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The world lost an exceptionally fine man and an internationally renowned surgeon when Ray Dawson died in December 2015 at his home in the Scotland.

His professional and social vision reached far beyond conventional horizons, while his courage enabled him to overcome every hurdle in the way to serving his country, and mankind in general, with the dedication and sensitive gentleness that came naturally to him.

Ray’s early experience in Rhodesia (now Zimbabwe) developed in him a deep and abiding respect for the people of the small-scale rural communities who lived hard lives in the African wilderness. He came to love the “Bush” with a wondering intensity that never left him, even when he was thrust into its harsh realities as the fierce Zimbabwean and Namibian guerrilla wars flared just after he gained his medical qualifications in 1975.

Here, amidst the violence of those remote combat zones which nonetheless offered unparalleled experiences and learning opportunities, he found a channel for his personal compassion and budding surgical skills. A Medical Officer (later, Major) in the Rhodesian Light Infantry Battalion (seconded from the Namibian-based surgical teams of the South African National Defence Force Medical Services), he applied his rapidly growing expertise in trauma care and vascular surgery to the welfare of combatants and civilians alike.

Ray’s medical training at the University of Cape Town (UCT) and Groote Schuur Hospital (funded by a De Beers’ Scholarship for Medicine)was at a time when the surgical department had reached a pinnacle in world recognition through the achievements of remarkable individuals such as Christiaan Barnard ,Jannie Louw and John Terblanche. Seizing the opportunities offered by this intellectually stimulating environment, especially it’s rapidly evolving expertise in vascular surgery; he graduated MB ChB with distinctions in surgery and forensic science, incidentally winning the prize for Best Student in Ophthalmology.

Subsequently he completed his training as a Registrar at the University of Rhodesia, as well as the University of Natal, Durban, and the University of the Witwatersrand, Johannesburg.  For a time, he was Senior Medical Officer in the Department of Surgery at the Ernest Oppenheimer Hospital in Welkom, a major centre of the South African gold mining industry, afterwards practising as a Consultant at the Mines Benefit Society, Rand Mutual Hospital and as a part-time Consultant at the Hillbrow Hospital, Johannesburg.

Later he graduated with FRCS(Edin) in 1982 and FCS(SA) in 2003.

Remaining in Johannesburg for some years, he entered private practice at the Brenthurst, Milpark, Sunninghill and Union Hospitals, initially in partnership with Neil Wright and subsequently in an expanded practice with Geoff Fotheringham and myself at Sandton Mediclinic  and the Netcare Olivedale Hospital. At all these hospitals he promoted and advanced vascular and general surgery to great effect, establishing an active private vascular laboratory amongst other achievements. Always underlying his activities in private practice was his recognition that surgeons like him were privileged to be able to operate on their patients, and one hardly need say that he invariably treated them with the deepest consideration and respect.

“When you find your passion, you express your talent, “Ray was wont to say, and so it proved in his life, where, despite the heavy demands of his teaching and private practice, he continually contributed in multiple ways to the advancement of surgery. He published and presented papers at high-level congresses convened, for example, by the Association of Surgeons in South Africa, the European Society of Cardiovascular Surgery, the SA Surgical Research Society, the Association of International Vascular Surgeons  (AIVS) and The International Society of Surgery, held variously in Belgium, Italy, Austria, Switzerland, the USA and Canada. Often he was a co-convenor of these conferences.

Harnessing his intense enthusiasm for surgery with his driving curiosity and deep insight, he was at first engaged in projects relating to the long saphenous vein as a conduit for distal bypass surgery; renal ischaemia in aortic surgery; and colon ischaemia in aortic surgery. A research scholarship from the Loewenstein Trust enabled him to explore ‘Ischaemic Colitis related to aneurysm surgery’. Later, he researched management strategies for ruptured aortic aneurysms; vein graft surveillance and stenosis; metabolic response in complex aortic surgery; endovascular therapy of varicose veins; and management of complications of renal access AV fistula procedures.

His contribution to International Surgery earned him an Honorary Fellowship to the American College of Surgeons in 2003 and an Honorary Associate Membership of the South African College of Surgery in 2002. These awards and the trajectory of Ray’s surgical career resulted in many invitations – 31in all – to be guest lecturer at congresses on diverse surgical topics. In addition, he co-authored twelve major published papers.

His services to the profession were extensive and profound, springing from his winning enthusiasm, his ability to relate closely to his colleagues at all levels and his organisational skills. He was a senior member of several professional bodies and at one time or another during his career he served as a Member of the Board of Directors of the SAMedical Association(SAMA) and of its Health Policy Committee, as well as chairman of its Private Practice and Specialist Private Practice committees. He served a term as president of the Vascular Association of Southern Africa (VASSA) and was on the executive for six years; and was Vice-President of the International Society of Cardiovascular Surgery (Southern Africa Chapter).

Ray was for five years president of the Association of Surgeons of South Africa (ASSA) and an executive director of Surgicom, ASSA’s business unit. During his tenure he made a presentation of behalf of ASSA in Mexico that won the first World Congress of Surgery for South Africa against considerable odds.

The medical profession and his numerous friends and associates in South Africa suffered a sad deprivation when Ray decided to move to Edinburgh in 2002. There, he very rapidly confirmed his stature as a teacher and practitioner of vascular surgery and was appointed Consultant Vascular Surgeon at the Lothian University Hospitals NHS Trust.

In short order, he was also appointed Tutor for the Higher Surgical Skills Course at The Royal College of Surgeons, Edinburgh; a Referee for the British Journal of Surgery; an Examiner for the Intercollegiate MRCS Examinations; and chairman of the Quality Improvement Committee of the department of Vascular Surgery at the Royal Infirmary of Edinburgh.

In line with his mantra of not thinking of work as work and play as play – but rather as living, Ray has always kept his quiet, relaxed demeanour, never losing his positive approach or his relish for life in the round.  A devoted family life with his delightful ophthalmologist wife, Joanna McGraw, his psychiatrist daughter, charming Siobhan and budding entrepreneur son, Ciaran, was always at the core of his being. His friends are grateful that notwithstanding his prolonged terminal illness (a burden that he bore with a smile) he was able to spend quality time with his two young grandchildren in Cape Town.

His death is a great loss to his many friends. We shall miss him and remember him forever.

Paul Cooke

Honorary Life-Vice President

Association of Surgeons of South Africa

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Jacobus Alwyn Van Zyl

Professor Kobus van Zyl died peacefully at his Bellville home on 10 May 2015.

Nephew of the first two Professors of Surgery at Stellenbosch University, he became the third in 1980. All who knew him will acknowledge, however, that this was not an appointment via family entitlement; his academic status was richly deserved and subsequently fulfilled over the next three decades, both before and after his retirement from fulltime practice at the end of 1994.

As a young Consultant in the early 1970’s, he was instrumental in re-organising Surgery at Karl Bremer Hospital, and a few years later at the new Tygerberg Hospital, along as yet largely unfathomed subspecialty lines. In the process, he entrenched Head- and Neck Surgery within Surgery at this institution, as it remains today.

Breast cancer management – and breast health in general – was his particular passion. He pioneered many firsts locally, including the establishment of a dedicated breast clinic, outreach initiatives to womens’ organisations and the community to provide information regarding breast health, conversion from traditional radical to modified radical mastectomy, adjuvant chemotherapy following surgery for breast cancer, diagnostic fine needle aspiration cytology, breast conservation in selected patients with early disease and sentinel lymph node biopsy. Some of his initiatives were met with scepticism – even hostility – by the surgical establishment at the time, but all were vindicated and became established practice within a few years. International recognition was, in fact, initially more forthcoming than locally and he was the only South African investigator to contribute to the 1980’s EORTC trials of local excision versus mastectomy for early breast cancer.

Kobus van Zyl was not just an innovator and advocate of evidence-based Surgery ahead of his time. He was also a dedicated, hands-on clinician, inspiring teacher and superb technical Surgeon. Surgery at Tygerberg / Stellenbosch University pays tribute to him and acknowledges the influence he has on our current practice.

Brian Warren

Division of Surgery

Tygerberg Hospital / University of Stellenbosch

Charl Dreyer

Charl Dreyer died suddenly in Cape Town on the evening of 13^th August 2015 while watching his favourite sport, tennis, on television. His untimely death has been a great loss to the surgical community of Cape Town. His journey in medicine started in 1974 when, after matriculating, he enrolled at the medical faculty at the University of Pretoria and graduated MB ChB in 1980. His internship at George Provincial Hospital was followed by compulsory military medical service and a senior medical officer post in orthopaedic surgery in Tembisa Hospital. In 1986 he started his surgical training in the Department of Surgery at the University of Cape Town, first learning to operate in the trenches at Cecilia Makiwane Hospital and a year later as a registrar at Groote Schuur Hospital. In March 1991 he passed his final surgical examinations and became a Fellow of the College of Surgeons of South Africa.

In the same year he joined the vascular firm at Groote Schuur Hospital where he, like many before him, was trained in the finer details of vascular surgery by Professor Ed Immelman. He subsequently honed his skills as a visiting surgical fellow at Addenbrooks in Cambridge. On his return to Cape Town, after completing his vascular apprenticeship, he established his private practice at the Christiaan Barnard Memorial Hospital. He remained closely affiliated to the Department of Surgery and the vascular unit at Groote Schuur Hospital as a senior consultant surgeon and lecturer.

Although Charl had excellent all-round surgical abilities, his foremost passion remained vascular surgery. He was one of the local pioneers of endovascular interventions and, in particular, advanced the cause and techniques of catheter-directed thrombolysis for arterial and venous thrombosis and the endovascular treatment of arterial aneurysms. His bedside manner was exemplary and his innate talents in the operating theatre were superb. He was a longstanding member of the Association of International Vascular Surgeons. At their annual congresses, often held at exotic alpine venues, he not only further developed his vascular repertoire but also learnt to ski.

Charl had wide-ranging knowledge in medicine, but also loved art, wild life and sport, especially tennis, where, when playing doubles, he would relish volleying at the net and was a wily master at disguising a variety of cunning and impish cross-court drop-shots to the consternation and chagrin of the opposition.

He was the doting father to his beautiful and talented daughter, Simone. Our condolences go to Simone, Helen, Jane, his friends and family.

Dr Kris Michalowski

Dear Colleagues

The African Surgical Outcomes Study (ASOS) website is live; http://www.asos.org.za/index.php

The website contains all the information about the study, the study documents necessary for ethics applications, frequently asked questions, contact details, and a page to register interest in participation.

It is imperative that ASOS has a broad representation across hospitals, and across Africa. We have already established potential collaborators in Algeria, Benin, Burundi, Egypt, Ethiopia, Ghana, Ivory Coast, Kenya, Libya, Malawi, Mauritius, Morocco, Mozambique, Namibia, Nigeria, Rwanda, Sierra Leone, South Africa, Tanzania, Tunisia, Uganda, Zambia and Zimbabwe.

Please could you visit the web site and register your interest to participate. It would be appreciated if you could also alert other potential collaborators to the ASOS web site, so that they can also register their interest, and we can expand this collaborative group across Africa.

We look forward to working with you on this important project.

Regards

Bruce Biccard and Thandinkosi Madiba