Bariatric Surgery in South Africa

Bariatric surgery is a group of weight-loss surgeries that involves making changes to the digestive system, some of which are non-reversible. The idea behind these types of surgeries is to help patients lose weight by either limiting the amount of food they can consume/digest at any one time or reducing their body’s ability to absorb nutrients. Some procedures do both. 

Bariatric surgeries should only ever be the final option when diet and exercise have proved inadequate and there are now serious health concerns caused by a person's weight. In general, these surgeries can only be an option for patients whose body mass index (BMI) is 40 or higher (extreme obesity). In certain cases, patients whose BMI is 30 to 39.9 may qualify for certain types of bariatric surgery if they have serious weight-related problems, such as type 2 diabetes.

The three most common types of Bariatric Surgeries are as follows:

1. Gastric Sleeve – The most common surgery, in which about 80% of the stomach is irreversibly removed, resulting in a sleeve or tube-like structure. This smaller stomach will not be able to hold as much food and produces less of the hormone that regulates appetite (ghrelin), which can lessen the patient’s desire to eat. 
2. Gastric Bypass – A more complicated procedure in which the stomach is divided into two parts; a small upper pouch and a large lower ‘remnant’ pouch. The small intestine is rearranged to bypass the large pouch. As a result, the volume of the stomach is significantly reduced. This causes food to go into the small upper pouch of the stomach and then directly into the small intestine. The small upper pouch can only hold around an ounce of food. Gastric Bypass is typically not reversible. 
3. Gastric Band – Involves an inflatable silicone device that is fitted around the top portion of the stomach to create a smaller stomach pouch. This procedure causes the patient to feel fuller with less food but still allows the body to digest food as usual, without malabsorption. The device can be removed when the patient reaches their desired weight.

The bariatric surgeries mentioned above are typically performed laparoscopically, in which the surgeon creates around one to five small incisions in the abdomen to insert a laparoscope (a long narrow tube with a camera) and surgical tools. The patients are usually given a general anesthetic, so they will not feel anything throughout the surgery.

How Long Should I Stay in South Africa?

After bariatric surgery, an overnight stay in the hospital is usually required. In some cases, you may need to stay longer (around 3 to 5 days). However, it is not advisable to leave South Africa as soon as you are discharged from the hospital. Stay at least 10 to 14 days following your surgery for initial recovery and follow-up checkups. During the follow-up checkups, your surgeon will remove your stitches and check your overall condition.

What's the Expected Recovery Time?

The recovery time may take around 3 to 6 weeks until you are allowed to go back to your normal activities, including work, with some restrictions. You must avoid heavy work and strenuous activities, such as lifting, pushing, or carrying heavy loads for at least the first three months after surgery. You should also avoid sitting and standing without moving for long periods to avoid blood clots forming in your legs.

What Aftercare is Required?

You will be given a special diet plan immediately after your surgery, as well as detailed post-operative instructions. Make sure to follow the diet plan and instructions to avoid complications and speed up your recovery. In order to maximize and maintain weight loss, it is important that you commit to healthy eating and regular exercise. There may be restrictions on how much food you can consume. You may also need to change your eating habits, such as eating 6 small meals instead of 3 large meals each day. You should take vitamins and mineral supplements to ensure proper nutrition. 

What's the Success Rate?

The success rates vary for each of the different types of bariatric surgery. In general, within the first six months following the surgery, most patients lose around 30% to 55% of their excess weight. Then, as early as 12 months after surgery, most patients lose over 70% of their excess weight. Patients could also maintain a 50% to 60% loss of excess weight for 10 to 14 years after their bariatric surgery. Although the success rates are high, there are risks associated with bariatric surgery, such as bleeding, deep vein thrombosis, infections, spleen injury, stenosis, and infections.

Are there Alternatives?

There is a non-surgical Bariatric procedure, known as the Gastric Balloon. This involves an inflatable device that is temporarily inserted into the stomach via endoscopic placement. A sizable area of the stomach is obstructed by the balloon or balloons, thus reducing the amount of food it can contain at any one time, leading to eventual weight loss. The balloons are usually removed after 6 or 12 months. 

If you cannot or do not want to undergo any surgery or medical procedure, you may be able to work with a doctor who is experienced in treating extreme obesity and a dietician as the alternative. They may recommend you to change your diet, adding physical activity, and prescribe medications.

Bariatric Surgery in and around South Africa

About South Africa

South Africa is home to some of the world's most luxurious private game reserves and lodges. Wildlife lovers come here from all corners of the globe in search of the "Big Five": lion, buffalo, leopard, rhino, and elephants. Coral reefs, shark dives, dragon-backed mountain ranges, white-water rafting, and golden beaches lapped by legendary surf breaks are some of South Africa's many other attractions. Traveling around this vast land and touring the vibrant cities, visitors can learn about the nation's turbulent history. Travelers coming to South Africa for medical treatments do so for cost savings, advanced medical technology, and the internationally qualified and skilled doctors. The country welcomes an ever-increasing number of medical tourists each year, many of which travel for Bariatric Surgery procedures. Medical Tourists travel from all across the globe, particularly from African countries with an inferior healthcare system. Popular destinations include the capital city, Pretoria, neighboring Johannesburg, and the stunning Cape Town.

Popular Parts of South Africa

With more than 57 million inhabitants, South Africa is the world’s 24th most populous nation. It is a multiethnic society with a large variety of cultures, languages, and religions. Known for its exhilarating outdoor adventure, fascinating wildlife, magnificent landscapes, and opulent history makes South Africa a truly magical destination

• Cape Town is the oldest city and the legislative capital of South Africa. This pleasant city has a lot to offer as you can Hike the Table Mountain, take a wine tour, cruise to Robben Island, relax on beautiful beaches, visit District Six Museum, discover Kirstenbosch Botanical Gardens, and watch the Boulders Penguin Colony or shop in trendy markets. 
• Johannesburg is the largest and the most populous city. It is changing rapidly into an ultra-modern metropolis. Other than being an urban city, it also boasts a rich history. Tourists can visit the Apartheid Museum to learn more about the country’s difficult past through exhibitions. Other museums such as MOAD and MuseuMAfriCA are also worth a visit to view the city’s art and history.
• Durban is a cosmopolitan city with sunny beaches and charming Afro-Indian culture. There are more Indian nationals residing in this city than any other country outside of India. It is the place to go if you want to see marine life. Visit uShaka Marine World where you can snorkel, dive, and interact with animals. 
• Pretoria is a scenic city and you will find various historic buildings with astounding architecture such as the Voortrekker Monument, Union Buildings, and Church Square with its statue of Paul Kruger. Those who are looking for some outdoor activities can explore Pretoria National Botanical Garden and Rietvlei Nature Reserve for some wildlife viewing.
• Kruger National Park is one of the largest national parks and one of the most exciting safari destinations in the world. Here you can view all of Africa’s safari species such as Lion, Elephant, Rhino, Leopard, Buffalo, Hippo, and Giraffe along with more than 100 mammal species and 500 varieties of bird.

Weather and Climate in South Africa

South Africa’s climate is determined by its situation in the Southern Hemisphere’s subtropical zone and between the Atlantic and Indian Oceans. The country is a year-round destination thanks to its varying regional climates. May to September is the Dry Season with little to no rain. The days are mostly sunny, but it gets cold in the evenings and mornings. The average temperature during this season is around 14 °C with June to August as the coldest months. The wet season starts in October and ends in April. There will be occasional short rain showers in the afternoon. The average temperature during the wet season is around 20 °C, but it can also be as high as 35 °C, especially in December, January, and February.

Getting Around in South Africa

The main and the busiest airport in South Africa is the O.R. Tambo International Airport. The airport is located in Kempton Park, near Johannesburg and Pretoria. It serves as the primary domestic and international gateway to and from South Africa. The airport operates flights to other cities in South Africa as well as numerous major cities in the world including London, Singapore, Sydney, Abu Dhabi, and Atlanta. There are also two other major international airports: Cape Town International and King Shaka International. The inexpensive way to travel around the country is by flying with budget airlines such as FlySadair, Kalula.com, and Mango.

South Africa has an excellent infrastructure and is easy to navigate. However, if you wish to visit several cities, expect to have at least one long-distance trip. You can travel around by bus, train, or rental car. There are several long-distance bus companies you can choose, such as Intercape, Translux, and Greyhound. The buses are relatively affordable and safe. They are generally equipped with air-conditioning and an onboard toilet. For short-distance travel, Baz Bus is the best choice. A one-way ticket fare starts at around 500 ZAR.

Although trains are slow, they are less expensive than flights and more comfortable than buses. Shosholoza Meyl long-distance trains serve Cape Town, Johannesburg, Durban, Bloemfontein, and several other major cities. This train is very affordable with tickets costing as low as 400 ZAR for a sleeper train. If you’re looking for a more luxurious train, try the Blue Train which offers comfortable compartments, good food, and wine for around 18,300 ZAR. 

Taxis are available to get around major cities. Tourists can hail one directly from the streets. However, since the taxi ranks are not common, it is best to call for one. The base fare can be different in every city, ranging between 11 ZAR to 20 ZAR. 

Tourist Visas in South Africa

A valid visa is required if you wish to visit South Africa. Citizens of more than 60 countries can enter and stay for up to 90 days. Other countries not listed in the visa exemption agreement must apply and obtain a visa to the nearest South Africa embassy or consulate. All visitors must hold a passport valid for at least 30 days after the expiration of their intended visit, and the passport must have at least two unused pages. 

Additional Information

1. Local Currency: South African Rand (ZAR) is the official currency. 1 USD converts to 14 ZAR.
2. Money & Payments: Tourists can find ATMs all around the country. Credit Cards are widely accepted. However, since South Africa has a reputation for scams, you should inform your bank about your travel plans to avoid declined transactions. It is also advisable to always bring some cash with you. Tipping is expected here and you can tip around 10% to 15% of the bill in restaurants and cafes and the standard tip in hotels is 10 to 20 ZAR. 
3. Local Language: There are 11 official languages in the country, including Zulu, Xhosa, Afrikaans, Northern Sotho, Tswana, Southern Sotho, Tsonga, Swazi, Venda, Southern Ndebele, and English. Zulu is the most widely spoken language.
4. Local Culture and Religion: As a secular state, South Africa has a diverse religious population. Most of the population follows Christianity. Other religions such as the traditional African religion, Islam, Hinduism, and Judaism are also freely practiced.
5. Public Holidays: The country has 12 public holidays such as New Year’s Day, Good Friday, Freedom Day, and Christmas Day.