The recently retired Executive Head of the Department of Medicine at Stellenbosch 肆客足球's (SU) Faculty of Medicine and Health Sciences (FMHS), Prof Helmuth Reuter, reflects on his diverse four-decade career in medicine. Born in Namibia, he discovered his passion for healthcare during his high school years, drawn to both scientific pursuit and patient care.
“I have changed careers more than anyone else I know," he reflects. “From cardiology to rheumatology to infectious diseases to rural health to clinical pharmacology to all sorts of [other] things."
Academic excellence
After graduating as the top MBChB student at SU in 1986, Reuter completed his internship at Windhoek State Hospital Complex. His journey then led him to the United Kingdom where he trained in internal medicine, rheumatology, tropical medicine and HIV medicine at prestigious institutions including Addenbrooke's Hospital and facilities linked to the 肆客足球 of Cambridge.
“I am better at explaining and thinking about diagnosis than standing in the theatre," he explains. “Part of internal medicine is to understand what is causing the disease, what are the potential complications and then comprehensive planning. That is what I like and think I can do well."
In 1999 Reuter attended an advanced course in rheumatology at the New York School of Medicine and the New York 肆客足球 Hospital for Joint Diseases. But it was inevitable that his diverse interests and concerns would eventually pull him in yet another direction.
Serving disadvantaged communities
“I feel it's quite important to think of the disadvantaged and those that can't fight for themselves. Tuberculosis is particularly prone in these communities because they may have issues of malnourishment and overcrowding," he says.
“One of the ways how TB can kill people is by causing tuberculosis of the outer lining of the heart: tuberculous pericarditis. This field is where it came together most for me – looking after the disadvantaged and my interest in infectious diseases and cardiology."
For this reason, Reuter completed a PhD at SU on the treatment of tuberculous pericarditis and did a lot of his early academic work on HIV, TB and heart diseases associated with those infectious diseases.
“If there is one part of medicine that interests me most, then it is the immune system," Reuter declares. “I also looked at the immune system in my work on tuberculous pericarditis.
“I am very interested in immune-mediated diseases – either when it is overactive or when it is underactive. The immune system can involve all different organ systems: it can involve inflammation in joints, blood vessels, the heart and the lung."
HIV/AIDS pioneer
In 2002 he completed an International Society for Infectious Diseases Diploma in HIV Medicine at the National Institutes of Health in Bethesda in the United States, which he regards as a career highlight.
“In South Africa and Africa [generally], there were very few people [at the time] who knew about the treatment for HIV/AIDS and it was very important to spread the gospel – that it is a treatable disease," he says. “It was very important to teach as many people as possible."
As a result, he became involved in TB and HIV training in Mozambique, Namibia and Zambia for many years. In South Africa, he singles out the HIV programme in Lusikisiki in the Eastern Cape – funded largely by the Nelson Mandela Foundation – as a memorable period.
“That allowed me to have direct contact with Nelson Mandela," he recalls. “That was very special in my life – the support that he showed towards that project, and the deep love that he had for other people."
Rural health innovation
Another career highlight was Reuter's time as Director of the FMHS' Ukwanda Centre for Rural Health from 2002 to 2007 while Professor of Internal Medicine. He believes the centre plays a vital role in interdisciplinary teaching and learning.
An additional reason for the Rural Health Centre's importance, he points out, is that it exposes students to the backgrounds of patients: “In a place like Tygerberg Hospital, patients are always referred in; students didn't have a feeling for where the patients come from.
“The Rural Health programme takes them to the places where patients live and gives them a better understanding of the importance of community and the context of the patient. This makes it a very good training platform for undergraduate students and family practitioners."
Academia calling
After he left the Centre for Rural Health, Reuter returned to his interest in rheumatology and established the Winelands Rheumatology Centre and the Winelands Medical Research Centre. But then academic medicine called yet again and, in 2016, he rejoined the FMHS as Professor of Clinical Pharmacology in the Department of Medicine.
Reuter believes his diverse academic and professional background stood him in good stead when he became Executive Head of the Department of Medicine in 2021. “The following years were difficult," he reflects. “It was post-Covid and it was in a time of severe austerity.
“But what was good about it was that all those different streams that I had worked in came together. I could lead by having experience of what others in the Department were feeling. After three years, I felt that was a task well completed and I could now start something else again."
Future plans
However, his departure from the FMHS in September is certainly no conventional retirement: Reuter intends to continue playing an active role in training. Through the Institute of Orthopaedics and Rheumatology in Stellenbosch, an academic centre in the private sector that he helped to establish in 2013, he intends to train senior registrars or fellows in rheumatology.
“We're creating a collaborative training platform with SU's FMHS," he explains. In addition, he plans to continue having an academic association with the Faculty by supervising students.
He also intends to continue as Honorary Clinical Professor of Internal Medicine at the 肆客足球 of Namibia – an appointment he has held since 2019 – where he is helping to develop a medical education development programme and a postgraduate diploma in infectious diseases.
Somehow he still plans to make time as well to continue pursuing his other great passion in life – camping. He travels widely on the continent where there is big game, in particular to Botswana, Namibia and Zimbabwe. “I like camping out in the wilds," he says. “It brings me closest to nature."?
