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The Surgeon’s Knife Can Wait

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Let’s face it – literally. In an environment where women work hard, live hard and play hard, they want to stay looking as young as possible for as long as possible.

Women nowadays are healthier and fitter than ever. They want to look as young as they feel, to remain competitive in the career place and social environment. So they need to appear younger and fresher to hold on to their careers and self-confidence.

Thanks to non-invasive aesthetic procedures or ‘liquid facelifts’ with a combination of rejuvenation aids like Botox, fillers, volume enhancers, Fraxel lasers, ultrasound, Intense Pulse Light (IPL) and skin resurfacing technology, surgical procedures like facelifts and mini facelifts can now be considerably postponed.

According to a New York Times report, the waiting lists of A-list plastic surgeons in the Big Apple have shortened from almost a year to a matter of weeks. Women are postponing ‘taking the cut’ thanks to non-invasive alternatives.

The good news is: unless your skin has lost all its elasticity, the knife can wait. But you will have to combine several procedures for the best, holistic rejuvenation results.

Two issues need to be addressed, says aesthetic doctor Alistair Clark of Sandton Aesthetic Institute (www.sandtonaesthetics.co.za) in Johannesburg, South Africa: loss of firmness and loss of volume.

Loss of volume is getting a lot of airtime at the moment. With age, the natural volume in the upper part of the face shifts downward, resulting in double chin, slack jowls and turkey neck. The face looks ‘flat’, having lost its sweet youthful curve, explains Johannesburg dermatologist Dr Pholile Mphofu.

The answer lies in a combination of Botox to iron out wrinkles, fillers like Restylane SubQ to repair loss of volume (cheeks, temples, lips) and a procedure like Ulthera ultrasound (which Madonna reportedly does) to stimulate collagen production and firm up features. Ultherapy can make one look 10-15 years younger, says Dr Natasha Chapman from Laserderm MedSpa in Sandton (www.laserderm.co.za) in Johannesburg and the results can last for two to five years.

One of the most exciting new treatments with Botox is its use for the so-called Nefertiti Facelift, relaxing the tight horizontal platysmal bands in the neck, softening horizontal neck lines and giving the neck and jowls a firmer, younger appearance says Dr Mphofu. Dr Nanita Dalton from Centurion (www.nanitadalton.co.za) says this is one of her favorite treatments for patients, because of marvelous results.

Other Rejuvenation Procedures

  • Carboxy therapy helps to improve blood flow to an area, delivering oxygen and nutrients, and stimulating wound healing and collagen formation. In France, carboxy therapy is used in many major operations to speed up recovery.
  • Fraxel laser treatments reduce and improve the appearance of marks and scars. They are very effective in removing sun damage and pigmentation. It can significantly reduce scarring after any plastic surgery, including facelifts, neck lifts, breast augmentations, tummy tucks, and even mole removal.
  • Ulthera and Thermage can be used to help tighten loose skin.
  • Chemical peels improve the appearance of the skin, particularly significant sun damage, fine lines, or poor texture. A peel increases cell turnover by removing layers of dead skin cells. As we age, our cell turnover rate decreases, leading to a build-up of dead cells, which makes skin appear dull, lifeless, and unevenly pigmented.

What it means

Botox: Botulinum toxin is a naturally occurring protein. When used as a drug it blocks the signals from the nerves telling the muscles to contract. It is used for expression lines like frowns and crows’ feet.

Fillers: Filler is a generic term for the 200+ products on the European market, of which about 10 are used in South Africa. The quality of fillers varies enormously and problems generally occur with inferior products and inexperienced injectors.

Fillers are a wonderful way to add volume, soften lines and take years off your age. The art of injecting fillers lies not only in the injecting technique, but also in being able to see what effect injecting fillers into certain areas will have on the patient’s appearance, says Dr Chapman.

Only reputable hyaluronic acid fillers should be used for lip and volume rejuvenation. There are hundreds of new hyaluronic fillers that have flooded the aesthetic market over the last few years. If cheap fillers are used and they are not FDA approved or are not a safe tried and tested filler that has stood the test of time, they could cause problems such as granulomas, keloids and infections.

Peels: Peels are generally acids that come in different strengths. Mid and deep dermal peels should only be done by doctors who are experienced.

Lasers: Laser treatments are suitable for hair removal, skin rejuvenation, skin resurfacing, treatment of pigmentation and melasma, skin tightening, acne scarring, vein removal, birth mark removal, wart removal, tattoo removal… the list is endless. Different wavelengths are used to treat different problems, and the laser operator needs to have a good understanding of laser physics and treatment protocols to avoid serious side effects. Certain lasers are not suitable for African or Asian skin, so do your homework beforehand.

 

Facelift Safaris

Cosmetic and medical tourism is growing amongst the wealthy and emerging middle class in Africa and also those from the UK and Europe, says Lorriane Melvill, founder of Surgeon and Safari in Johannesburg. Well-heeled women from neighboring countries like Botswana, Zimbabwe, Zambia, Mozambique, Kenya and Tanzania are increasingly choosing to combine a South African ‘holiday’ with some cosmetic surgery. “Surgery in South Africa offers them value for money,” she says. Clients can choose whether they want to combine a Cape winelands and coastal experience with a nip and a tuck, or opt for a bush experience during recuperation and follow-up doctors’ visits. The most sought-after procedures for medical tourists are breast augmentation, liposuction and tummy tucks amongst younger women, while facelifts and eyelid surgery are popular with women who are over 50.

Current Affairs

VE DAY MARKS THE END OF THE SECOND WORLD WAR-BUT THE WORLD IS STILL AT WAR

Just like the world is desperately seeking a cure to end the coronavirus pandemic which has killed over 275,000 people so far and leaving a trail of human, economic and social misery, the world too must find a way to end wars, or else we may be defeated as a civilization.

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UN Secretary-General Antonio Guterres calls on President Ashraf Ghani during a visit to Afghanistan’s capital Kabul to show solidarity with the Afghan people. Photo UNAMA / Fardin Waezi/June 2017.

The world commemorated the 75th Anniversary to mark the end of the 2nd World War also called VE Day on May 08, 2020.

With her nation, and much of the world still in lockdown, due to COVID 19, England’s Queen marked 75 years since the allied victory in Europe with a poignant televised address. From Windsor Castle, Queen Elizabeth said, “ the wartime generation knew that the best way to honour those who did not come back from the war, was to ensure that it didn’t happen again”.

But the world is still at war. Proxy wars or localised conflicts are wrecking havoc on human development and humanity in virtually every corner of the world. By the end of 2018, wars, violence and persecution have driven record numbers of over 70 million people from their homes worldwide, according to UNHCR, the UN Refugee Agency. This is the largest ever displacement of humanity, post 2nd World War.

Never has the appeal by the UN Secretary General Antonio Guterres been more pertinent: “The world is in pieces; we need world peace.” 

The United States signed a historic deal with Afghanistan that outlines a timetable and exit plan for American troops, setting the stage for the potential end to nearly 18 years of war in Afghanistan.  The UN Secretary General welcomed the US-Taliban peace agreement on February 29, 2020.  The United States also won the unanimous backing of the UN Security Council to this ambitious peace deal on March 10, 2020.

The implementation of the peace agreement will need leadership, courage and resolve and there will be spoilers who will attempt to upend the peace process. The road to peace will be characterized by violence, set-backs and numerous false starts, but it will need diplomacy, determination and drive to keep the peace process on track.

Hubris must not prolong the agony of this appalling war. 

The war has cost over $2 trillion and killed more than 2,400 American soldiers and 38,000 Afghan civilians. Casualties among Afghan security forces are estimated to have reached around 40,000 between 2007 and 2017.

Wars are appalling. As a combat veteran, I have witnessed first-hand how armed conflicts have transformed some of our finest soldiers into shells of the people I once knew. Combat is savage, it is brutal, it is reckless, it diminishes us as human beings and jeopardizes our humanity.

General William Sherman once said, “It is only those who have neither fired a shot nor heard the shrieks and groans of the wounded who cry aloud for blood, more vengeance, and more desolation. War is hell.”

There are no winners in Afghanistan, but let’s consider the consequences on all the women and men who fought in it.

Today, research backs up what soldiers have described for decades, and what was once called shell shock or combat fatigue. We have terms like Post Traumatic Stress Disorder (PTSD), chronic depression, cognitive impairment, and traumatic brain injury to help explain the symptoms suffered by active and returning soldiers.  

U.S. Army soldiers on security duty in Paktīkā province, Afghanistan, 2010. Sgt. Derec Pierson/U.S. Department of Defense

For a long time, many of the grim statistics about war centred on fatalities and did not include the conflicts’ deep mental wounds. Today we have a better understanding of the kind of moral and psychological toll wars take on soldiers, their families, and communities.

The United States is a leader in the understanding of psychological and emotional damage to soldiers and has taken some steps to address their mental health. The conflicts in Iraq and Afghanistan have left between 11% and 20% of military personnel suffering from PTSD. As many as 375,000 US veterans have been diagnosed with traumatic brain injuries between 2000 and 2017, mostly caused by explosions. 

But suicides in the US armed forces have continued to rise in recent years, reaching record levels in 2018 when there were 25 deaths per 100,000 service members. Former defence secretary Leon Panetta once said that the “epidemic” of military suicide was “one of the most frustrating problems” he had faced.

More than $350 billion has already gone to medical and disability care for veterans of the wars in Iraq and Afghanistan combined. Experts say that more than half of that spending belongs to the Afghanistan effort.

Homelessness among veterans is pervasive, and soldiers still struggle to access benefits and healthcare if they suffer from mental health issues rather than from physical wounds. At any given time in the US, more than 40,000 veterans are homeless, constituting around 9% of all homeless adults in the country. 

In the United Kingdom, spurred by a dozen suicides among Afghan war veterans in just two months, the government expedited new mental health programs to help deal with former military members’ PTSD and addiction. 

What does this now mean for the Afghan security forces? They and their families do not have the same support structures.

All this ‘hell’, but to what end? Afghanistan remains one of the world’s largest sources of refugees and migrants. Since 2004 alone, more than 1.8 million Afghans have become internally displaced. Afghanistan’s human development and progress has been set back by decades. Women and children have suffered the most and countless are emotionally and psychologically scarred for life.

While we like to see soldiers as stoic and heroic, we must open our eyes to the fact that wars scar minds as well as bodies, often in ways medical science cannot yet comprehend.

Just like the world is desperately seeking a cure to end the coronavirus pandemic which has killed over 275,000 people so far and leaving a trail of human, economic and social misery, the world too must find a way to end wars, or else we may be defeated as a civilization.

Siddharth Chatterjee, is the United Nations resident coordinator to Kenya. He has served with the UN and the Red Cross Movement in various parts of the world affected by conflicts and humanitarian crisis. He is also a decorated Special Forces veteran and a Princeton University alumnus. Follow him on Twitter @sidchat1

The views expressed in this article are the author’s own.​​​​​

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Climate Explained: How Much Of Climate Change Is Natural? How Much Is Man-made?

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How much climate change is natural? How much is man made?

As someone who has been working on climate change detection and its causes for over 20 years I was both surprised and not surprised that I was asked to write on this topic by The Conversation. For nearly all climate scientists, the case is proven that humans are the overwhelming cause of the long-term changes in the climate that we are observing. And that this case should be closed.

Despite this, climate denialists continue to receive prominence in some media which can lead people into thinking that man-made climate change is still in question. So it’s worth going back over the science to remind ourselves just how much has already been established.

Successive reports by the Intergovernmental Panel on Climate Change – mandated by the United Nations to assess scientific evidence on climate change – have evaluated the causes of climate change. The most recent special report on global warming of 1.5 degrees confirms that the observed changes in global and regional climate over the last 50 or so years are almost entirely due to human influence on the climate system and not due to natural causes.

What is climate change?

First we should perhaps ask what we mean by climate change. The Intergovernmental Panel on Climate Change defines climate change as:

a change in the state of the climate that can be identified by changes in the mean and/or the variability of its properties and that persists for an extended period, typically decades or longer.

The causes of climate change can be any combination of:

  • Internal variability in the climate system, when various components of the climate system – like the atmosphere and ocean – vary on their own to cause fluctuations in climatic conditions, such as temperature or rainfall. These internally-driven changes generally happen over decades or longer; shorter variations such as those related to El Niño fall in the bracket of climate variability, not climate change.
  • Natural external causes such as increases or decreases in volcanic activity or solar radiation. For example, every 11 years or so, the Sun’s magnetic field completely flips and this can cause small fluctuations in global temperature, up to about 0.2 degrees. On longer time scales – tens to hundreds of millions of years – geological processes can drive changes in the climate, due to shifting continents and mountain building.
  • Human influence through greenhouse gases (gases that trap heat in the atmosphere such as carbon dioxide and methane), other particles released into the air (which absorb or reflect sunlight such as soot and aerosols) and land-use change (which affects how much sunlight is absorbed on land surfaces and also how much carbon dioxide and methane is absorbed and released by vegetation and soils).

What changes have been detected?

The Intergovernmental Panel on Climate Change’s recent report showed that, on average, the global surface air temperature has risen by 1°C since the beginning of significant industrialisation (which roughly started in the 1850s). And it is increasing at ever faster rates, currently 0.2°C per decade, because the concentrations of greenhouse gases in the atmosphere have themselves been increasing ever faster.

The oceans are warming as well. In fact, about 90% of the extra heat trapped in the atmosphere by greenhouse gases is being absorbed by the oceans.

A warmer atmosphere and oceans are causing dramatic changes, including steep decreases in Arctic summer sea ice which is profoundly impacting arctic marine ecosystems, increasing sea level rise which is inundating low lying coastal areas such as Pacific island atolls, and an increasing frequency of many climate extremes such as drought and heavy rain, as well as disasters where climate is an important driver, such as wildfire, flooding and landslides.

Multiple lines of evidence, using different methods, show that human influence is the only plausible explanation for the patterns and magnitude of changes that have been detected.

This human influence is largely due to our activities that release greenhouse gases, such as carbon dioxide and methane, as well sunlight absorbing soot. The main sources of these warming gases and particles are fossil fuel burning, cement production, land cover change (especially deforestation) and agriculture.

Weather attribution

Most of us will struggle to pick up slow changes in the climate. We feel climate change largely through how it affects weather from day-to-day, season-to-season and year-to-year.

The weather we experience arises from dynamic processes in the atmosphere, and interactions between the atmosphere, the oceans and the land surface. Human influence on the broader climate system acts on these processes so that the weather today is different in many ways from how it would have been.

One way we can more clearly see climate change is by looking at severe weather events. A branch of climate science, called extreme event or weather attribution, looks at memorable weather events and estimates the extent of human influence on the severity of these events. It uses weather models run with and without measured greenhouse gases to estimate how individual weather events would have been different in a world without climate change.

As of early 2019, nearly 70% of weather events that have been assessed in this way were shown to have had their likelihood and/or magnitude increased by human influence on climate. In a world without global warming, these events would have been less severe. Some 10% of the studies showed a reduction in likelihood, while for the remaining 20% global warming has not had a discernible effect. For example, one study showed that human influence on climate had increased the likelihood of the 2015-2018 drought that afflicted Cape Town in South Africa by a factor of three.

Adapting to a changing climate

Weather extremes underlie many of the hazards that damage society and the natural environment we depend upon. As global warming has progressed, so have the frequency and intensity of these hazards, and the damage they cause.

Minimising the impacts of these hazards, and having mechanisms in place to recover quickly from the impacts, is the aim of climate adaptation, as recently reported by the Global Commission on Adaptation.

As the Commission explains, investing in adaptation makes sense from economic, social and ethical perspectives. And as we know that climate change is caused by humans, society cannot use “lack of evidence” on its cause as an excuse for inaction any more.

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The Rage And Tears That Tore A Nation

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Snapshots of the outrage against foreign nationals and protests against sexual offenders in South Africa in recent weeks, captured by FORBES AFRICA photojournalist Motlabana Monnakgotla.


As the continent’s second-biggest economy, South Africa attracts migrants from the rest of Africa. But mired in its own problems of unemployment and political instability, September saw a serious outbreak of attacks by South Africans on foreign nationals and foreign-owned businesses. And they have been ugly.    

The spark that fueled the raging fire was in Pretoria, the country’s capital, when a taxi driver was shot dead by a foreign national who was selling drugs to a youngster in the central business district (CBD).

The altercation caused a riot and the taxi industry brought the CBD to a standstill, blocking intersections. It did not stop there; a week later, about 60 kilometers from the capital in Malvern, a suburb east of the Johannesburg CBD, a hijacked building caught fire, leaving three dead. As emergency services were putting out the fire, the residents took advantage and looted foreign-owned shops and burned car dealerships overnight on Jules Street.

The lootings extended to the CBD and other parts of Johannesburg.

To capture this embarrassing moment in South African history, I visited Katlehong, a township 35 kilometers east of Johannesburg, where the residents blocked roads leading to Sontonga Mall on a mission to loot the mall and the foreign-owned shops therein overnight.

Shop-owners and workers were shocked to wake up to no business.

Mfundo Maljingolo, a worker at Fish And Chips, was among the distressed.

“This thing started last night, people started looting and broke into the mall and did what they wanted to do. I couldn’t go to work today because there’s nothing to do; now, we are not going to get paid. The shop will be losing close to R10,000 ($677) today. It’s messed up,” said Maljingolo.

But South African businesses were affected too.

Among the shops at the mall is Webbers, a clothing and footwear store. Looters could not enter the shop and it was one of the few that escaped the vandalism.

Dineo Nyembe, the store’s manager, said she was in disbelief when she saw people could not enter the mall.

“We got here this morning and the ceiling was wrecked but there was no sign that the shop was entered, everything was just as we left it. Now, we are packing stock back to the warehouse, because we don’t know if they are coming back tonight,” lamented Nyembe, unsure if they would make their daily target or if they would be trading again.

 Across the now-wrecked mall are small businesses that were not as fortunate as Webbers, and it was not only the shop-owners that were affected. 

Emmanuel Nhlane’s home was robbed even as attackers were looting the shop outside.

“They broke into my house, I was threatened with a petrol bomb and I had to stand outside to give them a chance; they took my fridge, bed, cash and my VHS,” said Nhlane.

Nhlane had rented out his yard to foreign nationals to operate a shop. He does not comprehend why his belongings were taken because he doesn’t own a shop. Now, it means that the unemployed Nhlane will not be getting his monthly rental fee of R3,700 ($250).

Far away, the coastal KwaZulu-Natal province of South Africa, was also affected as trucks burned and a driver was killed because of his nationality. This was part of a logistics and transport industry national strike.

Back in Johannesburg, I visited the car dealerships that were a part of the burning spree on Jules Street.

The streets were still ashy and the air still smoky, two days after the unfortunate turn of events.

Muhamed Haffejee, one of the distraught businessmen there, said: “Currently, we are still not trading.” 

Cape Town, in the Western Cape province of South Africa, which hosted the World Economic Forum (WEF) on Africa from September 4 to 6, was also witness to protests by women and girls from all walks of life outside the Cape Town International Convention Centre, demanding that the leadership take action to end the spate of gender-based violence (GBV) in the country.

There were protests also outside Parliament. What set off the nationwide outcry was the shocking rape and murder of Uyinene Mrwetyana, a 19-year-old film and media student at the University of Cape Town, inside a post office by a 42-year-old employee at the post office.

There was anger against the ghastly crimes and wave of GBV in the country that continues unabated. According to Stats SA, there has been a drastic increase of women-based violence in South Africa; sexual offences are up by 4.6%, from 50,108 in 2018 to 52,420 in 2019.

A week later, on a Friday, Sandton, Africa’s richest square mile and one of the biggest economic hubs, was shut down by hundreds of angry women and members of advocacy groups from across Johannesburg. They congregated by the Johannesburg Stock Exchange (JSE), the cynosure of business, singing and chanting, to demand “a 2% levy on profits of all listed entities to help fund the fight against GBV and femicide”.   

Among the protesters was Cebi Ngqinanbi, holding a placard that read: “I’m not your punching bag.”

“We came here to disrupt Sandton as the heart of Johannesburg’s economic hub. We want to make everyone aware that women and children are being killed every day in South Africa and they [Sandton] continue with business as usual, sitting in their offices with air-conditioners and the stock exchange whilst people on the ground making them rich are dying. That is why we are here, to speak to those that have economic power,” said Ngqinanbi.

She added that if women can be given economic power, they will be able to fend for themselves and won’t fall prey to abusive men, since most women stay in abusive relationships because men are more financially stable.

Amid the chanting and singing of struggle songs, Nobuhle Ajiti addressed the crowd and shared her own haunting experience as a migrant in South Africa and survivor of GBV. She spoke in isiZulu, a South African language.

“I survived a gang rape; I was thrown out of a moving car and stabbed several times. I survived it, but am I going to survive xenophobia that is looming around in South Africa? Will I able to share my xenophobia story like I can share my GBV story?” questioned Ajiti.

She said as migrants, they did not wake up in the morning and decide to come to South Africa, but because of the hardships faced in their home countries, they were forced to come to what they perceived as the city of opportunities. And as a foreign national, she had to deal with both xenophobia and GBV.

“We experience institutionalized xenophobia in hospitals; we are forced to pay huge amounts for consultation. I am raped and I need medical attention and I am told I need to pay R5,000 ($250).

“As a mere migrant, where am I going to get R5,000? I get abused at home and the police officer would ask me where I’m from because of my accent, I sound Zimbabwean. What does my nationality have to do with my husband beating me at home or with the man that just raped me?” she asked.

Women stop traffic while they hold up placards stating their grievences against GBV. Picture: Motlabana Monnakgotla

Addressing the resolute women outside was the JSE CEO Nicky Newton-King who received the memorandum demanding business take their plight seriously, from a civil society group representing over 70 civil society organizations and individuals.

The list of demands include that at all JSE-listed companies contribute to a fund to resource the National Strategy Plan on GBV and femicide, to be launched in November; transport for employees who work night shifts or work after hours; establish workplace mechanisms to provide support to GBV survivors as part of employee wellness, and prevention programs that help make workplaces safe spaces for all women.

Newton-King assured the protestors she would address their demands in seven days. But a lot can happen in seven days. Will there be more crimes in the meantime? How many more will be raped and killed in South Africa by then?

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