The History of the Vascular Society of Southern Africa (VASSA)
Lewis J Levien and Martin Veller
In the late nineteen seventies and early eighties vascular surgery progressively emerged as a distinct sub-speciality of general surgery. It became obvious that this emerging discipline required a subtle but real difference in approach and surgical skills, with specific requirements for training. For those interested in the emerging speciality, the formation of professional societies that would promote excellence in the development, teaching and practice of Vascular Surgery became progressively more attractive. Many had similar ideas in South Africa, despite reservations expressed by many of the senior academic surgeons in the Country. The visit of Andrew Nicolaides as the Michael and Janie Miller Professor to the Department of Surgery in Johannesburg in 1981 acted as an important stimulus to establish a vascular surgical society in South Africa.
At an initial meeting of interested individuals in 1982 (see Table 1 for attendees), it was decided to form a steering Committee, charged with performing the actions required to form and register an Association for vascular surgery. The steering Committee met in Bloemfontein under the Chairmanship of Kerneels Nel, and proceeded to form the Vascular Association of South Africa (VASA). Problems were encountered with the registration of this nomenclature with the Medical Association of South Africa, and when the first General Meeting at the Holliday Inn in Pretoria adopted the constitution proposed by the steering committee, the name Vascular Society of South Africa (VASSA) was formally adopted and the fledgling Society became a legal entity. In ?1994 the society changed it’s name to Vascular Society of Southern Africa (still abbreviated as VASSA, to allow Vascular Surgeons practicing in countries south of the Equator/Sahara to become full members of the society.
The 1985 meeting (VASSA’s 1st Biennial Congress) was the first VASSA function to which overseas visitors were invited, and appropriately Andrew Nicolaides and Wesley Moore were the first international guests. This meeting was the first of many successful VASSA congresses and workshops. During the proceedings of this meeting, the steering Committee (see Table 2) was re-elected to office as the first formal Committee for a period of two years, under the chairmanship of Kerneels Nel with Krynaauw Cilliers appointed as secretary. Much of the administrative groundwork was established during this time with VASSA becoming an affiliated society of the then Medical Association of SA (MASA), with a constitution that was developed to fit in with the administrative and technical requirements of MASA. In 1986 the first workshop on non-invasive ?vascular diagnosis was organised in Stellenbosch. This proved so popular that a decision was made to hold regular workshops with the purpose of allowing hands-on training in various diagnostic and surgical techniques.
A VASSA meeting held in Cape Town following the SRS meeting in 1987 resulted in a committee decision that the visitors and all future VASSA academic programs should be formally decided upon and controlled by the Executive Committee.
In 1987 John Robbs was elected as President of the Society, with Lewis Levien appointed as secretary. During this period the pattern was established of presenting VASSA workshops in those years in which there was an Association of Surgeons of South Africa (ASSA) biennial congress, and holding VASSA congresses in the alternate years. These meetings rapidly became very popular with the surgical registrars and junior trainees, resulting in a rapid growth in the numbers of members of the Society. Formal Corporate membership was offered to those interested members of the Pharmaceutical and Equipment trades, and the participation of the trade and sponsors in the social events of the Society was encouraged, resulting in close ties being formed with many of the sponsoring companies. Ethicon / Johnson & Johnson and Gore Associates played a major role in helping the fledgling Society to become financially viable. As a result of the generous support of many sponsors and participants in the trade exhibits at the meetings, the Society found itself in the position to offer full sponsorship to any registrar who presented a paper at a VASSA meeting. The Gore incentive award was established to promote research in vascular topics at the Registrar/junior consultant level. During this period considerable effort was expended in an attempt to formalise training and a career structure for vascular technologists. Lewis Levien established links with the North American Society for Vascular Technologists, and John Robbs explored many avenues for formal training and registration with the Council for Medical Technologists in South Africa.
During this time the Exco resolved that this committee should consist not only of elected members, but that an additional member be co-opted from each of the teaching centres not represented on the elected committee. In addition, a vascular technologist, Rita Ray from Durban, was co-opted onto the exco and served for nearly ten years.
At a very successful meeting and venous investigation workshop held in 1989, the Exco was re-elected unchanged and the President asked to serve a second term. A workshop on limb salvage was held in 1990, and a further workshop on the newly emerging endovascular techniques preceded the 1991 Symposium, all of these activities taking place at the Elangeni Hotel in Durban. During this period of time a decision was made to offer corresponding membership to all of the invited overseas speakers, past, present and future. ?(Table 4). The VASSA logo designed by Lewis Levien was accepted by the Exco and the first VASSA ties and badges were manufactured. Should the logo and its various components be described?
During the last of these meetings in Durban, Hymie Gaylis was elected President of the Society in recognition of the huge contributions that he had made to vascular surgery in Johannesburg and South Africa. Lewis Levien remained on as secretary. During this term of office, attempts were made to form formal liaisons with the European Vascular society and the International Society for Cardiovascular Surgery (ISCVS). When the advances to the European Society were unsuccessful, the president and secretary travelled to Lisbon in Portugal were a liaison with the ISCVS was established. The office bearers of the VASSA became the ex-officio office bearers of the new Southern African Chapter of the ISCVS, and membership of the chapter open to all members of VASSA.
1992 saw the organisation of a very popular workshop in Techniques and Complication organised by Ed Immelman in Gordons Bay at the Van Riebeek Hotel with Jerry Goldstone as the visitor. The following year was the tenth anniversary meeting of VASSA, and the two original guests, Wesley Moore and Andrew Nicolaides were invited to mark this auspicious occasion. In addition, Bob Rutherford added status to this meeting. At the general meeting held during the Bloemfontein meeting Ed Immelman was elected as President, with Lewis Levien remaining on as secretary. During this meeting the formal adoption of the constitution of the Southern African Chapter of the ISCVS was accepted.
The Presidency of Ed Immelman was characterised by a combination of academic excellence in the meetings and workshops, and amazing exuberance displayed in the social programmes. No-one who was present at the opening address of the Cape Town VASSA meeting will forget the amazing scene of the huge sharks swimming lazily behind Ed Immelman as he addressed the Society. Everybody looked forward to the next MacMed Banquet, each one more spectacular than the last.
After serving as secretary of the Vascular Society for a period of 8 years, Lewis Levien was elected as the President in 1994, with George Louridas serving as secretary. Lewis Levien served two terms in this office at a time when the issue of a separate sub-specialty for vascular surgery was being considered. Over the following four years a comprehensive syllabus for the sub-specialty of vascular surgery was drawn up and accepted. The Society submitted provisions and regulations for the College of Medicine exit examinations, to be called the Certificate in Vascular Surgery. This submission by the Vascular Society ultimately became the template used by many other interest groups seeking registration as sub-specialties. Academic meetings in the form of both workshops and biennial symposia of high academic standard continued to be organized at least once a year. The social functions, and in particular, the MacMed banquet, continued to be an eagerly anticipated annual event.
In addition to national academic meetings, the office bearers of the Society were appointed ex-officio office bearers of the Southern African Chapter of the International Society for Cardiovascular Surgery. Active participation in meetings in Japan, San Diego and Australia followed. When George Louridas emigrated to Canada, his place as secretary was filled by Martin Veller
One of the features of the VASSA workshops and symposia was the presence of several invited overseas guests at each of the meetings. These guest speakers were carefully chosen by the Committee for recognized excellence in their fields, and these guests contributed in no small manner to the academic content of the meetings. At the end of their visits in South Africa, after all the work had been completed, these distinguished guests were usually treated to a safari in Kruger Park or another nearby game park. A remarkable photograph is included showing the then President of VASSA changing a flat tire somewhere in central Kruger Park, being assisted in the task by the recorder of the Eurostar Registry, with the Senior editor of the Journal of Vascular Surgery reading the “how to” instruction manual.
Ray Dawson was elected to the position of President at the Sun City meeting in 1999. Martin Veller remained on as secretary. This period was characterised by formalisation of the exit examination, the Certificate in Vascular Surgery, and the first examinations held by the College of Medicine with VASSA appointing the examiners and setting the exam papers. Also during this time many efforts were expended to obtain better remuneration for vascular surgery in South Africa. Guidelines for clinical practice were formulated in an attempt to ensure high standards of practice and care for vascular patients
Cobus von Marle was elected as the seventh President of VASSA at the Bakubang meeting in 2001, with Martin Veller again acting as secretary. Consensus meetings with multiple disciplines were held and consensus documents drawn up to further assist in the efforts to improve standards of care. Regular participation by invited overseas guests and acknowledged local experts, continued to maintain the standard of excellence for which VASSA meeting had been characterised in the past.
At the 2003 meeting held at the Spier estate in Stellenbosch, Martin Veller was elected as the current President of VASSA with Talib Abdool-Carrim becoming the secretary.
