This week on Womanity, Dr. Amaleya Goneos-Malka speaks with Dr. Despina Demopoulos, a leading paediatric intensivist and Head of Paediatrics and the Paediatric Intensive Care Unit at Wits Donald Gordon Medical Centre. Dr. Demopoulos shared insights into her career, personal experiences, and vision for paediatric healthcare in South Africa. Her extensive career has included major hospitals in South Africa and the UK, such as Nelson Mandela Children’s Hospital and Queen Mary’s Hospital for Sick Children in London. Dr. Demopoulos also chairs the South African Paediatric Association and is an executive member of the South African Transplant Society.

Dr. Demopoulos was drawn to paediatric intensive care during her internship and specialization, particularly after an impactful rotation in the ICU at Baragwanath Hospital where she realized the immense potential to save children’s lives. She pursued a fellowship in paediatric ICU, a field she describes as an “absolutely amazing career”. Opening new paediatric units is a complex endeavour due to very limited resources in the country. Despite the challenges, she has been instrumental in establishing paediatric ICU beds in private hospitals, Nelson Mandela Children’s Hospital, and Wits Donald Gordon Medical Centre, driven by the significant need for specialized care for sick children in South Africa and Africa. She also emphasized the importance of supporting general paediatricians in remote areas through workshops, training, and direct advice.

One of her most memorable cases involved a one-year-old boy who, after oesophagus surgery, contracted a severe virus. Standard life support failed, leading to the use of ECMO (extracorporeal membrane oxygenation), a high-risk bypass procedure for the lungs and heart. Against the odds, and with the support of his “amazing parents,” the child survived and recovered, a testament to advancements in medical care that would have been impossible just two years prior.

Dr. Demopoulos highlighted significant advancements in her clinical interests:

• Transplant: Progress in living donor transplants, particularly liver donations from related donors, has been groundbreaking in South Africa and Africa, where this skill is unique. She aims to advance social equality in access to these transplants, ensuring all children, regardless of insurance status, can benefit.
• Sepsis: New global guidelines have improved the detection of sepsis in children. She stresses the importance of educating doctors to recognize signs of sepsis and listen to parents, who often know when their children are unwell.
• Pain Management: Dr. Demopoulos is passionate about ensuring no child suffers pain. Her units utilize evidence-based scoring systems, considering vital signs, facial expressions, and interaction with parents, to assess pain, especially in children who cannot vocalize it. Management includes both medical and non-medical approaches like distraction. She emphasized the holistic approach in paediatric ICU, treating not just the child but also supporting the entire family.

A significant portion of the interview focused on her dedication to teaching and addressing educational inequalities across the country. As chairperson of the South African Paediatric Association (SOPA), she has worked to establish protected teaching time and electronic resource sharing to bridge the gap between well-resourced universities and rural areas. SOPA has also launched a junior mentorship program to connect experienced paediatricians with junior doctors, recognizing the critical need for passionate mentors, particularly for women in medicine.

Dr. Demopoulos offered candid advice to young doctors, especially women, considering paediatrics or paediatric intensive care. She stressed the importance of passion, as the field is emotionally demanding and requires dedication, often involving late-night calls. She openly discusses the challenges of balancing family life, emphasizing the need for a strong support system and an understanding partner. She highlighted the unconscious gender bias in medicine and advocates for formal training in leadership skills, emotional intelligence, and empathy for women. She also believes in equal pay and women sponsoring other women in leadership roles.

To manage the emotional toll and demanding schedule, Dr. Demopoulos relies on friends, sisterhood, and personal time for activities like Pilates, reading, and walks. She acknowledged that while she can never fully detach from the loss of a child, which she describes as the “hardest thing ever” , maintaining a balance with personal life is crucial.

As chairperson of SOPA, her priorities include fostering unity and collaboration through the Child Health Collaborative, an initiative that unifies subspecialties, paediatricians, NGOs, and advocacy groups. SOPA also hosts monthly educational webinars, supports registrars through workshops, and collaborates with the College of Medicine in South Africa to improve teaching platforms. The association issues scientific and political statements on critical issues like child poisoning, violence against children, and climate change, acting as a voice for children and healthcare providers. SOPA has also partnered with the South African Journal of Child Health to encourage research and publishing among both junior and senior doctors.

Dr. Demopoulos concluded by sharing deeply personal moments that shaped her, including witnessing gender inequality in her father’s village, her parents’ strong work ethic, the loss of her father, and her own battle with breast cancer. These experiences, particularly her illness, made her a more empathetic doctor, profoundly impacting her perspective on life and healing. Her words of inspiration for young girls and women were: “Believe in yourself. You have a lot to offer, be there for each other. There’s nothing like a sisterhood and be kind to yourself. And don’t forget to dream, dream and go for it because you can do it. Definitely”.

Tune in for more…