​Approximately 50% of all pregnancies in South Africa are unplanned.

According to the Guttmacher Institute, an American research and policy organisation committed to advancing sexual and reproductive health and rights, 81% of unintended pregnancies in developing countries occur due to a lack of modern contraception. And in South Africa, only approximately 60% of women of child-bearing age are using modern contraception methods, says Dr Judy Kluge, a consultant obstetrician and gynaecologist at Tygerberg Hospital, as well as Head of the Family Planning Unit at Stellenbosch University's Faculty of Medicine and Health Sciences. She also teaches undergraduate and postgraduate students.

"There is a cost involved for society regarding children that are unplanned or unwanted," she says. "People need to realise that contraception is not completely effective. Many women also undergo abortions because contraceptives failed, they experienced side-effects or they were not informed about all the options." In Africa an estimated 34 in every 1 000 pregnancies are aborted, according to the Guttmacher Institute.

Kluge has been involved with the contraceptive implant Implanon NXT since its South African launch in June 2013. She is one of the handful of local specialists selected to be a master trainer for health care professionals regarding the insertion and removal of the implant.

Implanon NXT was officially made available in government health care facilities in February 2014. Kluge says the initial uptake was such that the company had to divert supplies from other countries to keep up with the demand. Unfortunately the demand has since decreased, and Kluge believes the problem might be a lack of counselling of women about their options.

She would like to see this change. "The implant is the most effective contraceptive available. It's even more effective in its ability to prevent pregnancy than sterilisation of a female or a male," she explains.

Kluge answers some frequently asked questions about the device:

What is Implanon NXT?

It is a small rod, some 4cm long and 2mm wide, that contains a synthetic hormone called progestogen. It is implanted just below the skin in the arm of the non-dominant hand. The hormone is then slowly released over a few years. Its registered usage is 3 years.

What is the action mechanism?

It suppresses ovulation. In lay terms it puts your ovaries to sleep and you therefore do not release an egg every month.

How does it compare to other contraceptive methods in terms of preventing pregnancy?

It's the most effective contraceptive available. It has a failure rate of 0,05 % for both typical use and perfect use, which means only 1 in 2 000 women will fall pregnant within the first year of use.

Female sterilisation has a failure rate of 0,5% in preventing pregnancy and male sterilisation 0,15%.

Other effective devices are intra-uterine devices (IUDs). The copper IUD has a 0,8% failure rate and the Mirena 0,2%.

In comparison injections, the most popular contraceptive in South Africa, has a typical failure rate of 6%.

With combined hormone methods such as the hormonal pill, a patch or a vaginal ring, the typical failure rate is 9%, in other words 9 out of 100 women will fall pregnant within the first year of use. The typical failure rate of condoms is 18%.

What are some of the other advantages of this method?

It's useful in the sense that the patient can just fit it and then forget about it.

Another advantage is that it is 100% reversible. As soon as the implant is removed, the hormones disappear from your system within a few days, therefore women regain their fertility almost immediately.

Because it is a progesterone only method and puts the ovaries to sleep, it can also reduce painful periods by 70%.

Lastly, the implant is cost-effective. Although the initial cost may be higher than that of some of the other methods, it still represents a massive cost saving from a public health perspective compared to the cost of an unplanned pregnancy. The cost of a normal delivery in a government hospital is more or less R2 000 per day, while abortions are even more expensive than contraception.

What are some of the concerns and disadvantages regarding this method?

As is the case with any hormonal method, women might experience hormonal side-effects, although they are less compared to those of the injectable method due to the relative small amount secreted.

It also wears out the endometrium, therefore bleeding patterns might be unpredictable. This is usually the most common reason for removal.

Women often want to know if it will affect their weight, but Implanon has no causal association with weight gain. Any hormonal method can affect your appetite, but the effect is highly individual.

Other side-effects with progestogen include possible moodiness and irritability, but it should not cause clinical depression.

Another complication for some women has been the removal of the implant in instances when it was inserted too deep. Training is taking place to improve removal techniques, but any woman who is struggling can be referred by her doctor or clinic to a specialist family planning centre, where the implant can be removed.

The bottom-line is that although some women may experience side-effects, they can be experienced with any method. With Implanon NXT the continuation rate is high. This means that the advantages outweighs the disadvantages for most women.

*Kluge is also the clinical lead for the Leading Safe Choices (LSC) project, a donor-funded initiative led by the British-based Royal College of Obstetricians and Gynaecologists (RCOG), which focusses on family planning. Among other things, the LSC programme trains health care professionals to counsel women on pregnancy options and contraception.

Additional sources: Guttmacher Institute (https://www.guttmacher.org/fact-sheet/induced-abortion-worldwide)

Caption: Dr Judy Kluge, Head of the Family Planning Unit, and Prof Stefan Gebhardt, Head of General Specialist Services at the FMHS' Department of Obstetrics and Gynaecology, are involved in the Leading Safe Choices initiative.

Photo: Damien Schumann

The 21^st symposium of the Nematological Society of Southern Africa was recently held in Ballito, KwaZulu-Natal, with the theme "Adapting to a changing environment". The symposium was attended by 103 nematologists from around the world, including ten students and researchers from the Department of Conservation Ecology and Entomology of Stellenbosch University, who all had the opportunity to present their work. These researchers were, Antoinette Malan, Jenna Ross, Caro Kapp, Nomakholwa Stokwe, Nicholas Kagimu, Deidré Odendaal, Agil Katumanyane, Annika Pieterse, Fisayo Daramola and Maryna Odendaal.

Delegates at the symposium were asked to vote for researchers who they believed gave the best presentations. At the gala dinner on the last evening of the symposium, it was then announced that three PhD students from SU were among the winners for best oral presentation. Deidré Odendaal and Annika Pieterse shared second prize for their oral presentations, while Nicholas Kagimu won third best paper presentation. Caro Kapp, also a PhD student, was the sole recipient of the George Martin memorial scholarship, a scholarship awarded annually by the NSSA to promote Nematology in Southern Africa.

Dr Antoinette Malan and Dr Jenna Ross act as co-authors for five chapters in a new book which was also launched at the gala dinner. The book, titled "Nematology in South Africa: A View from the 21st Century" has 26 chapters and includes an up-to-date summary of the achievements made in the field of Nematology in South Africa.

A Memorandum of Agreement (MOA) between the City of Cape Town and Stellenbosch University has paved the way for the mixed development of the Bellville Park University property located along the N1 freeway. The MOA dovetails the City's efforts to ignite urban renewal, economic growth and job creation in Bellville. Read more below.

The University purchased the property of some 69 hectares (erven 23974 and 1682, Bellvile) from the former Bellville Municipality in 1982 with the specific objective to establish a satellite campus in Bellville.

Part of the property currently accommodates the University's Business School, the School of Public Leadership, the Division for Part-time Studies and the Bellvista Lodge, while another portion is occupied by a golf driving range and toboggan track.

The remainder of the property is vacant although large areas of the site totalling approximately 23 ha are not suitable for urban development due to an old waste dump site and a quarry which have not been sufficiently stabilised.

The Memorandum of Agreement (MOA) concluded between the City and the University now makes provision for the development of non-academic facilities such as offices, retail space and residential facilities on the property, in addition to academic uses as per the original purchase agreement.

The City and University will share the net income received from the sale and/or lease of portions of the land, primarily to invest into the further development of the property.

'The City and the Stellenbosch University have been in discussions about the development of this property for many years. Given the importance of this strategically located gateway property we are anxious seeing it utilised and developed to its full potential. As such, the decision by both parties to take hands and to deal with this property on a partnership basis was a major break-through in the negotiations. We are heading into a new direction which would benefit not only the two parties, but also Cape Town's residents,' said the City's Mayoral Committee Member for Transport and Urban Development, Councillor Brett Herron.

'The proposed development of our Bellville Park property is an opportunity for the University to unlock the potential of a valuable asset in collaboration with the public and private sectors,' said Professor Wim de Villiers, Rector and Vice-Chancellor of Stellenbosch University.

'A combination of mixed development and the expansion of the academic campus, together with the protection of substantial areas of sensitive habitat will benefit the University, the City, the Tygerberg business community and local communities. We look forward to this innovative and mutually beneficial partnership with the City of Cape Town and other role players in the interest of economic development and financial sustainability,' said Professor De Villiers.

The MOA ties in with the City's intention to revitalise the Bellville central area, inclusive of the public transport interchange.

In March 2016, the City of Cape Town's Council adopted the Transit-Oriented Development (TOD) Strategic Framework which introduced a new approach to integrated spatial and transport planning.

The TOD Strategic Framework dictates the City's approach to long-term development by prescribing how new developments across Cape Town should happen and how existing public infrastructure should be transformed to deal with apartheid spatial inequality, the high cost of public transport, and urbanisation, while also stimulating economic growth.

'Bellville has been identified as one of the priority areas where we will either invest in the improvement of existing public transport infrastructure or provide new public transport infrastructure to ignite urban renewal, economic growth, and job creation. The purpose of transit-oriented development in this instance is to create a sustainable living environment and economy in the Bellville CBD – initiated by the City through investment in public transport and followed on by private investment in new developments in the immediate vicinity and surroundings of the public transport infrastructure.

'The MOA thus mirrors the new strategic direction that we have committed to undertake when Council adopted the new Organisational Development and Transformation Plan which identifies dense and transit-oriented growth as key to assisting us in building a more equitable and inclusive city,' said Councillor Herron.

Since the conclusion of the Memorandum of Agreement, a project team with representation of both the City and the University's administration has been established to finalise the details of a cooperative development agreement, and to compile an urban design framework and a bulk infrastructure and services plan.

The development of the property is subject to various statutory approvals and the necessary applications for subdivision of portions of the property will be submitted to the City for consideration in due course.

Residents will be able to comment on these applications – the City will inform residents when we have reached this stage of the process, and where and how to access the documents.

Over the last four months, the LaunchLab, a network of university campus-based business incubators, in partnership with Stellenbosch University (SU), Stellenbosch Innovation District (SID) and Sustnet, ran an entrepreneurial challenge to look for potential solutions that may improve the water and waste issues in the Western Cape and South Africa.

The LaunchLab received many sign-ups and pitch submissions, which were narrowed down to the best 11 finalists. The four winners of the Water & Waste Management Innovation Challenge were chosen on 17 May 2017. They are:

• Jacobus Els - Revolute; A soil moisture monitoring system designed for commercial farms and research usage.
  
• Peter Turner - GreenChain Technology; An automated grey water system, integrated with a rain water solution.
  
• Jurie Erwee - Bridgeiot; A smart geyser control system on an IoT platform.
  
• Bettina Botha - Eva Solutions; An Eva spheres solution, plastic balls designed from recyclable materials, aimed at reducing the evaporation of dam water by 90%.  
  

The judging panel consisted of six judges selected from the Stellenbosch Municipality, Israeli High Commission, Enkanini Research Center, Aurecon and Stellenbosch University.  These 4 winners each wins seed funding and incubation support from the LaunchLab for the next 6 months to be used to launch and grow their business ideas.

The LaunchLab will be carefully monitoring the development of these business ideas during this time to gauge their potential to positively impact or improve the water and waste issues in the Western Cape and South Africa.

The competition came in the wake of a worsening water crisis in South Africa and the Western Cape.

"South Africa is currently facing a multi-faceted water crisis, which, if not addressed effectively, has the potential to significantly limit the economic growth potential of the country," the SA Integrated Water Quality Management Plan reads.

"Currently the Western Cape Government is busy with a review of its 'Sustainable Water Management Plan'. The government's role in water management is an imperative, however, achieving more sustainable outcomes requires full participation by universities and researchers, the private sector and citizens," a LaunchLab statement reads.

​In celebration of Africa Day which took place yesterday (25 May), Nico Elema, Manager of the Centre for Collaboration in Africa (CCA), reflects on the need for collaboration between universities to address challenges in Africa:

Africa Day is celebrated on 25 May each year, and offers an ideal opportunity to rethink how Stellenbosch University can help solve the many challenges of our continent – including famine, sickness, poverty, climate change, political instability and piracy.

It is widely accepted that higher education institutions are viewed as vehicles of innovation, where new knowledge is generated in service of society. But for innovation to truly have a social impact, institutions have to collaborate across boundaries to find solutions for these challenges.

The Centre for Collaboration in Africa was established in 2016 after the restructuring of the Postgraduate and International Office, to foster SU's African interests on an institutional level. These interests include the institutional, bilateral agreements with African partners, thematic mobility programmes and supporting African initiatives, which is not only managed by Stellenbosch University International, but also by different faculties. 

One such initiative is ARUA (African Research Universities Alliance), a network of 16 African universities, of which we form part, aimed at promoting research on the continent. A total of 35 SU researchers will work in areas like Food Security, Water Conservation, Mobility and Migration and Poverty and Inequality.

Another example of how SU is promoting innovation on the continent is through the African Doctoral Academy, which has been supporting and advancing doctoral training and scholarship on the since 2010. In adition to this, networks such as PANGeA (Partnership for Africa's Next Generation of Academics) and  PeriPeriU (disaster risk management), create opportunities for the new generation of academics to embark on collaborative research and doctoral programmes, especially in the arts, humanities and social sciences. NEPAD SANWATCE also offers researchers the opportunity to participate in water-related research.    

Since the inception of AfriNEAD, a disability research evidence project initiated in the Medicine and Health Sciences, in 2007 more than 18 African countries have pledged their support to advancing the debate on how disability research can be used to accelerate the process of realizing equity and human dignity for people with disabilities in Africa.

These are only a few examples of the projects and programmes that SU is involved in. And through these initiatives and the fruits it bear, we strengthen the message that Africa is capable of developing herself, to create a better future for her people and to be a fully-fledged role player on the international stage. 

​

A major, new study on the country's emerging Shadow State

Changes in an organization can often take an emotional toll on employees and it is important that managers take this seriously.

This was one of the viewpoints of Prof Mias de Klerk of the University of Stellenbosch Business School in the Faculty of Economic and Management Sciences (EMS) in his inaugural lecture on Thursday (25 May 2017).

De Klerk said organizational change is emotionally more intimidating and disturbing than managers and consultants typically assume.

He added that any forced changes to jobs or work structures involve some sort of loss as it requires departure from well-known practices, or the social construction of a new identity.

"The difficulties encountered in implementing change do not simply result from being resistant to change. The immense negative affect experienced during change is likely to predispose employees negatively to the change and to become averse to the change and goals set by executives."

"Yet, the deeply experienced emotions are mostly being ignored in the discourse on resistance to change."

De Klerk said most of the studies about downsizing interventions focus on employer concerns, such as the costs and benefits of downsizing and the performance of the survivors.

He added that the loss, subsequent emotional experiences change holds for individuals and its underlying psychological mechanisms tend to be underplayed.

"Organizations tend to be indifferent and reluctant to acknowledge the severity of employees' perceived losses."

"Organizations need to be concerned about emotional trauma, grief and mourning when enacting change."

De Klerk said managers must embrace people's powerful sense of loss and help employees to adapt to the trauma of loss if they want to improve change resilience and change success.

"Ignoring the severity of perceived losses and disenfranchising the grief may conveniently suppress executives' anxiety. However, unless the severity of loss is acknowledged, grief is enfranchised and mourning is encouraged, change resilience and change success remains inconveniently unlikely."

He added that indifference and carelessness of leaders can compound emotional trauma.

"By acting as if nothing out of the ordinary had happened, leaders leave people feeling as if the organization does not recognize them as human beings. Organizations must build a capacity to allow grieving and mourning what is lost in order for the employees to heal and move on past the change."

De Klerk said we have much to learn about the ways people can be helped to reconstruct their psychological world after a loss that resulted from change.

• Main Photo: Pixabay
  
• Photo 1: Proff Eugene Cloete, Vice-Rector: Research, Innovation and Postgraduate Studies, Michael Morgan who also delivered his inaugural lecture, Mias de Klerk and Johan Malan, Acting Dean of EMS, at the event. Photographer: Amanda Matthee
  

Edu­cational assessment at schools and universities should be seen as a means through which teaching and learning can unfold and not just as something to test learners and students.

This is one of the key arguments in a new book by Dr Nuraan Davids and Prof Yusef Waghid of the Department of Education Policy Studies in the Faculty of Education at Stellenbosch University.

Their book Education, Assessment, and the Desire for Dissonance was published recently by Peter Lang.

Comprising 10 chapters, the book covers themes such as the failure of governmental strategies for educational assess­ment; the power dimensions of pedagogic relations and assessment practices; the use of measurements and metrics in South African forms of assessment; and deliberative assessment encoun­ters.

The book looks at educational assessment practices in schools and universities broadly, while also drawing from South African experiences.

The authors say they wrote the book because they were concerned about South African schools and universities' complacency and non-responsiveness to conceptions and practices of assessment.

They argue that inasmuch as attempts have been made to move away from measurement and metrics, assessment in South Africa remains mostly connected to control and predictability, as com­monly encountered in international trends in assessment.

"Assessment is overwhelmingly seen as something that has to be done in addition to teaching and learning. Such an understanding creates the impression that teaching and learning do not have an internal connection to assessment," says Davids.

"Educational assessment is constitutive of teaching and learning and not an add-on practice (a non-governmental practice), as is currently the case with assessment practices in South Africa."

They say they are concerned about school, university, and societal understandings that assessment can somehow be used to address learner or student performance, while simultaneously being used as a motivation for learning.

"Unless assessment yields the necessary information to improve teaching and learning, and unless teachers know how to analyse and apply this information, assessment, as we see in the Annual National Assessment or the National Senior Certificate, adds no value."

They argue that dissonance could be a way out of the quagmire of standardised "testing" measures that not only inhibit the pursuit of creativity, talent, and passions, but also make peda­gogic encounters a bit superficial and parochial.

According to the authors, edu­cational assessment aimed at improving teaching and learning can be successful if it also incorporates the idea that a learner or student should not necessarily accept a teacher's particular assessment of his or her work.

"The student has to be allowed to disagree with the teacher (show dissonance/disagreement) – but, of course, has to show reasonable justification for doing so. In the same way, teachers cannot simply retreat into their rooms and assign marks/assessments to students without engaging with them."

"We contend that dis­sonance in educational assessment offers an alternative to assessment practices that currently constrain the autonomy of students and of teachers."

"If teaching is understood as directing students towards the unfamiliar and yet-to-be-understood, then assessment needs to offer the potentiality for a questioning of the unfamiliar and the yet-to-be-understood."

The authors say they recognise that assessment is a complex and demanding encounter and that it means different things, teachers, learners or students.

"Because assessment is complex and demanding, it is something that people should do together. We would aver that educational assessment ought to be advanced by a desire to do things differently."

In this regards they propose an assessment within teaching as opposed to assessment of learning and an assessment for learning.

"Assessment within teaching and learning places the onus on both teachers and learners or students to consider the practice as something done in association with others. Such a view is different from the traditional ones that prejudice doing things for others. This would mean that assessment ought to be considered as an encounter."

The authors add that this type of assessment implies that teachers and students are present in pedagogical relation­ships that produce meanings and operations that are carried out in their own presence.

"Teachers and students are, or have the potential to be pedagogical equals." 

The authors say their book may appeal to academics, educational practitioners, policy analysts, students, and teachers.

• Education, Assessment, and the Desire for Dissonance is available at www.peterlang.com as well as leading online bookstores.

 Photo: Dr Nuraan Davids and Prof Yusef Waghid with a copy of their new book.

A team from Stellenbosch University (SU) and the Tygerberg Academic Hospital has recently performed a second penis transplant, making it the first medical centre in the world to successfully perform this procedure twice.

Prof André van der Merwe, Head of the Division of Urology at SU's Faculty of Medicine and Health Sciences (FMHS), led the marathon operation of nine and a half hours performed on 21 April at Tygerberg Hospital in Cape Town, South Africa. The recipient was a 40 year old male who had lost his penis 17 years ago due to complications after a traditional circumcision. His identity is being protected for ethical reasons.

"He is certainly one of the happiest patients we have seen in our ward. He is doing remarkably well. There are no signs of rejection and all the reconnected structures seem to be healing well," says Van der Merwe. The patient is expected to regain all urinary and reproductive functions of the organ within six months of the transplant. A colour discrepancy between the recipient and the donor organ will be corrected with medical tattooing between six to eight months after the operation.

"The success of this procedure in the hands of our transplant team is testimony to the high level of skill and expertise that exists in the public health sector in South Africa," says Prof Jimmy Volmink, Dean of the FMHS. "Also of considerable pride is the team's ability to balance compassionate and ethical patient care on the one hand, with a concern for the efficient use of scarce resources on the other."

"This is a remarkable, ground-breaking procedure. I would like to congratulate the Tygerberg Hospital and the SU surgeons for doing such a sterling job. Traditional circumcision has claimed many young lives in South Africa. For this patient, life will never be the same again," said Dr Nomafrench Mbombo, Western Cape health minister.

"Patients describe a penis transplant as 'receiving a new life'. For these men the penis defines manhood and the loss of this organ causes tremendous emotional and psychological distress," says Dr Amir Zarrabi of the FMHS's Division of Urology, who was a member of the transplant team. "I usually see cases of partial or total amputations in July and December – the period when traditional circumcisions are performed."

"We are thrilled on behalf of the patient and the change it will make in his life," says Dr Alexander Zühlke, who heads the FMHS's Division of Plastic and Reconstructive Surgery. "It is also a great achievement to be part of the team that has performed two successful penis transplants."

The team consisted of Van der Merwe, Zühlke, Prof Rafique Moosa, head of the FMHS's Department of Medicine, Zarrabi and Dr Zamira Keyser of Tygerberg Hospital. They were assisted by transplant coordinators, anaesthetists, theatre nurses, a psychologist, an ethicist and other support staff.

In December 2014 Van der Merwe and his team performed the world's first successful penis transplant and more than two years later "the patient is doing extremely well, both physically and mentally", says Van der Merwe. "He is living a normal life. His urinary and sexual functions have returned to normal, and he has virtually forgotten that he had a transplant."

Penile mutilation is more common in South Africa than elsewhere in the world due to complications of circumcisions performed as part of a traditional rite of passage on young men in certain cultures. There is no formal record of the yearly number of penile amputations due to traditional circumcisions, but one study reported up to 55 cases in the Eastern Cape alone. Experts estimate that as many as 250 partial and total amputations take place country-wide every year, with suicides also being reported. 

"At Stellenbosch University and Tygerberg Hospital we are committed to finding cost-effective solutions to help these men," says Van der Merwe. The procedure was part of a proof of concept study to develop a cost-effective penile transplant procedure that could be performed in a typical theatre setting in a South African public sector hospital. By applying lessons learnt from the first transplant, Van der Merwe and his team were able to significantly cut the costs of the second procedure.

The biggest challenge to this SU study is organ donation. "I think the lack of penis transplants across the world since we performed the first one in 2014, is mostly due to a lack of donors. It might be easier to donate organs that you cannot see, like a kidney, than something like a hand or a penis," says Van der Merwe.

"We are extremely grateful to the donor's family who so generously donated not only the penis, but also the kidneys, skin and corneas of their beloved son. Through this donation they are changing the lives of many patients."

The world's first successful penile transplant was performed by Van der Merwe and his team at Tygerberg Hospital in Cape Town on 11 December 2014.

The second was done a year and a half later, on 16 May 2016, at the Massachusetts General Hospital in Boston in the United States of America.

FACT SHEET

Technical details of the transplant

The entire penis was carefully dissected from the donor to keep blood vessels, nerves and other connecting structures intact. These were marked and connected to the recipient's correlating tissue during the transplant.

It is a complex procedure known as a composite tissue transplant, during which different types of tissue (nerves, blood vessels, muscle etc.) are cross-connected between the recipient and the donor organ.

The surgeons connected three blood vessels (each between 1 and 2 mm in diameter) to ensure sufficient blood flow to the transplanted organ; two dorsal nerves (also between 1 and 2 mm in diameter) to restore sensation; the urethra, which enables the recipient to urinate through the penis; as well as the corpus cavernosum (cavernous body of the penis), which will allow the patient to obtain an erection.

"The diverse presentation of the blood vessels and nerves makes the operation very challenging and means each case is unique. All these structures need to be treated with the utmost delicacy and respect in order to be connected perfectly to ensure good circulation and function in the long term," says Zühlke.

Micro-surgery was used to connect small blood vessels and nerves. The patient has since returned for a minor procedure to remove a small piece of dead tissue on the skin edges.

Immunosuppression

Through a process called an immune response, the body naturally rejects any foreign object inserted into or attached to it. During an organ transplant, this immune response has to be suppressed to prevent the body from rejecting the transplanted organ. An immune response can only be avoided in cases where the patient's own tissue, or that of an identical twin, is used.

"Transplants where several types of tissue are involved (muscles, nerves, blood vessels, etc.) require stronger immunosuppression treatment than transplants of organs involving fewer cells, such as kidneys," explains Moosa.

The immunosuppression medication used during penis transplants, although not usually used as a first-line treatment, is available in state facilities and is generally used after kidney transplants.

Although the dosage is reduced as time goes on, transplant patients have to take immunosuppression medication for the rest of their lives – even if they have made a full recovery.

Ethical considerations

Permission for the study was granted by SU's Health Research Ethics Committee (HREC) in 2011 and the transplant team has been in close consultation with ethicists and the HREC throughout the design and conduct of the study.

According to Dr Nicola Barsdorf, Head of Health Research Ethics at the FMHS, the research team adequately addressed the important ethical issue of therapeutic misconception (the risk that a research participant may not fully understand that this treatment is only experimental).

"The patient was repeatedly counselled over an extended period of time about the potential benefits and risks of the procedure. He had a clear understanding about the experimental nature of the transplant and provided his informed consent after multiple, comprehensive discussions about the voluntary nature of his participation," explains Barsdorf.

According to Barsdorf, careful consideration during the planning phase of the study allowed them to anticipate potential pitfalls, including:

• Therapeutic misconception refers to a participant's failure to fully understand the difference between research and treatment. It can include an overestimation of clinical benefit from an experimental intervention, as well as underestimation of potential risk of harm. To minimise the risk of therapeutic misconception the research team implemented a rigorous informed consent process. The recipient was counselled over a period of two years, during which his understanding of the risks involved were assessed and truly informed and voluntary consent to the experimental procedure was promoted.
• The ethicist's inputs spelled out risk mitigation steps for the emotional, social, psychological (as well as physical) risks that research participants might experience. The recipient was selected based on these inputs. A number of participants were eligible for scientific reasons, but at substantially higher risk of physical and psychological harm.

Psychological aspects

All patients considered for the study have to undergo extensive psychological evaluation to determine whether they are mentally fit to receive a transplant. Organ transplantation could have a negative psychological effect if patients can't associate with the organ.

Medical tattooing

Advancements in technology have expanded the age old custom of tattooing for medical purposes. Micro-dermal pigmentation is currently used to improve the appearance of individuals with medically-related physical imperfections.

Nipple and areola reconstruction by means of tattooing after a mastectomy is probably the most well-known application of this procedure. It goes a long way to help women regain their confidence and improve their self-image.

Reconstructive medical tattooing can also camouflage the appearance of ugly scars due to accidents, burn wounds and surgery. Furthermore, it is used to camouflage vitiligo (patches of white skin), using flesh-coloured pigments, or to help restore the appearance of missing hair lost due to disease (cancer or alopecia) or trauma.

According to Zühlke medical tattooing can also be applied in the case of penis transplants if there is a colour discrepancy between the donor and the recipient.

This should be performed by a tattoo artist who has specialised in medical tattooing. Although there is no experience with such a procedure, since the current transplant is only the third case in the world and tattooing has not been necessary in the other two cases, it would typically be performed from six months onwards after the operation and more than one session would probably be necessary.

Other penile replacement options

Current surgical options for patients include penis reconstruction involving free tissue transfer. During this procedure skin and soft tissue ("flap") is taken from the arm, reconstructed into a penis and attached to the body. A prosthesis can also be implanted to allow sexual intercourse, but it is expensive and complications may develop.

Media enquiries

Wilma Stassen

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wstassen@sun.ac.za

Marketing and Communications Office

Faculty of Medicine and Health Sciences     

Stellenbosch University

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More than 20% of South African children have symptoms of posttraumatic stress disorder (PTSD) and urgently need treatment.

Researchers at the Faculty of Medicine and Health Sciences (FMHS) at Stellenbosch University (SU) are studying new avenues of providing this essential psychological treatment in a violent society with a high exposure to trauma such as that of South Africa. This research has particular significance during Child Protection Week, commemorated from 27 May to 2 June, during which the focus is placed on the wellbeing of children.

In a study undertaken in South Africa, 14,5% of adolescents met criteria for PTSD. An additional 10,3% of adolescents met partial criteria for PTSD, but were still functionally impaired.

The FMHS study examines how kids and teenagers who have experienced a traumatic event and developed PTSD, can potentially be counselled by registered nurses trained by an expert.

"We hope our study can help increase the access of adolescents with PTSD to much-needed support in a developing country such as South Africa," says principal researcher Jaco Rossouw. The research forms part of his doctoral study in the Department of Psychiatry at the FMHS.

PTSD is a mental health condition that is triggered by exposure to actual or threatened death, serious injury, or sexual violence. As is the case with adults, PTSD in children and adolescents is usually chronic and debilitating. It can cause long-term suffering, with serious public health and economic implications that stretch beyond adolescence into adulthood.

Symptoms include avoidance behaviour, flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. Often teenagers with PTSD want to avoid talking about it, because it causes such intense emotions.

The study investigates the effectiveness of trauma treatment provided by registered nurses, trained by an expert, to socio-economically deprived adolescents in high schools in Cape Town. "This treatment, if proven successful, could help to significantly improve community access to specialised mental health services," Rossouw says.

"A trained professional psychologist can see 35 patients in a week. With 10 counsellors, that number can increase to 350. You need only one behaviour therapy expert to supervise and guide the counsellors.

"Within a South African context with its limited public health psychological services, it is crucial that we find ways of making these psychological interventions more readily available to the broader population," Rossouw explains.

The nurses offering the support are trained to provide prolonged exposure therapy as well as supportive counselling. Both these treatments have been proven effective in adults and adolescents with PTSD. "However, until now it has not really been tested in our context with nurses as counsellors and within a community setting," Rossouw says. Prolonged exposure therapy has been proven to be effective in community settings in the USA and Israel. Supportive counselling is widely used in crisis centres and community settings to treat sexually abused children and other traumas.

The study focuses on teenagers who were either exposed to trauma such as physical or sexual assault, or have witnessed sexual or physical assault or a violent death. These participants were recruited at their schools and received weekly PTSD treatment there.

The treatment consisted of prolonged exposure therapy or supportive counselling in up to 14 sessions of 60 to 90 minutes each. The children were monitored immediately after the treatment, as well as a few times thereafter (including a year later). Counselling was provided by six nurses who completed a one-year diploma course in advanced psychiatry at SU. Weekly supervision was provided by Rossouw. The counsellors attended a three-day training workshop on prolonged exposure therapy. They were also trained in supporting counselling for a day and had to complete 16 hours of practical training.

Thus far the results have been encouraging, Rossouw says. It appears as if the PTSD and depression symptoms of children who have received either of these treatments, have improved significantly. Depression is often comorbid with PTSD and it improves during treatment for PTSD. The teenagers who received prolonged exposure therapy maintained their gains after the treatment, whereas the gains of the group who received supportive counselling were not sustainable.

"The pilot feasibility study suggests that prolonged exposure therapy can be administered by previously inexperienced counsellors in a South African context. It is encouraging that nurses can be trained and supervised in a short time to administer the treatment in a resource-starved setting."

"Our campus community is appalled and shocked by this senseless act and our hearts go out to the family and friends of the student who has lost her life and to the injured student. We are very relieved to hear that the SAPS has arrested suspects in connection with the hijacking. The perpetrators should be met with the full extent of the law."

This was the message of Prof Wim de Villiers, Rector and Vice-Chancellor of Stellenbosch University (SU), on learning of the kidnapping of two Matie students over the weekend. Ms Hannah Cornelius, a BA Humanities student,  was found dead on Saturday (27 May), while a male student was admitted to hospital with serious injuries.

Prof De Villiers expressed his deepest condolences with those involved and said: "Our thoughts are with the victims of this horrific crime. We wish the injured student well and we will do everything in our power to assist – also in aiding the SAPS with their investigation."  

Staff of the Division of Student Affairs were in contact with the parents on Saturday night and started to provide support to Ms Cornelius' friends. Trauma counsellors have presented debriefing sessions at Ms Cornelius' residence and are on standby to provide support. The University's Crisis Service number is 082 557 0880 and students are encouraged to make use of the services provided.

The Police confirmed on Saturday afternoon that cases of murder, attempted murder and hijacking are under investigation. According to a SAPS statement the female student was found on Saturday morning at about 08:30 on the Knorhoek Road with injuries. A blue VW Citi Golf that they were driving was hijacked by three suspects. The SAPS requested that anyone who can provide further information to contact Crime Stop at 08600 10111.

• Read the Student Representative Council's statement here.
  

[Information updated on Sunday 28 May 2017]

​Stellenbosch University is moving towards implementing a full electronic student feedback system. Implementation of this system started on 01 May 2017.  A key priority of the process is to develop an information producing system that will focus on aspects of teaching that are closely linked with improved learning. Moving towards an electronic system will create the opportunity for a more flexible system which could contribute to such teaching and learning conversations. It will allow lecturers greater access to formative feedback possibilities and for reports to be made available quicker so as to enable lecturers to respond to feedback, if necessary. Students will then be able to experience the outcomes of their feedback.

For more information, click here:  http://www.sun.ac.za/english/learning-teaching/ctl/Documents/WebsiteInfo_Eng.pdf

The appointment of Desmond Crowie as coach of the Maties Football club heralds a new chapter for the Stellenbosch University team.

Crowie has been involved with football on a coaching level for some 22 years and was also a player for nine years. He comes to Maties from Milano United, a football club based in Grassy Park that plays in the national first division.

"It's a great challenge to start something new at the university. It's a new chapter in my coaching career, something totally different from what I'm used to. That in its entirety excites me," said Crowie.

He describes himself as a pragmatic coach. "I can adapt to the players at my disposal. I can relate to them and make them understand what's important to succeed – not only in soccer but also in life."

Crowie has big goals for the Maties club. He will focus on building a pool of players to work with and creating a winning mentality. He also wants to put structures in place for future participation in Varsity Football, implement recruitment structures and prepare the team to be competitive at USSA.

He knows it won't be easy and that challenges await him.

"I must change the mentality of the sport/soccer fraternity at Maties. We must show that soccer can be one of the top sporting codes if structures are in place. The scouting network on and off the campus must improve to attract more soccer players to the university."

Despite all the challenges he is very excited with what the future holds. 

"Building something from scratch and laying a foundation excites me. Once the foundation is solid winning can become a habit. Short-term success doesn't excite me; longevity is what's important."

​From 1 June Stellenbosch Municipality, like the City of Cape Town, will be subject to level 4 water restrictions. This will have a great impact on how everyone uses water.

In terms of the level 4 restrictions water may only be used for cooking, drinking and sanitation. Each person will also be limited to the use of 100 litres of water per day.

"This means Stellenbosch University no longer irrigates its gardens and sports fields, even though we have been using a limited quota of non-potable water from rivers to do this previously. There is no longer water available in the rivers. We are really experiencing a time of crisis and we ask everyone to make a contribution. Any waste of water will be regarded in a serious light and addressed," says John de Wet, Manager: Environmental Sustainability at Facilities Management.

"In addition to that which we are doing in the environment on campuses, we have also installed water-saving howerheads in residences and removed the heads of bath taps in residences to encourage students to take short showers."   

Do the following to keep to your 100 litres per person per day (this is not an all-encompassing list):

• Shower for only two minutes. Taking a bath uses between 150 and 200 litres of water.
• Collect your shower and basin water and re-use it to flush your toilet, and use it in the garden and for cleaning.
• Do not defrost food under running water.
• Use a cup for brushing teeth or shaving. Do not leave the water running.
• Turn off the tap while you soap your hands to wash them.
• Wait for a full load before using your washing machine. The washing machine uses between 90 and 150 litres of water per load of washing.
• Do your dishes by hand – this uses between 10 and 30 litres of water. A dishwasher uses between 40 and 75 litres of water per cycle.
• Drink tap water. Three to five litres of water are used to produce one litre of bottled water.
• Report leaking taps, sprayers and other devices to (021) 808 4666.
  

For more information contact John de Wet at jdewet@sun.ac.za or 021 808 942

​Dialogue between different generations needs to be continued as a matter of urgency. This wish was expressed during the Africa Day celebration at the Faculty of Medicine and Health Sciences (FMHS) at Stellenbosch University.

A symposium entitled "Africa universities – dialogue across generations regarding decolonisation and activism", was presented on 25 May to commemorate the founding in 1963 of the Organisation of African Unity, precursor of the African Union. The speakers varied from experts in the fields of decolonisation, higher education and co-operation on the continent, to staff members and student activists.

Prof Yusuf Chikte, Head of the FMHS' Department of Interdisciplinary Health Sciences, drew an analogy between the morning's misty weather and the initial hazy vision of what an African university and decolonisation ought to comprise and the way in which activism ought to be utilised. As the mist gradually disappeared, this vision also became clearer.

Prof Elelwani Ramugondo, special transformation advisor to the Rector of the University of Cape Town, emphasised that many parents in traditional societies no longer feel a connection with their children and cannot identify with the way in which they play. This compelled her to research children's games across the country – something that is apparently innocent, but to her a mirror through which the community can view itself.

During the course of the day this disconnection was traced to almost every university level and the concomitant wish was expressed that the necessary spaces for dialogue should be created – not only between generations, but also amongst contemporaries.

Ramugondo emphasised that dialogue should take place within the decolonisation framework. She referred to herself as a member of the transitional generation – the generation who was too young for the 1976 protests, but too old for the current protest actions at higher education institutions and who is caught between the two struggles. The ageing activists attach value to things such as a negotiated constitution, while the young activists don't necessarily feel the same and want to know whether the older activists were not also merely captured.

Ramugondo reminded young people that activism on social media is not enough; there is also work to be done on the ground.

Young activists, some of them from other African countries, mentioned the unwelcoming, Western culture they experience at SU, partly due to the demography of the staff. Questions were asked about the apathy amongst white students during protest actions and disagreement amongst staff about what they should do during such actions.

A future African university was portrayed as an institution where the focus is not solely on knowledge, but where problematic issues are introduced in the lecture hall and discussed.

Requests were put forward for research about endemic medical practices in order to prevent traditional medicine from remaining on the periphery, as well as for the packaging of medical terminology in an African context to ensure more meaningful hospital consultations with speakers of black languages.

The small number of accredited universities in Africa (only some 620) was emphasised by Prof Ahmed Bawa, chief executive officer of Universities South Africa. Many of these are very small institutions.

He highlighted several challenges, such as that universities in Africa are chronically underfunded and are not accessible as places where social problems can be solved. Language is also a critical issue. "We don't afford enough consideration to the question why universities are English, French or Portuguese. It is a fact that if Zulu, Xhosa and Sotho are not used for academic discourse, it will only be a matter of time before they will deteriorate."

Another critical question is the manner in which African universities can enter the global knowledge system on their own terms. According to Bawa local context is very important in this regard, but the standard has to be such that it can form part of the global content.

Stellenbosch University's Terra Vino Dohne Merino stud has since its formative years always enjoyed the invaluable support of the South African Dohne Merino stud farming community. The stud – the only one of its kind linked to a South African university – was in fact started in the 1970s thanks to the goodwill of breeders, says John Morris, farm manager of Mariendahl, one of Stellenbosch University's (SU) two experimental farms.

In Morris's office, he still keeps the waybills of the first Dohne Merino sheep which were brought by train from the Stutterheim district in the Eastern Cape to Stellenbosch. Between 1973 and 1975, 81 mostly gravid ewes were donated to the University by 22 farmers. The stud thus started off with a broad genetic base. Under leadership of Dr Jasper Coetzee, the Terra Vino stud was registered with the Dohne Merino Breed Society of South Africa in 1974, and is one of the oldest in the country.

Last year the Terra Vino Stud received the BKB Award in the Western Cape's Region Four. At the 2017 National Auction it ranked fifth place among the top selling studs. Its rams were sold for an average of R22 667.

The stud is respected for its very high stocking rate and a lambing percentage of about 166% which is achieved year on year.

"We breed hardy sheep, and have selected for fertility over the past 40 years," reveals Morris, who has been in control of the stud for the past 30 years. Three full-time members of staff – Manual Adams, Leonard Minnaar and Dino Adams – are responsible for the stud along with Morris.

The continued cooperation and partnerships with other breeders across the country have made it possible for the University over the years to obtain some of the best breeding stock possible.

In February this year, for example, SU obtained a quarter share in Ram JW150558, along with the Free State stud Crux Dohnes. The R220 000 paid for this prize ram is the most paid to date at the national auction, and is double what was paid for 2016's top seller.

In its turn, Mariendahl is the regular meeting place of up to 60 students and aspiring breeders who attend one of the two most important three-day workshops presented by the Dohne Merino Breeders Association. This year it takes place from 7 to 9 June.

SU's 41^st annual Production Auction will again take place on Thursday 20 July at neighbouring Elsenburg. There 60 Dohne Merino rams and 20 South African Mutton Merino rams from the Mariendahl Experimental Farm will be auctioned off.

For the past 40 years, the auction has been on the BKB auction calendar on the second Wednesday of July. This year, for the first time it will take place on a Thursday.

Busy experimental farm

The experimental farm lies on 300 hectares of government land close to Elsenburg Agricultural College, about 16 km outside of Stellenbosch. In addition to 450 Dohne Merino ewes and 150 SA Mutton Merino ewes, there is also a herd of 55 Simmentaler cattle. Pigs and poultry are also kept here. On an ordinary day there are 125 sows and a thousand young pigs on the terrain.

Ten full-time staff work on the farm. Morris has been part of the operation for the past 30 years, after starting in the farm's sheep and wool division in January 1987.

In addition to the commercial stock farming aspect of the farm, it also offers important training and research opportunities for researchers and students of the SU Department of Animal Sciences. Undergraduate students in Animal Sciences have come here since the founding years of the farm, in 1974, to do holiday work as part of their practical modules, among other things.

The facilities are also used by researchers of the Cape Peninsula University of Technology, Elsenburg Agricultural College and the University of Cape Town.

The farm has a testing station too for two renewable energy projects by Matie engineers, while it also boasts a small experimental plantation of blue gums studied by the SU Department of Forest and Wood Science. 

​

On Saturday 27 May, SUNCEP streamed its first tuition session live to Natural Science teachers in two different venues outside Stellenbosch, complementing the previous three contact sessions that were offered in Vredendal earlier this term.

SUNCEP's practice-based approach to professional learning entails contact tuition sessions, mentoring offered via cluster meetings, on-site support visits as well as e-support and e-mentoring.

The Centre for Learning Technologies at Stellenbosch University implemented an alternative conferencing software, called SUNStream where affordable two-way interactivity video-streaming via Adobe Connect is possible. Participants can "attend" these sessions anywhere and on any device such as a computer, tablet or even a smart phone.

This platform allows participants to communicate with one another, take polls interactively and also allows presenters to share documents on their own computer screen with the participants. The sessions can also be recorded and viewed later offline.

This session was streamed from the SUNCEP office to two groups of teachers: one group in Vredendal and another in Citrusdal.  A Vredendal based SUNCEP facilitator, Ms Christa Philander and the WCED Curriculum Advisor for Physical Sciences in the West Coast, Mr Lyndon Manas, attended and technically supported the teachers during the sessions.

SUNCEP has utilised the Stellenbosch University telematics platform and will continue to do so when applicable.  Rapid advances in technology have, however, made it possible to increase the two way interactive nature of broadcasts via streaming to any device and not just to telematic centres, thus strengthening SUNCEP's e-learning delivery of its short courses.

The SUNCEP team is very excited about this new platform.  "Now that we have tested the platform successfully, the possibilities are endless, especially to support teachers in deep rural areas, without anyone having to drive vast distances", said Dr Trevor van Louw, Director of SUNCEP. 

Photo: SUNCEP staff members preparing for the streaming: Mrs Danelda van Graan, Mrs Erika Hoffman, Mrs Pauline Hanekom, Mr Andrew Fair and Mr Shaun Graham.

Research networks within African academic and research institutions are important to understand the agricultural and economic value of orphan crops as well as the impact invasive species can have on them, writes Dr Ethel Phiri (Department of Genetics) and Dr Natasha Mothapo (Department of Botany and Zoology) in an article published on The Conversation website on Tuesday (30 May 2017).

• Click here to read the article.
  

Stellenbosch University (SU)'s Division for Research Development (DRD) won two national awards on Wednesday (24th May 2017) for its contribution towards research management in Southern Africa.

The DRD won the Organisational Award for Excellence in Research Management at the annual Department of Science and Technology (DST)/Southern African Research and Innovation Management Association (SARIMA) Excellence in Research and Innovation Management Awards. The winners were announced at a gala event at the Safari Court Hotel in Windhoek, Namibia.

The annual DST/SARIMA Excellence in Research and Innovation Management Awards celebrate excellence in research and innovation management in Southern Africa. These awards also acknowledge and encourage growth and achievement in the field of research and innovation management as a key enabler of research and innovation outputs and impact.

The Organisational Award for Excellence in Research Management recognises an organisation that is considered to be a path setter in research and innovation management and which has made a significant impact on building, encouraging and championing research and innovation within their organisation over many years. The nomination criteria also include that such an organisation should have developed and implemented initiatives and interventions during the period under review (2016), and that they should have shared their knowledge of best practice with the R&I Management community or had an impact in the R&I Management community beyond their own organisation.

Expressing her gratitude for the award, Dr Therina Theron, Senior Director: Research and Innovation at the DRD, said: "As a team we are very happy and humbled to have receive this acknowledgement from our professional peers. It inspires and further strengthens the DRD's commitment to offer an excellent professional support service to our research community".

At the same ceremony, Ms Aasima Gaffoor, also from the DRD, received the Award for Excellence in Early Career Research Management. This award recognises individuals who are newcomers (less than 5 years in the profession), who have demonstrated achievement within their own organisation, have contributed to improvements in processes/systems related to their role within their organisation, have contributed to the standing of the research or innovation support function at their organisation, and/or have shown engagement in the broader R&I community through involvement in relevant workshops, courses, conferences, etc.

"I am pleased and honoured to have received this award. It is a great motivator to continue to contribute to research management within our institution and beyond. The constant support and sound leadership provided by the Division for Research Development has afforded me the opportunity to grow and for that I am truly thankful," said Gaffoor.

• Main photo: Dr Therina Theron (middle) accepting the Organisational Award for Excellence in Research Management.
• Photo 1: Ms Aasima Gaffoor (middle) posing with the Award for Excellence in Early Career Research Management.

MORE ABOUT SARIMA

Established in 2002, the Southern African Research and Innovation Management Association is a stakeholder organisation that provides a platform for the promotion and facilitation of best practice in research and innovation management in Southern Africa. It strengthens the research and innovation system to ensure the social and economic development of the Southern African region. For more information visit www.sarima.co.za.

​Thursday the 1st of June a number of changes will come into force at the Botanical Garden.

The tropical glasshouse will be open to the public for the first time in years. The tropical glasshouse was originally constructed in the 1920's. The height of the roof has been raised with recent renovations to provide enough space for the bigger tropical plants. Technology has also been cleverly used to ensure that the glasshouse's temperature is kept between 18 and 30 degree Celsius without consuming a large amount of energy. The glasshouse is also currently the only functioning public tropical glasshouse in South Africa. A variety of tropical plants can be found in the glasshouse including jade vine, titan arum, (the biggest flower in the world), vanilla, cacao, cola nut, black pepper, bread fruit, curcuma, henna, panama hat palm, Darwin's orchid to name but a few.

From the 1st of June an entrance fee of R10 will be charged. A portion of this fee (R5) will be refunded for any purchase at the shop or restaurant.

"With rising pressure on various tertiary institutions it has become a necessity to become more self-sustainable and ensure that the Botanical Garden also flourishes into the next century. With the Garden being located so close to the bustling town centre there has also been a growing need to ensure that the Garden stays a peaceful and safe community hub and for this reason it was also decided to start charging a nominal entrance fee in 2017," says Martin Smit, Curator of the Botanical Garden.

Members of the Friends of the Botanical Garden, enrolled SU students and staff with active SU cards will be able to gain free entry. Groups that make prior arrangements, such as school groups, will still be allowed to enter the Botanical Garden free of charge.

Members of the public can become a Friend. Membership cards will be sold in the Botanical Garden's shop. Members will get a set number of visits per year (365) and will be able to let accompanying persons enter for free under their membership. Non-members will need to pay an entrance fee, part of which will be reimbursed for any purchases at the shop or restaurant. Groups that make prior arrangement, such as school groups will still be able to visit for free. Friends will also receive invitations to special events and talks.

• For more information on Friends of the Botanical Garden, liaise with Viola Calitz at tel. 021 808 3054 e-mail subg@sun.ac.za or visit www.sun.ac.za/gardenfriends