December 25, 2017, was the worst Christmas for the Warmback family.
The festivities began two days before with the arrival of Keith and Glenda Warmback’s children from the US. There was food and celebration as the couple saw their one-year-old granddaughter for the first time.
“That evening, we went out and my wife had a chicken salad [from one of the fast food restaurants]. The following day my wife Glenda started having a tummy ache. She went to lie down for a while. She fell asleep and I woke her up around 5PM and she said she couldn’t get out of bed because she wasn’t feeling well and had a running tummy,” says Keith.
Keith says he was woken up by barking dogs, in their room where Glenda was asleep, at about midnight.
“I went to see what was going on and I found Glenda on the floor. She said she thought she had a stroke,” he recalls.
He bundled her up and rushed her to the nearest private hospital.
“The staff was disastrous… They were disinterested in my wife’s condition and three others who were there with similar symptoms,” says Keith.
According to Keith, it was just the beginning of a series of mistakes. Eventually, Glenda’s lungs collapsed and she died at 2AM on Christmas day. She was 61 years old; they had been married for 41 of those.
“The painful thing is the incompetence at the hospital,” says Keith.
Doctors sited natural causes as a cause of death. The problem is, just 20 days before, the health minister had announced a foodborne outbreak called listeriosis. According to Keith, Glenda had all the symptoms and blood tests indicated she had it but she was never treated for it.
At the time of going to press, Glenda was one of 183 South Africans who had died from this disease since January 2017; 978 had been infected. It is the world’s worst outbreak of listeriosis, according to the World Health Organization (WHO).
“Listeriosis is the name of a disease that people develop when they eat food that is contaminated with the bacterium called listeria,” says Dr Juno Thomas, head of the Centre for Enteric Diseases at the National Institute for Communicable Diseases (NICD).
According to Thomas, this bacterium is found worldwide. It can be in soil, water and even faeces in many animals.
“Once in the environment, it is very difficult to get rid of because it attaches to things very easily. Once it attaches itself in an environment, it produces a layer of a sticky sugary slime that sticks onto the surfaces and makes it difficult to remove and resistant to disinfectants,” says Thomas.
According to Health Minister Aaron Motsoaledi, South African hospitals saw and treated an average of 60 to 80 patients affected by listeria between 2013 and 2016 with no problems.
Then, in July last year, doctors started seeing more cases of newborn babies born with listeria.
It was a cause for concern. They informed the NICD. A search, led by Thomas, began. On November 29, they found that at the time, 557 people had been infected.
“A team from the NIDC interviewed 109 patients to obtain details about foods they had eaten in the month before falling ill. Eighty five percent of the people reported eating ready-to-eat (RTE) processed meat products, of which polony was the most common, followed by viennas/sausages and then other ‘cold meats’,” says Motsoaledi.
Sixty percent of cases were reported in Gauteng, 13% in the Western Cape and 7% in KwaZulu-Natal.
“We think it affected Gauteng the most because of consumer behavior. Things like sausages, polony and viennas are staple street and household foods in Gauteng because they are affordable and quick to prepare. The economy of Gauteng also plays a factor. There are many more people who can afford to buy these items than other provinces,” says Thomas.
Even armed with this information, the source of the outbreak remained unknown.
Symptoms of Listeriosis:
“When you have an outbreak like this you have no idea where it comes from. We also had not seen many cases of listeriosis in the country, meaning it wasn’t a big health priority compared to all the other issues we have to deal with. For example, we saw 30,000 cases of malaria last year, rabies is a big concern, TB and many others were more severe,” says Thomas.
With hard work and vigilance, the outbreak was traced from Soweto.
Nine crèche kids under the age of five got ill and were admitted to the Chris Hani Baragwanath Hospital. Tests revealed that they had been infected. A team went to the crèche the very day and found kids had eaten polony manufactured by Enterprise Foods, owned by Tiger Brands.
“We then visited the Enterprise Foods factory in Polokwane that makes this brand. We took over 28 samples and they tested positive for the outbreak strain. The conclusion from this is that the source of the present outbreak can be confirmed to be the Enterprise Food production facility in Polokwane,” she says.
On Sunday March 4, Motsoaledi ordered a safety recall of all products from Tiger Brands.
After Motsoaledi’s announcement, Tiger Brands shares fell more than 10% when the market opened on Monday.
“It is devastating for me that our business is linked to this outbreak… we detected low levels of listeria in our products on the 14th of February. We took immediate precautionary measures which included immediately halting production of the affected product, quarantining all affected product within our distribution center and withdrawing all affected products manufactured on that day,” says Tiger Brand CEO Lawrence MacDougall at a press briefing the next day.
MacDougall, however, controversially denied any responsibility for the deaths.
“There is no direct link with the deaths to our products that we are aware of at this point. Nothing… All of our tests and results indicate that we kept a very high standard of quality protocols within those sites. The expectations going forward is that those standards are significantly increased if there is going to be a zero detection of listeria going forward,” he says.
Motsoaledi argues that there is proof the ST6 strain was found at their facilities.
“The fact remains that we have had an outbreak of listeria, we informed them [Tiger Brands], in terms of fair administrative justice, that we got the results and we were going public with them. I don’t think they did enough to make sure their produce is safe for consumption by the public. I believe the best way is for this to be a civil case rather than a government case,” says Motsoaledi.
Renowned corruption buster and private forensic investigator Paul O’Sullivan agrees. He is filing criminal charges against the board of Tiger Brands and has called upon them to step aside pending the outcome of the investigations.
O’Sullivan has teamed up with human rights lawyer Richard Spoor to bring charges.
“What is particularly shocking is that Tiger Brands, in its most recent annual report, placed product quality as number nine on the list of risks facing the company, when it should have been be at number one. We cannot think of a greater risk to the sustainability of any food company, than that of killing off your customers through recklessness or gross negligence. We are 100% certain that it will rank top of the list in next year’s annual report.”
What O’Sullivan finds completely unacceptable is that Tiger Brands is still in denial.
“On the one hand they close and deep-clean all the affected facilities, on the other hand they deny culpability and say they will meet each civil claim on its own merits, thereby indicating they will make it a long-haul for the litigants,” he says.
Gareth Lloyd-Jones, Chief Commercial Officer at hygiene and sanitation service provider Ecowize, however says government is to blame. He argues there should be a surveillance system that protects consumers.
“This type of rigorous investigation has been going on for the past couple of months, which is admirable, relevant and necessary and should have been part of a more robust routine surveillance and monitoring process in terms of food safety and legislation requirements,” he says.
According to retail analyst Syd Vianello, this can tarnish a brand that has spent decades trying to live up to high standards.
“How long is it going to take [Enterprise Foods] to convince consumers that the Enterprise brand is good for purchase again? We are talking about the value of the brand and the protection of the brand equity, insurance won’t even cover you for those kinds of losses. These can carry on for a very long time,” he says.
There is also a rub-off effect.
Ronald Dube, a manager at a supermarket in Johannesburg, says people have been returning all cold meats regardless of brand.
“People are afraid and have been returning all sorts of meat. We have also noted that sales of processed foods have gone down, no matter the brand,” he says.
Many people have also thrown away their cold meats but, according to Dr Johan Schoonraad, waste expert and group tactical specialist at EnviroServ Waste Management, there are only two options for disposing of listeria infected food waste – incineration or treatment and landfill disposal.
“The scale of the problem is too big for the incineration industry to deal with in any sort of reasonable timeframe, which leaves waste management companies with the option to do treatment and disposal to landfill,” he says.
Schoonraad says treatment can take many routes. You could sterilize the food waste, heating it and ensuring the material internally gets to 100 degrees which would kill the bacteria.
“If this was done, we could then landfill it without further treatment being required before disposal,” he says.
The other option is to chemically treat it prior to disposal.
According to Schoonraad, the problem is municipal landfills often have poor access control. The risk here, he says, is that the informal sector could enter and scavenge food material, which is then sold or eaten and could spread the disease.
“However, licensed hazardous waste sites have strict access control with no scavenging allowed at these facilities,” he says.
Nevertheless, South Africa remains in fear of this deadly disease.
Who is mostly at risk:
- Pregnant women
- Neonates (first 28 days of life)
- Very young infants
- Elderly persons >65 years of age
- Anyone with a weakened immune system (due to HIV infection, cancer, diabetes, kidney disease, liver disease, people with transplants and those on immunosuppressive therapy such as oral corticosteroids, chemotherapy, or antiTNF therapy for auto-immune disease)
Cure For Counterfeit Drugs?
Blockchain technology is also revolutionizing supply chains in the pharmaceutical industry, in the process, helping track fake medicines.
From genomics to robotics, technology is truly revolutionizing the healthcare sector. And while it’s easy to become consumed by exciting, futuristic trends like artificial intelligence (AI) diagnosis, digitized patient records and 3D-printed medical tools, technology is also transforming the pharmaceutical industry. How medication is prescribed, dispensed and administered is big business with McKinsey predicting the value of Africa’s pharmaceutical industry to be $65 billion in 2020.
But fake drugs are an ongoing and complex issue – they can cause death, have unknown side-effects, fail to treat illnesses, and sometimes even add to the spread of disease. According to World Health Organization (WHO) statistics, 42% of detected cases of falsified (or substandard) pharmaceuticals occur in Africa – reports estimate that between 72,000 and 169,000 children die each year from pneumonia because of counterfeit antibiotics while fake malaria drugs cause an additional 64,000 –158,000 deaths every year in sub-Saharan Africa. Both antimalarials and antibiotics sit among the most commonly-reported counterfeited drugs.
“Fake medicine distribution is rampant because business processes are siloed between the various industry stakeholders, which puts the industry at risk of fraud,” explains Heidi Patmore, a marketing consultant specializing in technology that’s changing consumer behavior.
“One solution to this would be cross-company process automation which could easily be enabled by a blockchain data interchange. This creates an open information system that all players can use to verify the authenticity of medication because it can track and trace it from when it’s manufactured to when it is dispensed to the patient.”
Companies such as IBM and SAP are working on blockchain solutions to weed out Africa’s counterfeit medication network. When medicine is returned to pharmaceutical manufacturers, for example, it is often re-sold instead of being destroyed. How can a small local pharmacy ensure what is returned is authentic? SAP are working with their existing client base – Merck, GSK, Ingelheim, McKesson and others – on a blockchain project to verify that any returned drugs are original.
IBM Research’s solution for Africa (currently in development in Haifa, Israel) includes a mobile interface and permissioned blockchain backend that enables each certified and authorized party in the network to initiate action, finish their transaction, and track its progress.
“It also includes the monitoring of temperature to ensure compliance with the proper conditions for transportation and asset transfer,” adds Inna Skarbovsky, a blockchain architect from IBM Research – Haifa. “Blockchain ensures full provenance for each medicine package, uniquely identified with a barcode or a serial number. This makes it possible for all authorized parties to track the drugs through the entire supply chain and the drugs’ life-cycle.”
This also allows significant cost reductions by eliminating each participant’s need to manage a separate system for traceability of its components. “It also improves procedural efficiency for change-of-hands, make it much harder for counterfeit drugs to be introduced into the supply chain and to be distributed to end-users,” says Skarbovsky.
Towett Ngetich is the CEO of Uthabiti Health, a Kenya-based pharmaceutical company that has implemented blockchain to bring transparency and accountability back to a country where statistics show that 30% of medicines sold are counterfeit. Uthabiti, which means ‘verify’ in Swahili, was started after Ngetich’s first-hand experience with the effects of fake health products: “Back in university, a significant number of students fell victim to unplanned pregnancies and unsafe abortions. With deep research, it was uncovered that there had been a supply of fake contraceptives and backstreet abortion pills into the student market,” explains Ngetich. More findings showed the presence of fake antibiotics, antiretrovirals (ARVs) and non-communicable diseases (NCD) medicines in the Kenyan pharmaceutical supply chain.
“Pharmaceutical science is the center of healthcare – one mistake in any drug composition or formulation has the risk of endangering a significant number of people. The need to access safe, affordable and quality health products in its simplest form means life and death in diagnosed health complications. Blockchain gives patients the ability to track and trace products using attached IDs – it also gives Uthabiti Health the ability to know where all our health products sit within each supply chain,” he says. Uthabiti Health procures medicines from different pharmaceutical manufacturers. Once received, they go to an internal laboratory for quality testing and are then labeled with the product’s safety lab report – attached in their codes is a unique blockchain ID. The medicines are then passed on to their partnering retail points, ensuring that the medicines dispensed to patients can be verified with something as simple as a text message.
“This brings in consumers in safe-proofing the supply chain of pharmaceuticals,” adds Ngetich.
The proliferation of fake drugs throughout Africa is complex – on average, medicine changes 30 hands before reaching the destined pharmacy – but blockchain technology has great potential to help stop counterfeit medicine distribution because it brings traceability and trackability to the entire pharmaceutical supply chain, ensuring the immutability of information.
While blockchain is still a relatively niche technology, it is slowly changing how organizations operate. Blockchain promises better security and transparency, but not necessarily for the customer, in the case of drug allocation: “Where blockchain technology could likely increase efficiency and simultaneously decrease the abuse of medicines, customers benefit. The pharmaceutical and related industries are unique however, in that the ‘consumer’ is also a patient – a vulnerable group with special needs and rights,” explains Candice De Carvalho, the founder of Easy Ethics CPD.
Although overall transparency in the supply chain increases through the use of blockchain, and this confers patient benefits, these must be weighed against patient privacy and confidentiality.
“With emerging technologies more freely available, we’ve observed an interesting shift in patient behavior, where data privacy is regarded less as an absolute by patients, in favor of a kind of sliding scale, where privacy itself is a currency that purchases medical benefits along the way,” adds De Carvalho. “Patients, for the right benefits, are perhaps more willing to part with some privacy privileges.”
De Carvalho questions the genuine knowledge that patients have of any exposure they experience through their use of novel medical device or systems innovations. The key drivers for the business are not necessarily unified with the total needs of the patient. However, the more the technology owners protect and balance the patient’s need for confidentiality and consent, the more they will ultimately see business benefit.
“In the context of a doctor-patient relationship, the doctor has a positive duty to enhance patient understanding so that the patient enjoys a truly informed consent. Does this then mean that technology providers are now responsible in the same way that medical health workers are?” she ends.
In Johannesburg, city-dwellers like Linah Moeketsi have taken the future of sustainable farming into their own hands. Where land is becoming scarce, they look to the skies.
Doornfontein is one of Johannesburg’s older inner-city suburbs with decaying buildings and dingy alleys that wear a dour, monochrome look.
Daily commuters and street surfers jostle with delivery vans and mountains of metal scrap but the grey of the concrete city makes it hard to believe that there could be a patch of green in a most unlikely location.
Above the humdrum of life here is a rooftop hydroponics farm looking down on the city, but upwards to a new route to restoration and urban preservation.
Atop the eight-floor Stanop building – offering a breath-taking view of the city and the landmark Ponte Towers in the distance – one woman has made it her mission to turn a grimy grey terrace into a green lung on the city’s skyline.
“City life is taking on a totally new direction… even people who think they couldn’t one day farm, find themselves on rooftops,” Linah Moeketsi tells FORBES AFRICA.
Moeketsi grows herbs, used to treat non-communicable diseases (NCDs), in a 250m x 500m greenhouse on the building’s terrace. But her rooftop farm is sans any soil – it uses a hydroponics system.
“I think because we are in the city and we would like to produce for people in the city, hydroponic farming is one of the answers because you can actually harvest more than twice the produce, and the growth rate is quicker and there is produce that you can have throughout the year that people demand because it is in a controlled environment,” she says.
On a windy Wednesday morning in October, we meet Moeketsi at her aerial green facility, a couple of days before she is to send some of her plant produce to the market.
She talks about her journey as an offbeat farmer. It all started when her father fell ill in 2013, when doctors failed to correctly diagnose his disease.
“They couldn’t see that he was diabetic. He didn’t show the signs of diabetes, but he had this foot ulcer that just wouldn’t go away,” she says.
“The future of city farming is great simply because we have more and more young people getting into this space. Even though it’s farming, they are looking at it from a very different angle.
Moeketsi decided to do her own research, so she read up books on African medicinal plants and used some herbs that belonged to her late mother, who had been a traditional healer.
“It took me a good eight months to help my dad and I actually saved him from having an amputation.”
The news of Moeketsi curing her dad’s diabetes using herbs spread. Sadly, her father died in 2016, at the age of 87. But she is proud to have helped prolong his life.
“So he passed away in his sleep, not sick, nothing, he was just old. But he was always grateful; he was like, ‘even when I die, I’m going to die with both my limbs’, so we would make a joke about it.”
READ MORE| Businesses At The Heart Of A Greener Future
After her father’s demise, Moeketsi rented some land and turned her knowledge on natural herbs into a fully-fledged farm. However, when the owner of the land returned, she was forced to vacate.
Land was always going to be a problem in the city. But instead of giving up, Moeketsi looked to the skies.
“Because of this passionate drive for an answer, I found myself researching what’s happening outside Gauteng and South Africa, and I saw in Europe, they were farming on rooftops,” she says.
In 2017, her dream became a reality when she secured a deal with the City of Johannesburg as part of an urban farming program, and started the rooftop project a year later.
When we visit her greenhouse, we are welcomed by the sweet lingering scent of herbs. It’s hot and humid, and two fans whir away to cool the air.
Moeketsi walks around the greenhouse wearing dark glasses and a white jacket, with a syringe in hand – she could easily pass off as a medical doctor.
She elaborates on the hydroponics system. There are four pyramids, each attached to their own reservoirs of water. On each pyramid, different plants, ranging from spinach, lettuce, sage, parsley, basil and dill, rest on beds with pipes connecting them to the reservoirs. Moeketsi plucks out one of the pipes and inserts the syringe; water spouts out of the tube and she returns it to the bed.
“Twice a day, you have to check that water is actually going through the pipes, because that’s how the plants get water and nutrients,” she explains, as she unblocks a pipe using the syringe. She says it’s one of the best ways to farm using little water.
“When you put in certain plants in the greenhouse, you know you are guaranteed sustainable farming because you can produce those plants and harvest them,” she says.
Moeketsi adds that this allows her produce to stay consistent season after season.
“So, from that point of view, it makes the city more sustainable in terms of food produce that is easily accessible and cost-effective for the consumer because not everyone around here can afford the high prices of food but they can at least afford what we sell, whether it is at R10 ($0.5) or R15 ($1).”
As Moekesti continues to tend to the plants, a farmer she works with walks in and begins filling up the reservoirs.
Lethabo Madela has known Moekesti for almost six years.
“When you look around Johannesburg, there is no space, so rooftops have saved us a lot, especially those of us that love farming,” says Madela. “I’m learning a lot and I think she [Moekesti] changed the whole concept of farming for me because I used to farm vegetables. I didn’t know culinary herbs or medicinal herbs.”
Moeketsi speaks of other farmers around the city who have taken to the rooftops to farm plants such as strawberries, lemon balm, spinach and lettuce.
In a suburb called Marshalltown, a 10-minute drive from Moeketsi’s farm, Kagiso Seleka farms lemon balm also using hydroponics.
He produces sorbet and pesto from his produce which is then used to make ice cream.
“It [hydroponics] is great for farming sensitive plants in terms of temperature. Lemon balm does not like frost. But it’s better to grow even out of season so you can set a higher price,” he tells us.
However, he says hydroponics farming is a luxury not many farmers can afford.
“It [hydroponics] does have a bit of a higher capital upfront, but you get a higher yield and higher quality, so people are willing to pay more. Hydroponic planting saves about ninety five percent of water soil farming in a water-scarce country,” says Seleka.
“We do have water shortages, and I know people are on the whole ‘organic trip’ but, is it more important to have an organic plant versus a water-saving environment?”
The Program Coordinator for Agriculture at the City of Johannesburg’s Food Resilience Unit, Lindani Sandile Makhanya, says there certainly are more rooftop farmers in Johannesburg now than ever before.
Converting idle terraces into avenues of profit is becoming a norm. There are new rooftop farms being set up every day, offers Makhanya.
He regularly visits Moeketsi’s farm to check on the progress and collect produce to sell.
“Urban farming in Johannesburg is rising, mainly because the idea of producing our own food is very important because most people are moving to urban areas and therefore it stands to reason that we have to try to produce as much as possible,” says Makhanya.
“[There is growth] even in animal production, although we are moving away from the bigger numbers, but we are involving the smaller ones; because of the space issue, they are increasing overall.”
For Moeketsi, her farm has changed her life and given her hope for a better future. In addition to the teas, tinctures, ointments and medicinal products she processes from her plants, she plans to include more by-products such as syrups in the future.
“The future of city farming is great simply because we have more and more young people getting into this space. Even though it’s farming, they are looking at it from a very different angle,” she says. “That is why the city is changing and rooftop farming is going to get bigger and bigger.”
Clearly, farming in Africa is covering exciting new ground.
How Virtual Therapy Apps Are Trying To Disrupt The Mental Health Industry
Millions of Americans deal with mental illness each year, and more than half of them go untreated. As the mental health industry has grown in recent years, so has the number of tech startups offering virtual therapy, which range from online and app-based chatbots to video therapy sessions and messaging.
Still a nascent industry, with most startups in the early seed-stage funding round, these companies say they aim to increase access to qualified mental health care providers and reduce the social stigma that comes with seeking help.
While the efficacy of virtual therapy, compared with traditional in-person therapy, is still being hotly debated, its popularity is undeniable. Its most recognizable pioneers, BetterHelp and TalkSpace, have enrolled nearly 700,000 and more than 1 million users respectively. And investors are taking notice.
Funding for mental health tech startups has boomed in the past few years, jumping from roughly $100 million in 2014 to more than $500 million in 2018, according to Pitchbook. In May of this year, the subscription-based online therapy platform Talkspace raised an additional $50 million, bringing its total funding to just under $110 million since its 2012 inception.
The ubiquity of smartphones, coupled with the lessening of the stigma associated with mental health treatment have played a large role in the growing demand for virtual therapy. Of the various services offered on the Talkspace platform, “clients by far want asynchronous text messaging,” says Neil Leibowitz, the company’s chief medical officer.
Users seem to prefer back-and-forth messaging that isn’t restricted to a narrow window of time over face-to-face interactions. At BetterHelp, founder Alon Matas notes that older users are more likely to go for phone and video therapy sessions, whereas younger users favor text messaging.
“Each generation is getting progressively more mobile-native,” says John Prendergass, an associate director at Ben Franklin Technology Partners’ healthcare investment group, “so I think we’re going to see people become increasingly more accustomed, or predisposed, to a higher level of comfort in seeking care online.”
The ease and convenience of virtual therapy is another draw, particularly for busy people or those who live in rural areas with limited access to therapy and a range of care options.
Alison Darcy, founder and CEO of Woebot, a free automated chatbot that uses artificial intelligence to provide therapeutic services without the direct involvement of humans, says that with Woebot and other similar services, there is no need to schedule appointments weeks in advance and users can receive real-time coaching at the moment they need it, unlike traditional therapy. The sense of anonymity online can also lead to more openness and transparency and attracts people who normally wouldn’t seek therapy.
Along with stigma, the cost of therapy has historically acted as a barrier to accessing quality mental-health care. Health insurance is often unlikely to cover therapy sessions. In most cities, sessions run about $75 to $150 each, and can go as high as $200 or more in places like New York City. Web therapists don’t have to bear the expense of brick-and-mortar offices, filing paperwork or marketing their services, and these savings can be passed on to clients.
BetterHelp offers a $200-a-month membership that includes weekly live sessions with a therapist and unlimited messaging in between, while Talkspace’s cheapest monthly subscription at $260-a-month, offers unlimited text, video and audio messaging.
But virtual therapy, particularly text-based therapy, is not suitable for everyone. Nor is it likely to make traditional therapy obsolete. “Online therapy isn’t good for people who have severe mental and relational health issues, or any kind of psychosis, deep depression or violence,” says Christiana Awosan, a licensed marriage and family therapist.
At her New York and New Jersey offices, she works predominantly with black clients, a population that she says prefers face-to-face meetings. “This community is wary of mental health in general because of structural discrimination,” Awosan says. “They pay attention to nonverbal cues and so they need to first build trust in-person.”
Virtual therapy apps can still be beneficial for people with low-level anxiety, stress or insomnia, and they can also help users become aware of harmful behaviors and obtain a higher sense of well-being.
Sean Luo, a psychiatrist whose consultancy work focuses on machine learning techniques in mental health technology, says: “This why some of these companies are getting very high valuations. There are a lot of commercialization possibilities.” He adds that from a mental health treatment perspective, a virtual therapy app “isn’t going to solve your problems, because people who are truly ill will by definition require a lot more.”
Relying on digital therapy platforms might also provide a false sense of security for users who actually need more serious mental-health care, and many of these apps are ill-equipped to deal with emergencies like suicide, drug overdoses or the medical consequences of psychiatric illness. “The level of intervention simply isn’t strong enough,” says Luo, “and so these aspects still need to be evaluated by a trained professional.
– Ruth Umoh, Diversity and Inclusion Writer, Forbes Staff.
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