Tag Archives: health

Ebola Hammers South African Tourism, while Rampant Bilharzia Goes Unnoticed

Although South Africa has had no confirmed cases of ebola and is thousands of miles from the epicentre of the epidemic in West Africa, it appears that its tourist industry is being hammered anyway.

According to local reports, panic over the disease is reminiscent of that generated by SARS in 2003, causing holiday-makers from Europe, the US and particularly Asia to cancel their travel plans to the country in droves.

Enver Duminy, chief executive of Cape Town Tourism, told national Sunday newspaper City Press over the weekend, for example, that, even though the organisation had issued numerous statements confirming the Mother City’s ebola-free status, its Asian tour promoters and trade contacts were experiencing cancellation rates of up to 90%.

And this despite the fact that the city is actually further from the centre of the epidemic in Freetown, Liberia (3,365 miles) than it is from London (3,172 miles).

But as unwarranted as such fears may be, they could potentially be disastrous for the local economy. Tourism is worth about ZAR18 billion (£1 billion) to the Western Cape, South Africa’s largest sightseeing destination by far, and employs a huge 150,000 people.

In fact, across South Africa as a whole, tourism contributes a significant 9% of GDP and accounts for one in 11 jobs, making it a hugely important, and often underestimated, industry.

As a result, in a bid to help try and prevent the spread of the disease to these shores, Finance Minister Nhlanhla Nene has allocated an extra ZAR33 million (£1.9 million) to help support the continent’s worst affected nations – Guinea, Liberia and Sierra Leone.

Each of South Africa’s nine provinces has also designated certain key hospitals to handle an outbreak should one occur, introduced trained response teams and implemented surveillance at all ports of entry, including thermal scanners at Johannesburg’s OR Tambo and Lanseria airports.

And such preventative measures would appear to be vital. According to the World Health Organisation (WHO) last week, the disease has already killed 5,160 out of the 14,098 people who have been infected with it in eight countries across West Africa.


But another dangerous illness worth considering, even though it has received nothing like the global attention of ebola, is bilharzia – or to use its scientific name, schistosomiasis.

Despite being a rather neglected condition to date, the WHO expressed concern last month that the spread of bilharzia may be about to hit epidemic proportions in South Africa.

It is estimated that as many as five million out of a total population of 53 million could be infected, with the problem being particularly acute in Kwa-Zulu Natal’s (KZN) humid, low altitude coastal areas.

The disease itself, meanwhile, is caused by a schistosoma parasitic flatworm that enters the skin through contact with infected fresh water from rivers and lakes. These parasites, which can live in the blood stream of their host for up to 30 years, develop over time into worms, which mate and release up to 500 eggs a day.

Some of these eggs are passed out in an individual’s urine or faeces, while others remain trapped in body tissue, the most common being the intestine, liver, bladder or reproductive organs, causing inflammation or scarring in the process.

While symptoms vary, for many people, they start with a rash or itchy skin within a few days of infection. The next stage is often a fever, chills, a cough, muscle aches and diarrhoea a couple of months later.

But, while the illness takes a number of forms and can even remain dormant in people’s systems for years, the ultimate outcome is generally immune problems and progressive organ damage.

While children are most vulnerable to the disease, it is actually its effect on women that is causing most concern to experts. Estimates are that about two million South African females are currently infected with bilharzia, which can cause severe gynaecological issues, including infertility.

Taking action

Other problems include severe pain and chronic bleeding, particularly during sexual intercourse, which mean that women are as much as three times more likely to contract HIV/AIDS – a disease already at pandemic levels among disadvantaged women in rural communities – if having sex with an infected partner.

And even more worryingly, the WHO believes that more than 150 million women across the continent suffer from this generally unrecognised form of the disease.

But there are things that can be done. If diagnosed early enough, the worms can be killed off quite easily with a single dose of the drug praziquantel, although the eggs cannot.

Children in particularly affected areas of South Africa are already given such medication once every two years for prevention purposes, although some experts believe that an annual dose would probably be more appropriate.

But there is currently no vaccine for bilharzia and, to make matters worse, the illness tends to go largely un- or mis-diagnosed. Too few medical practitioners are even aware of its existence, and those that are tend to look for blood in the urine as a primary symptom, which is not necessarily the case.

As Dr Eyrun Kjetland, an honorary lecturer at KZN University and the Norwegian Centre for Imported and Tropical Diseases, told a gathering of WHO experts, African doctors and leading researchers at the University last month: “It is a neglected tropical disease and there’s not a lot of attention on it. The pharmaceutical companies don’t care about it, there’s no donations coming forth and the authorities are not doing enough in paving the way to make it less of a public health problem.”

As a result, she is currently working with a number of other health experts in order to compile an information booklet. The document, which is due to be published within a couple of years, is intended to help doctors recognise the condition and treat it more effectively.

A team from KZN University is also undertaking research on the province’s south coast, where infection is rife, in a bid to come up with a wider plan of action for treatment and prevention. To this end, a draft report is already in the pipeline – and so it would appear, not a moment too soon.


Desperate Unemployment Levels Cause South Africa’s ‘Hidden Hunger’

According to official figures, a quarter of all South Africans are out of work – although, even more worryingly, unemployment levels are believed to be a vast two in five across the wider economy.

To make matters worse, this high rate of worklessness has changed little over the last five years – and as long as low economic growth continues to stymie desperately needed job creation, things seem unlikely to get better any time soon.

To put things in perspective, the government estimates that GDP needs to increase by more than 5% a year to cut unemployment to a somewhat more manageable 14% by 2020, not least to try and avert social unrest.

But the fact that Africa’s second largest economy has been significantly underperforming since the 2009 recession means that it has also been struggling to create jobs.

A series of damaging strikes and rolling power blackouts earlier this year served to put a break on economic expansion, prompting growth forecasts to be cut to a mere 1.4% this year compared with 1.9% last year.

As a result, Statistics South Africa’s third quarter labour market report indicated last week that the number of jobless had remained more or less static, dropping by a mere 3,000 to 5.15 million or 25.4% of the total workforce, down from 25.5% the previous quarter.

But long-term unemployment is a particularly concerning issue here if both individual lives and communities are not to end up blighted.

The stats indicate that some 1.4 million people in the country have been without work for more than five years. A further 1 million have been unemployed for three to five years and another 1.1 million for one to three years, which when taken together make up a massive 20% of the jobless total.

While the state does offer some level of benefits – or social grants as they are known here – for around 15 million people, the money is barely enough to keep body and soul together, meaning that all too many people are living in desperate, grinding poverty.

But this situation, combined with relatively low average wages levels – the median income for a South African household is ZAR 3,100 (£174.16) per month, according to a national study undertaken by the Southern African Labour and Development Research Unit of Cape Town University’s School of Economics  – makes it no surprise that the country remains the most unequal in the world in terms of the wealth gap.

To put it in perspective, according to a 2013 Global Wealth Report cited by Oxfam at the end of last month as part of its “Even It Up” campaign on global equality, the two richest people in South Africa together possessed the same amount of wealth as the bottom 50% of the population.

Wealth gap

These modern-day Randlords are luxury goods mogul, Johann Rupert, whom Forbes values at $7.6 billion, and diamond magnate, Nicky Oppenheimer who is worth $6.7 billion.

By way of contrast, while the number of South Africans living in extreme poverty may have fallen slightly to 17% of the total between 1995 and 2006, we are still talking about nine million or so people.

And such deprivation makes itself felt in various ways. On the one hand, it tends to fuel often violent crime such as the high-profile murder of Senzo Meyiwa, captain of national football team, Bafana Bafana. He was killed a couple of weeks ago following an apparent attempted robbery at his girlfriend’s home near Johannesburg.

On the other, it also results in too many people going hungry in a land of plenty.

Even though South Africa is self-sufficient in terms of food production, which means that there should be enough to go around all of its 53 million citizens, it seems that a quarter of the population (14 million) regularly suffer from poverty-induced hunger.

This means that, on a day-to-day basis, they do not know where their next meal will come from as they simply do not have enough money to buy food, according to another Oxfam report released in October entitled “Hidden Hunger in South Africa: The Faces of Hunger and Malnutrition in a Food-Secure Nation.”

And this situation has only got worse over the last six years as high inflation levels have seen the cost of basic items leap by a whopping 40%.

As a result, a further quarter of the population (15 million) is now also at risk of hunger, meaning that any cut to a household’s meagre income is likely to prove disastrous in terms of its members being able to afford to eat.

The worst-affected communities are, unsurprisingly, found in the informal settlements, where 38% of people suffer hunger on a daily basis. But even in more formal urban areas, where hunger levels are at their lowest nationally, one in five are also affected.

One of the surprising things about these depressing statistics though is that hunger does not necessarily translate into a slim physique. In fact, quite the opposite is true here.

As can be witnessed by simply walking down the street, South Africa is a nation of fatties – a 2010 health survey by pharmaceutical company, GlaxoSmithKline, found it to be the third plumpest country in the world.

Hidden hunger

A study published by medical journal, the Lancet, in May, also revealed that it was by far the fattest nation in sub-Saharan Africa, with a stonking 61% of the population being overweight or obese – double the global average.

But unlike in developed countries, the problem is one that afflicts women more than men. A massive seven out of 10 adult females display unhealthy levels of body fat compared with only two in five men.

The same is true for a quarter of girls and 20% of boys compared with a global average of 13% for both genders.

A key problem beyond the usual health concerns over increased risk of heart disease and illnesses such as diabetes though is that malnutrition is rife.

The issue is one of so-called “hidden hunger’, in which people eat regularly and put on weight but do not receive the nutrients and vitamins they need, resulting in long-term damage to their health.

Because money is scarce, all too many fail to eat healthily, opting instead for cheap, poor-quality, highly-processed food that tends to be carbohydrate-rich and full of salt, sugar and fat.

According to local news channel eNCA’s Checkpoint recent documentary entitled “Nutrition in the Black Community”, fat intake among members of urban black communities has jumped 60% over the last 50 years, leading to stroke rates that are double those of white communities. Half of South African children under the age of five are also malnourished.

As in developed countries, it seems that more junk food and less exercise are definitely taking their toll.

But the situation is also not helped by cultural perceptions among black communities. Big men are generally perceived as wealthy and successful, while large women are considered beautiful and healthy – and, if married, as having husbands who look after them properly.

Being thin, on the other hand, is often associated with having HIV.

So it seems that to really grapple with this time-bomb of an issue, the government is going to need to do more than simply set up yet another commission to talk about it.