IZINDABA
OBITUARY

Harry Stein, 1925 - 2014

The career of Harry Stein, who died at 89 on 31 December 2014, touched the lives of countless babies at Baragwanath Hospital in some of South Africa's darkest years during apartheid. In a career spanning 37 years, Harry became Head of Neonatology and later Head of Paediatrics at Baragwanath Hospital and Professor of Paediatrics at the University of the Witwatersrand until he retired in 1987. Baragwanath (now Chris Hani Baragwanath) was a national referral centre and the only hospital serving Soweto at the time, then with a population estimated to be in excess of 1.5 million people. Running paediatrics was a formidable task. Baragwanath had 400 children's beds and treated 100 000 child outpatients a year; 17 000 babies were delivered each year. There were very high rates of low birth weight and premature delivery, with over 3 000 babies a year weighing less than 2 500 g at birth and often premature. Many infants and children suffered from malnutrition. Harry made a major contribution to the care of premature babies born into highly disadvantaged situations, while at the same time producing pioneering studies and methodical research on neonatology, child malnutrition and their consequences. He trained a generation of medical students and young doctors, several of whom went on to major positions in paediatrics and child health in South Africa and overseas, for whom he remained a significant role model and who retain vivid memories of him to this day.

Harry was born in 1925 in Morgenzon, a remote South African town. His parents were Jewish Lithuanian refugees and he was the youngest of six children. He had a tough start to life, losing his father while his mother was pregnant with him. He spent his early years on a farm, but his mother moved the family to Johannesburg before he started school. When he left school he studied medicine at the University of the Witwatersrand. Following house officer jobs at Baragwanath in 1950, Harry decided on a career in paediatrics. He began higher training in Johannesburg and then spent a year in the UK gaining his paediatric specialist qualifications in London and Edinburgh. He returned to South Africa to complete his training as paediatric registrar at Baragwanath in 1954 and met his wife-to-be Yvonne, who was a social worker. They were married for over 61 years.

Following appointment in 1971 as Head of Newborn Services at Baragwanath, with over 3 000 low-birth-weight, often premature babies born each year and most needing specialised care, the idea of turning an entire ward into an incubator, with an adjoining ward for the mothers, took root. This proved a successful intervention, providing good care for babies at high risk. Harry was appointed to the Chair of Paediatrics at Wits in 1977.

Most of Harry's research concerned malnutrition and its consequences, and premature birth and/or low birth weight. In a randomised trial he conducted with John Pettifor (later his successor at Chris Hani Baragwanath), it was found that feeding very low-birth-weight babies their own mothers' untreated milk was demonstrably better than feeding them with pooled pasteurised breastmilk, which was the standard at the time.

Harry was an astute observer. He was the first to identify finger clubbing as a sign of cirrhosis of the liver (published in The Lancet) and also the first to recognise that veno-occlusive disease of the liver could occur outside Jamaica (published in papers in the BMJ). He also wrote a number of papers on idiopathic cardiomyopathy in children.

During the Soweto uprising of 1976 Harry never missed a day, driving to work whatever the risks. He fought repeated battles with apartheid authorities about the lack of equity for black people, especially around health and training opportunities, and was invariably at odds with them about resources for Soweto.

Harry enjoyed active outdoor family holidays, often at a rural farm. Here he provided care to local people, many of whom would arrive seeking medical help for their children and themselves. He loved outdoor activities, hiking in the Drakensberg mountains and following beautiful hiking trails along the South African coast, as well as playing tennis.

At 62 he took retirement and moved with Yvonne to London to be near his children. He worked as a consultant community paediatrician in Barnet, finally retiring five years later. He developed a series of health problems, but never lost his spirit and enjoyment of his family.

He is survived by his wife Yvonne, his children Alan, Mark and Lynne, and seven grandchildren.

Hoosen Coovadia
Stephen Tollman

University of the Witwatersrand, Johannesburg, South Africa hcoovadia@match.org.za