They’re all closed.



Movie Theaters. Bars. Nightclubs. Arenas. Cafes. In New York, Broadway and museums are shuttered. In San Francisco it’s even more dire. Across the country and the world, cities are shutting down, leaving humans from Seattle to Shanghai without traditional ways of finding distraction.



The mandate for social distancing that has proven essential at slowing the spread of the coronavirus will cut about $12 billion of entertainment revenue from the U.S. if the shutdown lasts until July,&nbsp;<a href="https://www.forbes.com/sites/rachelsandler/2020/03/16/cdc-all-americans-should-avoid-gathering-in-groups-of-more-than-10-people/#255b6cb5283d">as President Trump signaled</a>. Billions more are not being spent on creating new content as film and television production is frozen.&nbsp;



Things could get a lot worse.



“This is definitely unprecedented and turning everyone&#8217;s lives completely upside down,” says Ryan Borba, managing editor at concert tracker Pollstar.



The concert and live event industry brought in $34 billion last year,&nbsp;<a href="https://www.ibisworld.com/united-states/market-research-reports/concert-event-promotion-industry/" target="_blank" rel="noreferrer noopener">according to market research firm IBISWorld</a>. Simple math suggests that a three-month shutdown at this time of year could cost that industry $7 billion of lost revenue. Any longer and it starts to cut into the&nbsp;<a href="https://www.forbes.com/sites/zackomalleygreenburg/2020/03/06/as-coronavirus-cancels-sxsw-coachella-could-be-next-as-music-industry-braces-for-a-cruel-summer/#24e8eb076886">popular summer concert season</a>, which for LiveNation, the world’s biggest concert promoter, is when 70% of its attendance begins passing through the turnstiles. That’s bad news for the producers, songwriters, technicians and the&nbsp;<a href="https://www.ibisworld.com/united-states/market-research-reports/concert-event-promotion-industry/" target="_blank" rel="noreferrer noopener">269,025 concert employees</a>, including janitors, security personnel and ticket collectors. That’s not to mention the world’s&nbsp;<a href="https://www.forbes.com/sites/zackomalleygreenburg/2019/12/06/the-worlds-top-earning-musicians-of-2019/">top-earning musicians</a>, all of whom make the majority of their money performing.&nbsp;



“We’re beginning to see it affect the entire music ecosystem,” one prominent artist manager who <a href="https://www.forbes.com/sites/zackomalleygreenburg/2020/03/06/as-coronavirus-cancels-sxsw-coachella-could-be-next-as-music-industry-braces-for-a-cruel-summer/#20fa6f7d6886">told Forbes</a> on the condition of anonymity. “We’re getting calls from our agents about promoters canceling individual shows. Songwriters and producers have canceled flights into L.A. for sessions, so it’s starting to trickle down to the songwriting and production communities as well.”



On New York’s Broadway, where all 41 theaters are closed, the hit could be about $600 million, based on the amount they pulled in between mid March and July of 2019. During the 2016-2017 season, those theaters also supported more than 87,000 jobs and contributed $12.63 billion to New York City’s economy, according to&nbsp;<a href="https://www.broadwayleague.com/research/research-reports/" target="_blank" rel="noreferrer noopener">Broadway League</a>.



The effect on movie theaters is far more drastic. A complete shutdown across the U.S. will mean a $4 billion hit on the box office if they remain closed until July. On March 18, less than a month into the crisis, the national association of theater owner&nbsp;<a href="https://apnews.com/734c2aad0321b93811a13273c112d21f" target="_blank" rel="noreferrer noopener">requested a bailout</a>&nbsp;from the government.



“From the point of view of studios they are hemorrhaging money on the movie side,” says Mike Bloxham the senior vice president of global media and entertainment at research firm Magid.&nbsp;“There is a lot of money disappearing in China while 70,000 theaters are still closed.”



Once they do reopen, distributors will begin battling to squeeze a large number of films into a limited number of opening dates, including&nbsp;<a href="https://www.forbes.com/sites/maddieberg/2020/03/12/hollywood-braces-for-coronavirus-slump-the-movie-releases-pushed-back-so-far/#3be198ba2bed">some major releases</a>&nbsp;that include the latest&nbsp;James Bond&nbsp;movie, Disney’s&nbsp;Mulan&nbsp;and Marvel’s&nbsp;Black Widow, all of which have been&nbsp;<a href="https://www.forbes.com/sites/maddieberg/2020/03/12/hollywood-braces-for-coronavirus-slump-the-movie-releases-pushed-back-so-far/#ad8a4d02bed6">pushed back</a>.



“No one can precisely predict when public life will return to normal, but it will return,” Patrick Corcoran, the president of the National Association of Theater Owners, said in a statement on Match 17. “When those titles are rescheduled, they will make for an even fuller slate of offerings than normal as they are slotted into an already robust release schedule later in the year.”



Last year, entertainment companies spent $121 billion to create original content and they were expected to spend even more this year as new platforms, like short-form video platform Quibi, emerge and streaming giants like Netflix and Amazon Prime continue to plow through cash to produce new shows that lure in subscribers. Disney, Netflix, Universal and a number of other studios have all but&nbsp;<a href="https://www.forbes.com/sites/maddieberg/2020/03/13/hollywood-studios-disney-netflix-halt-film-and-tv-production-amid-coronavirus/#327ea2195d28">shut down U.S. production</a>. In California alone, that activity supported more than 722,000 jobs and $68 billion in wages, according to the Motion Picture Association of America. In New York City, television and film production support about 10% of total employment, whether directly or indirectly, and generates almost $9 billion each year.



“Right now, we’re working to keep everyone safe, support the industry and find ways to help it come back stronger than ever,” a spokesperson for Mayor’s Office of Media and Entertainment said.



The sentiment mirrored that of Colleen Bell, the executive director of California’s Film Commission who said, “The entertainment production industry in California has overcome challenges in the past, and it will endure this sudden shutdown. Until the COVID-19 situation improves, the focus is rightfully on the public health crisis. After that’s behind us, the industry will once again thrive here in the Golden State.”



While those logistics will reverberate widely across show business sectors, consumers may be in for even bigger, long-lasting changes.&nbsp;



For TV shows, the near-term effects could be disappointing for fans looking forward to fresh episodes of their favorite shows. FX’s&nbsp;Fargo&nbsp;has shut down production and will have to delay new episodes. More series are sure to follow. Streamers have already changed the way we watch TV—introducing binge-watching and slowly eliminating cable subscriptions—and the more that cable and broadcast series are delayed, the more likely we will continue to move away from the appointment viewing of television’s past.



In film, a far more dramatic shift just happened: consumers may no longer need to fight crowds at movie theaters on opening nights. Universal Studios announced Monday that it would begin releasing films like&nbsp;Invisible Man, Emma&nbsp;and&nbsp;The Hunt&nbsp;available for in-home, on-demand rentals despite the fact that these films were only recently released, blowing up the entrenched windowing schedule that gave theater chains exclusive rights to show movies first before they were released to in-flight entertainment, rental platforms and then television. Sony followed, releasing Vin Diesel’s&nbsp;Bloodshot&nbsp;for digital purchase only 11 days after its theatrical release.



Others will likely do same and if they do, it could&nbsp;lead the Academy of Motion Picture Arts and Sciences to&nbsp;<a href="https://www.marketwatch.com/story/oscars-keep-rule-requiring-movies-to-have-theatrical-release-to-be-nominated-2019-04-24" target="_blank" rel="noreferrer noopener">change their theatrical-release&nbsp;</a><a href="https://www.marketwatch.com/story/oscars-keep-rule-requiring-movies-to-have-theatrical-release-to-be-nominated-2019-04-24" target="_blank" rel="noreferrer noopener">rule</a>,&nbsp;which only allows films that open in a theatre and stay there for seven days to be considered for Oscars. It may also prompt Netflix to tighten its grip on the entertainment business with the purchase of a theater chain of its own. In 2018, the streaming giant looked at buying Landmark Theatres, but Cohen Media Group beat Netflix to the arthouse chain.



“If this continues for a long time, that will cause a change in how we consume content and allow newer titles to get to home video much faster,” says Asaf Ashkenazi, the COO of Verimatrix, a technology company that works with distributors in Hollywood. “If it’s a new title, you can delay it, continue to follow the traditional system and just wait. Or you can be more experimental and go directly to selling or renting online, which will allow more people to access it and get the revenue now.“&nbsp;



Other businesses are also turning to streaming, including&nbsp;<a href="https://www.forbes.com/sites/zackomalleygreenburg/2020/03/18/zombie-jamboree-for-a-struggling-livestream-startup-coronavirus-lockdown-offers-one-last-chance/#7811d2e15e24">concert-streamer StageIt</a>. The startup, which offers concerts from the likes of Jon Bon Jovi and Sara Bareilles, is on track to have revenue of $250,000 this week—about the same as its best month until now—and added&nbsp;10,000 subscribers in two days while hosting virtual festival “Shut In &amp; Sing.” Even New York’s Metropolitan Opera is in on it,&nbsp;<a href="https://operawire.com/metropolitan-opera-to-offer-up-nightly-met-opera-streams/" target="_blank" rel="noreferrer noopener">streaming nightly performances</a>.



The stars themselves are also shifting their approach to how they entertain and communicate with fans. “Together, at Home,” a new series of online concerts presented by the World Health Organization (WHO) and Global Citizen, has recruited Chris Martin and John Legend to give casual concerts from their living rooms via Instagram Live, taking requests from fans and singing songs like David Bowie’s “Life on Mars.” Using Instagram, pop star Lizzo led a meditation, Frozen’s Josh Gad read kids a story, and, on Twitter, Yo-Yo Ma played a “<a rel="noreferrer noopener" href="https://twitter.com/YoYo_Ma/status/1238572657278431234" target="_blank">song of comfort.</a>” Entertainers have already <a rel="noreferrer noopener" href="https://www.nytimes.com/2019/10/15/style/celebrity-phone-numbers.html" target="_blank">fully embraced </a>this kind of direct connection with fans and the pandemic may only accelerate that.



&#8211;<a href="https://www.forbes.com/sites/maddieberg/">Madeline Berg</a>, Forbes Staff, <a href="https://www.forbes.com/media">Media</a>

High angle view of audience enjoying comedy movie at cinema hall

Coronavirus Could Be A $12 Billion Hit To Entertainment And Audiences May Never Be The Same

As the COVID-19 coronavirus makes its way around the world, it’s increasingly likely that people will be exposed to the virus, which can resemble other flus and colds but — becomes increasingly dangerous as it gets more severe.&nbsp;



Here’s a quick guide to COVID-19 symptoms, what to do if you have symptoms, and when you should see a doctor. It can take 2-14 days for symptoms to actually appear after exposure to the disease,&nbsp;<a href="https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html" target="_blank" rel="noreferrer noopener">according to the Centers for Disease Control</a>, and when symptoms do appear, they tend to start gradually and become worse.



The main symptoms to look out for are:&nbsp;



<ul class="wp-block-list"><li>Fever</li><li>Shortness of breath</li><li>Coughing, usually dry (meaning little or no phlegm)</li></ul>



The World Health Organization adds that&nbsp;<a href="https://www.who.int/news-room/q-a-detail/q-a-coronaviruses" target="_blank" rel="noreferrer noopener">less common symptoms</a>&nbsp;may also include “aches and pains, nasal congestion, runny nose, sore throat or diarrhea.”&nbsp;&nbsp;



As you may have noticed, these symptoms apply to many other diseases as well. It’s impossible to tell whether you have COVID-19 without a test, and in some areas, there’s a shortage of tests. In the United States, the CDC is&nbsp;<a rel="noreferrer noopener" href="https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html" target="_blank">currently advising doctors</a>&nbsp;to give tests to:



<ul class="wp-block-list"><li>Patients already hospitalized who are showing symptoms</li><li>Patients showing symptoms who have other chronic illnesses that put them at higher risk, such as lung disease, heart disease, or diabetes</li><li>Patients showing symptoms who, within the past 14 days, had been exposed to someone who has a confirmed or suspected case of COVID-19&nbsp;</li></ul>



If you have mild symptoms and aren’t at risk, the CDC&nbsp;<a href="https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html" target="_blank" rel="noreferrer noopener">advises against</a>&nbsp;seeing a doctor.&nbsp; Instead, it recommends that you:&nbsp;



<ul class="wp-block-list"><li>Stay home and avoid public areas.&nbsp;</li><li>Try to separate yourself from the people you’re living with, even to the point of using a different bathroom, if possible</li></ul>



If you belong to a high-risk group, you should call your doctor to discuss what you may need. More advice about what to do when you’re home sick, including tips on cleaning and other care, can be&nbsp;<a href="https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html" target="_blank" rel="noreferrer noopener">found here</a>.



If you have more severe symptoms such as a high fever, shortness of breath, chest pain, bluish lips or a bluish hue in your face, you should see a doctor immediately. If possible, call ahead to your healthcare provider and let them know you’re on your way and suspect the symptoms are related to COVID-19. That enables them to adequately prepare for you and protect both employees and other patients from possible exposure.&nbsp;



One thing to note: right now researchers think it’s possible for people to be contagious with COVID-19 before showing any symptoms. The World Health Organization also notes that some people who are infected never appear to show symptoms or feel unwell, yet are still able to pass on the disease.&nbsp;



So even if you’re feeling healthy, it’s good to follow your local health authority’s&nbsp;<a href="https://www.forbes.com/sites/brucelee/2020/03/14/with-covid-19-coronavirus-here-are-10-ways-to-social-distance-yourself/#2caf43e9606c">guidelines about social distancing</a>&nbsp;in order to&nbsp;<a href="https://www.forbes.com/sites/tarahaelle/2020/03/13/why-everything-is-closing-for-coronavirus-its-called-flattening-the-curve/#1cef0c656e2b">decrease the risk</a>&nbsp;of spreading the disease further. Also, don’t forget to regularly and thoroughly&nbsp;<a href="https://www.forbes.com/sites/ninashapiro/2020/03/15/soap-and-water-1o1-why-its-best-for-covid-19-and-every-day/">wash your hands with soap and water</a>.&nbsp;



&#8211;<a href="https://www.forbes.com/sites/alexknapp/">Alex Knapp</a>, Forbes Staff, <a href="https://www.forbes.com/science">Science</a>

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What Are The Symptoms Of COVID-19 Coronavirus, And When Should You See A Doctor?

Topline: As the number of coronavirus cases surpasses <a rel="noreferrer noopener" href="https://www.nytimes.com/interactive/2020/world/coronavirus-maps.html?action=click&amp;pgtype=Article&amp;state=default&amp;module=styln-coronavirus&amp;variant=show&amp;region=TOP_BANNER&amp;context=storyline_menu" target="_blank">110,000 people</a> worldwide, with more reported daily, the federal government has issued a number of travel advisories⁠—here’s where to avoid, and where it’s probably okay to visit: 



<ul class="wp-block-list"><li>The&nbsp;<a href="https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html" target="_blank" rel="noreferrer noopener">Centers for Disease Control</a>&nbsp;has three levels of travel advisories, with Level 1 being the lowest caution and Level 3 being the highest (with China, Iran, Italy and South Korea on that Level 3 list).</li><li>The CDC has designated Japan with a Level 2 advisory due to ongoing community transmission of the disease, which means older people and people with chronic underlying medical conditions should reconsider traveling there, while Hong Kong is a Level 1 advisory, based on its risk of limited community transmission.</li><li>The&nbsp;<a href="https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/" target="_blank" rel="noreferrer noopener">State Department</a>&nbsp;also has a four tier travel advisory system, with Level 4 being the most severe warning, and says travel to Level 3 countries Azerbaijan, Mongolia and Turkmenistan should be reconsidered due to the outbreak; the department released a&nbsp;<a href="https://travel.state.gov/content/travel/en/traveladvisories/COVID-19-Country-Specific-Information.html" target="_blank" rel="noreferrer noopener">complete country-by-country advisory database</a>&nbsp;on Monday specifically for coronavirus.</li><li>“I think you can go anywhere [internationally] if you don’t mind being delayed by 14 days,” said Dr. Amesh Adalja, an infectious diseases scholar at Johns Hopkins University, adding, “it’s not in terms of ‘it’s safe’ or ‘not safe,’ but logistically feasible to get home in time” if a traveler is quarantined.</li><li>Adalja said that domestic travel within the U.S. is safe for most people, (and the CDC&nbsp;<a href="https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html" target="_blank" rel="noreferrer noopener">hasn’t recommended</a>&nbsp;travel restrictions within the U.S.) but “if you’re older or have underlying medical conditions, reconsider nonessential travel because we are likely seeing more community spread.”</li><li>“We have to dispel the notion that coronavirus is a travel-related illness,” said Adalja, because the virus has likely been spreading since November, and health officials are catching up to containment and treatment.</li></ul>



Crucial quote: &#8220;We already have community transmission within the United States,&#8221; Shira Doran, an infectious disease specialist at Tufts University, <a rel="noreferrer noopener" href="https://www.npr.org/sections/goatsandsoda/2020/03/06/812650868/coronavirus-travel-tips-to-fly-or-not-to-fly-what-happens-if-you-cancel" target="_blank">told NPR</a> Friday. &#8220;So, at some point, it&#8217;s not going to be any riskier to go to another country than it is to stay right here.&#8221;



Key background:&nbsp;The coronavirus outbreak has&nbsp;<a href="https://www.forbes.com/sites/isabeltogoh/2020/02/28/updated-here-are-the-destinations-affected-by-coronavirus-flight-cancellations-and-travel-bans/#4b33e377cd68">thrown a wrench</a>&nbsp;into travel worldwide, with numerous airlines cancelling flights, cruise ships quarantining passengers and even domestic trains, such as&nbsp;<a href="https://www.theverge.com/2020/3/7/21169393/amtrak-canceling-nonstop-acela-new-york-washington-dc-coronavirus" target="_blank" rel="noreferrer noopener">Amtrak’s Acela</a>, canceling service between major cities. Travelers around the world have been quarantined as countries work to contain the disease. Multiple&nbsp;<a href="https://www.npr.org/2020/03/03/811728989/coronavirus-cancellations-and-travel-bans-google-is-latest" target="_blank" rel="noreferrer noopener">businesses</a>&nbsp;and corporations have suspended travel for employees. Major conferences and events, like the&nbsp;<a href="https://www.forbes.com/sites/carlieporterfield/2020/03/06/sxsw-cancelled-amidst-coronavirus-fears/">South By Southwest</a>&nbsp;music and culture festival, have also been called off. The CDC has recommended travelers avoid all nonessential travel to Level 3 countries⁠: China, Iran, Italy and South Korea. (Entry by Chinese and Iranian nationals has also been suspended due to the outbreak). And the State Department has advised against all traveling by cruise ships.



Tangent: 15 countries. <a rel="noreferrer noopener" href="https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/" target="_blank">That’s how many</a> are designated “Level 4, Do Not Travel” by the State Department. But only one country⁠—China, where the coronavirus is believed to have originated⁠—was designated Level 4 due to the outbreak.



&#8211; <a href="https://www.forbes.com/sites/lisettevoytko/">Lisette Voytko</a>, Forbes Staff, Business

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Here’s The Worst Places To Travel Because Of The COVID-19 Coronavirus Outbreak

Millions of Americans&nbsp;<a href="https://www.nami.org/learn-more/mental-health-by-the-numbers" target="_blank" rel="noreferrer noopener">deal with mental illness</a>&nbsp;each year, and&nbsp;<a href="https://mhanational.org/sites/default/files/2019-09/2019%20MH%20in%20America%20Final.pdf" target="_blank" rel="noreferrer noopener">more than half of them</a>&nbsp;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.&nbsp;



Still a nascent industry, with most startups in the early&nbsp;<a href="https://www.cbinsights.com/reports/CB-Insights_Mental-Health-Briefing.pdf?utm_campaign=Webinars&amp;utm_medium=email&amp;_hsenc=p2ANqtz-9vLgEn6AfsUf_nXfn8UtBBrkhgfEFm7LsQrRFoI68CJsrXrU-zXKTi8M0sgpMW0unONnbLsAVUe6BO0cr2Vj1A0ZPhQiu4178Y2bOAidtpFApBFyw&amp;_hsmi=55818280&amp;utm_content=55818280&amp;utm_source=hs_automation&amp;hsCtaTracking=8133605e-ef8d-41b5-add2-a79fc7aa7322%7Cf61454a1-0ed7-46eb-87c7-40f56ce494c0" target="_blank" rel="noreferrer noopener">seed-stage funding round</a>, these companies say they aim to increase access to qualified mental health care providers and reduce the social stigma that comes with seeking help.&nbsp;



While the <a rel="noreferrer noopener" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5897664/#__sec1title" target="_blank">efficacy of virtual therapy,</a> compared with traditional in-person therapy, is still being <a rel="noreferrer noopener" href="https://www.thecut.com/2016/12/the-potential-danger-in-therapy-apps-like-talkspace.html" target="_blank">hotly debated</a>, 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&nbsp;<a href="https://pitchbook.com/news/articles/a-look-at-the-boom-in-vc-funding-for-mental-health-startups" target="_blank" rel="noreferrer noopener">Pitchbook</a>. 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&nbsp;<a href="https://www.northwesternmutual.com/life-and-money/how-much-does-therapy-cost-and-how-do-you-pay-for-it/" target="_blank" rel="noreferrer noopener">go as high as $200</a>&nbsp;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.&nbsp;



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.&nbsp;“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.&nbsp;



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.”&nbsp;&nbsp;



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.&nbsp;



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 &#8220;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.



&#8211; Ruth Umoh, Diversity and Inclusion Writer, Forbes Staff.

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How Virtual Therapy Apps Are Trying To Disrupt The Mental Health Industry

Data from South Africa has shown that&nbsp;<a rel="noreferrer noopener" aria-label=" (opens in a new tab)" href="https://www.iol.co.za/lifestyle/health/sa-a-growing-nation-of-obese-adults-1763279" target="_blank">over two thirds of young women</a> are overweight and obese. This predisposes them to non-communicable diseases such as diabetes and hypertension. Most women are not exercising enough, and consumption of processed and calorie-dense foods and high amounts of sugar is common.



It was this knowledge that sparked the establishment of the&nbsp;<a rel="noreferrer noopener" aria-label=" (opens in a new tab)" href="http://ahd.ca/research/helti-south-africa" target="_blank">Health Life Trajectories Initiative</a>. It’s being run in South Africa, India, China and Canada and aims to provide interventions that can help young women stay healthy before, during and after pregnancy. 



In South Africa, this randomised controlled trial will provide one-on-one support as well as peer group sessions to over 6000 young women. The idea is provide them with information, and to help them set and maintain goals for healthier lifestyles.



Researchers from the Medical Research Council and Wits University’s&nbsp;<a rel="noreferrer noopener" aria-label=" (opens in a new tab)" href="https://www.wits.ac.za/dphru/" target="_blank">Developmental Pathways for Health Research Unit</a>&nbsp;are running the South African arm of the study. We wanted to start by better understanding our target population – that is, young women aged between 18 and 24 living in Soweto. 



READ MORE | <a rel="noreferrer noopener" aria-label="Local Solutions Can Boost Healthier Food Choices In South Africa (opens in a new tab)" href="https://www.forbesafrica.com/health/2019/03/15/local-solutions-can-boost-healthier-food-choices-in-south-africa/" target="_blank">Local Solutions Can Boost Healthier Food Choices In South Africa</a>



Soweto is a large, densely populated urban township which comprises one third of Johannesburg’s population. Soweto is becoming rapidly urbanised, but the majority of people are still very poor and struggle to provide food for their families.



<a href="https://www.sciencedirect.com/science/article/pii/S1499404619301782" target="_blank" rel="noreferrer noopener" aria-label=" (opens in a new tab)">We conducted</a>&nbsp;a series of focus group discussions and in depth interviews to unravel health behaviours, barriers and facilitators to wellbeing and health with young women from Soweto who had not yet had a child. We also asked them about what sorts of interventions they’d prefer to support and guide them.



The women offered important insights that showed it’s not enough to simply promote healthy eating and exercise without considering the very real environmental and structural constraints present in South Africa.



<h2 class="wp-block-heading">Barriers to healthy choices</h2>



The 29 participants spoke about many different facets of health. These included happiness and mental wellbeing, faith, social support, body image, and lifestyle behaviours.



They identified many barriers to healthy eating, among them the cost of and access to healthy food options. Some women also said they had little access to exercise facilities such as gyms and were afraid to exercise on the streets because they feared being assaulted or harassed. One woman said:



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">No, I don’t feel safe because we have drug addicts, traffic, women trafficking: it’s not safe for us to walk in the streets.</blockquote>



The women we interviewed painted a picture of an environment in which healthy behaviours are difficult to implement or sustain. One said:



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">Small businesses that are opening up in my community and they all sell fries, literally they just all sell fries…</blockquote>



Women told us that cheap and unhealthy fast foods are on every street corner: “bunny chow” – hollowed out bread stuffed with curry – vetkoek (a fried dough bread stuffed with different fillings) and fried chips are affordable and available within a few steps of most houses. As a result, women did not want to go out of their way to purchase healthier, more expensive foods.



Our interviewees also didn’t feel able to demand that healthier food be bought for their homes, because many were not contributing financially and were therefore not in a position to control food purchases. Women reported being financially dependant on relatives and male partners.



READ MORE | <a rel="noreferrer noopener" aria-label="New Ways Of Thinking On Health, Arts And Humanities Are Emerging In Africa (opens in a new tab)" href="https://www.forbesafrica.com/arts/2019/05/10/new-ways-of-thinking-on-health-arts-and-humanities-are-emerging-in-africa/" target="_blank">New Ways Of Thinking On Health, Arts And Humanities Are Emerging In Africa</a>



<h2 class="wp-block-heading">Exercise</h2>



They also said that opportunities for physical activity were neither provided nor prioritised for women in Soweto. Some women said that a lack of facilities made it difficult for them to participate in any exercise, as they did not have access to gyms or fields to exercise.



Other women told us that there were gyms, sports grounds, parks, and even free aerobics classes at community halls in their area. However these facilities often get vandalised quickly, and can no longer be used. More importantly, they didn’t feel safe enough to exercise on the streets, perhaps by jogging or running. They also felt unsafe walking around in leggings or tights. Women were fearful of human trafficking, sexual assault, and violence –&nbsp;<a href="http://www.samj.org.za/index.php/samj/article/view/12218" target="_blank" rel="noreferrer noopener" aria-label=" (opens in a new tab)">very real issues in this community</a>.



Crucially, our research found that young women did not see obesity as a sufficient reason to change their behaviour. But they said they would be motivated to exercise and eat better if they were diagnosed with a non-communicable disease like diabetes.



This suggests that obesity has become normalised in South Africa – and this needs to be addressed.



<h2 class="wp-block-heading">Policy interventions</h2>



These findings are now being worked into our interventions, and we are cognisant of the contextual realities that may affect young women’s ability to change their lifestyles. We hope that this research, along with whatever findings emerge from our interventions, will inform policy makers and motivate them to implement necessary changes in this community.



Women in Soweto and in South Africa in general need support to live healthier lifestyles. This support needs to come from policy makers. If South Africa does not step up and support young women by providing them with access to safe spaces and affordable healthier foods, and by controlling the oversupply of unhealthy options, the country may not be able to curb its ever increasing rise in obesity and related non-communicable diseases.



-Alessandra Prioreschi: Associate Director and Researcher at the Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand



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Young women in Soweto, South Africa, say healthy living is hard. Here’s why

Imagine bringing the best of all academic disciplines, artistic creations, activist experience and health care knowledge to bear on understanding and addressing current health care concerns. Rather than silos of people working in their specific areas of interest, imagine collaborations committed to listening and learning from all participants.



This is the vision of Medical and Health Humanities in Africa. It’s a field that grew out of <a href="https://wiser.wits.ac.za/medical-humanities">the medical </a><a href="https://wiser.wits.ac.za/medical-humanities" target="_blank" rel="noreferrer noopener" aria-label="humanities  (opens in a new tab)">humanities </a>in the US and <a href="https://www.dur.ac.uk/imh/research/">UK</a>. It brings together academics, researchers, practitioners, creative artists, health care seekers and providers.



Essentially, it straddles disciplines and practices in an effort to address health concerns. Artists compose music to open up understandings of health care and specific conditions, such as <a href="https://victoriahume.com/delirium">delirium</a>. Some academics open up new conversations about existing health concerns like <a href="https://uct.academia.edu/CarlaTsampiras">AIDS</a> or use everything from yoga to photography to <a href="https://www.lateralleap.co.za/publications/">observation and drawing</a> to help educate health sciences students. Others pair academics and artists to help young people talk about <a href="https://wellsexuality.com/" target="_blank" rel="noreferrer noopener" aria-label=" (opens in a new tab)">sex and sexuality</a> or <a href="https://ehwoza.com/">tuberculosis</a>.



At its core, Medical and Health Humanities is about conversations and collaborations between people who are interested in health. This encourages new understanding, practice and knowledge. It also seeks to provide “translators” who can make often complex ideas in science and humanities accessible. They can also use creative arts to change perceptions, frame new questions and direct new discussions that result in more nuanced answers to health issues.



While still a relatively new field on the African continent, it is growing and gaining momentum. The latest milestone is the first English-language special issue of the globally respected&nbsp;<a href="https://mh.bmj.com/">BMJ Medical Humanities Journal</a>&nbsp;to deal exclusively with work on and about medical and health humanities in Africa.



The special issue came out in December 2018. It showcases work from various countries in Africa, among them Nigeria, Malawi, Kenya, Tanzania and South Africa.



The projects profiled in this special issue, and others elsewhere on the continent, reveal the vital role Medical and Health Humanities can play across Africa in bridging the gaps between disciplines to improve people’s experiences of health care.



<h4 class="wp-block-heading">Beyond disciplinary boundaries</h4>



One of the Medical and Health Humanities projects highlighted in the BMJ’s special edition deals with digital storytelling and antiretroviral adherence in&nbsp;<a href="https://mh.bmj.com/content/44/4/239">KwaZulu-Natal, South Africa</a>. Another article shows how&nbsp;<a href="https://mh.bmj.com/content/44/4/253">opium, thalidomide and contraceptives</a>&nbsp;contributed to the making of modern South Africa.



The projects and articles themselves are, of course, important. But another critical element that must not be overlooked is how the field exemplifies inter-, trans- and multidisciplinary research and practice. It removes people from their disciplinary silos.



This is becoming increasingly important across academia. In the worlds of medicine and health, people often work on similar concerns in familiar ways; in doing so, they miss out on <a href="https://mh.bmj.com/content/41/1/2">new perspectives</a>. Working across disciplines and practices is a way to learn from each other and reflect on how things could be changed for the better.



And, crucially, it creates conversations about how we might improve our collective understanding of health and wellness.



<h4 class="wp-block-heading">Different forms</h4>



On the African continent, the Medical and Health Humanities community is also trying to do things differently when it comes to how research is conducted and presented.



If a field is genuinely committed to collaboration, collective engagement, building networks and relationships, it must do more than work quickly to “produce measurable outcomes” limited to academic articles. It must spend time building connections that extend beyond one event or “outcome”.



We attempted to do this during the writing of the special issue of the BMJ Medical Humanities journal. We were among a group of practitioners in South Africa who pooled resources from two universities to bring as many people who were working on the special issue together as possible. We wanted to ensure that experienced and emerging writers from multiple disciplines and practices had a chance to benefit from each other’s knowledge and experiences.



A workshop was held in 2017 at the Wits Institute for Social and Economic Research (WiSER). Participants came from Zimbabwe, Kenya, Nigeria, Tanzania, Malawi, Swaziland, South Africa, the UK and Canada and presented and discussed their work.



From this, people put together a range of material for the journal and the <a href="https://blogs.bmj.com/medical-humanities/">blog</a> linked to the special edition. Some of this material took the form of academic articles; there are also podcasts, photographs, pieces of music, images and poetry.



This allowed us to present creative and academic work in a format that was more accessible to those with digital access and moved beyond academic journals. After all, part of what the field is concerned with is maintaining critical, intellectual rigour while making information available to people in a number of ways. In doing this the field tries to break down some of the barriers that prevent people from sharing work or ideas.



<h4 class="wp-block-heading">New networks</h4>



There is more to come for the Medical and Health Humanities field in Africa. A group called the <a href="https://medicalandhealthhumanitiesafrica.wordpress.com/">Medical and Health Humanities Africa network</a>has been established. CODESRIA, the Council for the Development of Social Science Research in Africa, among others, has been drawn into discussions about growing the field’s networks on the continent. The second conference organised by the <a rel="noreferrer noopener" aria-label=" (opens in a new tab)" href="https://malawimedhumsnetwork.wordpress.com/" target="_blank">Malawi Medical Humanities Network</a> will be held in Zomba, Malawi in August and a workshop in Johannesburg in March called State of Dis-ease will continue these exciting new conversations.



-Carla Tsampiras; Senior Lecturer in Medical Humanities, University of Cape Town



-Nolwazi Mkhwanazi; Senior researcher, Wits Institute for Social and Economic Research, University of the Witwatersrand



&#8211;The Conversation

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New Ways Of Thinking On Health, Arts And Humanities Are Emerging In Africa

Tim Hogins’ concept of the outdoor gym is to make health and wellness accessible to all.

Tim Hogins was 11 and selling sweets on the streets when he would look longingly at the queues of people waiting to board the bus to the plush Sun City resort in South Africa.
It was a forbidden world of play and luxury and he was quietly determined to one day build one of his own everyone could access.
The former delivery boy and security guard who grew up in dusty Randfontein in South Africa is today the CEO of Green Outdoor Gyms (GOG), an outdoor health, wellness and lifestyle company growing in size.
<div id="attachment_37215" style="width: 310px" class="wp-caption alignleft"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-37215" class="size-medium wp-image-37215" src="https://www.forbesafrica.com/wp-content/uploads/2018/09/GOG-Park-Gym-Equipment-03.08.2018-83-1-300x200.jpg" alt="" width="300" height="200" srcset="https://cms.forbesafrica.com/wp-content/uploads/2018/09/GOG-Park-Gym-Equipment-03.08.2018-83-1-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2018/09/GOG-Park-Gym-Equipment-03.08.2018-83-1-600x400.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2018/09/GOG-Park-Gym-Equipment-03.08.2018-83-1-768x513.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2018/09/GOG-Park-Gym-Equipment-03.08.2018-83-1-1024x684.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2018/09/GOG-Park-Gym-Equipment-03.08.2018-83-1.jpg 2048w" sizes="auto, (max-width: 300px) 100vw, 300px" />A GOG lifestyle park in Lanseria, Johannesburg</div>
When we meet him, the 39-year-old entrepreneur, who once sold koeksisters (sticky spicy treats), offers a table laden with sweets, savouries and fruit. Hogins helps himself to a slice of banana bread as he begins to tell his story. 
“Growing up poor is actually a good thing. It gave birth to ambition, it gave birth to my desire to be successful,” he says.
<a href="http://www.forbesafrica.com/entrepreneurs/2018/04/09/painting-houses-building-1-95-billion-development/" target="_blank" rel="noopener">READ MORE: From Painting Houses To Building A $1.95-Billion Development</a>
“The outdoor gym concept was born because I saw kids doing push-ups and pull-ups in the park.” 
Hogins’ parents died when he was in his 20s. “That is where the Tim Hogins story started,” he says. 
He invested capital with a friend to launch his pet outdoor gym project. GOG’s first park was in the township of Soweto.
“GOG is for the everyday person who cannot afford commercial and expensive gyms. It also doesn’t hinder the high-earning people from using it. South Africa is a family-oriented country, and soon we will have people at the gyms from all walks of life,” he says.
To date, GOG has installed 388 outdoor gyms in South Africa. The company has built two lifestyle parks in Gauteng with a third to follow at the end of the year.
“The health and fitness industry is the largest in the world and it grows year-on-year. I saw an opportunity from a health and fitness perspective. People want to live longer, they want to live healthier so they spend money on health and fitness,” says Hogins.
Growing up, he was no stranger to entrepreneurship.
<img loading="lazy" decoding="async" class="size-medium wp-image-37214 alignright" src="https://www.forbesafrica.com/wp-content/uploads/2018/09/GOG-Park-Gym-Equipment-03.08.2018-14-300x194.jpg" alt="" width="300" height="194" srcset="https://cms.forbesafrica.com/wp-content/uploads/2018/09/GOG-Park-Gym-Equipment-03.08.2018-14-300x194.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2018/09/GOG-Park-Gym-Equipment-03.08.2018-14-600x389.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2018/09/GOG-Park-Gym-Equipment-03.08.2018-14-768x498.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2018/09/GOG-Park-Gym-Equipment-03.08.2018-14-1024x664.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2018/09/GOG-Park-Gym-Equipment-03.08.2018-14.jpg 2048w" sizes="auto, (max-width: 300px) 100vw, 300px" />
“My dad was trying to survive. We had a café. But as you know a café does not make much money. On the side, he tried to do some construction, and my mom, because of the circumstances, decided to sell too. All my life my parents were selling something. My mom sold koeksisters and cakes; she became a caterer. There were always people at my house buying something, be it sweets, be it toffee apples…We sold whatever,” he recollects.
In his quest to build outdoor wellness areas, many a time it meant turning dusty pieces of land into landscaped spaces.
<blockquote>“In many instances, we literally transformed a dumping site into an outdoor gym. One instance you see a dumping site and the next you see kids on swings and gym equipment all around,” he says.</blockquote>
Engaging the community, GOG also uplifts the areas it operates in.
With hopes to list on the Johannesburg Stock Exchange next year, Hogins will give his staff an opportunity to invest in his vision.

09.05.2018-65

Turning Dusty Spaces Into Green Gyms

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.
<div id="attachment_35790" style="width: 310px" class="wp-caption alignleft"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-35790" class="size-medium wp-image-35790" src="https://www.forbesafrica.com/wp-content/uploads/2018/04/keith-300x200.jpg" alt="" width="300" height="200" srcset="https://cms.forbesafrica.com/wp-content/uploads/2018/04/keith-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2018/04/keith-600x400.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2018/04/keith-768x512.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2018/04/keith-1024x683.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2018/04/keith.jpg 2048w" sizes="auto, (max-width: 300px) 100vw, 300px" />Keith Warmback lost his wife Glenda to Listeriosis on the Christmas day of 2017. Photo by Motlabana Monnakgotla.</div>
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.
<a href="http://www.forbesafrica.com/focus/2017/05/01/rat-race-silent-killer/" target="_blank" rel="noopener">READ MORE: The Rat Race Against The silent Killer</a>
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.
<div id="attachment_35791" style="width: 310px" class="wp-caption alignright"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-35791" class="size-medium wp-image-35791" src="https://www.forbesafrica.com/wp-content/uploads/2018/04/Kieth-wife-300x200.jpg" alt="" width="300" height="200" srcset="https://cms.forbesafrica.com/wp-content/uploads/2018/04/Kieth-wife-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2018/04/Kieth-wife-600x400.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2018/04/Kieth-wife-768x512.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2018/04/Kieth-wife-1024x683.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2018/04/Kieth-wife.jpg 2048w" sizes="auto, (max-width: 300px) 100vw, 300px" />Keith looks at an image of his wife (right), Glenda Warmback. Photo by Motlabana Monnakgotla.</div>
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.
<h2>Symptoms of Listeriosis:</h2>
<ul>
<li>Fever</li>
<li>Diarrhoea</li>
<li>Vomiting</li>
</ul>
“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.
<a href="http://www.forbesafrica.com/focus/2016/09/01/deadly-75-billion-business/" target="_blank" rel="noopener">READ MORE: A Deadly $75-Billion Business</a>
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&#8230; 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&#8230; 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&#8217;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&#8217;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&#8217;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.
<h2>Who is mostly at risk:</h2>
<ul>
<li>Pregnant women</li>
<li>Neonates (first 28 days of life)</li>
<li>Very young infants</li>
<li>Elderly persons &gt;65 years of age</li>
<li>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)</li>
</ul>

bowl of chopped ham sausage, from above

Death, Denial And Fear: What Listeriosis Cost South Africa

United States-based speaker, author and futurist Jack Uldrich was in Johannesburg recently for the 2017 Future of Health Summit held by FORBES AFRICA and Philips. Amid all the talk about AI eye robots, virtual nurses, the potential for blockchain to transform electronic health records, and even the inception of ‘uber-ambulances’ as one doctor in the audience proposed, Uldrich spoke some more to FORBES AFRICA about what the future holds for technology, healthcare and life:
Technology companies will lead the future of healthcare. Tell us more. 
From my perspective, it’s all about data. Amazon, Google, even Facebook, know so much about us, they are going to figure out how to use data to keep us healthy, and they are going to figure out how to make money keeping us healthy, using data.
Which means people will probably live a lot longer – how is technology going to aid longevity? 
Longevity is a wonderful problem to have but it is going to impose serious societal pressures on government. In the West, our social security systems are geared for a life expectancy of below 80, but we are going to be living to a 90 and potentially a 100. Africa might not be that high yet, but society is going to have to deal with this; public policy-makers will have to deal with thinking about this issue yesterday. 
What will be interesting is we might begin to rewrite social contracts, in the sense that if we live to be a 100, maybe it will make sense for young parents to spend a lot more time, when they are in their 2os and 30s, understanding that they will be able to work full-time from 40 to 90 years of age for example. There will be a lot of different potential solutions to this and we have to get creative.
8,000 days of the internet; what will another 8,000 days mean for the internet? 
This is where people have to understand exponential growth. Without a doubt, the internet has been transformative, but we are still in the early days of this revolution, and we are next going to move to the Internet of Things, and the transition is as though we are looking in the internet. Information and data is going to be all around us and we are going to be able to leverage that data to understand our health better, and to use that information to engage in healthier behaviour that keeps us healthy.
<div id="attachment_32467" style="width: 253px" class="wp-caption alignleft"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-32467" class=" wp-image-32467" src="http://www.forbesafrica.com/wp-content/uploads/2017/06/Jack-Uldrich-683x1024.jpg" alt="" width="243" height="364" />Futurist Jack Uldrich</div>
What next after the Fourth Industrial Revolution? 
Industry 4.0 and the Internet of Things are, in my mind, interchangeable terms, but we are just at the beginning. Today, 20 billion physical objects are connected to the internet, by 2020, an estimated 50 billion, and by 2030, a trillion. But that means our wearable devices, our electronic health records, our rooms, are all going to be connected, and we are going to be able to leverage that data to do, think and act differently about our health in the very near future.
Will robots ever replace us fully? 
I don’t think they will fully replace us. The way I think about technology and humans is this: we just celebrated the 20th anniversary of a computer beating the world’s best chess player. Computers have gotten significantly smarter in the last 20 years but there is still one thing that can still beat the world’s most powerful computer in chess, and that’s an average chess player using an average computer. Human experience, intuition, plus technology take us to a higher level and when I think about the future of physicians, other healthcare professionals, those that thrive are going to be those that leverage technology and let technology do what it does really well, and then we will focus on the more human aspect. And for healthcare, this is really important. People don’t just want the best treatment; they want to be heard, they want to understand their options for disease and treatment. Could a computer do that? Yes, but I think that humans for the foreseeable future will be significantly better.
<a href="http://www.forbesafrica.com/technology/2017/06/13/create-jobs-age-robots-low-growth/" target="_blank" rel="noopener noreferrer">How To Create Jobs In The Age Of Robots And Low Growth</a>
Are virtual nurses considered far more effective than real nurses?
<blockquote>If I have any advice about the future, it is to learn how to embrace ambiguity.</blockquote>
We frequently like to think the world is going to happen one way or another way. And virtual nurses are a wonderful example. In the West, many patients prefer being checked out by virtual nurses, and that’s because they don’t feel judged, they can ask as many questions, and because of that, they are getting better information. So let’s allow the virtual nurses to check people out of the hospital, which then frees up the nurse to spend a lot more time on the human aspects and taking care of patients. The human touch is really important to the recovery process and if we can have more healthcare professionals engaging in real human activities, that’s a wonderful thing.
What about the new <a href="https://www.wired.com/2017/06/googles-ai-eye-doctor-gets-ready-go-work-india/" target="_blank" rel="noopener noreferrer">AI eye doctor</a> that Google has come up with, and putting to work in India? 
Google has collected millions of images of the eyes of patients with diabetes, and from those images, we can now engage in preventative actions that will prevent potentially hundreds of thousands of people from going blind. They are going from India to Africa to the entire world.
Your take on <a href="https://www.forbes.com/sites/joannmuller/2017/06/13/in-the-race-toward-self-driving-cars-gm-has-something-apple-and-googles-waymo-lack-a-car/#7b9c2196764f" target="_blank" rel="noopener noreferrer">self-driving cars</a>…? 
In every city around the world, the average automobile sits idle 22 hours a day so that is a waste of capital resource. In a world of driverless vehicles, we are going to be able to have fewer vehicles, but we are still going to be able to get people from their destinations, and what this means is people will start trading ownership of cars for access. But these vehicles will be clean, safe and cost a fraction of what we spend on transportation. 
In the future, transportation is going to be thought of as a service much like electricity, in the sense that you will just pay for the transportation that you need, for the kilometers you drive or are driven.
Will the seat configurations change in a driverless vehicle; do we still sit in the front? 
If you own a driverless vehicle, you can sit wherever you like, and for the near future, you will sit where you traditionally sit, but as you grow more comfortable with it, you might sit in the back and then we are going to start redesigning, and instead of all of the seats facing forward, we might actually face one another and have conversations with our peers, but here’s where it gets interesting. People will still own vehicles, but because of blockchain technology, they might be able to share that vehicle with strangers and rent out that vehicle when they are not using it, and make money off of that vehicle.
Objects that will alert us to heart attacks before it happens; is this technology available now? 
The idea of a heart attack ringtone is being worked on. There is a doctor in San Diego named <a href="http://www.mddionline.com/article/ringtone-tell-you-you-are-having-heart-attack-thats-no-joke-heart-doc-tells-stephen-colbert" target="_blank" rel="noopener noreferrer">Dr Eric Topol</a> who has spoken about this idea for a few years. Computer chips are becoming small enough that we can already put them in the human body, and those computer chips have sensors and we can now detect the proteins that float around in our bodies that are indicative that you are about to have a heart attack. So that computer chip will be able to alert you and your healthcare provider even before a heart attack happens, and you will be able to take preventative action. 
It’s not science fiction, it is science fact.
What is the zaniest thing you have heard about the future, say five years from now? 
Within the next five years, the possibility that we are going to be able to begin 3D-printing human organs is a possibility. In 10 years, the odds increase even more. But in five years, there is a chance it may happen. What is crazy is today a car can be a 100 years old, but you can keep it operating because you just get it a new motor or a new pump, but we might begin thinking about the human body that way. Your part might go, but we might just print you a new one using your stem cells that we know will work in your body. But we need to begin to think that just because we can, is this necessarily a wise path that we can take, and this is where we need philosophers, citizens and politicians, etc to engage.
Do we really need to live that long? Is it going to be economically viable? 
At this stage, what I tell people is let us give up on answers, let us just stick to questions for the time being. We need to ask better questions about the future, and this idea of longevity and 3D-printing human body parts… we need to ask a lot of questions about these and many other issues.
Where is Africa in terms of advances in tech? 
Africa is behind today but the potential to rapidly catch up to the US is a real possibility because virtually every technology is not only getting better, it is getting more affordable. In many cases, counter intuitively, the infrastructure of the West and our powerful political organizations might actually slow down some innovation. And I think the opportunity for Africa to not only catch up but to also potentially leapfrog in some areas is a real possibility, and I think the West should have some humility and begin looking to Africa for innovations that I think are really going to surprise us, just as the way <a href="https://www.cnbcafrica.com/news/east-africa/2017/01/04/mpesa-economic-impact-on-kenya/" target="_blank" rel="noopener noreferrer">mobile payment took off in Kenya</a>. I think the West might need to catch up to Africa in some cases as well.
<a href="http://www.forbesafrica.com/focus/2016/07/01/industrialization-ditched-tech/" target="_blank" rel="noopener noreferrer">Industrialization Ditched For Tech</a>

‘Not Science Fiction, But Science Fact’

IIt’s a sunny Thursday, and I am at the Mobile Military Health Formation of the SA Military Health Service in Pretoria, South Africa’s capital city, to meet Limpopo-born Molatelo Nkoana, a 31-year-old woman who has dodged more bullets than most.
Nkoana’s running a little late, but then she arrives, sallying into the boardroom. She is on duty and in uniform, and proceeds to tell me about her life and the career she almost embarked on.
After completing her secondary education, Nkoana says she first went on to study and train as a nurse. But that wasn’t to last long; she gave it up midway – to join the military, a decision she would never regret.
“Basically, it was about the money, I was young and wasn’t getting enough money, so I went on the market,” says Nkoana.
The enthusiastic 22-year-old applied, and was recruited three months later, reporting to the Thaba Tshwane military base in Pretoria for basic training. She also trained in Kimberly, Bloemfontein and the Western Cape.
Nkoana had thought only the physically fit could join the military, but soon discovered it offered multiple careers one could explore. With her nursing background and experience, Nkoana chose to be a paramedic.
In March 2013, Nkoana was one of the 200 soldiers of the South African National Defence Force (SANDF) selected to go to the Central African Republic (CAR) as part of South Africa’s peace-keeping mission there.
They would go on to fight a series of battles outside Bangui in the CAR. And Nkoana was the only woman on the frontline.
Michel Djotodia, leader of the rebel alliance, Seleka, had declared himself the new president of CAR and forced the then serving president, François Bozizé, out of the country.
It wasn’t going to be an easy task for the SANDF.
Nkoana takes me back to noon on that fateful Friday on March 22, 2013 when she first spotted the rebels; she remembers it all like it was yesterday.
She literally transports me to CAR with her vivid detailing of the series of events that unfolded. As she relates this story of death and danger, I hear the bullets, the gunshots and the rebels roar; I see the ravages of war in CAR.
Nkoana was amongst the first to see the rebels attack.
“We saw a civilian running away from those people, the rebels. I was at the gate of the base’s duty room. I ran to the sick-bay as a medic and told the people that the rebels are coming, the rebels are coming.”
When she reported it, nobody believed her. But she persisted, proceeding to gather her bulletproof vest, helmet, and weapon.
Her fellow soldiers only believed her when the Officer Commander (OC) ordered them to prepare and check what was happening outside the base. He tasked a team from the special force.
Around 5PM, this team was ambushed by the rebels, but they fought back tenaciously, and the rebels fled.
Three men of the special force team returned injured, one shot in the chest, the other had sustained a fracture in his femur and the third was wounded.
For the first time, the base knew it was rough outside.
“As medic personnel, we took them to civilian hospitals outside to get other doctors to help us,” recalls Nkoana.
Around 10PM the following day, the rebels came back again firing bombs. The SANDF could hear the entire din from their base. The Sergeant Major asked Nkoana to go with them to replenish food for the soldiers who had been on night vigil.
She grabbed her medical bag, helmet, bulletproof vest, weapon and left with the men, not hesitating for a minute.
It was around 12PM, when she along with the others drove 15-20 kilometers to the location of the stranded soldiers; it was quiet when they got there, but as soon as the rebels saw the SANDF vehicles, they started shooting again.
“We went out of the car and took cover, and then we started shooting back. While fighting, I managed to get one of the guys that was injured and suggested I take him back to the base because he could not run, fight or do anything,” she says.
The OC opted otherwise and Nkoana and the injured men had to wait even as the bullets rained over their heads.
At 5PM, as they were heading back to camp, the squad was ambushed again. This was when a number of lives were lost, says Nkoana, for the first time sounding emotional.
They did what they did before: stop the vehicle, step out and take cover.
As Nkoana was taking cover, one of the soldiers had been shot in both legs and was screaming out for her. She bandaged him but the chaos was far from over; yet another soldier was calling for one of the two medics that were there. He had almost missed a bullet but it had grazed his neck.
By then, Nkoana and the other medic could see dead bodies all around them. The injured soldiers shouted to them to leave because they were going to die.
“We told them we can’t leave. We are still alive and we can at least take cover with you. Let’s move to a safer place; the guy that was shot in the legs said he couldn’t walk and we should leave him there.”
The team refused and carried him to safety.
Around midnight, the OC called from the base asking for Nkoana. Many of the soldiers were already back at the base, but the young woman had stayed on with the other fighters.
“When they called, I switched off my phone because it was loud and we could hear the voices of the rebels from where we were hiding.
“I switched the phone back on and sent a message telling them ‘we are here, we are hiding, we’ve got two patients and we cannot get out of this cover’.”
Nkoana had full faith she was going to return home to her son in Senwabarwana, her hometown in South Africa’s Limpopo province. It kept her alive.
She thought she would be running on foot back to the camp because there was nothing that could rescue them.
Many soldiers died, but many of the rebels also died, so there was not going to be any mercy towards the SANDF.
Nkoana then received a text advising her and her patients to remain in hiding and stay calm. Around 4AM, she received a call asking if they were still undercover; they were then instructed to somehow make their way to the airport.
“The commander of the rebels was requesting the SANDF to go back to their country,” she says.
But Nkoana and the injured soldiers had to travel another 15 kilometers to the airport; she was still unsure of their safety. Their hideout was next to a tar-road and the rebels were driving up and down firing bullets into the sky.
A peace agreement had been signed, so the soldiers could go back to camp; get their belongings and head home to safety.
“[But] we were not sure the people in the streets knew of the peace agreement because if they see us they will shoot us; the agreements were done at the base and not in the streets,” says Nkoana.
They refused to come out of hiding.
They heard the Casspir (armed ambulance) that was sent to fetch them and the bodies of the dead soldiers, but they were still unsure if it was safe to surface. The vehicle went up and down, back and forth, looking for them.
“Around 7AM, the next day, we decided to go. They sent me a message to just surrender; I then told the guys ‘the Major says we should surrender’. I was the Corporal by then and the guys asked if we should shoot. I told them ‘no, because if you shoot one bullet, they will kill all of us’.”
Nkoana took command of the situation, complying with her superiors at the base.
The drama didn’t end there though.
Just as they got on to the road, the rebels came after them and took their weapons, bulletproof vests, ammunition and they were instructed to lie down. They then had to stand up and walk in a single file not knowing where they were being taken.
On the way, they climbed on to a bakkie (pickup truck) driven by other rebels which took them to their base. The soldiers at the base had started packing, and they had to pack up too. They were all then taken to the airport to head back home to South Africa. Finally, it was all over.
Nkoana was a 27-year-old woman who defied death at the hands of the rebels. She was honored with a bravery medal, invited to the opening of Parliament in South Africa in 2014 and was given the Sword Of Peace.
Like Nkoana, another South African woman was also honored for her bravery fleeing the rebels in CAR, with an equivalent of R3 million ($323,000 at the time) supporting the mission, in her bag.
Susette Gates, a mother of two sons, currently living in Pretoria, was deployed as the financial officer of the South African mission in CAR in charge of payroll. Before being employed by the SANDF, she had been a hairdresser, she says, laughing, when she speaks to us.
Like most people looking for jobs, she had applied for an open post at the Wonderboom military base and been accepted; she continues to work here.
I meet her at this base – she’s not in uniform – and in her own office adorned with family portraits, certificates and medals.
She was the only other woman besides Nkoana selected for the CAR mission. Those fearful moments in CAR are forever etched in her memory.
When the rebels were attacking the SANDF, Gates was watching a horror movie on her laptop at the base. Little did she know the horrors unfolding around her.
Ironically, she was informed about the chaos in CAR on the phone by her sister in South Africa. Only then did she realize there was no electricity and people had left their homes at the camp.
She called out to everyone but was the only one left. She was later relocated to another place where she spent the night.
“The next morning, I went back to get my belongings. The next thing the rebels were in the base and they took everything, they even took the cars,” she says.
“If they could grab food, clothes whatever. I had my money with me; they opened my bag and asked what it was. I told them it was clothes and asked if I could keep it, but the bag of money was under the clothes.”
Gates was released and managed to get away with the R3 million; the money she had hidden under her clothes and that belonged to the SANDF.
The trip to the airport was grim because all she saw was a dry and dirty town, gunshots going off in the background. On the flight back home, she knew there were dead bodies of colleagues on the plane. Gates almost kissed the ground when she landed in South Africa, she says.
Both these women returned as heroes and were honored by South Africa’s Defence Minister Nosiviwe Mapisa-Nqakula in 2014. Of the 185 soldiers who survived the war, the two women stood out amongst the men. Today, there are other women fighting the rebels in the CAR like they did, risking their lives and saving the lives of the men around them.

Molatelo-036

Heroes Among Men

South Africa’s economic hub Gauteng is tapping into healthcare and medical tourism with renewed vigor.
With a R34.2 billion ($2.4 billion) budget and three medical training facilities located at universities and tertiary hospitals, Gauteng Health MEC Qedani Mahlangu is promoting health tourism and ensuring the province’s hospitals boast state-of-the-art equipment to attract overseas patients.
Mahlangu is spending her resources on HIV and AIDS awareness and prevention and reviving the health economy with R10 billion ($717 million) set aside for primary healthcare services – clinics, community healthcare centers, district hospitals and community health workers – and R10 billion ($717 million) to tertiary services and central hospitals.
“When we went to the World Cup in 2010, one of the things we said in our bid document, we said we have the best infrastructure for everything including healthcare and treatment,  we have healthcare facilities across the board,” says Mahlangu.
With the funds generated from medical tourism redeployed into healthcare facilities, it’s a sound investment for South Africa.
“Medical tourism is important because we have the best trained medical professionals – our nurses are highly sought-after,” she says.
“European and American travelers come in as tourists and then sometimes use our services. We are still affordable and of good quality. The waiting time is longer in many jurisdictions in the world. A lot of people come here to do procedures. We should support and promote it more.”
Promoting country-to-country relationships is part of Gauteng’s plan to market medical tourism. However, the greatest growth in medical travel to South Africa in recent years is from neighboring countries whose public healthcare systems are in a state of crisis.
“Gauteng has a relationship with Katanga Province [in the Democratric Republic of Congo] who pays money to our account at Charlotte Maxeke hospital – almost $500,000 of that is used for treatment. These patients come to us rather than going to Europe,” she says. South Africa’s own public healthcare system is overburdened and under-resourced but it can still deliver quality treatment often unavailable elsewhere on the continent.
“Over the past 10 years, Johannesburg has played host to thousands of visitors seeking health, wellness and medical services – often combined with short holidays either prior to or post their treatments and procedures,” corroborates Laura Vercueil, communication manager at the Johannesburg Tourism Company.
As Gauteng moves towards producing its own healthcare products, Mahlangu is also looking to empower women in the process.
“We’re starting producing on a small scale with products used in hospitals. A number of products used in-theatre are being purchased from women co-operatives. For an economy of our size and located strategically in the African continent, we have to develop the industrial capacity to deliver on these products,” says Mahlangu. Gauteng is on the fast track to becoming a health hub. Hopefully, all of South Africa will soon follow.

Qedani-etch-new-new

Health Hospitality

Walk into Maureen Allem’s Skin, Body &amp; Health Renewal clinic in upmarket Illovo in Johannesburg, and it feels like setting foot in a furniture showroom catalogue. It’s all pretty pastels, crystal, chandeliers, silver cutlery and dreamy drapes.
Aesthetics – of body and décor – is a consistent theme here. For a customer walking in with hopes of body rejuvenation, the setting does half the job.
Allem materializes in a stunning turquoise kaftan. At age 56, she is perhaps the best advertisement of her booming practice. Her skin is tight, flawless and glowing.
Her non-surgical, integrative/anti-ageing and weight loss company is in its tenth year. Allem has focused on treating ageing with facial and body rejuvenation techniques.
But the outer appearance, she says, is only one side of the story. She recommends the holistic approach incorporating inner health as well.
“The whole new buzzword in medicine is ‘functional’ and personalizing your lifestyle,” she says.
It’s hard to keep up with Allem’s studied descriptions, in breathless sentences, of the underlying causes of most disease and ageing issues.
“Optimize your vitamin D…optimize your liver…70 percent of all disease starts in the gut…”
The South Africa-born Allem was a general practitioner in a provincial hospital for 10 years, followed by a career conducting lifestyle assessments for executives, before she started her own practice in 2000 in her Hyde Park home offering botox and filler treatments.
Her life – and success – didn’t have a linear narrative though. She was in her third year of medicine when she dropped out to get married, becoming “a farmer’s wife” in South Africa’s Free State province.
“I was sewing curtains and playing bridge [on the farm]. Things were not well in the marriage. I realized I made a big mistake and wanted to go back to medicine. I had a two-year-old and a five-month-old [children]. I went to speak to the dean [of my medical institution]. I was 24, and he said, ‘it will be impossible’. I had to find a house in Sandton and adjust to a new life.”
Allem completed her medicine and today, runs 17 renewal clinics across South Africa, including six in Cape Town. She owes it to her team of doctors.
“It’s important to surround yourself with intelligent people; people who are not intimidated by you. Get geniuses around you…and embrace what you love best,” she advises.
And to the women wanting to enhance their looks, she says: “Age is just a number. Fix yourself up.”
<h2>Crowning Glory</h2>
<h5>Steven Turpin, Creative Design Team Educator of Morroccanoil, was in South Africa recently to launch a new line. Here, he shares tips on hair care.</h5>
Moroccanoil specializes in oil-infused hair treatments and an extended line of luxury hair products.
<img loading="lazy" decoding="async" class="size-medium wp-image-30734 alignleft" src="http://www.forbesafrica.com/app/uploads/2017/05/Jaguar-PS-Shutterstock.com_-200x300.jpg" alt="" width="200" height="300" srcset="https://cms.forbesafrica.com/wp-content/uploads/2017/05/Jaguar-PS-Shutterstock.com_-200x300.jpg 200w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/Jaguar-PS-Shutterstock.com_-300x451.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/Jaguar-PS-Shutterstock.com_-600x903.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/Jaguar-PS-Shutterstock.com_-681x1024.jpg 681w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/Jaguar-PS-Shutterstock.com_.jpg 680w" sizes="auto, (max-width: 200px) 100vw, 200px" />
Give us some tips on how to have the best hair? 
Turpin: “Healthy hair starts with a healthy scalp. Many of us forget about treating and maintaining the scalp. Our balancing result-driven scalp treatments will balance sebum levels in dry and oily scalp, exfoliate and cleanse. Massaging the product once a week will increase blood flow, feed the hair follicle and lead to strong healthy hair growth. Using good quality shampoo and conditioner and considering a deep treatment a few times a month if needed will ensure gorgeous hair all year round.” 
– Jessica Ramoshaba

IMG_7205

‘Fix Yourself Up’

Our beauty editor was the only journalist from Africa to meet Sharon Stone in Berlin, Germany, where the 57-year-old actress was launching the Restylane Proof in Real Life campaign as its brand ambassador. We asked her what keeps her going:
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<h4>Do you fear ageing? How do you feel about ageing gracefully?</h4>
No, I would not fear ageing. I had a massive brain hemorrhage in 2001 and I nearly died. I have the experience of knowing what it is like to consider the possibility of not ageing.
In reality, it is a stupid concept to fear ageing. Ageing is a beautiful thing. Ageing is a gift, a gift that we need to embrace. We don’t have to embrace it by thinking it would just be great to shrivel up, and bend over and then fall down and die.
We can embrace ageing valiantly; we can embrace ageing gracefully. I love the saying ‘gracefully surrendering the things of youth’. I think that is a beautiful thing. Sometimes when we surrender the things of youth, we surrender them wistfully. We have moments of sadness, moments of little heartbreak for not having the things we had when we were younger. It is a fact. You see them go by, and there is a wistful sadness when they go, but you have to let them go. It is ridiculous to try and keep them. It’s beautiful then to look at who you are.
And if you have to lock yourself in the bathroom with a bottle of booze and stay in there until you get it, it is a good thing to do! Make friends with the one you are right now, and your former self. You have to do that, because that is the now that you are, and you want to stay in the now and move forward.
If you keep looking backwards, you are just going to fall down. All you have is the possibility of looking forward.
&nbsp;
<h4>What is the campaign about and why did you get involved?</h4>
Proof in Real Life is a project I am working on with the pharmaceutical company Galderma to challenge misconceptions that aesthetic treatments create extreme results.
Many people are interested in aesthetic treatments but some are put off because they only see one side of the story – the images in magazines of extreme looks and altered facial features.
People these days want more subtle enhancements so they look like a healthier version of themselves, just taking off a few years or refreshing their appearance.
I got involved because I was excited and interested by the idea of providing first-hand evidence that allows people to judge the results for themselves. I myself had fillers to rebuild my face after my stroke.
I really support the concept of encouraging greater openness and awareness of aesthetic treatments. Although it is becoming a much more accepted practice, people can find the choice daunting and are scared of making inappropriate decisions.
I hope that this project will improve awareness of aesthetic treatments and the results so that people are better able to make an informed decision.
[Ten sets of identical twins were used in the Proof in Real Life campaign. One twin of each set had treatments since February. They were introduced on stage by Sharon Stone to compare and prove how good and natural the results of aesthetic treatments in real life can be. Restylane fillers helps add volume and definition to the skin, whilst Restylane Skinboosters increase hydration.]
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<h4>What would you tell a younger woman about growing older?</h4>
‘Don’t try so hard.’ I think, when we’re young, we try way too hard. We don’t realize simply being young is enough. There’s nothing wrong with being young and not knowing &#8211; that is the beauty of being young.
Now that we are living so much longer, we over-think age, but we have to stop and reframe it. A lot of us, we buy into the concept ‘this age means that’. But we have to put a pin in that and step back and realize: a certain age just doesn’t mean what we were told it was going to mean.
You have to think: I really could live a whole lot longer than I depended on, my life could be a whole lot different. I’ve got a lot more life ahead of me than I thought I was going to! So if I want energy, and I want to have hope and dreams, I actually can. I have to reframe this now. In order to get my energy, how do I take care of my health and wellbeing, to get this all back together again for this piece of my life that I’m going to have.
Because this is the age where we didn’t think we were going to have another big chapter of our lives. And we have – we can have another career if we want. We have an opportunity to look at the world and shape the world.
When we were children, women weren’t out there fighting to see if we could shape the world. Women that were ahead of us were out there trying to fight so that we could break the glass ceiling with our heads, and our generation did break the ceiling with our heads. Guess what, we didn’t just get a broken head, we get to have another chapter.
This is what is very exciting for me: If we’re going to have another chapter, let’s look damn good while we have it. Let’s look great, let’s feel great and let’s go get it. And let’s not blow up the f*^$#g planet while we’re doing it. Let’s see how we have a peaceful future; let’s see how we have a feminine reality. How can we create a beautiful future, let’s see what we want to do with this next piece, because we have it, and I don’t think we knew we were going to.
We’re going to have to blast that engine again, and it is just such a great opportunity, because we’re up to that. It’s like they are calling our name. We’re the women who have experience, we’re the women who have the education and we are the women who have wisdom.
We all know, because we all were younger, that there is a power in looking good. It is not a secret, but it is a secret we never openly said: If you look good, you get your power. You get stuff done! However you do it, there is a power in looking good. We want to look good, because there is stuff we need to do and we need to get it done!
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What is your best treatment before a red carpet appearance?
Before a red carpet, I put my makeup on, and then I get into the bathtub. It makes my skin look radiant and my makeup look really good after it has been a bit steamed up.
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<h4>If you have fillers or an aesthetic procedure, what would you ask the doctor beforehand?</h4>
I would ask: How much downtime? Will it bruise? Will it hurt, because I am a real baby?
Aesthetic procedures have improved and evolved enormously over the years: For example, think back to our parents’ generation, when women got these horrible facelifts and they would look like they’ve been sucked through a wind tunnel and their hairline would recede – we can all see the evolution. We’ve been through the phase where everyone wanted gigantic lips, and now everyone wants gigantic butts, right? All these different phases…
The thing, for me, that you want to stay true to, which never goes out of style, is classic beauty. And that is a subtle thing. It’s staying true to your own self.
I tell my children (they are boys) that boys are like trees and girls are like flowers. You have to remember every flower is not a white rose. There are a thousand flowers in the garden and it is important to remember what flower you are, and try to turn yourself into a different flower.
We need to keep ourselves fresh and make ourselves into the best flower that we are. I think that is the key here with these aesthetic treatments. It allows us to stay fresh, but who we are. The best evolution of aesthetic treatments is that it allows us to not change ourselves into someone else. It allows us to stay who we are, and make a subtle change to feel fresh and happy. I noticed with the treated twins in the campaign that they just felt happy; they didn’t feel different. That is a good thing.
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<h4>Do you have a secret to beauty?</h4>
It’s a mystery to me. My parents were gorgeous, they were so good-looking, it was just crazy. For me to be good-looking was no mystery, my parents were just beautiful.
I think, as you get older, it’s not as much about the looks you were born with. It’s about the way that you live your life. If you are a mean person, you look like it when you get older. It is about having happy thoughts. You never look bad with lines around your eyes – I think everybody with lines around their eyes looks great because you know that person lived their life laughing and they had a happy life. But happiness is a discipline. Pleasure is a thing you have for a second and it goes away. Happiness is a choice that you make that sustains you. If you go two-three days and you’re unhappy, you have to stop and look at your life and think ‘what do I have in my life that is crushing me?’ And cut it loose. A person, situation, food, drink, whatever it is. You’ve got to stop it. You have to stay with the discipline of happiness, it is like burning at the gym, it’s a real thing.

Sharon-Stone-etch

‘There Is A Power In Looking Good’

When Ben Ajofu was diagnosed with hypertension at the age of 35, doctors told him he would be on medication for the rest of his life. Ajofu proved them wrong; within three to six months of taking moringa, he realized his blood pressure had lowered.
“I didn’t really want to take medication at 35 for the rest of my life,” says Ajofu.
The improvement in Ajofu’s health led to him becoming one of the most enthusiastic advocates of the moringa plant in Ghana. He is the founder of Moringa King, a producer of juice and powder containing parts of the plant.
The moringa leaf is thought to have numerous health benefits. The plant contains high amounts of magnesium, potassium, zinc and vitamin E, which are important nutrients to combat hypertension, a condition of unusually high blood pressure.
Growing up, Ajofu thought he would become an engineer or a pilot. His parents always put education first. At the age of 11, Ajofu moved to Britain and completed his university degree there. Although he began working at the age of 17 as a bicycle mechanic, it was during his first year at university that his entrepreneurial journey began.
“The mobile phone network Orange had just launched in the UK so we approached an Orange dealer, grabbed a couple of phones and started selling them in university,” says Ajofu.
The success of this led to Ajofu setting up Business Mobiles after university, a company that sold mobile phones to businesses in Britain.
“I was approached by some investors in the UK who were interested in investing in Ghana because of my Ghanaian heritage and as a result I provided consultation on the Ghanaian terrain,” says Ajofu.
During one of his trips to Ghana, Ajofu discovered the moringa plant. After extensive research, he realized the health benefits the plant could provide.
“I realized moringa was very good for regulating blood pressure, combined with a healthy lifestyle. I did more research and established that most households in Ghana have a moringa tree but the main issue was how to access the nutrients from the plant,” he says.
He formulated a drink full of the plant’s nutrients.
“Moringa King came out of a need for myself to find a solution, so I didn’t have to be dependent on using medication for the rest of life and, after seeing the results, I knew others would benefit from the product too.”
The start-up phase of the business was arduous. Ajofu began by sourcing raw materials that were sustainable and readily available. Ghana is the largest exporter of pineapple in Africa and hence has an abundant supply.
“My wife and I would wake up early each morning to get pineapples and blend them into juice before adding the moringa. We did not have a car so we used taxis to deliver to clients,” says Ajofu.
Before they could sell the product, Ajofu had to overcome the difficulty in securing certification of his product by the Food and Drugs Authority in Ghana. After three years of trading, the company has a staff of 10 and an annual turnover of GHC300,000 ($79,000). It counts two of the world’s largest hotel brands, Movenpick and Kempinski, as clients as well as being stocked in all the major fitness and retail outlets in the country.
“The plan is to expand and get a farm whereby we can control access to raw materials for our production. We are also speaking to local growers and getting women involved in agriculture so we can buy from them and as a result have an impact in local communities,” says Ajofu.
There is a methodical process to get the finished product.
“We harvest only the best leaves, then we go through a washing process to get rid of any organisms in the leaves. After this the leaves are juiced. We then get pineapple from a farm, which we process, into pineapple juice and blend the moringa into the juice along with dandelion leaf and raw ginger. The final product is the Moringa King juice.”
Moringa King has ambitious plans and is looking to increase production so it can enter the markets in neighboring West African countries as well as be stocked in major international retail outlets. To do this the company needs investment, something Ajofu has found difficult to source. In addition to his own money, Ajofu has relied on friends and family to fund the Moringa King business. With bank interest rates being too high and government funds extremely difficult to access, private investment is the only way the company can grow. In the meantime, Ajofu is keen to grow the company organically and is optimistic about the future.
Although he started the business to make money, Ajofu is pleased that his products also improve the health of his customers.
“My juice is actually transforming lives in terms of making people healthier and better. That is a secondary benefit of product but it is fulfilling to know that my product is transforming lives,” says Ajofu.
Like the juice, the business looks to be healthy.

A Healthy Body And  Business

Having suffered panic attacks for 10 years, Zane Wilson could have easily thrown her hands in despair. Instead, pain led to creativity. She formed a support group to help others face their deepest fears, and is today free of the painful episodes that traumatized her life.
Today, this support group, which started in the hallowed halls of the Sandton library in Johannesburg initially attended by a group of 80 people 20 years ago, is the South African Depression and Anxiety Group (SADAG), founded by Wilson, a South African businesswoman.
<img loading="lazy" decoding="async" class="size-medium wp-image-29776 alignleft" src="http://www.forbesafrica.com/app/uploads/2017/05/100_2074-225x300.jpg" alt="" width="225" height="300" srcset="https://cms.forbesafrica.com/wp-content/uploads/2017/05/100_2074-225x300.jpg 225w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/100_2074-300x400.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/100_2074-600x800.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/100_2074-768x1024.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/100_2074.jpg 767w" sizes="auto, (max-width: 225px) 100vw, 225px" />
“I started the group and soon had to get a second phone, which rang night and day. I have had calls from people all over Africa looking for help. I have never had an attack since.”
Wilson’s first experience of a panic attack was on the highway, on her way to a business meeting.
“I suddenly felt hot. My palms started sweating. I started shaking and my heart started beating fast. I was terrified, but couldn’t understand why. I thought I was losing my mind,” recalls Wilson.
The attacks got worse, at times going up to three or more episodes a day.
“I was the director of a very busy company and had more and more attacks. I became acutely suicidal.”
She sought medical help, which included blood tests, assessments, even a lumbar puncture, and attended counselling, but they were all in vain. It got to a point where she couldn’t lead a normal life.
“I couldn’t even go to a shopping mall or a grocery store without an attack starting. I was determined to keep working and my husband had to follow me to work and I’d come back with staff. It reached a point where I couldn’t even be at home on my own. I would have to be dropped off at a neighbor’s. Eventually I was sent to a professor of psychiatry and he told me that I was suffering from panic attacks,” says Wilson.
This is a route most victims are familiar with. According to SADAG, South Africans will, on average, visit 11 doctors and spend over R20,000 ($1,800) on medical investigations before arriving at the diagnosis.
Recent research points to strong genetic or hereditary factors that might predispose some to paralyzing panic. Attacks can be triggered by non-biological factors too. Stressful experiences, caffeine, cold and flu medications, Lariam (the anti-malarial drug), appetite suppressants and local anaesthetics containing adrenaline may cause attacks that last an average of four to six minutes.
Clinical psychologist Lee-Ann Hartman says of all the disorders within the spectrum of anxiety and depression, panic attacks are the most treatable. With the right therapy, she claims 90% of people recover greatly and the remaining 10% can experience significant recovery.
“It’s very important to seek help early on, as once it starts developing, the sufferer will associate the panic attack with a certain place, person or situation. Mental illness as a whole is greatly underestimated and grossly under-resourced. In South Africa, one in 10 people suffer from HIV/Aids – whereas one in three people will experience mental illness at some point in their lives.
“People suffer in silence and among high-achieving women, there is always the fear it will be seen as a weakness.”
Hartman says that a panic attack is a false alarm set off by our innate ‘fight or flight’ instinct where a slew of hormones are released.
“When the fight or flight response happens in an appropriate situation, you don’t think about your trembling, increased heart rate&#8230; But when it comes out of the blue for no reason, your cognitive interpretation is ‘what is happening to me, am I having a heart attack’?”
She recommends a full medical to determine the underlying physiological – and psychological – factors.

Tag: Health

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