Prof Sean Chetty was appointed Executive Head of Stellenbosch University's Department of Anaesthesiology and Critical Care in mid-April, just as the Covid-19 virus was beginning to spread more rapidly in South Africa.

As a result, he immediately found himself tackling various tasks at the same time. "I'm very aware that my new job means that I need to be juggling a couple of balls," Chetty acknowledges. "The one is that I need to be managing the Department within this crisis. But, at the same time, I need to be planning for after this crisis.

"It will be a disaster if future plans are left until the crisis is over because we'll end up with a situation where we get to the end of this pandemic, [and then] there will be a vacuum because nothing was planned."

Chetty's strategic plans for the Department are based on six pillars that he presented when he was interviewed for his new position: teaching and learning, research, social impact, transformation, people development and external relations. "Everything else that I developed is based on those six pillars," he adds.

Within this framework, a key objective is to position the Department to cope with new challenges within the field. "At the moment, Anaesthesiology and Critical Care is a single department in the Faculty of Medicine and Health Sciences," Chetty explains.

"Yet anaesthesiology has vastly grown from when it was first developed, and certainly from when the structure of our faculty was formed. In the past, it was just the work within the theatre environment and anaesthetising patients. Globally, that has grown a lot to become multifaceted.

"Anaesthesiology now includes critical care, peri-operative medicine (which is really new and exciting, and one of the areas I want to develop for the Faculty and the Department), pain medicine and what we know as anaesthesia services. In the Stellenbosch University environment, I'm hoping to develop these four distinct areas of interest within Anaesthesiology."

Some progress has already been made in this direction. Before he took up his present position, Chetty was interim head of 3CU, which incorporates three critical care structures within Tygerberg Hospital. "This will hopefully be the precursor to a critical care medicine division in the faculty," he says.

Chetty points out that he has a particular interest in pain medicine. In fact, he declares, developing this field is why he joined Stellenbosch University in the first place from the University of the Witwatersrand four years ago: "While it's quite a mature field internationally, pain medicine is a new and exciting field within South Africa.

"It's one of the few fields that fall distinctly into anaesthesiology: pain management is a huge part of what anaesthesiologists do. The part that is underdeveloped in South Africa is chronic pain." Chetty estimates that there are probably only around 10 clinicians in the country that have significant experience in managing patients with chronic pain or in performing interventional pain management procedures.

And yet chronic pain, he notes, can have a devastating impact on patients and the health system, and, more generally, on the economy: "We already have a chronic pain service at Tygerberg Hospital. My intention is to expand this to enable more training and to develop a research programme around that."

Another research and training stream that he intends to develop is within cardiac anaesthesia: "One of the strong areas in our Department is the expertise in this field. I'd like to harness that experience so that we can engage in a robust research programme to improve patient care in this field.

“My personal interest within the anaesthetic portfolio is in obstetrics anaesthesia. My PhD [at the University of the Witwatersrand in 2016] was in the field of obstetrics anaesthesia and pain management for these patients. There is a huge area we can develop here."

In addition, Chetty believes the international network he has built up since he entered the profession in 2003 will be invaluable in this process. (Just before he took up his current position, he was a research fellow at Harvard Medical School and the Massachusetts General Hospital in the United States.)

He is excited about peri-operative medicine as well: "This is an emerging field globally. It is going to revolutionise the practice of anaesthesiology, and is certainly something that I want us to develop a strong research and training platform in within the next five years."

But, as his six pillars indicate, Chetty's strategic plans extend way beyond the campus. "As a university, we serve not just to train the people that are here, but also to contribute to the training within our greater community," he states. "And for us that's the eastern metro of Cape Town and most of the eastern part of the Western Cape Province."

The department has already started anaesthesiology training at smaller regional hospitals: "That is part of the social impact that I want to see for the department; that we don't just train and develop people from within, but also look after the greater community outside."

Another aspect Chetty identifies as a key priority among his strategic plans is transformation: "Anaesthesia has traditionally been a very poorly transformed discipline. This department has made a lot of progress, both in terms of gender and racial equity.

"But we're not where we need to be; we certainly don't represent the demographics of the country. We need to improve that. Together with Tygerberg Hospital and its employment equity targets, I think we're making really good inroads. We need to be a department that is representative of the population that we serve.

"And, with that, we need to grow academically from within those previously marginalised groups. We have to look after our people, both in terms of job satisfaction and in terms of academic development."

Chetty is clearly passionate about his chosen area of specialisation – he describes anaesthesiology as a beautiful melding of science and art – and is brimming with ideas on how to expand its reach and increase its impact. "We have massive potential," he says. "There's so much we can improve on; there's so much we can do."

Photo credit: Damien Schumann

Accessible healthcare is a critical policy lever for moving out of poverty, says Dr Anja Smith, who forms part of RESEP, a group of researchers in the Department of Economics at Stellenbosch University. Along with her colleagues, Smith explores issues of poverty, income distribution, social mobility, economic development and social policy.

With a particular interest in the health system, Smith's work highlights the important role that well-functioning health systems play in the lives of individuals, especially women. She tells us more about her research, and how it is making a difference in the lives of women in South Africa.

Tell us more about your research.

I am an economist who focuses on the health system: health-seeking behaviour, the intersection between the supply and demand sides, and the quality of healthcare. Within this area, I have undertaken various research projects on the role of gender in health-seeking behaviour and sexual and reproductive healthcare. I've conducted research on the timing of access to antenatal care for both adult women and adolescents in the Western Cape, measured the quality of contraception healthcare in South Africa, and also looked at gender differences in health-seeking behaviour for tuberculosis symptoms.

Why or how did you become interested in this specific area of research?

I am passionate about solving developmental problems that allow people to move out of poverty, or prevent them from falling into poverty in the first place. Quality, accessible healthcare is a critical policy lever for moving or staying out of poverty.

Why do you think this is such an important area of research for South African women?

Good-quality contraception care is vital for women's futures. Unplanned pregnancies can have very negative consequences for women's health (such as maternal mortality), educational achievement, autonomy and labour market participation, as well as for the overall health and well-being of women and their (other) children.

Good-quality antenatal care at the right time during pregnancy is critical for the health of women and their babies. South Africa has a high maternal mortality rate. Many of these deaths can be prevented by quality antenatal care. Women who receive good-quality antenatal care at the right time give birth to healthier babies. We know that good health at birth has long-term benefits for an individual, both as a child (better educational achievement) and in adulthood (labour market earnings).

What would you consider the greatest impact of your research on women in the country?

I recently had the privilege of working on the health section of the NiDS-CRAM (National Income Dynamics Study – Coronavirus Rapid Mobile) survey. This broad, nationally representative survey measures, among others, the impact of the new coronavirus and government's lockdown response on people's health-seeking behaviour.

We conducted a separate survey, the CRAM-MATCH (Coronavirus Rapid Mobile for Maternal and Child Health), looking more specifically at women who recently gave birth or are currently pregnant. We found that many had not recently accessed important healthcare for their babies or themselves (during pregnancy). These findings were widely shared with policymakers, who will now hopefully put in place service delivery solutions to ensure that pregnancy care and immunisations are not interrupted during the lockdown, or that people do not stay away from important healthcare out of fear for the virus. We have received good feedback from our partners in government and know they are reading and considering our report at this sensitive time for our country.

I recently attended a workshop with officials from the Western Cape Department of Health. We spoke about the research I had been involved in where we measured the quality of contraception care in the Western and Eastern Cape. One of the state doctors in the room said he “loved the research". Signs like these show that policymakers are engaging with my research, and that it will hopefully lead to changes in the way healthcare services are delivered, reaching vulnerable women.

What would your message be for the next generation of women researchers?

Find a research area that you are passionate about and identify good mentors in that area. They do not necessarily have to be women. I have been lucky enough to have excellent women and men as mentors during my career.

If you believe in your research, see it through to the end. Academic research often feels like a long drawn-out process, but there are rewards at various points along the journey. Celebrate every milestone (even just submitting a journal article) and be very kind to yourself when your research does not find fertile ground. If you are working on important and valuable research questions that you feel passionate about, your work will eventually reach the right audience. And once you become successful in your research area, stay humble and kind.​

All medicines have the potential to cause unwanted, uncomfortable or dangerous effects also known as adverse drug reactions (ADRs).

“To protect patients and to identify and characterise evidence-based causal relationships between ADRs and their suspected medicines, data must be communicated efficiently and effectively along all stages of the pharmacovigilance* system," says Dr Max Schurer who obtained his doctorate in industrial engineering at Stellenbosch University recently.

According to Schurer, the primary goal of any pharmacovigilance system is to improve and protect patient safety by enabling health care professionals to make more informed therapeutic decisions.

“Pharmacovigilance is based on the medical assessment of ADRs or drug-related problems collected within organised health programmes and is crucial in the pharmaceutical world to prevent illness and death that might result from ADRs.

“Achieving this goal is dependent on the successful communication of relevant ADR information from the patient to the relevant pharmacovigilance authority. One such method of communication is the spontaneous reporting of ADRs, which is widely regarded as the cornerstone of data generation in pharmacovigilance during post-marketing authorisation safety surveillance.

“Unfortunately, spontaneous reporting systems (SRSs) face problems such as under-reporting and the communication of incomplete, unrepresentative, and uncontrolled data. Data management is a key principle of pharmacovigilance and the vast majority of safety information is as a result of spontaneous reporting of ADRs."

In terms of pharmacovigilance, an interoperable SRS would be a system in which data on ADRs is reported once with high quality to facilitate the analysis of the causes of the adverse reaction. It should be a transparent system where data is accessible by all stakeholders, including those involved with public health programmes, regulatory authorities, marketing authorisation holders, healthcare professionals, etc.

Schurer says stakeholders in pharmacovigilance operate SRSs with different goals in mind such as maintaining regulatory compliance, mitigating financial risk, or protecting and promoting patient safety in public health programmes.

He points out that the lack of standardisation and interoperability among these systems results in a reduced capability to detect and characterise new ADRs. Within healthcare, interoperability refers to the ability of different information technology systems and software applications to communicate and exchange data. This information is used to ensure that when there is uniform movement of health data from one system to another, the clinical or operational purpose and meaning of the data is preserved and unaltered.

To help address some of these challenges, Schurer developed a model that pharmaceutical companies and regulatory authorities and even institutions like the World Health Organisation can use to improve the interoperability of their product safety information systems. This type of model, which considers technical, social, and organisational factors, can be used to drive improvement and control progress.

Schurer says the model will promote and improve interoperability by addressing the degree of integration of the systems involved, offer guidance on which system components need to be improved, as well as provide a means for measuring interoperability progress across SRSs in the global pharmacovigilance landscape.

“If the model leads to more interoperable SRSs, then acquiring the necessary data to facilitate statistical analysis of ADRs in determining their causality is made easier and more efficient. This will ultimately lead to better and safer medicines being on the market and help prevent medicine-related problems, including drug-related illnesses and deaths."

Schurer adds that the model was implemented in a case study by a prominent national regulatory authority in the SADC region and the results were promising.

He says pharmacovigilance teams of the future must include, among others, clinicians, engineers, statisticians, computer scientists, and IT developers, adding that we should not only view pharmacovigilance activities as a mechanism to achieve regulatory compliance, but also to gain a competitive advantage.

*A system in which important evidence-based data about medicines and their potential adverse reactions are gathered and communicated to relevant stakeholders".

FOR MEDIA ENQUIRIES ONLY

Dr Maximillian Schurer

Email: max.schurer@gmail.com

ISSUED BY

Martin Viljoen

Manager: Media

Corporate Communication and Marketing

Stellenbosch University

Email: viljoem@sun.ac.za

​As African cities become increasingly urbanised, most households end up living in informal settlements, challenging urban planners on the obligation to build sustainable cities and communities. Also, the demand for energy grows. Because energy stands central to the global move into the Fourth Industrial Revolution, Africa's ability to participate in this revolution will be compromised if energy sufficiency is not secured.

Research is increasingly revealing energy insecurity to have gendered impacts. The policies and practices designed to address energy access tend to be gender blind, thereby insufficiently responding to the requirements of the urban poor.

With the launch of the GENS Trilateral Research Chair in October 2019 and the subsequent development of GENS Living Labs, SU aims to work with communities in co-designing solutions to energy insecurity, specifically in poor urban areas in Africa. A gender-conscious approach is assumed in this work.

Collaborating for success

Mainstreaming Gender for Energy Security in Poor Urban Environments – in short, Gender for Energy Security (GENS) – is one of two Africa-UK trilateral research chairs in South Africa, awarded in 2019. The GENS chairholder is Prof Josephine Kaviti Musango from the School of Public Leadership at SU. This trilateral chair constitutes a collaboration between SU, Brunel University London (BUL) and the University of Nairobi (UoN). Working closely with Musango on this research chair are the principal investigators Dr Fabrizio Ceschin from BUL and Dr Amollo Ambole from UoN. The GENS chair is being funded for a five-year period by the National Research Foundation and the Newton Fund (through the British Council).

Musango hopes that the funding will continue beyond five years, as this research chair will be invaluable to improving the lives of women in poor urban areas on the African continent.

The GENS Trilateral Research Chair will bring together a diverse suite of experience from fields such as system dynamics, renewable energy policy, sustainable design, gender innovations, humancentred design and collaborative design.

SU's School of Public Leadership (SPL) will be hosting a number of postgraduate students who will conduct research for the chair. Also, postgraduate students from the Department of Industrial Engineering are involved in the chair's research. According to the former director of SPL, Prof Johan Burger, this research chair is a huge milestone for the school and is helping SU achieve its Vision 2040 goals by advancing knowledge in service of society.

* This article featured in the latest edition of Stellenbosch University (SU)'s  multi-award winning publication Research at Stellenbosch University . Produced annually by SU's Division for Research Development (DRD), this flagship publication offers the national and international research community as well as other interested parties a comprehensive, yet accessible overview of innovative and interesting research being done at the institution.The theme of the edition is Research for Impact which is one of SU's core strategic themes from its Vision 2040 and Strategic Framework 2019–2024.

Click here to access the virtual copy.   ​​

​Some Cape fur seal (Arctocephalus pusillus pusillus) mothers may nurse their young for several years longer than previously thought, thereby potentially improving their offspring's chances of survival.

The observations of this unusual behaviour has now been published in the journal African Zoology in an article entitled “Prolonged nursing in Cape fur seals (arctocephalus pusillus pusillus) at Cape Cross colony, Namibia".

Researchers from the Namibian Dolphin Project, a research project run by Sea Search Africa, made the observation at the Cape Cross colony in Namibia. Cape Cross is one of the world's largest breeding colonies of Cape fur seals, hosting up to 210 000 animals. While adult males are only present during the breeding season, females stay at Cape Cross all year long with their offspring, hunting in the nearby waters.

Dr Anna Osiecka, lead author, says Cape fur seals normally wean their young within a year: “It appears that some may choose to keep the bond with their pups or even feed unrelated pups. As seal milk is very rich in fat and protein, this extra 'free' food can give their offspring an upper hand by allowing the young to grow larger and improve their chances of survival.

“For male pups, this can translate into better chances to defend a harem and father offspring when they grow up, as larger males tend to be more successful," she explains.

What we know about maternal care in Cape fur seals

Cape fur seals are the only seals which breed in southern Africa, with a range from southern Angola to the Port Elizabeth, in South Africa. “These animals were hunted to the brink of extinction in the last century, but with appropriate protection measures they have recovered and became numerous throughout their range", says Dr Simon Elwen, a marine mammal expert and director of Sea Search.

When they reach maturity, Cape fur seal females give birth to a single pup annually. Pups are weaned at 10-12 months and getting separated from their mother earlier often results in death. To sustain this long period of nursing, mothers spend about half of the time out at sea feeding, leaving their young alone onshore in big nursery groups.

According to Dr Tess Gridley, a postdoctoral fellow at Stellenbosch University's Department of Botany and Zoology, Cape fur seals are a fascinating species. She is leading the research project on their biology and behaviour in South Africa and Namibia.

Dr Osiecka says the observations prove that mother-and-pup relations are not as simple as previously thought. “Mothers can continue nursing their older offspring if the year's pup dies or is lost as a still birth. This is a great advantage to the older pups: they can grow larger faster, and this will ultimately increase their chances of survival and reproduction when they grow up."

This also implies that seals can recognise their family members over many years and maintain their bonds.

While physically costly, prolonged nursing may also benefit the mother. Removing excess milk helps to prevent mastitis, and in some cases it may be simply be more efficient to support older, healthy offspring, e.g. if the new pup is very sickly or lost.

“In some species nursing inhibits future pregnancies – we don't know yet if this is the case with Cape fur seals, but if so, prolonged nursing could also provide a year without a pregnancy, allowing the mother to recover her physical condition," says Osiecka.

Prolonged suckling has been observed in other fur seals, though it is often attributed to milk theft or mistaken identity with females nursing an unrelated pup.

“This is not the case in our observations. In all of the cases, the females were aware and allowing of the situation, and sniffed the sucklers. This is how these animals recognise each other, and it implies that the females know and accept the sucklers."

However, Dr Osiecka points out that there is still much to learn. “Our observations, and in fact all descriptions of unusual nursing in fur seals, are based on opportunistic sightings. We are still not sure how females decide on whether to extend nursing their young, or whether adoption takes place in this species. Longer, dedicated studies are needed to better understand the social dynamics of these animals." 

On the photos above: A Cape fur seal mother nurses a year's pup (right) and a two-year-old juvenile simultaneously.  The Cape Cross colony in Namibia hosts up to 210 000 seals. Photo: ©Anna N Osiecka/Sea Search

​​Full report: Osiecka, A. N., Fearey, J., Elwen, S., & Gridley, T. (2020). Prolonged nursing in Cape fur seals (Arctocephalus pusillus pusillus) at Cape Cross colony, Namibia. African Zoology, 1-7. https://doi.org/10.1080/15627020.2020.1768144

Media interviews only

Dr Anna Osiecka - ​E-mail: ann.osiecka@gmail.com

Dr Tess Gridley - nam.dolphin.project@gmail.com

This article was first published on The Conversation. Read the original article here.

The COVID-19 pandemic and the consequent public health response of lockdown has brought into sharp relief the constraints faced by women across the board.

We have been keeping a keen eye on the impact it's having on women in academia – our field of work and research. What we're observing, and what's being backed up by research, is that women are facing additional constraints as a result of COVID-19.

These range from the added burdens and responsibilities of working from home, through to the fact that fewer women scientists are being quoted as experts on COVID-19, all the way to far fewer women being part of the cohort producing new knowledge on the pandemic.

None of these constraints are new. Earlier research confirms that women academics carry large teaching burdens, with relatively little time for research and publication compared to their male colleagues, many of whom do not carry equivalent domestic responsibilities.

Increased pressure on women academics caused by the COVID-19 pandemic is magnifying this fractured landscape of gender parity in academia. The impact is being felt in terms of productivity. This is manifesting itself in terms of public exposure, knowledge generation and who is being called on to provide advice.

Academic output

An article in the World University Rankings points to the bias towards men experts in media coverage of COVID-19. Written by a group of women scientists, the article points out that women are advising policymakers on the outbreak, designing clinical trials, coordinating field studies and leading data collection and analysis. But, when it comes to media coverage, there is a bias towards men. While epidemiology and medicine are women dominated fields, men get quoted far more often than women about the pandemic.

A June 2020 article in the correspondence section of a leading medical journal, The Lancet, makes the same point. It points out that women have made up just 24% of COVID-19 experts quoted in the media and 24.3% of national task forces analysed.

Women's outputs are being affected in other ways too. A recent article in Science News shows that fewer women were first authors on articles related to COVID-19. This was especially so in the first months of the pandemic. They compared 1,893 articles published in March and April 2020 with those from 2019 in the same journals, and found that first authorship for women declined by 23%.

This they attribute to the increased demands of family life during the pandemic.

The Guardian newspaper also reported a decrease in women's academic outputs, with the journal Comparative Politics reporting that submissions by men went up by 50% in April.

The Lancet article makes the same point.

Recent data from the US, the UK and Germany suggest women spend more time on pandemic-era childcare and home schooling than men do. This is particularly difficult for single-parent households, most of which are headed by women.

Domestic constraints

The article by women scientists in The Lancet makes it clear that none of the challenges are new.

But, they write, COVID-19 has led to unprecedented day care, school and workplace closures exacerbating challenges.

For decades, women in academia and professional practice have striven to achieve work-life balance, juggling professional and domestic responsibilities.

Institutional support for women in terms of maternity leave, childcare facilities, lactation rooms, flexible working hours and protected research time varies across institutions in South Africa. It is lacking in many.

And now women are working from home, where they are also expected to take care of children and elderly parents, do home schooling, clean, cook and shop.

Addressing the problem

This disproportionate effect on productivity of women has the potential to bleed women from academia. This will have a negative impact on the diversity that is critical for excellence in academia and in civil society.

None of this is factored in to promotion criteria or performance assessments, when women in academia compete directly with their male counterparts. Consequently, women are seriously underrepresented in academic leadership, perpetuating a patriarchal institutional culture in tertiary educational institutions.

Some global funding agencies, among them the European and Developing Country Clinical Trial Partnerships and the National Institutes of Health, have recently started to consider constraints facing women scientists in grant applications. This effort needs to be seriously expanded.

This could be done via revisions to existing policies and proactive development of new policies to create optimal gender balance in research. Funders also have a responsibility to explore how institutions that financially benefit enormously from research funding via indirect costs support women scientists in academia.

Scientific journals are becoming sensitive to gender balance and diversity with respect to authorship. But the requirement for gender equity in terms of participants included in research studies and authorship must be tightened.

Similarly, conference panels and keynote speaker selection are in dire need of appropriate representation of women, especially those from the global South, whose voices are underrepresented in international academic meetings and scientific conferences. Anything less than these efforts will perpetuate pre-COVID-19 levels of gender inequity and lack of diversity. Sadly, academia will be the poorer for it.

About the authors

Prof Keymanthri Moodley is the Director of the Centre for Medical Ethics and Law at Stellenbosch University's Faculty of Medicine and Health Sciences.

Professor Amanda Gouws is a professor of Political Sciences and SARChI Chair in Gender Politics at Stellenbosch University

​​​Dr Nthabiseng Moleko is used to wearing many hats. She is a lecturer and researcher at the University of Stellenbosch Business School, a poet, an author and serves as a commissioner on the Commission on Gender Equality.

Despite being a very busy woman, Moleko is on a mission to alleviate poverty and fight for the economic rights of women in South Africa. As part of South Africa's Women's Month celebrations, Moleko shares some insights on her academic journey and the importance of finding a research area that complements one's passion.

Tell us more about your research.

My research is primarily focused on pension funds, savings and institutions in capital markets, with an emphasis on the implications of savings and capital markets for growth in the economy. The research I undertook sought to empirically investigate the effect of pension assets and their transmission to growth in the South African economy. I also undertook research looking at increasing the participation of women in the economy, with a focus on the sciences, technology, engineering and mathematics sphere, artisans and manufacturing. In addition, I assessed the monitoring tools in the national gender machinery. This was done for a South African Board for People Practices publication that focused on the role of women at work and in the economy.

Why or how did you become interested in this specific area of research?

When I first embarked on research, I identified a gap as a practitioner and realised that I needed to do investigations at a national level. The topic emanated from my own journey of having worked in an asset management company in charge of Africa's biggest infrastructure fund in the pension fund management industry. I had an interest in how we could strengthen the linkages between financial markets, pension funds in particular, and national development goals. This included reducing poverty and increasing national productivity and economic output, using an African model for capital markets. Having worked in the private and public sector, I identified a gap in the research area of how pension funds could be used to advance national development in emerging markets, on which very little research had been done in South Africa. The other aspect of interest stemmed from my desire to see the poor economic outcomes for women addressed.

Why do you think this is such an important area of research for South African women?

The work I did for my doctoral thesis investigated the transmission of pension savings to growth. The relationship and co-integration between savings, bond and stock markets and growth, using empirical analysis to ascertain the relationships between variables, has a direct effect on livelihoods. Women can enter quantitative and statistical spaces where there is a paucity of work done, the message being that no matter how technical or complex, we too are able to get the work done! 

What would you consider the greatest impact of your research on women in the country?

The ability to inspire and enter the academic space as the first woman in this discipline is not only groundbreaking, but also truly life-changing, as you are able to find new ways to solve national problems, using research to innovate and think of solutions in the development finance discipline. Universities are critical enablers for producing knowledge and ideas that break new boundaries, produce solutions and can advise policymakers. If implemented, the policy recommendations emanating from my research would improve economic gains and yield growth outcomes that are needed in South Africa, directly improving the lives of women and those who are impoverished.

What would your message be for the next generation of women researchers?

Plan your academic journey and find yourself a research area that complements your passion, areas of interest and long-term goals so that you can merge your research with your post-research life, whether inside or outside academia. We are in need of solutions to the multiple problems and complex issues faced on the continent, be they economic, in healthcare, scientific, the built environment and all other spheres and disciplines. I am proud to be black, in academia, and in the quantitative and economic space, which is predominantly male-dominated. If doors could open for me, a girl from Umtata, it is possible for other girls too, no matter their background.

 You can follow Moleko on Twitter and Instagram at @drnthabimoleko.

Michael Allcock (5) is in the home straight of walking 50 km in support of Stellenbosch University's #Train4Fees campaign. In fact, the campaign's youngest fundraiser might even add a few kilometres to his goal now that the campaign's end date has been extended to 31 August.

Launched on 1 June 2020 by Maties Sport and the Development and Alumni Relations Division (DAR), the campaign aims to help student athletes who have lost financial backing due to the impact of COVID-19.

To date R837,512 has been raised, and Michael has reached 75% of his R5 000 target.

According to his mom, Candice Egan, the preschooler's age – five – played a role in the decision to set targets of 50km and R5000.

Egan, who works in the Development and Alumni Relations Division, describes Michael as a very curious, very energetic boy who is interested in what goes on around him.

When he heard her discussing the #Train4Fees campaign, he decided that he “also wanted to play".

“I thought it might be a good way of getting rid of some excess energy, and all for a good cause," says Egan.

Michael wears a fitness tracker for their walks through their neighbourhood as he likes to take different routes.

“That way we know how far he has gone – usually between 1.5 and 2.5 km per walk."

Although he doesn't completely grasp the #Train4Fees concept, Michael – who attends Barkly House Pre-Primary School in Kenilworth when there isn't a pandemic – has a vague understanding that what he does will help “big kids go to school".

Egan would like her children to learn the importance of sharing and develop empathy for people who are less fortunate. As they grow older, they will hopefully realise that anyone can make a difference by doing the little that they can, she adds.

With the extended end date, the campaign now has a new fundraising target of R2 million.

"We currently have over 300 student athletes who have applied for financial assistance and we would ideally want to help all of them," says Hans Scriba, Fundraising Manager.

So how can YOU get involved?

You can sponsor any of the fundraisers on the Maties GivenGain platform in your chosen sport - rugby, soccer, cricket, netball and hockey – or support other sporting codes on the Maties Sport Page – or you can sign up to become a fundraiser for #Train4Fees, by either running, cycling, skateboarding or power walking yourself … whatever fitness training you enjoy.

• #Train4Fees on Maties Alumni website: https://www.matiesalumni.com/train4fees/
• #Train4Fees on GivenGain website: https://www.givengain.com/cc/train4fees/
• ​Michael's GivenGain page: https://www.givengain.com/ap/mikey-allcock-raising-funds-for-stellenbosch-university-alumni-south-africa/

Stellenbosch University will, for the first time in the university's history, have a student working towards a PhD in neuromuscular diseases, thanks to a £105 000 (R2.2 million) grant from the Guarantors of Brain, an organisation in the UK that funds research in neurology.

Dr Kireshnee Naidu, a neurology graduate from the university, who finished last year, will start her PhD soon under the supervision of Dr Franclo Henning, senior lecturer in Neurology.

In an interview, Henning said the grant came about after the university was approached by investigators from the University College London (UCL), who, last year launched an international collaboration called the International Centre for Genomic Medicine in Neuromuscular Disorders (ICGMND).

The centre – headed by Professor Michael Hanna, Director of UCL Queen Square Institute of Neurology – brings together skills and resources from five countries with the aim of advancing the genetic diagnosis of patients with neuromuscular disorders. These include motor neurone disease, inherited neuropathies and muscular dystrophy.

The centre is collaborating with a few South African universities, besides SU, including the Universities of Cape Town, Pretoria and North-West University, as well as centres in other lower-middle-income countries, including Brazil, Turkey and India.

Their research will look into the phenotyping and genotyping of inherited neuromuscular disorders in lower-middle-income countries where genotyping has not been available up till now.

"Genetic diagnoses are becoming increasingly available, thanks to technology, but at the moment most inherited disorders cannot be treated. Only those related to inherited enzyme deficiencies can be treated.

"We have no idea what the genetic landscape in South Africa is like with regard to inherited disorders – of which neuromuscular disorders are just one example – because we've never been able to apply modern genetic analysis outside of research and on a small scale in this country.

"Through this project, we are going to be able to genotype all our patients with inherited neuromuscular disorders, so we will get a better idea of what forms of neuromuscular disorders we see. Of course it is very likely that the mutations causing these disorders in our population is different from high-income countries as we have a different population make up. In addition, we are able to contribute, through data sharing, to the global research community in search of treatments for these conditions," said Henning.

"Part of the project involves the training of a PhD fellow, which is the position which Naidu is taking up."

"This is an awesome opportunity because we would not be able to train a PhD fellow without this kind of funding, as it covers salary and tuition fees for a period of three years," said Henning. “This has never been possible in the past. We are excited that this will be the first PhD in neuromuscular diseases that will be done at this university.

"All in all it is a really great opportunity for us to pursue."

Photo credit: PIXABAY

A R3 million grant from the South African Medical Research Council (SAMRC) will enable Stellenbosch University (SU) scientists to test the efficacy of a novel gene-based point-of-care screening tool that will help clinicians determine the best course of cancer treatment.

Professor Maritha Kotze, principal medical scientist in the Department of Pathology at SU's Faculty of Medicine and Health Sciences, will spearhead this interdisciplinary research project entitled Development and validation of a pharmacogenomics platform using point-of-care screening tests and application of whole genome sequencing in cancer treatment.

This award relates to the recent launch by the SAMRC of a cutting-edge, national research facility that will refine the science of genomics for implementation of personalised medicine.

The facility aims to unlock Africa's diverse gene pool and to grow capacity for whole genome sequencing as the most comprehensive testing strategy available in South Africa. "Prof Kotze's project will facilitate the reporting of complex whole genome sequencing data to patients using a multi-disciplinary team approach," said Mrs Rizwana Mia, Program Manager for Precision Medicine and the SAMRC Genomics Centre. She also noted that the project addressed critical data warehousing and data dissemination tools to enable a secure clinical workflow. Kotze said a major focus of this initiative is to match the medication administered to cancer patients with their genetics based on both host (germline) and tumour gene profiles.

Novel point-of-care assays recently developed by Kotze and co-workers under the SAMRC Strategic Health Innovation Partnership (SHIP) program and the Innovate UK Newton Fund initiative in Precision Medicine, will be used as a first-line screen to determine the need for whole genome sequencing at the SAMRC Genomics Centre. An important focus will be to identify the cause of cancer and treatment failure or medication side effects, as well as explain cardiovascular or other co-morbidities found to be most common in the study database developed. This resource was developed over more than a decade with support from the Cancer Association of South Africa. "The database informs development of an adaptive pathology-supported genetic testing algorithm, which is continuously modified and refined to minimise the chance that something is missed that could benefit a patient. We are motivated by a desire to not only treat the cancer, but the person as a whole," Kotze said.

The pharmacogenomics platform, once developed in collaboration with both the public and private sectors, will help to reduce the burden of cancer and other non-communicable diseases (NCDs). "For selection of patients for whole genome sequencing we start with an NCD/wellness screen to help resolve complex cases step-by-step. In many cancer patients it remains uncertain whether genetic or lifestyle factors, or a combination of both, is involved," she said in an interview.

Kotze indicated that the planned pharmacogenomics platform may also support responsive research and development as required during pandemics like COVID-19 that affects cancer treatment. "For me, innovation is about bridging the knowledge gaps as they arise. It is our duty as scientists to ensure that what we discover will, in the end, be useful to clinicians and could empower them to provide the best care to their patients." The platform will help scientists to return their research results to eligible cancer patients, by making use of an adaptive report template currently developed under the Open Genome Project supported by the Technology Innovation Agency of South Africa. These reports are subject to approval by an expert review panel for clinical use by the referring clinician, supported by genetic counsellors. Co-investigator, Dr Nicole van der Merwe, will play a key role in this context by using a three-tier approach from sample to result, starting with 1) a questionnaire-based assessment to inform appropriate use of 2) point-of-care DNA testing of key NCD pathways that are evaluated during or after a genetic counselling session to 3) inform the need for whole exome/genome sequencing in uninformative cases. For the first time, South Africa's burden of cancer and other NCDs will be addressed by simultaneously assessing risk factors associated with disease development, recurrence risk and response to treatment considered relevant to each individual patient.

Kotze said her research team was honoured to be awarded the grant. "I am very excited about the opportunities that opened up as a result of this project. I see it as a recognition of the effort I've put in during my scientific career to find the place where genetic testing can add value to existing pathology results, thereby overcoming the limitations of each when used in isolation. This platform will help to bridge the remaining communication gaps and implementation barriers as we move from single- to multi-gene testing and full genome-scale data generation."

Mia concluded that this is a culmination of long-term persistence as the SAMRC SHIP Program has supported the development of the breast cancer and NCD testing solutions developed by Kotze and her team from 2014. It is indeed a complement to the team for progressing these precision medicine solutions along the innovation value chain from applied basic research to a tangible African-centric solution. She added that Kotze's project is amoung nine recipients with a total investment of R25 million made by the SAMRC SHIP Program in collaboration with the Distributed Platform in OMICS (DIPLOMICS) to invest in the development of pharmacogenomics research and innovation that address treatment-associated risk in the South African population affected by prevelant NCDs.​

​​NEW TESTAMENT

Postdoctoral Research Fellowship: Embodying in/and New Testament interpretation

3 year period

Scope of Research: The Faculty of Theology, Stellenbosch University, announces one postdoctoral research fellowship in the discipline group Old and New Testament. The research focus is on the theme of embodiment in and with regard to the interpretation of the New Testament, with attention to both texts and contexts.

Requirements: A doctorate in New Testament (obtained within the last 5 years) * Excellent research skills * Proven academic experience, expertise and interest in New Testament and the ancient languages, with a specific focus on embodiment and related themes.

Duties: Development and production of high quality research outputs in relation to the overarching theme of corporeality / embodiment, in New Testament and related texts, in both ancient and later contexts * Participation in the public activities of the Faculty in as far as relates to the research focus * Academic work in collaboration with the Office for Theological Research and the Ministry of Research and Formation of the Western Cape Synod of the Dutch Reformed Church.

Commencement of duties: 1 October 2020

Closing date for applications: 11 September 2020

Send a letter of application, a comprehensive curriculum vitae, the names and contact details of at least two referees, as well as an article based upon your dissertation or a short summary (2-3 pages) regarding the nature and purpose of your dissertation to:

Prof Jeremy Punt, Faculty of Theology, 171 Dorp Street, Stellenbosch, 7600, or per email to jpunt@sun.ac.za (before or on 11 September).

Inquiries: Prof Jeremy Punt, tel 021 808 2615, email jpunt@sun.ac.za

​It was the best of times; it was the worst of times. This is how Dr Ruenda Loots, a lecturer in the School of Public Leadership (SPL), described the shift to online teaching that was brought about by the Coronavirus Disease 2019 (COVID-19) pandemic.

Loots, who coordinates the undergraduate diploma programme in Sustainable Development in partnership with the Sustainability Institute at the Lynedoch EcoVillage, said the practical nature of the diploma programme presented unique challenges in the switch to online teaching.

“Our diploma programme focuses on cultivating an entrepreneurial mindset within our students. We often teach about VUCA (volatility, uncertainty, complexity and ambiguity) in the world. The pandemic has pushed us as lecturers to practise what we preach and adapt quickly to the continuously changing environment.

“Our programme is relatively small (79 students across three cohorts) and we have developed strong relationships with our students. This has allowed us to transition together into the online space, while being aware of the limitations and frustrations that happen along the way. The pandemic has created valuable real-world learning opportunities for our teaching staff and students.

“Most students in our programme have managed the transition reasonably well. The students are remarkably tenacious and have shown a lot of grit. They speak about the anxiety we are all experiencing amidst the chaos but they are using the skills they have developed during the programme to adapt."

She described the resources she uses to conduct her online teaching lessons as a “mixed bag of tricks".

“Zoom is very useful for creating short videos. You can record your screen with slides or notes plus a video of yourself at the same time. I don't like being filmed but it does add a human touch to the online space. Zoom videos are small in size and great for data-light learning.

“I also often use the forum function on SUNLearn to encourage peer-to-peer learning. It helps to divide students into smaller discussion groups. Student participation seems to increase when they are required to share their thoughts with two or three peers as opposed to the whole class."

However, Loots found the demands of family life during this time especially challenging.

“The first five weeks of lockdown was near impossible. We did not have the usual support we rely on at home and the preparation for emergency remote teaching was intense. Things have stabilised now and we are finding a slower, healthier pace for work and family life. The new pace is probably more sustainable in the long-run, regardless of whether we work from home or the office."

According to Loots, online teaching requires more planning and careful time management.

“It takes much less time to prepare for in-person contact sessions, especially because questions and conversations happen organically during class and in breaks," she said. “But it takes intentional design to create conversations in the online environment. Technical aspects take up a lot of time, like setting up the online activities, reviewing activities, recording lectures and uploading content."

Having now acquired first-hand experience of the advantages and challenges of online teaching, she sees it as a tool that can be successfully utilised by the Faculty and SPL post-COVID-19.

“Hybrid (contact and online) learning opens up exciting prospects for our diploma programme specifically. It gives us the opportunity to connect with international guest lecturers virtually and frees up more time for experiential learning during contact sessions," said Loots.​

• ​Main photo: Dr Ruenda Loots (centre) with Prof Ingrid Woolard, Dean of the Faculty of Economic and Management Sciences, and Mr Willem Jordaan, Editor of Die Burger, at a function in 2019 where Dr Loots received the top lecturer award in the School of Public Leadership (SPL).
  
• Diploma in Sustainable Development photos: Second-year students designing a permaculture garden, and community breakfast hosted by students.
  

              

​​​​In 1997, the South African National Defence Force (SANDF) started appointing women in all types of positions, including combat positions. Since then, Prof Lindy Heinecken from the Department of Sociology and Social Anthropology at Stellenbosch University (SU) has been researching the challenges and debates associated with incorporating women in the military. Looking back, her research on military women has not only shifted gender binaries in the SANDF but also increased people's mindfulness and understanding of the different tensions that gender integration evokes.

As part of SU's Women's Month celebrations, Prof Heinecken tells us about her research.

Can you tell us more about your research?

For the past 30 years, I have been researching the military, with a specific focus on personnel issues. With the military being a highly masculine institution, gender integration has been a key research focus.

Why or how did you become interested in this specific area of research?

Initially, I worked at the Centre for Military Studies (CEMIS) at the Military Academy in Saldanha. In 1997, all the SANDF positions, including combat posts, opened up to women. As part of my work as a researcher at CEMIS, I was commissioned to do a study on the challenges and debates associated with incorporating women in the military, particularly in combat positions. Since then, my research on women in the military has expanded considerably, and I looked at a range of issues that affect women who serve in the military. These include issues affecting recruitment and retention, their deployment on peacekeeping missions, issues of sexuality and gender harassment and the impact that more women have on the military in terms of 're-gendering' the military.

Why do you think this is such an important area of research for South African women?

Violence and war affect men and women differently. The United Nations Security Council Resolution, 1325, called for the greater inclusion of women in the military and on deployment on peacekeeping missions. The need to have more women in the military is not only a right but also a necessity. In many ways, they make a unique contribution in addressing the challenges that local women face in areas affected by armed conflict. They can engage more readily with the local population; local customs often do not allow men to talk to other 'local' women. Besides that, women have a more conciliatory approach to conflict resolution. Hence, understanding the obstacles that affect women's integration in the military and their deployment on peacekeeping missions is critical. Even more so where the military is deployed within and among the local population, whether internally or on peacekeeping missions.

What would you consider the greatest impact of your research on women in the country?

I consider myself a 'public sociologist' and therefore, the type of research I do is meant to be of some 'practical' value, beyond academia. I have been a keynote speaker at many of the Department of Defence Gender Conferences and have briefed the South African Infantry Formation and Army Command Council on issues of gender integration. I definitely think I have been able to shift gender binaries in the SANDF and been able to get them to understand the different tensions that gender integration evokes.

Do you have any message for the next generation of women researchers?

To always have a gender perspective in their work. Gender matters as the events that unfold around us, like COVID-19 affects men and women differently due to the power dynamic embedded within society.​

It was with heartfelt shock and sadness that management at Stellenbosch University's Faculty of Medicine and Health Sciences (FMHS) received the news that Covid-19 related complications had claimed the life of their colleague and friend, Prof Lungile Pepeta, Executive Dean of the Faculty of Health Sciences of Nelson Mandela University on Friday, 7 August 2020.

The sense of shock and sadness still lingers and Prof Pepeta will be dearly missed, but the experience of engaging and working with him as well as the tributes pouring in for him, call for a celebration of his rich life and legacy.

Prof Pepeta was a highly qualified and seasoned medical practitioner whose experience in public and private health facilities in urban and rural settings impressed upon him the need to train healthcare professionals who are equipped to service the communities in which they will be practising. In this, he shared the vision of the Nelson Mandela University to have its Faculty of Health Sciences and its soon to be launched Faculty of Health Sciences oriented towards primary healthcare, i.e. on prevention rather than cure. For three and a half years, he led the Faculty with conviction, commitment and boundless energy towards the realisation of this vision.

At the same time, Prof Pepeta was a prime example of an academic engaged in his local community. He was actively involved in the Eastern Cape's response to the Covid-19 pandemic and led his university to also become involved in practical ways such as providing necessary medical equipment and making its mobile clinic available for testing. He wrote or co-wrote and publicly spoke about the pandemic and how to deal with it in comprehensible, practical terms, always bearing in mind the opportunities this crisis created for improving healthcare in the province.

The faculty extends its sincere condolences to Prof Pepeta's family and wishes them the support and strength they need to come to terms with this tragic loss. We trust that the family may find solace in the knowledge that their loved one was respected, deeply appreciated and highly valued by his peers. 

The FMHS also extends its deep condolences to the executive leadership of the Nelson Mandela University and the staff and students of the Faculty of Health Sciences. The Committee's thoughts are with the Faculty management that has to steer it through this huge, unexpected setback and wishes them wisdom and strength in picking up the baton to realise the university's vision for the Faculty, building on Prof Pepeta's legacy.

We are saddened that Prof Pepeta will not be there to welcome the first students of the new Faculty of Health Sciences next year and guide and inspire them on their journey to becoming competent, caring and engaged health professionals.

Prof Pepeta was completing his PhD in paediatrics in the Department of Paediatrics and Child Health at the FMHS. His academic supervisor, Professor Mariana Kruger said the whole department is shocked and saddened by the news of Prof Pepeta's passing. “In this research, Prof Pepeta, had undertaken very important and innovative research in the management of patent ductus arteriosus (PDA) in infants and was recognised internationally for his unique contribution to this field.

“He was well-respected in our medical fraternity, with a passion to serve especially the children of the Eastern Cape through his chosen sub-specialty Paediatric Cardiology."

FMHS Dean, Prof Jimmy Volmink, also commented on the considerable contribution Prof Pepeta's made to the South African medical field. “Professor Lungile Pepeta was an extraordinary clinician and an innovative researcher. He never forgot his roots and returned to the Eastern Cape after training respectively at UKZN and WITS. It is our honour that he chose Stellenbosch University's Faculty of Medicine and Health Sciences to register for his PhD," Volmink concluded.

Prof Pepeta will live on in the fond memories of everyone who knew him. May his soul rest in peace. 

​Like many other performance spaces in the world, the Endler Concert Series, as part of the Music Department at Stellenbosch University, had to suspend its weekly concerts due to the COVID-19 outbreak and the measures put in place to contain the virus. Artists and various role-players in the sector are looking to online platforms as an interim measure that could offer artists some financial recourse in the face of months of lost work that evaporated due to the global pandemic, as well as to find a way to maintain contact with audiences in this time of social distancing and little contact.

The Endler Concert Series has taken the initiative to revise the 2020 concert planning and gather resources to be able to present an online concert every two weeks from 23 August until December 2020, featuring students, alumni, lecturers and local artists. “The vision is to keep the Endler concert hall alive, until we return to face-to-face events, so that audiences can safely enjoy professionally produced concerts from their homes," says Fiona Grayer, Artistic Manager. “I am so pleased this online series strongly supports local content and in fact, seven out of the eight concerts feature works by South African composers! In addition to this, we are commissioning two Cape Town composers, Hugo Veldsman and Matthijs van Dijk, to create new works that will live beyond this crisis."

 “Concerts will be entirely free, but if people wish to show support, donations will be possible via a SnapScan with these contributions from the audience going towards recuperating the costs of recording and producing the concerts. For the SU Jazz Band concert in September, donations will go directly to a charity – the Stellenbosch Work Centre for Adult Persons with Disabilities, who annually partner with the SU Jazz Band to raise much needed funds for the Centre. The SU Jazz Band concert is generously supported by SAMRO and ConcertsSA."

“We take great pride in our curation of these concerts which present a wide variety of music including rarely performed works by Nadia Boulanger and Rebecca Clarke. It is a new world for the music industry - events can be produced from anywhere and broadcast to a global audience. Our primary concern is the health and safety of our audiences, musicians, and students. It has become very clear that large groups of people will not be able to safely gather for the remainder of the calendar year due to the COVID-19 pandemic. Currently, we are exploring options for concerts of our Departmental ensembles in smaller gatherings when possible but for now we hope our audience will join us in the virtual concert hall."​

For more detailed information about where to watch, when to watch, who will be performing, what will be performed please visit www.endler.sun.ac.za or follow @sukonservatorium on Instagram or like the Stellenbosch Konservatorium Facebook page.

Prof Danie Brink, Dean for Faculty of Agrisciences, recently completed the gruelling 4 day, 240km Berg River Canoe Marathon. This year is the 59^th year since hosting the first Berg River Canoe Marathon, which stretches from Paarl to Velddrif. Even though the marathon was not able to take place this year due to COVID regulations, an Ultra-Paddle Marathon was instituted in its place, where rowers had to complete the same distance in the same amount of days, from anywhere in the world!

Prof Brink was one of 10 rowers from Maties Canoe Club that completed this distance, according to the traditional Berg River route. Struggling to perform at his best, he approached a Campus Health Service (CHS) Sports Medicine Physician for a tele-consultation (the option during Covid-19 lockdown guidelines) to determine the cause and management of a possible underlying injury, with the aim of participation in the race. He was referred to the CHS Physiotherapy Practice for important treatment modalities in the overall management plan. With the race being around the corner, the therapists attending to Prof Brink knew they had no time to waste! With only a few days of training still left before the team departed for their race, resting his injury was not an option and managing it became the priority. Prof Brink had as many sessions with the therapists as time allowed and the most important aspect was to equip him to be able to manage it on his own during the race.

The race ended up being very tough, with the river being very full for the first 2 days and forcing the team to adapt to the circumstances. Day 3 and 4 was not any easier and they rowed for 6-8 hours per day, with the longest distance being 73km in one day. In the end, the team completed their race and Prof Brink was happy to report that his injury held up and that the treatment he received helped him complete his race with no complications!

The CHS Sports Medicine and Physiotherapy Team is happy to have been a part of Prof Brink's journey in preparing for this race. Well done Prof Brink - we wish him all the best with his future canoe endeavours!

​Girls and female athletes are commonly concerned about eating too many calories but eating too few calories for their level of activity can result in a serious condition termed Relative Energy Deficiency in Sport (RED-S). ​Although this can also occur in men, it is more common in active women as well as sports where weight or a lean figure is emphasized, like gymnastics or Ballet for example.

Previously, there was an entity called the Female Athlete Triad. The triad included Menstrual dysfunction, disordered eating and Osteoporosis (weak bones). As our understanding of the condition expanded, it became clear that the underlying problem is the energy imbalance and the systems affected by this imbalance reached far beyond bone and menstrual health as described in the Female Athlete Triad.

RED-S now includes all the body's systems that can be negatively affected as depicted in the image below:

KEY QUESTIONS AND ANSWERS:

What is Relative Energy Deficiency?

Each of us have different energy requirements based on our gender, height, level of activity as well as other factors. Once your energy intake is not enough to meet the demands of your energy use, you have a state of relative energy deficiency or low energy availability. For all your body systems to work at their best, we want the Energy availability to match the Energy Expenditure. The diagram depicts the situation where the calories consumed is too few for the calories used.

Does this mean there is an eating disorder?

Not always, no. There can be various causes, only one of which is an eating disorder like Anorexia or Bulimia. Disordered eating is a better term as this includes a wider spectrum of conditions ultimately resulting in Low Energy Availability.

Are only elite athletes at risk?

No, all athletes at various levels of competition can be at risk. It is very easy for even recreational athletes to develop RED-S with all the societal pressures on leanness as well as all the fad-diets doing their rounds.

Why are menstrual cycles so important?

Many women would not mind the absence of their periods, but a normal menstrual cycle is a marker for good hormonal health. Oestrogen, one of the primary hormones involved in the menstrual cycle, is very important in the maintenance of your bone health.

Will starting an oral contraceptive pill (OCP) fix the problem?

No, OCP's often mask this abnormality. An oral contraceptive pill does not change the nutritional problem and merely masks it. OCP's do not cause a regular menstrual cycle, but merely results in regular withdrawal bleeds because ovulation is supressed.

How is RED-S diagnosed?

RED-S is a diagnosis of exclusion, which means that all other medical causes must be excluded first. It is important to educate all levels of athletes, parents, coaches, trainers as well as doctors to recognize some of the warning signs used to identify an energy deficiency. It may not be necessary in every case to do expensive tests, but looking at the athlete and listening to history can give us some very valuable clues, like:

1. Menstrual irregularities: Ranging from long cycles to complete absence or disappearance of periods not due to pregnancy
2. Low calorie intake or dietary restrictions
3. Low Body Mass Index
4. Recurrent injuries including stress fractures, shin splints or persistent hip pain
5. Poor performance, very high training loads or a recent increase in training load
6. Rapid weight loss
7. Feeling cold on warm days
8. Changed sleeping habits
9. Increased fatigue
10. Constipation and bloating

Why is treatment so important?

It is important to treat energy deficiency as it is not only detrimental to one's athletic performance, but also negatively affects your long-term health.

What does treatment entail?

Prevention by adequate awareness and early intervention is ideal. Depending on the symptoms, it is advised to consult a doctor, ideally someone experienced in the field like a sports medicine physician. Treatment involves a multi-disciplinary approach with the primary aim to restore the energy availability.

If you are concerned about your health and the possibility of RED-S, please contact Campus Health Service to make an appointment with a Sports Physician. 

Stellenbosch Campus: 021 8083494/6 or Tygerberg Campus 021 938 9590

Dr Karen du Preez, a clinical researcher with the Paediatric TB Research Programme at the Desmond Tutu TB Centre, recently received a grant of nearly R9 million ($540 000) from the National Institutes of Health (NIH) in the United States for a project which will help to provide more knowledge about tuberculosis meningitis in children.

Du Preez, who is currently in the final stages of her PhD, said the awarding of the grant is an "incredible opportunity".

"Despite tuberculosis (TB) being a treatable and preventable disease, it is still one of the top 10 causes of death in young children globally. TB meningitis (TBM) is a very serious form of TB. The symptoms are often non-specific, which can cause delays in diagnosis and lead to poor outcomes (death or life-long disability). Young and HIV-infected children have the highest risk of developing TBM," she said.

Her project is entitled Interdisciplinary and multi-level approach to estimate the disease burden and outcomes of childhood tuberculosis meningitis.

Du Preez successfully applied for a Fogarty Emerging Global Leader Award from the NIH. The purpose of the award is to provide research support and protected time (three to five years) to an early-career research scientist from a low- or middle-income country (LMIC) who is in a junior faculty position at an LMIC academic or research institution.

She said she was very excited about the grant. "This award provides me with the opportunity to not only do really important research, but also to develop specialized research skills in spatial and mathematical modelling. It also gives me the opportunity to build a research network with local and international world experts, which will be an extraordinary resource for me when leading future research projects and funding applications."

This is a career-development grant, and a successful application relies on identifying appropriate mentors that is willing to support the applicant. "I'm extremely privileged to have a team of world experts, both locally and internationally, who are willing to support and mentor me for the duration of this award. I have been working at the Desmond Tutu TB Centre, Department of Paediatrics and Child Health since 2008, and the mentorship I have received from Professor Anneke Hesseling and the support I have received from the department has been instrumental in my successful application."

Du Preez said her research will be conducted over five years, and has three aims. "TB pro​grammes are not required to routinely report data on TBM, and we have no idea how many children are affected or how much TBM contributes to TB mortality in children. Our first aim is therefore to estimate how many children in the world develop TBM every year, and how many of the TB deaths in children are due to TBM, using mathematical modelling. 

"Secondly we will use routine TB data from South Africa, to understand differences in where children with TBM are treated and reported at a national level. We will also use this data to identify predictors of poor TB outcomes in children with TBM. This will help us to identify where in South Africa interventions to improve diagnosis and outcomes are most needed.

"Lastly, we will work closely with routine health services in Cape Town using multiple data sources to identify all diagnosed and undiagnosed children with TBM over a two-year period. All identified children will be eligible for enrolment in an observational cohort study that will collect data on diagnostic certainty, disease severity, comorbidities, outcomes and missed opportunities for both TB preventive therapy and earlier diagnosis of TBM. This could help us to develop diagnostic algorithms to assist with earlier diagnosis, and identify opportunities for targeted interventions to improve TBM prevention and care.

She said the grant funding will primarily cover staff and activities specifically related to the research project, as well as career-development activities.

Associate Professor Christine Lochner recently added another string to her bow when she won a prestigious National Science and Technology Forum (NSTF) Award – otherwise known as a "Science Oscar".

Lochner received the TW Kambule-NSTF Award in the Researcher Category. This was in recognition for her contributions through research over a period from 6 years up to 15 years of research. Her focus has mainly been on obsessive-compulsive disorder (OCD), described as “a common and debilitating condition that contributes to individual and societal suffering and massive economic costs".

Co-director of the SAMRC Unit on Risk and Resilience in Mental Disorders and with a PhD in Psychiatry, Lochner is no stranger to awards. She has previously received, among others, the Rafaelson Fellowship Award for outstanding young investigators in neuropsychopharmacology research by the Collegium Internationale Neuropsychopharmicologicum (CINP), the Lundbeck International Neuroscience Foundation (LINF) Sponsorship Award for young scientists, NRF rating and the Chancellor's Award for Research Excellence from Stellenbosch University.

Commenting on her latest achievement, she described the awards as a "celebration of South African excellence and a lovely surprise. It's a feather in one's cap to be a recipient of an award of this prestigious nature. I'm thankful for the recognition and encouragement."

Lochner said the award was also a golden opportunity to put the spotlight on the importance of scientific research in the field of mental health and how this can benefit society.

Since 2001, Lochner has launched several awareness campaigns and comprehensively collected clinical and genetics data from almost 1000 patients with obsessive-compulsive conditions as well as MRI data from a subset, culminating in an extensive database that has led to collaborations with leading scientists worldwide, and resulted in numerous publications.

Asked why it her work on raising awareness about OCD is important, she said there are about 1.2 million people in South Africa with OCD or obsessive-compulsive related disorders (OCRD). OCD is an important mental disorder given its prevalence and associated disability.

"Knowledge about OCD and about OCRDs (such as trichotillomania) has grown exponentially over the last 20 years, but it seems that there are still a number of myths – a disconnect between what OCD really is and how the average person understands it. For example, people often confuse being neat and organized with having OCD!

"I am hopeful that my work, and that of my colleagues, on OCD and OCRDs will contribute to close that knowledge gap, and to help people to learn what these conditions are about. This will likely increase empathy for, and patience with those with the condition, and facilitate help-seeking. If a person (or the parent of a young child) are able to recognize and label symptoms, then he or she is more likely to seek help, and to seek help from an appropriate clinician. 

"I believe my work contributes to current knowledge of these impairing conditions which may translate into increased accuracy of diagnosis and better care – of the individual as well as society. The burden of disease associated with these conditions – i.e. on a personal/emotional level, as well as the financial burden – is thus ultimately decreased by work of this nature and scale. The quality of life of these patients and their loved ones will hopefully subsequently improve."

Expanding on how this condition can lead to suffering and costs, she said: "These disorders are associated with significant distress and functional impairment – for the individual, for the people who care for him/her, his/her family or his/her significant others, as well as society.

"In addition to mental burden, there is a significant economic/monetary cost to living with OCD. For example: to the individual with washing/cleaning concerns and compulsions, the expense related to cleaning/disinfecting materials; to those with harm-related concerns, the expense of driving back and forth to check for potential damage, or extensive phone calls to check/prevent harm, or to those with illness/body concerns, the extensive visits to specialists and repeated examinations. Also, OCD is often associated with comorbidities – for example, a significant number of people with OCD have depression requiring clinical attention. Adding to this, the reduced efficacy at work – it all adds up.

"It can be concluded that successful treatment of OCD has the potential to provide significant economic benefits – for the individual and for society."

Asked what is next for her in her career, Lochner said while the Covid-19 pandemic and lockdown have brought about many challenges, she will continue with her teaching and supervision at the university.

"Over the next five years, my primary research interests will remain focused on the compulsivity/impulsivity spectrum of disorders, including OCD, trichotillomania and problematic use of the internet.

"With colleagues and collaborators, I hope to continue contributing to work linking the significant clinical aspects of OCD and OCRD with their neurobiological underpinnings, as well as linking them with specific brain structures.

"I am also involved in a number of other foci, all with local and international collaborators and have been awarded a grant from the National Research Foundation to conduct a multinational project that aims to advance personalized medicine in the area of clinical neuroscience.

"My work is not nearly done."

Photo credit: Wilma Stassen

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In the interest of good corporate governance, transparency and accountability, Stellenbosch University (SU) provides context and background to the court order delivered in the Western Cape High Court on Thursday 13 August 2020 according to which a request in terms of the Promotion of Access to Information Act (PAIA) has been granted.

Dr Leon Schreiber, a SU alumnus, requested SU in March this year to make available information that Judge Burton Fourie used in his investigation. The Fourie investigation of November 2019 followed a request from Dr Schreiber to the University Council to investigate his complaint against Prof Wim de Villiers, Rector and Vice-Chancellor of SU. The Fourie investigation found that these allegations were unfounded and Prof De Villiers was absolved of any blame.

The SU Council accepted Judge Fourie's report on 2 December 2019 and the full Fourie report (Read the accompanying SU statement here) was also published on SU's website at that stage for the sake of transparency.

The University is convinced that the underlying documents and information now being provided to the DA and Dr Schreiber will confirm Judge Fourie's finding.

The University refused the initial PAIA request in March 2020 for reasons justified by the institution in terms of Section 44(1)(a) of the Act. According to the Act, “the information officer of a public body may refuse a request for access to a record of the body if the record contains an opinion, advice, report or recommendation obtained or prepared; or an account of a consultation, discussion or deliberation that has occurred, including, but not limited to, minutes of a meeting, for the purpose of assisting to formulate a policy or take a decision in the exercise of a power or performance of a duty conferred or imposed by law".

It was the University's judgment that the inquiry by former Judge Fourie, which was intended to serve the Council with a recommendation, as well as the information which he obtained and considered during his inquiry, and included in his report to the Council, falls within the scope of section 44(1)(a). As the University also stated in a media statement at the time, the institution would reconsider this decision – to refuse the PAIA request – if a court application were brought. (Read SU's statement here.)

A court application did indeed follow, and the University decided not to oppose the application on the strength of legal advice, and taking into account the relevant factors and the legal costs of litigation. This was communicated to Dr Schreiber and the DA's lawyers, as well as that the University was agreeing to give access to the records of the Fourie investigation.

The following was emphasised in the communique sent to the applicants' attorneys: “that the respondents permissibly refused to provide the records under Section 2 11(1)(a) of PAIA; and that none of the records reveal any substantial contravention of, or failure to comply with the law. To the contrary, they support the conclusion reached by Judge Fourie in his report ".

The court order of 13 August 2020 followed the University's decision not to oppose the application.

Factual errors

A media statement from the DA on 13 August 2020 following the court order, written by Dr Schreiber, contains factual errors and misrepresentations that require correction.

The most important of these is an allegation that the Court would have confirmed that “the management of Stellenbosch University (SU), led by Rector Wim de Villiers, broke the law by trying to keep information of critical public importance secret". This is untrue. Neither the University nor the Rector violated a law. Prof De Vlliers was not involved in the handling of the PAIA request.

The court did not make any judgment or findings as alleged in the statement. There were therefore no convictions or violation of the law. The PAIA legislation does provide for criminal offenses (section 90), but it is not an offense to refuse a record in good faith, even if it was later found that the reasons for the refusal were unjustified or incorrect. It is therefore not correct that the initial decision to refuse the PAIA request had been “illegal". There was therefore no question of “breaking the law" and even less of “trying to keep information of criteria public importance secret".

The court order was necessary to set aside the University's initial decision and to give the applicants access to the records.

Chancellorship

SU also noted the allegations on social media, through SAfm, that Prof De Villiers would have “offered" the chancellorship to Justice Cameron. It is also devoid of all truth. The Rector is not in a position to offer a chancellorship, as the Chancellor is elected by an electoral college. According to the Fourie report, the evidence at best showed that the Rector, as he was obliged to do, helped to identify suitable candidates for the nomination of candidates for the position of the new Chancellor.

Prof De Villiers put it this way: “There was no attempt at secrecy. It was common knowledge that a number of prominent SU alumni, including members of the SU Rectorate, regarded Justice Cameron as an excellent candidate for the election of a new Chancellor. It is also totally unrealistic to allege that one person yielded so much influence to convince a bench of ten prominent Constitutional Court judges to find in favour of Stellenbosch University, and all but two of this Electoral College to vote for Justice Cameron." (The Electoral College consisted of 39 people.)

END