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Child saved in HIV+ transplant Wits University doctors transplanted the liver from a mother living with HIV to her critically ill HIV negative child By Staff Reporter news@inner-city-gazette.co.za
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nner-City based Wits University doctors transplanted the liver from a mother living with HIV to her critically ill HIV negative child, who had end-stage liver disease. In South Africa, a country with the largest anti-retroviral therapy (ART) programme in the world, people with HIV live long and healthy lives. The success of this world-first operation thus presents a potential new pool of living donors that could save additional lives. Leveraging “living positive” to save more lives In a paper published in prestigious, peer-reviewed journal AIDS on October 4, 2018, scientists in surgery, ethics, and HIV from the University of Witwatersrand, Johannesburg (Wits) explain how a chronic shortage of organs compromise their efforts to save lives, and how the decision they made to perform a world-first operation could advance transplantation. Jean Botha, principal investigator and transplant surgeon is Professor of Surgery in the Department of Surgery in the School of Clinical Medicine, Faculty of Health Sciences at Wits University. “Two aspects of this case are unique. Firstly, it involved intentional donation of an organ from a living HIV positive individual. Secondly, pre-exposure prophylaxis [medication to protect atrisk individuals from contracting the HI
Wits Transplant Team FROM LEFT TO RIGHT: Dr June Fabian, Dr Harriet Etheredge, Prof. Jean Botha, Prof. Caroline Tiemessen Dr Francesca Conradie
virus] in the child who received the organ may have prevented the transmission of HIV. However, we will only know this conclusively over time,” says Botha, who is also Director of Transplantation at the Transplant Unit at the Wits Donald Gordon Medical Centre. Currently, the Wits Donald Gordon Medical Centre is the only Transplant Programme doing living donor liver transplantation in southern Africa. It is also the first privately administered teaching hospital in Johannesburg and, as a Wits hospital, advances specialist training and research. In this case of transplanting a liver from an HIV positive donor to a non-infected recipient, the transplant team had to unpack the potential risks and benefits to both. The Human Research Ethics Committee (Medical) at Wits University approved the liver transplantation from the mother living with HIV to her HIV negative child. Their personal details remain confidential. The child – on the waiting list for a deceased donor for 180 days (the average is 45 days) – was frequently admitted for
life-threatening complications of endstage liver disease. Without transplant, the child would certainly have died. However, saving the child’s life needed to be balanced against harm to the donor and the risk of almost certainly transmitting HIV if the mother was the donor. Dr Harriet Etheredge is a medical bioethicist who holds an honorary position in the Department of Internal Medicine, School of Clinical Medicine at Wits, and oversees Ethics and Regulatory Issues at the Wits Donald Gordon Medical Centre. “Extensive efforts were made to identify either a deceased liver donor or an HIV negative living donor for the child before considering an HIV positive parent donor. Transplanting HIV positive organs is not illegal in South Africa; however, it is not considered best practice internationally because of the risk of HIV transmission to the recipient. To minimise risk to donors and recipients, this operation is offered only under exceptional circumstances. Full consent is required from the parents who must be
able to care for a child infected with HIV,” says Etheredge, whose PhD is in the field of medical ethics and organ transplantation. In this transplantation case, the mother asked a number of times for the opportunity to save her child’s life by donating a segment of her liver. For this mother, quantifying the risk was simpler for the transplant team. Dr Francesca Conradie, HIV clinician, notes, “When considering an HIV positive parent, it is important that they have an undetectable viral load. This means that they know they are HIV positive and that they have been taking their antiretroviral medication properly for at least six months”. This made the risk of donation equivalent to that of an HIV negative living donor. However, living liver donation is never a risk-free procedure, and the team took care to ensure that the mother understood the full ambit of the risk she was undertaking. “Our Independent Donor Advocate helps the parents understand the risks, makes representations to the transplant team on behalf of the donor if necessary,
and provides emotional support throughout the process,” says Etheredge. Intentional transmission of HIV to save a life The transplant team faced the dilemma of saving the child’s life whilst at the same time knowing that the child might end up HIV positive because of this decision. However, because this intentional HIV positive living donor liver transplant is likely a world first, the actual chance of transmitting HIV was unknown. The team decided to work on the basis that the child would contract HIV, and provide management accordingly. But in the time since the transplant, there have been some surprises when it comes to the child’s HIV status. “In the weeks after the transplant, we thought that the child was HIV positive, because we detected HIV antibodies,” says Botha. The transplant team then accessed specialised testing by HIV experts at the National Institute of Communicable Diseases (NICD) who subsequently could not find any active HIV infection in the blood stream of the child, meaning there is a chance that the child is HIV negative. Caroline Tiemessen is Research Professor in the School of Pathology at Wits and head of Cell Biology within the Centre for HIV and STIs. “At the moment, we are developing new methods for testing the child, and we hope to be able to have a definitive answer to the question of seroconversion in future.”
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For further information Contact Boston on 011 551-2000, e-mail info@boston.co.za, visit www.boston.co.za, or Facebook.
Getting to the Starting Line: Investing in South Africa No degree or diploma exemption? No problem! This is YOUR path to access higher education and degree or diploma studies. Visit any Boston support centres nationwide to find out more about the range of Higher Certificates! By Dr Rob Stegmann, Boston City Campus & Business College
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sychologist, Angela Duckworth, has studied what makes successful people, successful. She discovered that the hallmark of high achievers is this quality she calls grit— the combination of passion and perseverance for a singularly important goal. At Boston, we have witnessed students who have grit, who despite the odds stacked against them, have somehow managed to push through and graduate. We have also observed students who have all the ingredients for success.The passion is there.The will to achieve is there.But for one seemingly insurmountable obstacle—finances—these students will not see the finish line. It has too often been the case that students will either exclude themselves from pursuing a higher education qualification or will drop out mid-stream because of a lack of financial support. At Boston, we feel that education is too important for the lack of finances to be the reason for not pursuing a higher education qualification. We believe that gritty prospective students who are already
showing their commitment to making a go at life by taking the first steps to apply at Boston, deserve an investment in their future. And, so, in the spirit of Ubuntu—a person is a person through other people—Boston is committing itself to make an investment in the future of South Africa by partnering, financially, with prospective students. This investment will mean that prospective students enrolling in one of the many Higher Certificates on offer at Boston will get a chance to pursue their dreams and take ownership of their futures. The investment in YOU is a shared investmentin YOUR future. Boston will invest up to a third of the fees for a Higher Certificate and students will be required to contribute the remaining fees (with flexible payment options). South Africa’s future is too important not to make this investment. The rewards for students and society are incalculable. Overcoming the obstacle that the lack of finances often poses for students pursuing higher education, so the research has shown, makes a significant
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FACTOID: Why are Higher Certificates (NQF Level 5, 120 credits) important qualifications? In 2017, 86 364 candidates obtained the National Senior Certificate (NSC) with endorsement for Higher Certificate entry only, excluding these students from entry to Degree or Diploma studies. The Higher Certificate is an entry-level higher education qualification that is primarily vocational, with strong industry-oriented focus to provide students with the basic introductory knowledge, cognitive and conceptual tools and practical techniques for further higher education studies and/or entry into the world-of-work. impact on the psycho-social well-being of students and this has a positive effect on the successful completion of one’s studies. In turn, the impact on the broader society is also noticeable. Graduates who find employment not only make a contribution to the economy, they become billboards for the transformative power of education. Grit is important. It is what will get you over the finish line. But, sometimes you need someone to
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get you to the start line. At Boston, we believe that our investment in students with an NSC (Higher Certificate endorsement) applying for any of ourHigher Certificates will get students to the starting line where we know they will show their grit and reach their dreams and make an impact on South Africa. [Benefit by choosing Boston. Textbooks included! No application fees! A unique student experience. Study from home/work OR
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Construction on Inner City intermodal transport facility delayed
By Staff Reporter news@inner-city-gazette.co.za
T
he City of Johannesburg is a major sub-Saharan transport hub with hundreds of thousands of visitors, workers and residents travelling between the city and destinations across South and Southern Africa. To guarantee that they can travel safely and with dignity, the City has been constructing a long distance and cross border bus and mini bus taxi transport interchange alongside Park Station in the Inner City.
To be named the Johannesburg International Transport Interchange (JITI) when completed, it will have facilities for 20 buses and over 150 taxis to rank at any one time as well as holding facilities for over 600 taxis. There will also be retail facilities, waiting spaces and ablution facilities. The project was being implemented for the Department of Transport by the Johannesburg Development Agency (JDA), the Development Agency of the City of Johannesburg. The project, on which construction started in July
2016, was due to be completed within the next couple of months. However, construction has been delayed due to the fact that the leading Joint Venture partner of the main contractor on the project, Basil Read, filed for business rescue in June 2018. This was after a number of delays and challenges that the JDA had been facing with the construction consortium which lead to the contractor failing to reach practical completion in March 2018. As a result the JDA had no option but to terminate the contract with
the Joint Venture Consortium, as the Joint Venture could not provide the necessary construction guarantee as required and they did not have the financial capacity to complete the works says Christo Botes, CEO of the JDA. The JDA is now proceeding with a new procurement process to source a new contractor. This will lead to at considerable delay and completion is now targeted for September 2019. “We apologise, especially to our long distance and cross border visi-
tors, for this delay but promise that when complete, JITI will change your experience of long distance travel� said the Member of the Mayoral Committee for Transport, Cllr. Nohlanhla Makhuba. Detailed traffic and pedestrian management plans can be downloaded on www.jda.org.za, updates can be found on Facebook (Johannesburg Development Agency). While the process for the procurement of a new contractor continues, the JDA has made sure that the site will be well secured.
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Pay increase for Security officers By Staff Reporter news@inner-city-gazette.co.za
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he long-awaited new private security prescribed minimum wages kicked-in on 01 October 2018, the Department of Labour announced. The previous prescribed minimum wages in the sector expired on 31 August 2018, with the new sectoral determination supposed to start on 01 September 2018. However, this was delayed due to a pending collective agreement. Although the sector recently registered at the Bargaining Council, they have not concluded a collective agreement, the department said, adding that the current sectoral determination will still be enforced. According to the department, the current minimum wage increases for all other categories (e.g. Clerical staff, artisans, control centre operators, drivers, general workers etc.) of employees including Grade A and B security officers, have been determined by utilizing the consumer price index (CPI) plus 1% as stated in the Sectoral Determination which totals to 6.4%. Grade C, D and E is predetermined rates as per Private Security Sectoral Determination published in the Government Gazette no: 39156 dated 1 September 2015 which was signed as part of the threeyear minimum wage determination. The new minimum wage for security officers in Area A which constitutes major metropolitan areas will be R5 209 (2016: R4 896), Grade B is R4 668 (2016: R4 387 and Grade C is R4 102 (2016: R3 797) and D and E is R4 102 (2016: R3 792). While the new minimum wage for security officers in Area 2 (all other areas) for Grade A will be R4 323, Grade B is R3 934 and Grade C, D and E is R3 414. Area A includes major metropolitan areas such as:
Alberton, Bellville, Benoni, Boksburg, Bloemfontein, Brakpan, Camperdown, Chatsworth, Durban, East London, Germiston, Goodwood, Inanda, Johannesburg, Kempton Park, Kimberley, Klerksdorp, Kuils River, Mitchell’s Plain, Nigel, Oberholzer, Paarl, Pietermaritzburg, Pinetown, Port Elizabeth, Pretoria, Randburg, Randfontein, Roodepoort, Sasolburg, Simon’s Town, Somerset West, Springs, Stellenbosch, Strand, The Cape, Uitenhage, Vanderbijlpark, Vereeniging, Westonaria, Wonderboom, and Wynberg. The announcement was made at the end of the Private Security public hearing held in Kimberley, Northern Cape which is reviewing the current prescribed minimum wages and conditions of employment for the Private Security Sector. Labour Deputy Director for Employment Standards, Shaun Feldman, told the hearing that workers and employers in the industry need to make their inputs before the promulgation of the new sectoral determination. Feldman cautioned that the current review comes on the back of tough economic conditions amidst a recession. He said the Bargaining Forum had proposed a 6.7% increase in the new minimum wage determination. The Private Security Sectoral determination applies to every employer and employee in the sector including car guards. Private Security Sector includes employers and employees associated for the purpose of guarding or protecting: fixed property, premises, goods, persons or employees, in including monitoring and responding to alarms at premises which are guarded by electronic means. The rates are determined by areas where duty is performed. Workers in the Private Security are demanding a minimum wage of R7 500.
Contact Lorraine Makgale on:
4 - 11 October 2018
CoJ Bursary Applications for 2019 academic year now open
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he City of Johannesburg is committed to providing skills development opportunities, not only for its employees, but also for the youth of Johannesburg. This commitment is supported by the City’s approved training and development policy, which makes provision for a bursary scheme as a strategic mechanism to help students who intend to pursue academic studies at recognised tertiary institutions in South Africa. The scheme funds undergraduate studies to the tune of R25 000 a year. In a statement the City says, “we understand and fully appreciate the challenges that young people face when they want to enroll for a degree or diploma at institutions of higher learning. “This is compounded by high rates of unemployment in the country as a whole. Many of our residents, especially our youth, have to bear this on a daily basis. On our part, the City is offering 100 bursaries for the 2019 academic year. “This will help our youth to upgrade their skills
and improve their prospects for employment. “While these spaces are limited, we encourage every young person to apply. “This year’s bursary applications opened on Tuesday, 25 September and will close on Friday, 12 October 2018. Forms can also be collected from the Metro Centre in Braamfontein, downloaded from the City’s website www.joburg.org. za, City’s Facebook/Twitter pages and the University of Johannesburg portal. “Preference will be given to South African citizens, who permanently reside in Johannesburg and intend to pursue full-time undergraduate studies in one of the following fields: Sciences, Finance, Engineering and Management. The key criteria governing the award of the City’s bursary include: · Academic merit; · Confirmation of residence in Johannesburg; and · Financial need.
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ew arrival Simon Murray wasted no time in opening the scoring for The Clever Boys in the eigth minute from the penalty spot, converting a penalty he won after being judge by the referee as being brought down by Peter Leeuwenburgh. The hosts looked to settle after their shaky start, Riyaad Norodien and Matthew Rusike the main outlets for City in the opening half hour, but the Wits defence had their numbers and kept them relatively quiet. Rusike had a chance to level mat-
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