Mediclinic Bloemfontein vascular surgeon named first female president of VASSA

Professor Asha Malan, a vascular surgeon at Mediclinic Bloemfontein, became the Vascular Society of Southern Africa's (VASSA) first female president in October. 

Once the only vascular surgeon in central South Africa, she is committed to training others and advancing complex aortic aneurysm care. 

Taking the lead at VASSA

Professor Malan , who practises at Mediclinic Bloemfontein, says she didn’t immediately realise she was the first woman to lead VASSA in its 40-year history, but it’s something she’s proud of. “Vascular surgery – and surgery in general – has long been a male-dominated field. But things are changing, and we now have some powerhouse women in surgery.”

Still, she explains that vascular surgery, which treats conditions of the arteries, veins and lymphatic system, demands long, intense hours. “That’s why, in vascular, we still don’t necessarily have the number of female specialists that we want.” As a mother, she says she’s grateful for her husband’s support, which has enabled her to build her career and take on the VASSA presidency.

Having been the only vascular surgeon in central South Africa up until last year, and one of only 65-70 practising countrywide, she says this figure is “nowhere near enough”. For example, France has a similar population size to South Africa but has about 20 times the number of vascular surgeons.

“It’s a work in progress,” she continues, referencing the need for further government support for training. “That’s part of my role as VASSA president – to look at how we can encourage and train more vascular surgeons in South Africa.”

Professor Malan also wants to use her VASSA presidency to raise awareness about the importance of this specialty. “I had a rude awakening when I realised how little patients, doctors and even specialists know about what we can offer,” she says.

“One of the initiatives I’m launching with VASSA is to make the field much more visible on social media We’re looking at growing the society, including more people outside the classic vascular surgeon group – like those in allied health or nursing – and involving more patients and trainees.”

Bringing world-class vascular expertise to central South Africa

Professor Malan, who worked in the public health sector until last year, now runs a busy private practice. “There was a big unmet need in the private sector,” she explains.

Having trained and worked in the Netherlands, Switzerland and the United States, Professor Malan has built deep expertise in her field. “My main interest is complex aortic aneurysm work,” she says. She is one of only a small number of surgeons in South Africa with this specialty, and the only one in Bloemfontein.

That’s why she’s working towards establishing a state-of-the-art vascular centre at Mediclinic Bloemfontein within the next two to three years, which will ensure access to treatment for a greater number of patients in the surrounding areas. However, the need for vascular surgery extends further afield, Dr Malan explains. "I currently see patients from across central South Africa – a region with roughly 10 million people.”

The importance of vascular surgery training

An associate professor at the University of the Free State, Professor Malan has always enjoyed teaching others about vascular surgery. “I started by teaching students and registrars, and now I also train general practitioners, established specialists and even patients,” she says. She also shares her knowledge through outreach programmes, including a recent Mediclinic-sponsored initiative that trained GPs in primary care and vascular conditions.

Patients with vascular-related conditions are often seen by general surgeons, especially in underserved regions, but Professor Malan explains the urgent need for more vascular surgeons: “Vascular surgery has moved into a completely different subspecialty. Through training, you learn how to be a completely new type of surgeon,” she says. She adds that the field is constantly evolving, and while the possibilities in South Africa are enormous, there is still plenty of work ahead.

One of the key areas of progress is endovascular therapy. “We can fix things from the inside that most people never knew was possible,” Professor Malan says. For example, previously, operating on a complicated aneurysm would involve a ten-hour operation opening the patient's chest and abdomen, followed by weeks in ICU on dialysis.

“We can now do that procedure within 3-4 hours,” she explains. “The patient won’t need any ventilation and goes to the ward 2-3 days later. That has revolutionised both our practice and our offering for many different pathologies.”

Another key focus in vascular surgery is limb salvage. “Using endovascular techniques, we can repair even the smallest blood vessels in the foot, restoring blood flow so wounds can heal and amputations can be avoided,” Professor Malan says.

“Patients need to know their options. Without this knowledge, they can’t make informed decisions about their care.”