resilient health system, we saw that in Covid, when we outperformed many, much better resourced countries… We might not have a lot of resources, but we have a lot of resourcefulness.”
On a bookshelf, a trophy is marked: “University of Cape Town Graduate School of Business: student who contributed most towards the learning of others”.
Despite such accolades, De Vries refers to himself as a mediocre student at medical school.
‘Wow, I’m actually useful!’
“When you are a mediocre student, you are always catching up; you’re always the last one to catch the question. But after my first shift in emergency (at the Conradie Hospital in Pinelands) I was like, wow, I’m actually useful! I was comfortable with the chaos; I was comfortable making high value decisions with little information. Suddenly guys who were the smartest in class were asking me for advice. And then came the realisation that it’s not just about the knowledge, but also about how you think.”
The eldest sibling, De Vries – his father worked as a builder then a quantity surveyor, and his mother was a teacher – matriculated at South Peninsula High School in Diep River. “I did not want to squander my matric… so I guess medicine was just the thing to do,” he says. His wife Layla, an occupational therapist, discouraged him from dropping out of medical school.
“I thought about stopping in third year, in my fourth year and in my sixth year. I enjoy drawing and was drawn to architecture, the creativity. But we had married in my fifth year, and my wife said to me: just see it through.”
These life choices appear to have served him well. His face lights up discussing memories on the job. There was the mission to Antarctica in a chartered jet to save a Norwegian researcher in 2012; five years later he found himself on the Nile in a riverboat ambulance, sirens wailing.
In 2010, he joined humanitarian organisation Gift of the Givers in Haiti, after the earthquakes there. This inspired him to co-author an editorial entitled Haiti Disaster Tourism – A Medical Shame.
“Haiti was difficult and made me realise that … ethics must govern a rescue response,” he says.
Two months into his tenure, De Vries possibly faces his biggest leadership challenge yet – as peers look to him to translate optimism into strategy.
See more from MedicalBrief archives:
Groote Schuur Hospital CEO retires
Western Cape experts appeal for end to health budget cuts
Groote Schuur Hospital’s ICU adapted to the pandemic
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