PG welcomed and thanked members for joining the meeting.

Apologies were noted.

No acknowledgements were noted.

• Dr Stephen Grobler 25.03.1958 – 18.06.2022 (PG)
• Dr Leonie Schoeman 09.04.1962  – 17.06.2022 (TH)
• Professor Krikor Erzingatsian Deceased 12.07.2022 (PG)

PG read the obituaries and advised that the obituaries will appear both on the ASSA website and in the SAJS.

• Dr Brian Warman 25.11.1952 – March 2022

Information was just  received concerning the sad news of the passing of Dr Brian Warman in March this year, after a short struggle with Motor Neuron disease.  He retired about four years ago from his practice in Umhlanga.  Dr Funnel said the Brian would be remembered for his sincerity, honesty and wonderful spiritual faith.

Members were requested to  honour the passing of these valued ASSA members, who were important leaders in surgery, by observing a minute of silent reflection.

1. The minutes of the last AGM held on 20 August 2021 were approved without changes or additions.
   Proposed: C Warden
   Seconded: P Matley
2. The agenda was accepted without changes or additions.
   Proposed: I Buccimazza

History is full of “what if’s”….

What if Alexander the Great had not died of peritonitis at the age of 32 years? Who knows how much more he would have contributed to global expansion, perhaps changing the world’s geopolitical landscape?

And, what if there was no Association of Surgeons of SA? To begin with, we would not be in this magnificent setting for the first in-person ASSA conference in 3 years, but on a more teleological level, there may not have been a College of Surgeons of SA, which as you know is the training body for surgeons. Allow me to explain. It was ASSA who in 1947 saw the need for an internationally recognized South African college to enable postgraduate higher qualifications, which up to that point could only be obtained abroad. Thus, ASSA was the catalyst for the founding of The College of Physicians and Surgeons of SA which was registered as a non-profit organization in July 1955. And the rest is history. The College of Surgeons is now a constituent college of The College of Medicine of SA.

Over the decades, ASSA’s role in surgical training waned, and the mandate shifted to a more administrative one. The quality of surgical care in SA became the preserve of the College of Surgeons. And as ASSA retreated further away into the shadows of “acting constructively to address issues relevant to its membership”, namely furthering the interests of qualified surgeons in SA, there was a real threat of retreating into oblivion…. Our membership numbers dropped and we struggled to find our relevance.

And then along came COVID…. Professional activities, except for dire emergencies, were suspended. Training, research and educational meetings followed suit.

That dystopian time was a real test for those in leadership positions.

We, already in a precarious position, found ourselves at a cross-road. But under the determined chairmanship of Professor Paul Goldberg, ably assisted by an energetic steering committee and indefatigable secretariat, ASSA was reset and recharged. This formidable crew to whom I personally and we collectively owe a huge debt, kept ASSA firmly on course during probably the most difficult time of its existence. When the door to in-person activities closed, the window of harnessing cyberspace opened. The new version of ASSA took the lead in surgical education: virtual tutorials have now extended the reach of training, which has become inclusive; professional activities via virtual programmes continue to educate from the comfort of our offices or studies; communication has improved to unprecedented levels: the weekly newsletter and other forms of social media keep us updated on forthcoming activities and the contemporary website leads to a cornucopia of resources. A modern challenge of social networks is self-serving monologues which engage no-one. Our dialogue has always been honest, humble and concerned for the common good of ASSA members.

And so, 75 years later, ASSA has come full circle, tending to all our needs as surgeons: education, career development and other interests, in a collegiate and respectful manner.

The response to these efforts has been phenomenal: our membership has grown to over 900 members; support for this bi-ennial conference has been unparalleled and there is renewed pride for the Association. I believe that ASSA is now stronger and more relevant than ever.

This would not have been possible without the resilience of you, our members, who have demonstrated tremendous fortitude during the dark days of the pandemic. As elective surgery became obsolete, many of us felt sidelined; in fact, it felt more like a spectacular fall from favour: we were stripped of our traditional arenas, the operating theatres, and abandoned by our trusted companions the anaesthetists – reassigned to the role of intensivists. Accustomed to being decisive, busy and addicted to the art of surgery, the sudden loss of purpose and value questioned our relevance. But like the proverbial phoenix, we have risen from the ashes stronger and with renewed purpose.

I salute you, surgeons of South Africa, your skills will never be dispensable….

And now it is time to say farewell. It has been the highlight of my career to serve as president of ASSA. Thank you for your confidence in my ability and for your tremendous support over the past 3 years. I think I have over-stayed my welcome!

In departing, I commend the following aspirations to the ASSA membership and new committee

• Continue to grow and remain united. There is strength and a multitude of possibilities in numbers and unity.
• Transitions happen all the time and change is necessary for growth, but ensure you continue to build on the work initiated by others, for the common good.

To paraphrase the Roman philosopher, Cicero “This one thing should be (our) objective, to identify…..the interest of all.”

To my successor: the chain is yours now; wear it with pride and may it always remind you of your service to ASSA and the surgeons of SA.

Thank you for your kind attention.

The President’s report was proposed by E Le Grange

I think ASSA has adapted to a changing environment quite well.  The pandemic has changed everything.

I have been fortunate to have a great team to work with over the last 3 years.  Ines has been incredibly supportive and her sage advice absolutely appreciated.  Tim is always most helpful and full of advice.

Membership:  ASSA was a dying organisation.  The retirements exceeded the new membership.  All attempts to persuade specialist surgeons to join yielded little.  Over the last 2 years that has changed.  Our membership has more than doubled.  While there has been a significant increase in membership of surgeons, the majority of new members have been trainees and medical officers.  How many of the trainees will remain members after they qualify is still an open question, but even if its 10% we will continue to grow.

Membership has also expanded outside South Africa.

Tutorials:  Shortly after the start of the pandemic, it became clear that teaching was suffering.  The establishment of online tutorials drew a surprisingly large audience to the extent we had to increase the capacity of our zoom platform.  We split the tutorials into those targeted at the final and the intermediate examination candidates.  I expected that the tutorials would stop attracting as many participants once lockdown eased.  This did not happen.  The Universities altered their teaching schedules to include the content in the tutorials.  The candidates liked the exposure to national tutors and examiners.  The tutorials also generate a not insignificant net income stream.

ASSA now offers 4  online ethics events per year.  The number of members who join these are increasing.  The President’s Forum is also a new online event where the President identifies a topic of interest to surgeons. It is also becoming an increasingly popular event.

The reduction in travel for the ASSA Augmented Exco to 1 face to face meeting per year and the others online, has made substantial savings in time to the attendees and additionally saved ASSA significant finance.

Mbulelo has made major changes to how ASSA finances are run.  He will say more about this in his report.

Claire has been a great secretary with the introduction of the weekly newsletter instead of multiple emails on a daily basis.  She has also made a major impact on our electronic presence and she has taken on the tutorial program.

ASSA would not run without Alison and Susan in the secretariat.  They both have amazing institutional memory.  They respond immediately when they are asked to do something and before you know it, it’s done.  Often it’s done before you even ask.

The Chairman’s report was proposed by E Le Grange and seconded by SR Thomson.

CW presented her ‘When, What, Why’ report in Power Point format.

Salient points include:

1. ASSA represents all general surgeons and provides considerable support to, and interaction with, the affiliated societies
2. ASSA is now registered with official NPO status in compliance with government regulations
3. ASSA is a lobby group for surgery with a collaborative voice with regular interactions with government, with SAMA, NHI, HPCSA and legal advisory groups
4. Interacting with international organizations such as ASGBI, BJS
5. Good international relationships are held with PAAS, WACS and COSECSA as well as contacts through global surgery
6. The academic heads of all the surgery units in South African universities sit on ASSA’s extended executive committee
7. ASSA has initiated several educational and CPD activities.  Outreach initiatives to neighbouring countries will recommence now that COVID is no longer a threat
8. Current membership includes 383 fully paid-up surgeons, so many of whom have contributed willingly to the ASSA registrar tutorials.  Total membership is 1027 with 300 of these being registrars who pay no fees, 29 international members, 57 retired members, 244 medical officers, 11 honorary members.
9. The education platform now includes the weekly intermediate and final year registrar tutorials, ethics talks and president’s forum
10. SAJS is going fully online and will be accessible through the ASSA website
11. Social media – Twitter is proving a popular communication medium for several members
12. ASSA’s weekly newsletter is going well with grateful thanks to the website managers, Plastic Duck Armada, whose professional assistance is greatly appreciated
13. ASSA is a volunteer organization and members are invited to get involved with any of the initiatives and to make recommendations for any improvements.

The Secretary’s report was proposed by I Buccimazza and seconded by MZ Koto. 

Appendix 1 Presentation

Appendix 2 Financial Report

MR presented Power Point report, thanking the executive for their understanding of the need to modernize and overhaul the financial management of the association.  The financials presented for the year ending February 2022 have been audited by JN Chartered Accountants who have compiled a good, cautious report on the status of ASSA’s finances.

1. The assets, given a nominal value of R1, are the IT systems and office equipment valued at approximately R10,000 with depreciation
2. The equity fund held by Personal Trust is composed of three funds, regulated on the risk profile, each running at a relative rate of about 33%
3. The two call accounts have gained about 29% due largely to reduced expenditure during years of the pandemic
4. Membership fees and administration contributions from societies have not been increased for the last three years but Augmented Executive Committee agreed that to an increase of 5% in 2023, in order to maintain reserves.  In addition, registrars who currently enjoy full membership at no cost, will be required to pay and initial membership fee of R200.00
5. Dividends and interest indicate a loss of 7% during the financial year
6. Main expenses have been consultation fees, professional fees and website management
7. R200,000.00 was spent on the purchase of 40 shares in the ASSA-SAGES Congress which will be repaid post congress
8. Book value is now at about R5 million

MR explained the details of the budget figures given for the year ahead and reported that a new software system, Xero, has been commissioned and will be implemented in the coming months. This will be integrated with the website which will need considerable re-building to accommodate this and set up a payment gate.  The cost of the re-build will be applied to one society, ASSA, in the first instance but single invoicing for multiple memberships will still be possible.

A Nedbank account for the society has been opened and will be operational when the new system goes live.  NPO registration has been finalized and VAT registration is in process.

Remuneration for the two members of the secretariat, previously at different levels according to agreed numbers of days worked by each incumbent, will be increased and  equalized based on the advice given by an accountant, taking cogniscance or the increased workload for both.

Comment from the members was invited – approval confirmed.

Proposed: SR Thomson

Seconded: E Le Grange

IB, acting as election officer advised that the President of the Association serves for two years and cannot be re-elected.  Nominations for the incoming President were submitted and an electronic ballot was conducted.

All four office bearers indicated that they were available, if elected, to serve another two-year term. The following were re-elected unopposed:-

Ø  Chairman – Professor Paul Goldberg

Ø  Vice Chair – Professor Timothy Hardcastle

Ø  Treasurer – Dr Mbulelo Renene

Ø  Secretary – Dr Claire Warden

Voting papers were distributed and fully paid up ASSA members were invited to nominate the four additional members to serve on the executive committee. Five nominations were accepted and voting for the four members ensued.

Noted that the incoming executive committee would be entitled to co-opt up to four additional members to ensure academic and geographic representivity on the executive.

Subsequent to this meeting the votes were counted and the members of the newly elected  ASSA Executive Committee were announced at the ASSA-SAGES 2022 Gala Dinner on Saturday 13^th August 2022.

Chairman     Professor Paul Goldberg

Vice Chair    Professor Timothy Hardcastle

Treasurer     Dr Mbulelo Renene

Secretary     Dr Claire Warden

Elected:-      Professor Christo Kloppers

Dr Jeanne Lubbe

Professor Dan Montwedi

Professor Maeyane Moeng

Nil

Emeritus Professor JH Becker, one of the surgical giants in South Africa, accepted his certificate from IB and responded that he had not expected to be conferred with such and honour after 50 years in surgery during which time he had seen so many changes in the practice.

Hononary Life Membership recognizes members in good standing who have been members for at least ten years.

1. Dr Chris McCosh who was not able to attend the meeting and would receive his certificate after the event
2. Professor John Robbs who accepted the certificate with thanks saying that recognition  from his peers was one of the most important honours for him.

PG announced the incoming President of ASSA, Professor Zach Koto, who will hold office for two years.

The new President accepted the presidential chain of office from Dr Buccimazza commenting that she had left a huge legacy to follow.  He thanked members for their confidence in voting him into this position of honour.

PG took great pleasure in handing the Outgoing President’s certificate and medal to IB and thanked her again for her dedication and support during her tenure.,

The next annual general meeting of the association will be held during the Wits Biennial Surgical Symposium, 26^th-27th June 2023.  Date, time and venue to be confirmed.