“He’s braindead, there’s nothing you can do, and you must start considering organ donation.”
This is what Anzel Schoeman was told by her sister while they were flying back to South Africa.
In 2005, they were on holiday in Egypt. As she was leaving a museum in Cairo, she was told to phone her father urgently. Tranquility turned to trauma. Her husband Nico Theron had been in a motorbike accident; Schoeman took the first flight home.
At the Pretoria East Hospital, Schoeman was with the doctors when they performed a series of tests to determine whether he was brain-dead or not.
“It’s traumatic to see this but it was then I realized this is just a body lying here; the brain is not operating, it’s a machine pumping air into the body,” says Schoeman.
With this realization, Schoeman had no hesitation in agreeing to donate Theron’s organs.
“Just before I left, we had discussed the subject because my sister was a doctor. For me, it wasn’t such a struggle to make the decision, [I didn’t have to wonder] ‘would he have wanted this?’ ” she says.
When a person dies, their heart, lungs, pancreas, kidney and liver can be used to save up to seven lives, according to the Organ Donor Foundation of South Africa (ODF). In addition to that, up to 50 people can be helped with tissue donation. The eye’s corneas, skin, bone, tendons and heart valves are used for this.
Schoeman agreed to donate most of Theron’s organs, but the doctors couldn’t use his lungs because of the scar tissue that formed during the trauma. The organs need to be harvested as quickly as possible to increase their effectiveness during the transplant process. Amid the trauma, and with little time to come to terms with what had happened, Schoeman made a sentimental decision.
“At that stage, I didn’t want to give his corneas because he had the most beautiful light blue eyes. I just couldn’t get over myself to say yes for the eyes.”
Unfortunately, that legacy is not being lived up to today.
“We have one of the lowest donor per million population rates; we have 1.8 donors per million population,” says Samantha Nicholls, the Executive Director of ODF.
“There is a critical shortage of organ donors in South Africa. Currently over 4,300 adults and children are awaiting a life-saving transplant and less than 600 transplants are performed annually. Many patients can wait years for a transplant and many die waiting as a result of this shortage,” she says.
There are a few reasons for this shortage, says Nicholls. These include a lack of awareness, religious and cultural misconceptions, and a lack of urgency.
“People do not realize the great need and do not want to think about their own death and the gift they could give through their death. They think it will never happen to them, some think organ donation is unnecessary because they are fit and well, and they do not consider those who are affected by organ failure,” says Nicholls.
Two women who are acutely aware of South Africa’s dire need for more organ donors are Annette Otto and Lizette Cooke. As Procurement Co-ordinators – for healthcare company Netcare – they work with organ donors every day.
They need to assess the patient to see if they are a possible candidate. They then need to talk to the patient’s family to see if they would like to donate. If the family agrees, the procurement co-ordinators do assessments, such as blood tests and x-rays, to determine the functionality of the organs. Once all this is done, they need to refer with everyone else involved in the process to decide who’s going to use what.
It’s a long and emotional process.
“It’s a body lying on a bed on machines and there’s a heartbeat and all the organ functions are there. It looks like this person is sleeping and you have to go and convince the family that this person is dead. Only when they understand that he’s dead can you talk to them about organ donation, otherwise they think you’re going to kill him to get his organs,” says Otto.
The World Trade Organization estimates that 5% to 10% of organ transplants around the globe are done so illegally. In South Africa, between 2001 and 2003, 109 illegal kidney transplants took place at St Augustine’s hospital in Durban.
An Israeli organ-broking syndicate allegedly brought paying Israeli citizens in to South Africa, where they would receive a kidney from willing sellers for $120,000.
“I’m not aware of any incidents of illicit trade… It’s difficult to police, these things can happen. What we can’t account for is illicit trade in human organs for uses other than transplantation; for medicinal uses in the communities, for body parts being stolen from mortuaries. That I’m sure happens. But from a transplant perspective, we have organ registers of what transplantation happens around the country and we look out for this type of thing,” says Professor Jerome Loveland, the Head of Paediatric Surgery at Chris Hani Baragwanath Hospital, in Soweto, and the President of the South African Transplantation Society.
To help prevent trafficking, two independent doctors have to verify that a person is dead before organs can be harvested. Schoeman took part in this process when her husband died.
“Before this, his hands would twitch and I’d call the doctors and tell them. But they said, ‘No, the brain is trying to send impulses to the body but nothing is happening’,” says Schoeman.
“There are various tests they do. One of them is called the doll’s eye where they keep the eyes open and move the head from side to side. If there’s brain function, your eyes will try to focus on something as they turn the head, and there was nothing. The other one is they prick them with needles on their knees and underneath their feet and watch whether they flinch. Another one is taking them off the oxygen and see if they want to inhale. These things are instinct, you can’t control them,” she says.
Otto’s first case was helping Schoeman through the process of organ donation.
“Annette and them came and explained the benefits of organ donation. They don’t switch off the machines because they want the organs. They’re not like vultures sitting there waiting. They keep you calm and updated,” says Schoeman.
It can be a delicate process.
“The family has to have time to absorb everything you tell them. You can’t give them all the information and then say you need a decision. You have to step back and let them do what they need to do,” says Cooke.
“We help them make a decision, at a difficult time, that is right for the family. Organ donation is not always the right decisions for a family, especially with different cultures,” adds Otto.
“I was dealing with two young men who lost their sister and they knew about organ donation but one of them said we have a problem because he had to speak to the elders. He said I know my sister would have wanted to donate organs but when I speak to the elders they’re not going to understand this. So he had to decide whether he continues and doesn’t tell the elders, or is he going to talk to the elders,” says Otto.
“The younger generation is open to organ donation but the older generation isn’t. If he had gone ahead with the donations he could be extricated from the community,” says Cooke.
Although Otto and Cooke’s job is to find organs that could save someone else’s life, there is an ethical line they can’t cross.
“I had boys who wanted to donate organs but they hadn’t included their grandmother, who raised them, in the decision. They said she would say no but I had to tell them to speak to her. She needed to be part of the decision,” says Otto.
“It’s the same if someone says they only want to donate kidneys, you can’t use the rest of the organs. One girl said we can’t use her dad’s eyes or his heart. She said he looked at me with his eyes and he loved me with his heart. The other organs we could have but the eyes and heart were emotional to her.”
It’s not only an emotional time for donors. Thousands of people in South Africa are anxiously waiting for an organ.
“I’ve also been with people who are on the list waiting for organs… They sit and wait for somebody to die. For them to mentally get past this [guilt] of wanting somebody to die so they can live – I tell them it’s ok to ask, because it’s ok for us who are left behind,” says Schoeman, who works as a volunteer for ODF.
Being on this list doesn’t guarantee you’ll get an organ.
“The first thing you have to take into account is blood group compatibility. The next question is who is the sickest patient on the list. It is tailored by the size of the organ, so the height and weight of the donor come into the decision-making process. You can’t put an adult’s liver into a five-year-old. Last Saturday, the sickest patient was a 19-year-old woman with an auto-immune disease and she got the liver. However, access to a transplant unit is different. If you’re living outside an urban area, and the same applies if you’re not on a medical aid, your access to a transplant center is not as easy,” says Loveland.
Loveland often has to travel with the organs on a commercial plane as they are transported from the donor in one city to the recipient in another. He keeps the organ in a cooler box on his lap during the flight.
“They need to be kept cold. When we harvest organs, we instill a cold preservative fluid into the organs to preserve them and bring down the metabolic rate. It allows us an opportunity to keep the organ out of the body but that time is very limited. For a kidney, you’ve 24 hours as your cut-off but for a liver you’re looking at eight hours. The sooner we can get them where they need to be the better,” he says.
In many cases in South Africa, those that need organs don’t get them.
“If a patient dies while waiting for an organ it is devastating. It’s part of the reality; you’re working with death all the time,” says Cooke.
Cassie Walkers, a former policeman, was fortunate enough to get a kidney from his daughter, Philna, in October 2016. Emotion floods through him as he talks about having to take an organ from his child.
“It’s a big thing; but I had to decide [between taking my daughter’s kidney or] to go on like that and die within two or three years, you can’t go on dialysis forever… I knew my chances weren’t good, to get an organ with the right blood type and at my age, there was almost no chance,” says Walkers.
Walkers has polycystic kidneys. He says when the doctors removed his kidney it was as big as an ostrich egg and weighed 14kg.
“I was in hospital for three weeks to take the kidney out,” he says. He creates a rugby ball sized shape with his hands to show the hole they had to cut in his abdomen.
“They had to take it out in pieces.”
His life has changed dramatically since the transplant.
“It’s unbelievable. I’m living again. Within the next three or four weeks I’m going to play golf again… I haven’t played for 10 years because I wasn’t able to hold a club,” he says.
Because it was his daughter, Walkers knows who he got his kidney from. Donors that aren’t family need to be kept anonymous.
“An organ donor and their family have just made a massive decision and they need to be alone in that. You don’t need seven, eight or nine families harassing them, even if it’s to say thank you. Also, it’s up to us medical practitioners to decide what organs are suitable to use and how to use them. It’s not for the patient to then go and say ‘I’m 23, why did you put a 44-year-old’s liver into me?’ ” says Loveland.
Accidentally, Schoeman has met one of the recipients of Theron’s organs. She gave a speech at a tribute day attended by families of donors and recipients. She told her story and mentioned the date of Theron’s death, which triggered the curiosity of a particular family.
“This lady came up to me. I could see she was very nervous. She was asking me questions about my husband and eventually I said ‘ma’am, what do you want to ask me?’ She kept quiet and her husband was standing next to her and then she said, ‘you know what, my husband has your husband’s kidney’. The tears just started flowing and eventually his two sons came to me and just stood there; they couldn’t talk to me. The one eventually said ‘I’m a lawyer, I know how to use words, that’s my business, but the only words I can say to you is thank you because my dad is still alive’,” says Schoeman.
While talking to FORBES WOMAN AFRICA about this, tears start streaming down her cheeks.
“For me, it was nice to meet them and see this person doing well. There was nothing like me seeing something of me, or my husband, in this person. There was no such feeling. I was just so overjoyed that this father still had their father and grandfather.”
She says after Theron’s organs were harvested and the recipients were prepared, her own process of healing started and it helped to know she had helped someone else.
“I had this peace of mind to give. By giving you’re helping so many others.”
As Walkers finally walks on a golf course again, he will understand this more than most.
No Seat At The Global Table For Indigenous African Cuisine
Gastronomic tourism based on African food could easily increase and create new value chains that unlock billions in untapped wealth for the continent, but what is stopping us?
Food and tourism are an integral part of most economies, globally. Food is undeniably a core part of all cultures and an increasingly important attraction for tourists. To satisfy their wanderlust, contemporary tourists require an array of experiences that include elements of education, entertainment, picturesque scenery and culinary wonders. The link between food and tourism allows destinations to develop local economies; and food experiences help to brand and market them, as well as supporting the local culture and knowledge systems.
This is particularly important for rural communities, where 61% of sub-Saharan Africans live, according to the World Bank last year. These communities have often felt the brunt of urbanization, which has resulted in a shift away from rural economies. If implemented effectively, Africa could get a piece of the gastronomic tourism pie, which was worth $8.8 trillion last year, according to the World Travel & Tourism Council.
However, there is currently very little public information to pique the interest of tourists about African food. World-renowned South African chef Nompumelelo Mqwebu sought to remedy this with her self-published cookbook, Through the Eyes Of An African Chef.
“I think where it was very clear to me that I needed to do something was when I went to cooking school. I trained at Christina Martin School of Food and Wine. I thought I was actually going to get training on South African food and, somehow, I assumed we were talking indigenous food.
“I was shocked that we went through the whole year’s curriculum and we didn’t cover anything that I ate at home; we didn’t cover anything that my first cousins, who are Sotho, ate in Nelspruit (in South Africa’s Mpumalanga Province); we didn’t cover anything that would come from eSwatini, which is where my mother is from,” Mqwebu says.
By self-publishing, she has ultimately contributed to a value chain that has linked local food producers and suppliers, which includes agriculture, food production, country branding and cultural and creative industries.
“I am a member of Proudly South African, not only my business, but the book as well. Part of the reason is that the cookbook was 100% published in South Africa. So, everybody who worked on the cookbook, and printing, was all in South Africa, which is something quite rare these days because authors have their books published abroad.”
The Proudly South African campaign is a South African ‘buy local’ initiative that sells her cookbook on their online platform as its production adheres to the initiative’s campaign standards. Self-publishing has allowed Mqwebu to promote her book for two years and to directly communicate with her audience in a way she thought was best, while exposing her to a vast community of local networks. She recalls her first step towards creating her own body of work.
“I was in culinary school when I wrote the recipe for amadumbe (potato of the tropics) gnocchi. We were making gnocchi and I thought, ‘so why aren’t we using amadumbe because it’s a starch?’ and when I tasted it, I thought, ‘this could definitely work’. I started doing my recipes then.
“And there was talk about, ‘we don’t have desserts as Africans’. I did some research and found we ate berries, we were never big on sugar to begin with. That’s why I took the same isidudu (soft porridge made from ground corn) with pumpkin that my grandmother used to make and that became my dessert. “I also found that when I went to libraries looking for indigenous recipes, I couldn’t really find something that spoke to me as a chef. I found content that looked like history books. It was not appealing. It was not something, as a chef, I could proudly present to another chef from a different part of the world, so I knew I had to write my book,” Mqwebu says about the award-winning recipe book that chronicles African cuisine.
Financial and health benefits
According to the World Travel & Tourism Council, in 2018, the tourism sector “contributed 319 million jobs, representing one in 10 of all jobs globally and is responsible for one in five of all new jobs created in the world over the last five years. It has increased its share of leisure spending to 78.5%, meaning 21.5% of spending was on business.”
To narrow in on how lucrative food can be, the World Food Travel Association estimates that visitors spend approximately 25% of their travel budget on food and beverages. The figure can get as high as 35% in expensive destinations, and as low as 15% in more affordable destinations. “Confirmed food lovers also spend a bit more than the average of 25% spent by travelers in general.”
However, there is a widely-held view that the African continent is not doing enough to maximize its potential to also position itself as a gastronomic tourism destination, using its unique edge of indigenous knowledge systems (IKS).
“We are not a culinary destination and we will never be while we are still offering pasta as the attraction for our tourists,” Mqwebu says.
Dr George Sedupane, who is the Coordinator of the Bachelor of the Indigenous Knowledge Systems program in South Africa’s North-West University, echoes Mqwebu’s sentiments.
“I often cringe when I go to conferences and there are guests from all over the world and we serve them pasta. Why would they come from Brazil to eat pasta here? They can have pasta in Italy. Why don’t we serve them umngqusho (samp and beans)?
“We need to be creating those experiences around our culture. We are failing to capitalize on our strengths. There is a lack of drive to celebrate what we have,” says Sedupane, who also teaches modules and supervises research in indigenous health and nutrition.
Writer and historian Sibusiso Mnyanda says current innovations in African food technology are born out of necessity, rather tourism and cultural ambitions.
“Food security is becoming an issue that is leading to IKS around farming being prioritized. In Nigeria, they are innovating dry season farming, because of deforestation and soil being de-cultivated.
“So those indigenous knowledge strategies are being used in countries where it is a necessity and where there are enough advances related to the fourth industrial revolution. The traditional ways of producing food are not only much more organic, they are also crop-efficient,” Mnyanda says.
Nigeria may have inadvertently innovated a health solution related to colon cancer through its diet. Sedupane tells FORBES AFRICA an anecdote.
“There was a study where the colons of an African country that did not consume a lot of meat was compared to Europeans. The Africans had a much better profile as a result and there are people who want to buy African stool to get that kind of rich bacteria, that you get on an African plant-based diet.”
The study Sedupane is referring to was conducted in Nigeria and it states that: “Nigeria showed the average annual incidence of colorectal cancer was 27 patients per year. This shows that even if it seems that incidence rates are increasing in Nigeria, such rates are still about one-tenth of what is seen in the truly developed countries.”
In a bid to find reasons for this rarity of colon and rectal cancer, the study concluded that, among other reasons, the protective effects of Nigeria’s starch-based, vegetable-based, fruit-based, and spicy, peppery diet, and geographical location which ensures sunshine all year round, played a role in the country’s colon health.
Interestingly, it seems the potential value of African food could not only be based on what goes in but what also comes out as healthy faecal matter is big business globally. In 2015, The Washington Post published that one could potentially earn $13,000 a year selling their poop.
The American-based company OpenBiome has been processing and shipping frozen stool to patients who are very sick with infections of a bacteria called C.difficile. It causes diarrhea and inflammation of the colon, leaving some sufferers house-bound. “Antibiotics often help, but sometimes, the bacteria rears back as soon as treatment stops. By introducing healthy faecal matter into the gut of a patient (by way of endoscopy, nasal tubes, or swallowed capsules), doctors can abolish C. difficile for good… And yes, they pay for healthy poop: $40 a sample, with a $50 bonus if you come in five days a week. That’s $250 for a week of donations, or $13,000 a year,” the publication stated.
Sedupane is of the view that a diet which includes indigenous foods could vastly improve one’s quality of life.
He says small changes could be made, such as including more of indigenous greens, namely sorghum and millet, to breakfast. The grains are gluten-free and produce alkaline which boosts the pH level of fluids in the body and reduces acidity.
“Moving to our legumes, we have indlubu (Bambara groundnut) which is very rich and helps in the secretion of serotonin in the brain. This so important nowadays with the increase of depression. It’s easy to digest, and is great for cholesterol and moderating blood sugar,” Sedupane says.
Mnyanda is also of the view that food is imperative to health and medicinal properties. He says traditional healers primarily use natural herbs in their practice. “These are used in pain relief and healing. Things like cannabis, camphor, African potatao and red carrots. So, food is not just used for nutritional purposes.”
Other African superfoods include, Baobab fruit, Hibiscus, Tamarind, Kenkiliba, Amaranth, Moringa and pumpkin leaves.
Cultural and historical benefits
Gastronomic tourism also includes the promotion of heritage sites that are known to revolve around dishes that are of historic importance. They enhance the travel experience, they encourage the acquisition of knowledge and a cultural exchange.
There is a unanimous view that vast amounts of knowledge have been lost to history and there is a huge knowledge gap in African societies as a result of colonization and urbanization.
“Part of the colonial agenda was to make sure food security did not belong to indigenous groups. Therefore, archiving of these knowledge systems was not a priority. Especially during industrialization, where people moved from their villages to the city you found that the knowledge got left behind,” Mnyanda says.
He offers a contemporary example of how modernization continues to push African practices to the fringes: “To this day, abathwa (the San people) hunt their meat, but you find that because of changing agricultural practices and land reform on the Kruger National Park, they are being forced to move into the cities and industrial areas, therefore they are no longer able to practice their culture of hunting. As a result, their diet is changing.” Sedupane shares the view that the fundamentals of farming and astrology have also been exiled from public knowledge.
“The fundamentals of IKS were based on the understanding of the laws of nature – how and when things were done. Harvest cycles were linked with understanding astrology. They would not harvest until certain stars were visible in the sky. There was a dependence on nature.
“With industrialization, rather than working with nature, humans are seen as being above, as controlling, as directing it. The natural cycle is often tempered with rather than trying to work with it.”
Not all is lost however. There are historical practices that have stood the test of time and continue to be a part the few foods that are internationally associated with South Africa. Mqwebu says that, “historically, we ate more plants than meat because our ancestors had to hunt and the game back then was not tame. So, there were no guarantees that you would return with meat. And that’s where things like umqwayiba (biltong) come from. They had to preserve the meat, because wasting was not part of the culture”.
According to a 2015 exploratory research project conducted under the guidance of research institute Tourism Research in Economic Environs and Society director Professor Melville Saayman, biltong contributes more than R2.5 billion ($163 million) to the South African economy.
Perhaps, like the faecal transporting company, Africa will soon realize the ‘wasted’ opportunity and that there is loads of money to be made in gastronomic tourism for all its inhabitants, whether they are rural or urban, technological or indigenous.
Potential Cases Of Vaping-Related Illnesses Are Climbing
The number of potential vaping-related illness incidents under investigation by health federal authorities keeps climbing, as officials narrow their search on counterfeit vaping products, according to a report from the Washington Post.
- The Federal Drug Administration and the Centers for Disease Control said Friday they are investigating 215 potential cases of respiratory illness reported after use of e-cigarettes across 25 states. That’s up from 153 last week.
- Health officials say patients reported a gradual start to symptoms, such as breathing difficulty, shortness of breath and chest pain before hospitalization. Some cases reported vomiting, diarrhea, fevers or fatigue.
- According to the Washington Post, the investigation is focusing on counterfeit or black-market products that use potentially mislabeled solvents that consumers buy themselves.
- The announcement comes a week after the first vaping-related illness death was reported in Illinois.
Key Background: Although scientists are still unsure of vaping’s long-term health impact, most believe that e-cigarettes are a less dangerous nicotine source than tobacco cigarettes. The CDC recommends that all nonsmokers stay away from vaping.
The CDC warned users Friday of buying e-cigarette products off the street or adding any substances to products that are not intended by the manufacturer.
-Rachel Sandler; Forbes
Tasty Vegan Options: Consumed By Healthy Eating
The restaurant market still hungers for healthy options. This entrepreneur is feeding that need, serving earth-conscious customers and gym junkies.
Her desperation for a healthy meal fueled the fire for business.
Leigh Klapthor, 31, couldn’t find enough eateries that sold healthy food that was not bland, so decided to start her own.
“It is no fun to go out with friends and you are always the girl with the green salad,” she says.
“I wanted to find a way where being healthy is not such a chore and I also wanted for it to be affordable.”
Klapthor, who dropped out of a course in marketing communications at the University of Johannesburg, ditched a job in corporate marketing to pursue her passion for food.
In 2017, she started Sprout Café at the Stoneridge Centre in Edenvale in Johannesburg with a loan she received from her husband’s business and money that was given to them as a wedding gift.
“Everybody underestimates what everything will end up costing [when starting a new business]. In my mind, I thought R150,000 ($10,588) would work. I thought I would get my shop fitting and everything done and in the first month we would be able to pay salaries with the money we make,” says Klapthor.
But she soon realized the unforeseen challenges faced by many entrepreneurs. She had to eventually pump in a capital of R350,000 ($24,706) to start the venture.
“So I had a couple of life lessons at the beginning. I had to end up using our savings but I didn’t mind having to do that because I trusted and believed in the vision.”
But though she did, the banks did not because they often declined all her loan applications.
“I think there are so many young black and enthusiastic individuals that have brilliant ideas and vision but the investment capital is not there. Though I do not have the capital as well to assist them, I would say keep going because the vision is greater,” Klapthor says.
Sprout Café offers health food, light meals, vegan food, and vegetarian and ketogenic diet food.
With her corporate marketing skills, she advertised her food on social media and gained a lot of traction.
“I want to create food on Instagram and people are like, ‘oh my God, I want to eat that’ and when they come into the store, it is the same deliverable they receive,” she says.
Sprout Café turns over R3 million ($211,677) annually and has 10 employees.
After only two years of business, she has recently opened a second branch in the heart of the busy Moove Motion Fitness Club in Sunninghill in Johannesburg.
“There are people that are on specific diets and there is no one that is giving these people food. There is no one that is saying, vegan people want to be healthy too. They are making a conscious decision to preserve the environment and preserve their health and they are making these decisions but there is no one that is there to accommodate them.”
Klapthor says that the world is moving towards a plant-based lifestyle and she believes that many have recently caught on to that idea recently.
Trend translator Bronwyn Williams of Flux Trends, reiterates Klapthor’s views on how the world is adopting healthier habits. She believes that Generation Z is choosing good, clean fun the most.
“Yes, South Africa is not exempt from the global movement towards more locally-sourced and earth-friendly products and packaging,” Williams says.
However, Williams believes that because 64.2% of the South African population still lives in poverty, clean and organic food still remains costly for the majority of people.
“That said, unfortunately, earth-friendly consumer options remain a luxury that only the upper middle class can really afford to support and enjoy… certified organic, eco-friendly products tend to cost far more—up to 40% more than ‘regular’ packaged produce, it would be disingenuous to say that what the market wants is locally-sourced, earth-first produce when the majority of South Africans are struggling just to put any food on the table,” Williams says.
Though Klapthor knows more people are opening healthy-eating establishments because they see that it is a trend, she believes that they need to be in touch with the reality of an ordinary person’s life and consider the cost implications.
“You can’t charge someone R150 ($10.59) for a Beyond Meat burger and expect her to come back tomorrow for the same burger. People are tight with their money and they work hard for it, they do not want to let go, for instance, of R500 ($35.29) in three days,” Klapthor says.
“We want to provide a healthy lifestyle, something that is consistent and that people can live through, and not just a treat-themselves-to at the end of the month. Every day, you should be able to eat a Sprout meal without having to feel any kind of guilt and shame.”
Obviously, it is a concept that has worked and keeps her business healthy as well.
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