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When Professor Blanche Cupido embarked on her journey as a consultant in general cardiology in South Africa, she anticipated encountering occasional congenital heart disease presenting in the adult setting. She did not, however, foresee the substantial unmet need for adult congenital heart disease (ACHD) care. It was this need that drove her to apply for and win a Women As One Escalator Award in 2020.

“I was frequently encountering patients who had received treatment for their congenital heart disease during childhood, but lacked follow-up care as adults,” Prof. Cupido explained. “Many of these individuals sought emergency services or required treatment during pregnancies due to cardiovascular complications.”

Prof. Cupido had identified a significant gap in the South African clinical landscape—not just within her institution but nationwide. While pediatric cardiologists were available, there was a stark absence of specialists for adult congenital heart disease. Determined to address this gap, she pursued specialized training in ACHD at the Leeds General Infirmary, United Kingdom, aiming to establish a dedicated service upon her return.

“Initially, there was reluctance to fund an adult congenital heart disease service,” Dr. Cupido shared. “The hospital sought evidence of demand, but no historical data existed for what would be a pioneering initiative.”

The overall number of cardiologists in South Africa is alarmingly low, with approximately one cardiologist per every 350,000 people. This scarcity is partly due to the country’s focus on immediate health crises, including high rates of HIV, tuberculosis, rheumatic heart disease, and maternal and infant mortality. Although noncommunicable diseases like type 2 diabetes and heart disease are on the rise, they often receive less attention due to budgetary constraints.

Undeterred, Dr. Cupido remained dedicated to improving the lives of her patients. She utilized her Escalator Award to help develop and enroll patients in the Adult Congenital Heart Disease arm of the PROTEA (Partnerships in Congenital Heart Disease) registry. The registry, the first of its kind in South Africa, aims to track patient outcomes across various congenital heart diseases over their lifetimes. It runs under the auspices of the Children’s Heart Disease Research Unit (CHDRU), led by Prof Liesl Zuhlke and they hope to expand enrollment throughout Sub-Saharan Africa.

Today, Prof. Cupido’s service caters to nearly 2,000 adult patients with congenital heart disease with referrals coming from other hospitals, particularly pediatric centers that lack expertise in managing adult patients. Despite the progress, however, the workload remains immense. Prof. Cupido is still just one of two physicians in South Africa who specialize in adult congenital heart disease. Her responsibilities also extend beyond ACHD to include treating heart failure, performing cardiac imaging, and performing coronary interventions.

“Winning the Women As One Escalator Award has elevated what started as a fledgling idea to both immediate success for my patients and to international recognition for the needs we continue to face in South Africa and other Low-and-middle income countries,” Prof. Cupido emphasized. “The connections formed through Women As One have truly been invaluable to my career, especially as I hope to continue to transform the landscape of ACHD care in Africa.”

Looking ahead, Prof. Cupido is excited to enhance her service offerings for adults with congenital heart disease, particularly as she shifts her primary focus towards research. To young women aspiring to pursue a career in cardiology, Prof. Cupido offers this advice: “Expect challenges, but seek out mentors. Don’t suffer in silence. The connections you make through organizations like Women As One are crucial.”