With medication and technology, science is increasingly improving the lives of people living with HIV and reducing new infections.
On August 8, 2018, a day before Women’s Day in South Africa, 23-year-old Saidy Brown observed six years of being on antiretroviral (ARV) treatment.
We meet Brown in her hotel room in Benoni in the East Rand in the South African Province of Gauteng.
She sits still, reflecting on her life after a long and busy day. She has just returned from a group meeting with other young HIV activists.
Her t-shirt is unapologetic and as loud as her activism. “HIV POSITIVE #TEST & TREAT,” it reads. In the dim light of her room, she recollects her dark journey to becoming an HIV activist.
Brown was diagnosed with HIV at birth. However, she only found out she had it at the age of 14.
Brown grew up in a small town called Itsoseng in the North West Province of South Africa. In June 2009, while attending a youth day event, Brown and some of her friends decided to get tested for free.
The eager teen received some pre-counselling from one of the nurses.
“I remember getting into that room and the lady asked me two questions, ‘what would you do if you find out that you are HIV negative’?”
“I would continue living,” Brown said.
“What will you do if you find out you are HIV positive?”
“I would go out there and educate people living with HIV,” she said to the nurse.
Brown tested positive. Her whole life changed in the space of five minutes.
“After she told me, the first thing I said was ‘how? I didn’t do anything, I am only 14’.”
While her friends were discussing their results, Brown broke the news to them. They were all surprised.
“I then told them ‘no, I’m kidding, I am negative’.”
Brown was ashamed and could not confide in anyone.
“I really wanted to go home and cry. Like, I didn’t even know where I got it from,” Brown says.
She was afraid of what her family, friends and community would think of her. For months, she kept it to herself. But the secret about her health was too overwhelming.
Later that year, Brown joined a drama club. They rehearsed for a play to be staged on World AIDS Day, on December 1. She played the daughter of a woman who was HIV positive.
Little did her peers know that Brown was actually telling her real life story. A few days later, conversations with Brown’s drama teacher got her to divulge her secret.
She later gathered up the courage to confide in her aunt. Her aunt then revealed that Brown’s late parents had indeed been HIV positive.
“I was angry at my aunt for not having tested me earlier on, I was angry at my parents for having died before me knowing, I was angry at God, I was just angry at everyone,” she says.
She turned to writing to cope. The first piece she wrote was titled An Open Letter To HIV.
“I will always remember this line because I paused there and I cried so much. There is a line where I said, ‘because of you I feel less pretty’.”
This marked the beginning of her activism. She shared the letter on social media and it reached thousands.
For 14 years, Brown had lived a healthy life with the disease without any treatment. Brown disclosed her status to close friends and received huge support.
It was only when she turned 18 that her health began to deteriorate. Hesitant to start treatment, Brown thought about the rumors she heard about the side-effects of ARV.
When she went for blood tests, she was told her CD4 count had dropped. According to experts, when the CD4 count drops below 200, a person is diagnosed with Acquired Immunodeficiency Syndrome (AIDS).
“I think that was when reality started kicking in that ‘you need to be on treatment’,” she says.
In 2012, she finally started ARV treatment. Since then, Brown has been living a healthy life
She uses her experience to encourage others living with HIV and to break the stigma. In June 2017, she recited An Open Letter To HIV at the eighth South African AIDS Conference addressing HIV/AIDS and gender-based violence.
She held governments and societies accountable.
The same year, she received the Red Ribbon Foundation Youth for Change HIV/AIDS Activist Award.
In 2018, she was recognized as one of the Mail & Guardian 200 Young South Africans, for her work as an activist.
Brown considers herself an “HIVictor” and reaches thousands on her social media platform spreading awareness about the disease.
“There is life after an HIV diagnosis,” Brown shared with her followers on Twitter.
Today, Brown is HIV-undetectable.
She has been virally suppressed for two years now.
According to a report by UNAIDS in 2018, being undetectable means that the virus is un-transmittable.
This means that people who are HIV positive with an undetectable viral load cannot transmit HIV sexually.
This was proven in 2017.
Dr Sindisiwe van Zyl is a clinician and general practitioner with a special interest in HIV and women’s health.
She also uses her social media to spread awareness on the disease.
“The aim of ARV treatment is to achieve an undetectable or suppressed viral load. What is the viral load? It is the number of HIV copies in the blood. HIV uses CD4 cells to make copies of itself. If one is taking ARV treatment, the efficacy of the treatment is proven by an undetectable viral load. You’re still living with HIV, but you’re taking the treatment so well that the virus cannot make copies of itself,” she tells FORBES AFRICA.
“The viral load blood test tells us when undetectable levels have been reached and it takes 12 to 24 weeks to achieve this,” Van Zyl says.
Three significant studies were done between 2007 and 2016 on sexual transmission of HIV among thousands of couples.
According to UNAIDS: “In those studies, there was not a single case of sexual transmission of HIV from a virally-suppressed person living with HIV to their HIV-negative partner.”
“For many people living with HIV, the news that they can no longer transmit HIV sexually is life-changing. In addition to being able to choose to have sex without a condom, many people living with HIV who are virally suppressed feel liberated from the stigma associated with living with the virus,” UNAIDS says.
However, the stigma still does exist.
A 28-year-old millennial, who requested not be named, tells FORBES AFRICA that she had never heard of what it means to ‘undetectable’.
When asked if she would be willing to have sexual relations with someone who was HIV positive but their viral load was undetectable, she says she is unsure.
“I would but I would be worried because mistakes happen. What if medical practitioners thought it was undetectable but they made a mistake and now my life is at risk,” she asks.
She is not alone in thinking this way.
From a quick social media search, it is evident many users are not well-informed about what an undetectable viral load means.
Some social media users who disclosed to be living with HIV said that even their own doctors had not informed them about what it meant to be ‘HIV undetectable’.
Through hashtags such as #UequalsU and #UndetectableEqualsUntransmittable, awareness around being ‘HIV undetectable’ has spread globally, giving freedom to many HIV positive people to share their status.
“[These are] the hashtags of the century, in my opinion! What does #UequalsU mean? If the viral load is undetectable, then one cannot transmit HIV!” Van Zyl says.
It is such activism that has contributed to the strides in HIV research.
A doctor from the Wits Donald Gordon Medical Centre in Johannesburg agrees.
“I think that’s what makes the HIV space unique. Those activists are crucial… When patients talk, they talk as if they don’t have a voice, but with the activists, they have a voice and they are taken seriously and I think that has also been one of the big drivers,” Dr June Fabian, a nephrologist and clinical researcher at the medical center, tells FORBES AFRICA.
Transplanting to save a life
Two years ago, doctors from the transplant unit at the Wits Donald Gordon Medical Centre performed what is believed to be the world’s first HIV positive liver transplant.
Currently, the center is the only transplant program doing transplants from one living person to another in southern Africa.
The liver of a mother living with HIV was transplanted into her critically-ill HIV negative child.
After the transplant, the child was monitored and the doctors were not able to find HIV within the child’s system.
The child had been on a waiting list for more than 180 days and was frequently admitted for life-threatening complications of end-stage liver disease.
Professor Jean Botha led the procedure.
He was approached by the child’s mother to consider using her as her baby’s donor.
“We have had a case where we proposed the idea but the mom said, ‘I cannot live thinking that I’ll give HIV to my child’, and she said ‘no’, and the baby died,” Fabian, who was a part of the team, says.
It was a very complex situation.
They reviewed the implications of the transplant, consulted with other experts and then spoke to the ethics committee at the University of the Witwatersrand (Wits).
“They came back and said, ‘if you are weighing up this child dying versus giving the child HIV then do it because, obviously, you want to prevent the child from dying’,” Fabian explains.
With the go-ahead, the team proceeded with the operations and assumed that the child would have the virus after the procedure.
But their assumptions were wrong.
“After the transplantation, we saw a seroconversion event. What that means is that the child became HIV positive,” Professor Caroline Tiemessen from the Wits School of Pathology and Centre for HIV and STIs, National Institute for Communicable Diseases, said in a report.
Soon after, they observed that the virus was no longer detectable. They then monitored the child’s antibodies and tested the viral load, however, she said it has remained undetectable since.
They have since not been able to trace the virus within the cells of the child.
“The liver is an immune organ so it’s the liver’s job to kill bugs… so I think in a way we might have struck it lucky with the liver. I don’t know if we can say what happened here is going to happen with a heart, a kidney or a lung,” Fabian says.
Despite not being able to detect the virus, the child was placed under ARV treatment.
Fabian says the only way to know for sure that there is no HIV in the child is if they completely stop treatment.
However, it would be a risk.
In 2017, a similar case was announced where a nine-year-old South African who had been diagnosed with HIV at a month old, received treatment, and then maintained remission after suppressing the virus for almost nine years without the treatment since 2008.
It has been more than a year since the liver transplant took place and both the mother and child are recovering well.
According to Fabian, they plan to continue doing more tests.
HIV Positive: The New Living Donor Pool?
At a time when South Africa is experiencing a shortage of organ donors, this may be a solution to the problem if people living with HIV may be able to donate organs.
In the early 2000s, Fabian’s work dealt with organ transplants and HIV before ARVs were created.
“We started seeing the disease untreated, and there was a lot of kidney disease so that was what sparked my interest and I started a study in the clinic with patients with HIV and kidney disease,” she says.
However, HIV patients back then were excluded from transplantation.
“We were basically throwing away organs from HIV-positive donors because we weren’t using them,” she says.
With a shortage of organ donors, Fabian says they lost 25 children on the waiting list.
According to an article by theSouthAfrican.com, there are around 4,300 people waiting for organ donations in South Africa in need of new livers, kidneys, lungs or hearts.
“The inclusion of HIV-infected people as living donors created the new living donor pool,” say experts from the Wits Donald Gordon Medical Centre.
This means that people like Brown who have been living with an undetectable viral load could be eligible as donors after tests have been done.
As for whether or not HIV-positive patients could potentially become blood donors, more work needs to be done in that field.
At the moment, Fabian does not think it is possible.
“I don’t know if you would put someone on life-long antiretroviral for a blood transfusion. I don’t think the benefit outweighs the risk when you can source blood from non-infected donors and the person isn’t going to die if they don’t get the transfusion,” Fabian says.
The evolution of ARVs
The first ARV treatment trial happened in the 1990s and in 2004, South Africa first rolled out its ARV program to people living with HIV.
ARV treatment has gone from taking several tablets a day to one pill daily.
Now, patients, particularly in South Africa, can receive free treatment.
According to a report on HIV and AIDS financing by the South African Health Review, South Africa has the largest number of persons living with HIV and on ARV-treatment in the world, with this figure scaling up by approximately 400,000 persons per annum.
UNAIDS estimates there are 20% of people on ARV therapy globally.
HIV-related deaths have been decreasing as the number of people receiving ARVs is growing.
In 2008, the death rate was about 220,000 to 260,000 in South Africa.
In 2016, estimates between 96,000 to 140,000 of AIDS-related deaths in the country were reported.
“I think what is underappreciated is how much people’s lives have changed with ARVs and with access to ARVs and how much the science and the funding with ARVs has driven it from being a very complicated regimen to one tablet a day,” Fabian says.
And now, access to obtaining ARVs has become easier and they are getting smaller.
“The tablet is getting smaller and smaller, which is great for storage, great for carrying, makes it cheaper, it’s also easier to swallow,” says Professor Francois Venter, the Deputy Executive Director at the Wits Reproductive Health and HIV Institute.
Last year, South Africa saw the introduction of an ATM which uses electronic and robotic technology to dispense medication.
This allows patients to collect medication without having to queue at hospitals.
On the continent, clinical trials of injectable ARV drugs are currently underway.
This is part of a large-scale trial that will be conducted in six other countries –Kenya, Malawi, Botswana, Zimbabwe, Uganda and Swaziland.
According to a news report in The East African, the aim of the study is to introduce an injection once every two months.
“They are starting to work on a new implant. It is very early days but it is very, very exciting. So instead of taking your ARVs you just get an implant every year,” Venter says.
“ARVs are looking more and more like hormonal contraception … It is like having several choices.”
He predicts that they will become available in the next five to 10 years.
Other new developments include the HIV vaccine trial (please read more on pages 44-47).
As HIV research grows rapidly, Fabian says that other chronic disease studies can gain from its developments.
“If you look at how we manage TB [tuberculosis], there is very little progress that has been anywhere as rapid as HIV, in terms of making treatment accessible and simple for people,” Fabian says.
Venter agrees: “The funny thing is people with HIV are now living longer than the general population in certain spaces.”
A study in the United States found this to be true.
In 2014, an estimated 45% of those HIV-infected were older than 50, amounting to 428,724 people, while 27% were older than 55 and 6% were 65 and older, according to the Centers for Disease Control and Prevention.
However, more work still needs to be done in this regard.
Venter says that technology has significantly aided HIV research.
“There are new ways to measure HIV which are getting more available and the price is coming down,” he says.
“There are also new ways for testing for HIV which are very exciting.”
“Because the cost of antiretrovirals has gone down so dramatically, HIV is actually relatively cheap to treat, compared to diabetes,” he says.
“It also keeps people away from the medical system which is very expensive,” he adds.
Despite the great strides taken to improve HIV treatment, a cure is still nowhere to be found.
“I think we are getting closer [to a cure] with vaccines,” Fabian says, hopeful.
Venter, on the other hand, believes we are still far from discovering a cure.
“I am not particularly hopeful because I think the scientific challenges of it are so hard that I am not sure it is going to be possible, but I hope I am wrong,” Venter says.
He says that there have been large amounts of money diverted to looking for a cure and that we are learning more about the immune system.
“Even if we may not find a cure, we are going to learn a lot about vaccines and the complexity of the human body,” he says.
For now, the importance of spreading awareness is still essential. Activists like Brown and Van Zyl can attest to that.
The world has gone from a deadly epidemic, to undetectable victories and vaccines in three decades.
We are witnesses to history in the making. Where will you be when a cure is found?
How LinkedIn Is Looking To Help Close The Ever-Growing Skills Gap
As the job market has evolved, so too have the skills required of seekers. But when 75% of human resources professionals say a skills shortage has made recruiting particularly challenging in recent months, it would appear as though the workforce hasn’t quite kept pace. Now LinkedIn is stepping in to help close the gap.
On Tuesday, the professional social network announced the launch of a “Skills Assessments” tool, through which users can put their knowledge to the test. Those who pass are given the opportunity to display a badge that reads “passed” next to the skill on their profile pages, a validation of sorts that LinkedIn hopes will encourage skills development among its users and help better match potential employees with the right employers.
READ MORE | Not Just Equality, But Recognition Of Excellence
“We see an evolving labor market and much more sophistication in how recruiters and hiring managers look for skills. … We also see a changing learning market,” says Hari Srinivasan, senior director of product management at LinkedIn Learning. “The combination of those two made us excited about changing our opportunity marketplace to make the hiring side and the learning side work better together.”
So how exactly does it work? Let’s say a user wants to showcase her proficiency in Microsoft Excel. Rather than simply listing “Excel” in the skills section of her profile, she can take a multiple-choice test to demonstrate the extent to which she is an expert.
If she aces the test, not only will a badge verifying her aptitude will appear on her profile, but she will be more likely to surface in searches by recruiters, who can search for candidates by skill in the same way they might do so by college or employer. If she fails, she can take the test again, but she’ll have to wait a few months—plenty of time to develop her skillset.
The tool has been in beta mode since March, and while just 2 million people have used it—a mere fraction of LinkedIn’s 630 million members—early results seem promising. According to LinkedIn, members who’ve completed skills assessments have been nearly 30% more likely to land jobs than their counterparts who did not take the tests.
READ MORE | Challenging The Gender Divide
“This has been a really good way for members to represent what they know, what they are good at,” says Emrecan Dogan, LinkedIn group product manager.
While new to LinkedIn, the practice of assessing candidates’ skills has been a standard among hiring managers for decades. But when research commissioned by LinkedIn revealed that 69% of employees feel that skills have become more important to recruiters than education, LinkedIn felt as though this was the time to give job seekers the opportunity to prove themselves from the get-go.
As important as the hard skills that members can put to the test through LinkedIn’s new tool may be, Dawn Fay, senior district president at recruiting firm Robert Half, encourages those on both side of the job search not to forget the importance of soft skills. “You wouldn’t want to rule somebody in or out just based on how they did on one particular skill assessment,” she says.
“Have another data point that you can use, question people about how they did on something and see if it’s something that can feed into the puzzle to find out if somebody is going to be a good fit.”
-Samantha Todd; Forbes
Why The High Number Of Employees Quitting Reveals A Strong Job Market
While recession fears may be looming in the minds of some, new data from the Bureau of Labor Statistics shows that the economy and job market may actually be strengthening.
The quits rate—or the percentage of all employees who quit during a given month—rose to 2.4% in July, according to the BLS’s Jobs Openings and Labor Turnover report, released Tuesday. That translates to 3.6 million people who voluntarily left their jobs in July.
This is the highest the quits rate has been since April 2001, just five months after the Labor Department began tracking it. According to Nick Bunker, an economist at the Indeed Hiring Lab, the quits rate tends to be a reflection of the state of the economy.
“The level of the quits rate really is a sign of how strong the labor market is,” he says. “If you look at the quits rate over time, it really drops quite a bit when the labor market gets weak. During the recession it was quite low, and now it’s picked up.”
The monthly jobs report, released last week, revealed that the economy gained 130,000 jobs in August, which is 20,000 less than expected, and just a few weeks earlier, the BLS issued a correction stating that it had overestimated by 501,000 how many jobs had been added to the market in 2018 and the first quarter of 2019. Yet despite all that, employees still seem to have confidence in the job market.Today In: Leadership
The quits level, according to the BLS, increased in the private sector by 127,000 for July but was little changed in government. Healthcare and social assistance saw an uptick in departures to the tune of 54,000 workers, while the federal government saw a rise of 3,000.
The July quits rate in construction was 2.4%, while the number in trade, professional and business services, and leisure and hospitality were 2.6%, 3.1% and 4.8%, respectively. Bunker of Indeed says that the industries that tend to see the highest rate of departuresare those where pay is relatively low, such as leisure and hospitality. An unknown is whether employees are quitting these jobs to go to a new industry or whether they’re leaving for another job in the same industry. Either could be the case, says Bunker.
In a recently published article on the industries seeing the most worker departures, Bunker attributes the uptick to two factors—the strong labor market and faster wage growth in the industries concerned: “A stronger labor market means employers must fill more openings from the ranks of the already employed, who have to quit their jobs, instead of hiring jobless workers. Similarly, faster wage growth in an industry signals workers that opportunities abound and they might get higher pay by taking a new job.”
Even so, recession fears still dominate headlines. According to Bunker, the data shows that when a recession hits, employers pull back on hiring and workers don’t have the opportunity to find new jobs. Thus, workers feel less confident and are less likely to quit.
“As the labor market gets stronger, there’s more opportunities for workers who already have jobs. So they quit to go to new jobs or they quit in the hopes of getting new jobs again,” Bunker says. He also notes that recession fears may have little to do with the job market, instead stemming from what is happening in the financial markets, international relations or Washington, D.C.
So what does the BLS report say about the job market? “Taking this report as a whole, it’s indicating that the labor market is still quite strong, but then we lost momentum,” Bunker says. While workers are quitting their jobs, he says that employers are pulling back on the pace at which they’re adding jobs. “While things are quite good right now and workers are taking advantage of that,” he notes, “those opportunities moving forward might be fewer and fewer if the trend keeps up.”
-Samantha Todd; Forbes
No Seat At The Global Table For Indigenous African Cuisine
Gastronomic tourism based on African food could easily increase and create new value chains that unlock billions in untapped wealth for the continent, but what is stopping us?
Food and tourism are an integral part of most economies, globally. Food is undeniably a core part of all cultures and an increasingly important attraction for tourists. To satisfy their wanderlust, contemporary tourists require an array of experiences that include elements of education, entertainment, picturesque scenery and culinary wonders. The link between food and tourism allows destinations to develop local economies; and food experiences help to brand and market them, as well as supporting the local culture and knowledge systems.
This is particularly important for rural communities, where 61% of sub-Saharan Africans live, according to the World Bank last year. These communities have often felt the brunt of urbanization, which has resulted in a shift away from rural economies. If implemented effectively, Africa could get a piece of the gastronomic tourism pie, which was worth $8.8 trillion last year, according to the World Travel & Tourism Council.
However, there is currently very little public information to pique the interest of tourists about African food. World-renowned South African chef Nompumelelo Mqwebu sought to remedy this with her self-published cookbook, Through the Eyes Of An African Chef.
“I think where it was very clear to me that I needed to do something was when I went to cooking school. I trained at Christina Martin School of Food and Wine. I thought I was actually going to get training on South African food and, somehow, I assumed we were talking indigenous food.
“I was shocked that we went through the whole year’s curriculum and we didn’t cover anything that I ate at home; we didn’t cover anything that my first cousins, who are Sotho, ate in Nelspruit (in South Africa’s Mpumalanga Province); we didn’t cover anything that would come from eSwatini, which is where my mother is from,” Mqwebu says.
By self-publishing, she has ultimately contributed to a value chain that has linked local food producers and suppliers, which includes agriculture, food production, country branding and cultural and creative industries.
“I am a member of Proudly South African, not only my business, but the book as well. Part of the reason is that the cookbook was 100% published in South Africa. So, everybody who worked on the cookbook, and printing, was all in South Africa, which is something quite rare these days because authors have their books published abroad.”
The Proudly South African campaign is a South African ‘buy local’ initiative that sells her cookbook on their online platform as its production adheres to the initiative’s campaign standards. Self-publishing has allowed Mqwebu to promote her book for two years and to directly communicate with her audience in a way she thought was best, while exposing her to a vast community of local networks. She recalls her first step towards creating her own body of work.
“I was in culinary school when I wrote the recipe for amadumbe (potato of the tropics) gnocchi. We were making gnocchi and I thought, ‘so why aren’t we using amadumbe because it’s a starch?’ and when I tasted it, I thought, ‘this could definitely work’. I started doing my recipes then.
“And there was talk about, ‘we don’t have desserts as Africans’. I did some research and found we ate berries, we were never big on sugar to begin with. That’s why I took the same isidudu (soft porridge made from ground corn) with pumpkin that my grandmother used to make and that became my dessert. “I also found that when I went to libraries looking for indigenous recipes, I couldn’t really find something that spoke to me as a chef. I found content that looked like history books. It was not appealing. It was not something, as a chef, I could proudly present to another chef from a different part of the world, so I knew I had to write my book,” Mqwebu says about the award-winning recipe book that chronicles African cuisine.
Financial and health benefits
According to the World Travel & Tourism Council, in 2018, the tourism sector “contributed 319 million jobs, representing one in 10 of all jobs globally and is responsible for one in five of all new jobs created in the world over the last five years. It has increased its share of leisure spending to 78.5%, meaning 21.5% of spending was on business.”
To narrow in on how lucrative food can be, the World Food Travel Association estimates that visitors spend approximately 25% of their travel budget on food and beverages. The figure can get as high as 35% in expensive destinations, and as low as 15% in more affordable destinations. “Confirmed food lovers also spend a bit more than the average of 25% spent by travelers in general.”
However, there is a widely-held view that the African continent is not doing enough to maximize its potential to also position itself as a gastronomic tourism destination, using its unique edge of indigenous knowledge systems (IKS).
“We are not a culinary destination and we will never be while we are still offering pasta as the attraction for our tourists,” Mqwebu says.
Dr George Sedupane, who is the Coordinator of the Bachelor of the Indigenous Knowledge Systems program in South Africa’s North-West University, echoes Mqwebu’s sentiments.
“I often cringe when I go to conferences and there are guests from all over the world and we serve them pasta. Why would they come from Brazil to eat pasta here? They can have pasta in Italy. Why don’t we serve them umngqusho (samp and beans)?
“We need to be creating those experiences around our culture. We are failing to capitalize on our strengths. There is a lack of drive to celebrate what we have,” says Sedupane, who also teaches modules and supervises research in indigenous health and nutrition.
Writer and historian Sibusiso Mnyanda says current innovations in African food technology are born out of necessity, rather tourism and cultural ambitions.
“Food security is becoming an issue that is leading to IKS around farming being prioritized. In Nigeria, they are innovating dry season farming, because of deforestation and soil being de-cultivated.
“So those indigenous knowledge strategies are being used in countries where it is a necessity and where there are enough advances related to the fourth industrial revolution. The traditional ways of producing food are not only much more organic, they are also crop-efficient,” Mnyanda says.
Nigeria may have inadvertently innovated a health solution related to colon cancer through its diet. Sedupane tells FORBES AFRICA an anecdote.
“There was a study where the colons of an African country that did not consume a lot of meat was compared to Europeans. The Africans had a much better profile as a result and there are people who want to buy African stool to get that kind of rich bacteria, that you get on an African plant-based diet.”
The study Sedupane is referring to was conducted in Nigeria and it states that: “Nigeria showed the average annual incidence of colorectal cancer was 27 patients per year. This shows that even if it seems that incidence rates are increasing in Nigeria, such rates are still about one-tenth of what is seen in the truly developed countries.”
In a bid to find reasons for this rarity of colon and rectal cancer, the study concluded that, among other reasons, the protective effects of Nigeria’s starch-based, vegetable-based, fruit-based, and spicy, peppery diet, and geographical location which ensures sunshine all year round, played a role in the country’s colon health.
Interestingly, it seems the potential value of African food could not only be based on what goes in but what also comes out as healthy faecal matter is big business globally. In 2015, The Washington Post published that one could potentially earn $13,000 a year selling their poop.
The American-based company OpenBiome has been processing and shipping frozen stool to patients who are very sick with infections of a bacteria called C.difficile. It causes diarrhea and inflammation of the colon, leaving some sufferers house-bound. “Antibiotics often help, but sometimes, the bacteria rears back as soon as treatment stops. By introducing healthy faecal matter into the gut of a patient (by way of endoscopy, nasal tubes, or swallowed capsules), doctors can abolish C. difficile for good… And yes, they pay for healthy poop: $40 a sample, with a $50 bonus if you come in five days a week. That’s $250 for a week of donations, or $13,000 a year,” the publication stated.
Sedupane is of the view that a diet which includes indigenous foods could vastly improve one’s quality of life.
He says small changes could be made, such as including more of indigenous greens, namely sorghum and millet, to breakfast. The grains are gluten-free and produce alkaline which boosts the pH level of fluids in the body and reduces acidity.
“Moving to our legumes, we have indlubu (Bambara groundnut) which is very rich and helps in the secretion of serotonin in the brain. This so important nowadays with the increase of depression. It’s easy to digest, and is great for cholesterol and moderating blood sugar,” Sedupane says.
Mnyanda is also of the view that food is imperative to health and medicinal properties. He says traditional healers primarily use natural herbs in their practice. “These are used in pain relief and healing. Things like cannabis, camphor, African potatao and red carrots. So, food is not just used for nutritional purposes.”
Other African superfoods include, Baobab fruit, Hibiscus, Tamarind, Kenkiliba, Amaranth, Moringa and pumpkin leaves.
Cultural and historical benefits
Gastronomic tourism also includes the promotion of heritage sites that are known to revolve around dishes that are of historic importance. They enhance the travel experience, they encourage the acquisition of knowledge and a cultural exchange.
There is a unanimous view that vast amounts of knowledge have been lost to history and there is a huge knowledge gap in African societies as a result of colonization and urbanization.
“Part of the colonial agenda was to make sure food security did not belong to indigenous groups. Therefore, archiving of these knowledge systems was not a priority. Especially during industrialization, where people moved from their villages to the city you found that the knowledge got left behind,” Mnyanda says.
He offers a contemporary example of how modernization continues to push African practices to the fringes: “To this day, abathwa (the San people) hunt their meat, but you find that because of changing agricultural practices and land reform on the Kruger National Park, they are being forced to move into the cities and industrial areas, therefore they are no longer able to practice their culture of hunting. As a result, their diet is changing.” Sedupane shares the view that the fundamentals of farming and astrology have also been exiled from public knowledge.
“The fundamentals of IKS were based on the understanding of the laws of nature – how and when things were done. Harvest cycles were linked with understanding astrology. They would not harvest until certain stars were visible in the sky. There was a dependence on nature.
“With industrialization, rather than working with nature, humans are seen as being above, as controlling, as directing it. The natural cycle is often tempered with rather than trying to work with it.”
Not all is lost however. There are historical practices that have stood the test of time and continue to be a part the few foods that are internationally associated with South Africa. Mqwebu says that, “historically, we ate more plants than meat because our ancestors had to hunt and the game back then was not tame. So, there were no guarantees that you would return with meat. And that’s where things like umqwayiba (biltong) come from. They had to preserve the meat, because wasting was not part of the culture”.
According to a 2015 exploratory research project conducted under the guidance of research institute Tourism Research in Economic Environs and Society director Professor Melville Saayman, biltong contributes more than R2.5 billion ($163 million) to the South African economy.
Perhaps, like the faecal transporting company, Africa will soon realize the ‘wasted’ opportunity and that there is loads of money to be made in gastronomic tourism for all its inhabitants, whether they are rural or urban, technological or indigenous.
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