Have played a crucial aspect in steering the association via its restructuring in to the South African Healthcare Association, the new organisation has but to show an active commitment to human rights in health.Far more extensive analysis is needed when assessing facial structure in SIDSEditor–In their brief report on facial structure in infants who died from the sudden infant death syndrome Rees et al evaluated the part of retroposition of maxillae and mandibles in predisposing to narrowing and occlusion in the upper airway within the sudden infant death syndrome.1 Their hypothesis assumes that maxillary, mandibular, or bimaxillary retroposition reduces the nasopharyngeal airway. This may well appear logical, but a array of congenital syndromes exhibit maxillary hypoplasia, like Binder’s syndrome (maxillonasal dysplasia), in which a decreased nasopharyngeal airway has been measured; individuals with Binder’s syndrome are certainly not prone to obstructive apnoeas.two In adult obstructive sleep apnoea the patency from the nasopharyngeal airway is partly determined by environmental elements for instance obesity, allergy, and infections plus the distribution of submucosal fat furthermore to facial type. The authors’ preceding cephalometric work was primarily based on four adults with obstructive sleep apnoea whose families had a history in the sudden infant death syndrome. This function PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20030704 suggests a frequent pathophysiology for obstructive sleep apnoea and sudden infant death syndrome through a familial tendency towards maxillary retroposition. As neonates are obligate nasal breathers, nevertheless, fundamental variations exist in between the sudden infant death syndrome and obstructive sleep apnoea. Investigation from the impact of facial type by use of recognised bony and soft tissue lateral cephalometric landmarks could be beneficial inside the evaluation of nasopharyngeal airway patency. Methodological errors might outcome in the use of lateral cephalography at necropsy; these incorporate difficulty in making certain a constant mandibular position and theBMJ VOLUME 318 six FEBRUARY 1999 www.bmj.comResponse in the BMA’s secretary Editor–There is going to be quite a few who will likely be surprised to find in the pages with the BMJ, published by the BMA, a letter so heavily important of the BMA. This underlines the freedom get C29 enjoyed by the editor with the BMJ. I welcome the opportunity to respond vigorously on behalf with the BMA and, in particular, to reassure the South African Healthcare Association (SAMA) of our continuing help. The award signals a recognition in the element played by Mandell in making certain that the healthcare profession in South Africa owned as much as its past sins along with the roots of these attitudes. The Medical Association of South Africa was open and explicit in accepting its share of blame ahead of the Truth and Reconciliation Commission. Its leaders, like Mandell, willingly accepted considerable individual danger within this course of action. The BMA’s message to doctors and to healthcare associations in Medicine Betrayed,1 and in our forthcoming human rights report, is that owning as much as past errors and looking to make sure that they are not repeated will earn the respect and trust of colleagues. The suggestion that Mandell as well as the new South African Medical Association are unforgiven might be a very damaging message to existing transgressors. Lewin and de Gruchy may well sincerely think what they’re saying, however they are misguided and do not reflect the actual processes of alter in South Africa. The South African Healthcare Association represents the majority of do.