LOCUM Official Publication of the National Association of Locums in South Africa
PROPERTY
BUYING SECTIONAL TITLE PROPERTIES
Lifestyle
FASHION
WINTER WARDROBE
PHARMACY DISPENSING ERRORS
MOTORING
E D I T I O N 12
2017
C A R O F T H E Y E A R 2017
TRAVEL DESTINATIONS GAME LODGES - SOUTH AFRICA
HEALTH | TRAVEL | MEDICAL | JOBS | FASHION | MOTORING
6 EDITOR • Message 8 NALSA PRESIDENT • Message 10 PROPERTY • Buying Sectional Title Properties 16 TARYN HARRIS • Energy Vampires 22 MOTORING • New Cars is SA • Car of the year • Lexus LC 500 28 FASHION • Winter Fashion 30 WILD LIFE PHOTOGRAPHY • Photography Tips 34 TRAVEL • Waterford 4x4 • Thabaledi Lodge • Bona Bona Game Reserve • Augrabies Falls National Park • Mokala National Park • Iwamanzi Game Reserve • Maison Chablis Franschhoek 48 PHARMACY • Dispensing Errors 54 PHOTOGRAPHY • Impressions of Cape Town 56 HEALTH • Foods to Avoid while Pregnant 60 CAREER CLASSIFIEDS 2
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EDITION 12
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Pharmacists, QPB’s, Pharmacy & Clinic nurses
EDITOR
EDITOR
EDITOR’S MESSAGE
Francois Rossouw
t feels like yesterday that I was making holiday plans for my December vacation. The year has really flown by. Winter is upon us and with that the usual colds and flu. So get those flu injections and stock up on vitamin C. In this edition we Francois Rossouw look at dispensing errors in our pharmacy section. (Page 48) Our medical focus is on pregnancy and healthy eating as well as foods to avoid while pregnant. (page 56) On page 10 our property guru, Terence von Molendorff, shares some helpful tips on buying sectional title properties. In the motoring section, we have a look at new vehicles available in South Africa, the 2017 car of the year as well as the Lexus LC500. There is some winter fashion advice and tips on page 28. Dr Landi Lombard shares his wildlife photos and photography tips with us on page 24. In our travel destination section, starting from page 34, we take a look at some beautiful game lodges in South Africa. Gunter Komnick’s impressions of Cape Town is on page 54. The career classified section, at the back of the magazine, features more permanent and locum placement opportunities.
J&T Style Graphics
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For our first time readers, some basic information on our magazine. We are the official magazine of NALSA (National Association of Locums in South Africa). The magazine is bi-monthly and available in both printed and digital format. Please visit our website for more info and any back issues of the magazine.
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Locum Lifestyle Magazine makes no representations, endorsements, warranties or guarantees about any of the products and/or services offered or advertised within this magazine. Locum Lifestyle expressly disclaims any and all liability relating to or arising from the sale, distribution, manufacture, use or misuse of all products and all services offered and advertised within this publication.
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ARTICLES & PHOTOGRAPHS
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NALSA
NALSA
NATIONAL ASSOCIATION OF LOCUMS IN SOUTH AFRICA
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MESSAGE FROM THE PRESIDENT
aving been involved in the locum business sector and in particular the pharmacy sector over the past eight years, I’m pleased to say it’s been a very rewarding journey for me. I have met so many great men and women who demonstrated a true passion in their work. The pharmacy system in South Africa is recognised as the best on the African continent. The expertise and knowledge of our pharmacists makes healthcare available in a most convenient, accessible and affordable manner. According to the Medpages Database, there are more than 10 000 pharmaceutical organisations, pharmacy distributors and pharmacies across South Africa. Many people enjoy the convenience and benefits of having a ‘family’ pharmacy or one which is their local community pharmacy and where they know the pharmacists and the pharmacy staff knows them in-turn. The pharmacist is increasingly becoming involved in the delivery of primary care services to support the community’s health. These include weight management, diabetes management, smoking cessation, sleep disorders, blood pressure monitoring and medicine checks, to name a few. Following are pharmacist advice and tips that I’ve found useful: Mornings are the best time to fill prescriptions Like doctors, pharmacists are less likely to make you wait first thing in the morning. As Martin Ochalek, a pharmacist in Miami, puts it, “Once the doctor calls start coming, it slows down everything.” Another time saving tip: call to confirm your prescription is ready for collection. If it takes slightly longer: be patient Getting the wrong prescription can have serious negative consequences, which is why it pays to be patient. “Time pressures can contribute to medication errors,” says Sally Rafie, PharmD, a medication safety specialist at the UC San Diego Health System. “The pharmacist does far more than count pills and place them into a bottle. Pharmacists are reviewing allergies, drug interactions, dosing and much more to be sure you get medication that will be safe and effective for you.” You shouldn’t always go for generic medicine, however generic medicines are definitely cheaper, so weigh up the pro’s and con’s First, a primer on generics: According to the FDA, they are “identical to a brand-name drug in dosage form,
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Andro Engelbrecht
safety, strength, route of administration, quality, performance characteristics and intended use.” So why do they cost less? Once a brand-name drug hits the market, it holds its patent for around 20 years and no other pharmaceutical company can make or sell it until the patent expires. But once it does, companies are free to manufacture it without the cost of building it from scratch. Keep in mind that not every drug has a generic, and that even when one does exist, a pharmacist may not always recommend it. You don’t substitute certain medications that treat seizures because the generic may dissolve at a different rate, which is an occasional difference between generic and brand name drugs. On the generic, there’s a chance they could still have a seizure. A chance you don’t want to take. Don’t wait until you’re out of medicine to order refills As we all know, doctors are busy people and they’re the ones who hold the key to you getting a refill for your medication. Which is why it’s important to give your pharmacist a few days to obtain a new script. A good rule of thumb: let the pharmacist know when you have five or six pills left. This is especially true for maintenance drugs like blood pressure medications. Missing a day or waiting extensive periods of time between dosages can have harmful effects. Build a relationship with your pharmacist “Like any healthcare provider, patients are better served if they develop a relationship with their pharmacist,” says Jordan. “They’re willing to spend extra time with you and it’s always helpful to know the person on the other end of the phone line. A good pharmacist will automatically provide many of the answers, including when to take the medication, whether or not to take it with food, what the side effects are and if it needs to be refrigerated. “A patient needs to walk out of a pharmacy confident that they know what to do,” Porter says. “If they’re not, then they need to ask more questions.” In the end, the customer is the one who will suffer the consequences. According to Jordan, “If people stop taking medication before they should or don’t use them as prescribed, they may end up in the emergency room.” While allergies are typically included in your medical file, speak up if the pharmacist doesn’t ask. As Porter puts it, “The ultimate responsibility is on the patient to make the pharmacist aware.” Source: http://askyourpharmacist.com.au/
TIPS WHEN BUYING SECTIONAL TITLE PROPERTY
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o you have decided to buy sectional title property. It is a great way to get a property in the area that you want without having to pay a fortune. Whether it’s for residential purposes or for an investment, here are a few important factors to take into consideration. OWNERSHIP: You are essentially buying into a section of property. Yes you are the owner of the apartment, but there are more areas that are co owned by all the owners. Make sure what your property, as there are a few ways in which the other areas could be registered i.e. exclusive use, common property etc. Remember, if it’s yours, you need to maintain it. LEVIES: Levies are a very important factor when
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deciding on Sectional Title, as these are usually a big expense. If you are buying for investment, this comes off your rental income and if you are residing in the property yourself, levies can determine if it was worth buying in the first place or whether you should carry on renting. RULES: Complex rules and the enforcement thereof is absolutely critical if you want to raise the property prices. If there are no rules, the complex will very soon become unpleasant,
PROPERTY
Services, as they have a track record of outstanding property management. It is also important to attend the Annual General Meetings, so that you can find out what is happening within the complex and voice your opinions. NEW LEGISLATION: In October last year there was new legislation introduced to sectional title, the Community Scheme Ombud Service. They are a governing body handling all Body Corporates and disputes. Unfortunately they are not free, they charge all Body Corporates a monthly fee. This fee is minimal, however the laws that need to be complied with can be a big factor, especially the compulsory reserve fund, which will very quickly make a levy seem low until this is added on.
By: Terence von Molendorff (CEO Red Pepper Properties) and you will quickly see more properties in the market. The rules are a common ground for all residents and if everyone abide by them, then everyone will together in harmony. MANAGEMENT: Proper managing agents can be the make or break of a complex. It has stood the test of time that if there are decent managing agents and decent trustees, the prices of the properties are destined to go up. We personally prefer to use HJ Management
FINANCIALS: The buyer of a sectional title property is entitled to a copy of the scheme’s financial statements. It is crucial to ensure that the financials of the sectional title scheme are not showing signs of discrepancy or debt. Analysing the financial statements of the Body Corporate will ensure that the building is well-managed and financially stable. This will reveal how healthy the savings balance is, the number of creditors looming and whether you are about to purchase a share of debt already incurred. Banks will also not grant loans to buyers looking to purchase in an insolvent complex, so be weary, one day you might want to sell and end up stuck. RENTAL INCOME: Is it really worth buying into a complex? Hypothetically, if you are paying a bond, levies and rates, you will be paying more than what you can rent for (if you don’t give any deposit). You will get capital LOCUM LIFESTYLE
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growth yes, however, is paying the higher bond amount less than the capital growth each year? TRANSFER FEES: Make sure you are aware of what the transfer fees and duties are before you commit. These can easily be a deal breaker, as it is payable in cash. A good deal can quickly become an over spend when you get the invoice from the transfer attorneys. PREMISES HOMEWORK: It is important to see the premises in the day and also at night. If you view a property at 12h00 in the afternoon, most people are at work. Make sure you see the complex in the evening when everyone is home.
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What is the parking situation. Are there big busses and trailers standing around? Is there loud music playing or people making a nuisance of themselves? People generally underestimate how important this is, a complex looks very different when everyone is home. What does the security setup look like? How easy is it to get access to the property? MAINTENANCE: What does the building look like from the outside? Is it well maintained? When last was the building painted, as this is one of the biggest expenses in sectional title, and if there is not sufficient reserve funds, there will be is a special levy coming your way.
CDE: Centre for Diabetic Excellence Kuilsrivier CDE
DISCOVERY HEALTH • Anglovaal Medical Scheme • Discovery Health Medical Scheme • Edcon Medical Scheme • IBM South Africa Medical Scheme • La Health • M-Med • Quantum Medical Scheme • Retail Medical Scheme • Anglo Medical Scheme ETERNITY PRIVATE HEALTH • Chartered Accountants Medical Aid Fund • CA-Vital & CA-First Choice
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MEDSCHEME • MBMED • Metrocare • Siemens Medical Scheme METROPOLITAN HEALTH • Pick ‘n Pay Medical Scheme MEDSHIELD • Medshield
Y O U R - P A R T N E R - I N - D I A B E T E S
cde.kuilsrivier@telkomsa.net. The CDE was established 20 years ago to help patients and doctors manage the growing epidemic of diabetes. The Head Office in Houghton is responsible through a nation wide clinic system, for the care of more than 20 000 patients. There are clinics in every province and a list thereof can be found on the CDE website: www.cdecentre. co.za under service providers.
WHEN JOINING THE PROGRAM PATIENTS ARE ELIGIBLE FOR THE FOLLOWING SERVICES PER YEAR: • 2 Doctor appointments • 1 Dietician appointment • 2 Diabetic educator appointments • 1 Podiatry appointment • 1 Retinal photo or appointment with an eye doctor • 2 HbA1c’s – average 3 month blood sugar reading • 1 Lipogram • 1 Kidney function • 1 Full blood count
Patients receive all diabetic (oral and insulin) medication from the clinic,
including a new glucose meter, glucose strips and needles. The medication is included in the program. The CDE Kuilsriver opened its doors on the 1st of September 2009 and specialises in the management of type 1 and 2 diabetes and is an accredited pump centre. For more information contact: cde.kuilsrivier@telkomsa.net. They have two diabetic educators, a dietician and a podiatrist. The centre falls under the care of endocrinologist, Dr Landi Lombard. LOCUM LIFESTYLE
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How to deal with energy vampires & avoid being “glamoured” Energy vampires here are many people who we encounter in our lives that leave us feeling drained and as though the life has been sucked out of us. Often it’s not only a person, it can be an entire organisation or group of people that affect us this way. The way they show up varies. Sometimes it’s a boss who bullies, a friend who is constantly complaining about life, a colleague who finds flaws in all your suggestions. Someone you feel you need to walk on egg shells around and watch what you say, as it’s often misconstrued and they get defensive or shut down. The way we speak of these encounters is indicative of how it actually affects our sense of health, our mood and energy levels. For example, “I can only handle her in small doses”, “I feel like I need to take a shower afterwards”, “It’s like I’m under attack”, or “It’s a toxic environment”.
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Various plots at play In most cases, these people are not trying to leave you feeling this way. They don’t wake up in the morning, rub their hands together with evil intent and plot how they will ruin your day and take your life force. Like you, they are winging it and doing their best to live their life and make meaning thereof based on their beliefs about how the world operates. There are complex subconscious issues at play and, most of the time, the way they are showing up is
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due to their own fears and unhealthy (and often unconscious) perspectives – so they have developed strategies to protect themselves based on what they perceive as REAL. These strategies often keep them locked in a personal hell, feeling like a victim or like they are constantly under attack which results in them feeling alone, insecure and in a state of fight or flight, which then also weakens their ability to manage stress or social interactions. The boss bully might have a fear that he will lose respect, power or his job, based on an unconscious belief that everyone is out to get him. Maybe he suffered a betrayal in the past and now shows up constantly defending himself or he believes those in power need to be ‘hardcore’. The friend who is always complaining might believe she is not worthy of a happy life and that she is being punished for not being good enough, so she keeps up the pretence due to fear of actually noticing the good in her life and having it taken away. A hint of drama and power plays Everyone likes a bit of drama. In fact, humans are addicted to it. The programme’s we watch and the books we read keeps us captivated especially if there’s some sense of drama. It’s even evident in the online comments or letters in the newspapers and especially in global politics – those who agree or disagree are not afraid to voice their opinions loudly. Everyone defending their individual or collective “truth” based on a need to control their experience of life and justify their outlook and
ABOUT TARYN HARRIS: Taryn is an executive coach, relationship architect, life designer, speaker, systems wizard and creator of the IN-BODY programmes. Taryn teaches people and organisations to access their power. Visit www.tarynharris.com
opinions. We all share a desire to be seen, heard, acknowledged and appreciated. However we also fear this, because it means we are then exposed and might become prey or proven wrong, which might result in a perceived loss of power and relevance. And when we “win” we feel justified, and more in control. Pay attention to the conversations you or others are having – most of them are filled up of juicy titbits to really sink our teeth into and confirm our views and relevance. Remember how many vampire movies and series were all over our screens not so long ago? To a large extent, these programmes speak to our collective unconscious beliefs around power, vulnerability and being in danger. It appeals to the ego part of us that tries to protect us from perceived threats and establish a sense of psychological safety. We can identify with the vampires and the victims because we all have strategies, fears and trust issues, even if they are irrational. Lost in translation: Don’t think you are immune. You can also morph into an energy vampire. When you are having a bad day or when you are complaining about your own personal energy vampires and how they are the problem, how they are inconsiderate and disrespectful, or how they are derailing your search for inner joy, you then become the one who is indulging in drama. You are the one becoming an energy sapping
vampire to those listening to your tirade. Every story has a villain, a hero and a victim and we all have a role to play at different occasions. You have to take control of your own energy and you have to make a conscious decision on which role you choose to play ... villain, victim or hero. Shape shifting & taking the stake out of the heart You can’t force people to change to fit into your world view or control the environment. However, you can become a Shape Shifter and take your power back by changing the way you relate and react to them, by coming from a more objective, adult perspective. By making space for their views, without taking them on. This might involve improving your own level of emotional intelligence (the capacity to be aware of, manage, and express one’s emotions and to handle interpersonal relationships judiciously and empathetically ) or social intelligence (refers to your ability to handle other’s emotions, to inspire and help develop others based on your level of skilled interaction). By having compassion for them and acknowledging the drama that is playing in their heads and heart, you will be better equipped to interact with them. And by taking yourself out of the power play, you create an invisible protective shield around you (like some big garlic cloves around your neck), where you don’t let their behaviour or opinions affect you. This is a healthier option than absorbing their issues and
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making it your own. Remember to have compassion for where they are and the pain they are in whilst putting boundaries in place to look after you. Change the plot Remember, you are human and even the most “evolved” still get triggered. It’s part of our nature. So if the energy vampire is too much and you don’t have the capacity to shape shift or not get triggered, then my invitation is to change your relationship with them as much as you can. Identify what the environments, actions, beliefs and conversations are that bring out your and their energy vampire and avoid it by putting up personal boundaries. Change the role you are playing and the scenes you appear in. Have an assertive conversation, expressing your view and desire for a new script. Before you do, assess what the implications might be if your view is misconstrued. What would be the worst case scenario and if you would be okay with the outcome. Decide what is more important: being right or the relationship itself? Are you actually open to finding a new way of relating to this person or group? How serious is this situation really? Change the script 1) Start by ensuring you pick the right time and place to have the conversation. 2) Give context to conversation in a kind, but clear way “ I would like to have a conversation with you about /explore new ways of how we can have a richer friendship/work better together to achieve the business objectives etc” 3) “When you... (State action/behaviour and stick to facts. No shaming or attacking the person) it results in me feeling/interpreting (express how you interpret the actions and what they mean to you). What I would prefer going forward to ensure (desired outcome) is “x”. What are your thoughts? (Ask for what you need and then let go of what the outcome is, whilst working with what they contribute to find a new way of relating) Inner warning system: Alarm bells! Your body warns you when you get triggered or
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when you are feeling threatened. We all have different signals. Sometimes our breathing gets shallow, or we feel hot, or our throat constricts or we feel the hair at the back of our neck stand up. Our body is telling us we are moving into a flight or fight state. What is your inner warning system? Once you know what it is, when you notice the alarm bells, have a strategy in place to help you from getting sucked into the power play. Maybe it means excusing yourself and going to the bathroom or just taking deep breaths, or imagining growing fangs to help you take yourself less seriously. Whatever works for YOU. Experiment and find one. Exception to the Rule: 2 out of the 10 There are a minority who do wake up and plot to take your life force and control you. In vampire movies, you often see them at the door “glamouring” their prey. Glamouring is the vampire form of hypnotising, that results in them being allowed “in” and your defences being dropped. They seem to make sense. They seem to care. They are masters of deception and usually very intelligent, which enables them to easily influence. Many sociopaths are skilled at brainwashing and controlling. Again, trust your instincts. Your inner warning system will let you know ‘this doesn’t feel right’ and again, make sure you don’t give your power away by letting them “in”. It’s only doom and gloom if you believe it is. We have strategies to keep us safe. However, sometimes we react to life and people as though we are in mortal danger, but we aren’t. There isn’t a bad guy and it’s just the drama that’s got our attention. In vampire movies, the rule is, a vampire can only enter your home if you invite it in. You have choices: You can keep the door closed, open the door but keep them on the other side of the threshold, or invite them in. Most of the time, when there is a knock at your door, it’s not a vampire but a person – just being human. Ultimately, it’s your choice. Step out of the drama Trust your instincts!
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Diani Beach Kenya
B E I N G T H E U N D I S C O V E R E D G E M , O R R AT H E R “ N E X T B I G T H I N G ” T H E BEACHES ON THIS BEAUTIFUL COAST ARE ONE OF A KIND ALONG THE I N D I A N O C E A N S T R I P, P R O U D LY C L A I M I N G I T S S P O T A L O N G T H E L I K E S O F, M AU R I T I U S , Z A N Z I B A R A N D M A DAG A S C A R .
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he beach resorts of Kenya have long been the secret playground of Arabic and Persian trade merchants looking for an excuse to go on holiday, as they have known about these beautiful coastlines for ages. The Europeans and South Africans followed suite and now everybody thinks that they have been the ones who started Kenya when in fact it was the Swahili tribe (one of the oldest living cultures on earth) , they got to the beach first.
Neptune is nestled in-between lush tropical gardens and boasts one of the biggest sea fronts in the area. It’s an 4* resort and the ever popular all-inclusive meal plan will ensure that you come back for more The Two restaurants serve local and international cuisine whilst the two bars Tembo and Farah ensures you stay hydrated during the day.
South Africans have realized that these beautiful beach resorts are again the place to be and that this beautiful coast line is sure not to be forgotten. Hakuna Matata is the way of the Swahili and if you manage to visit this beautiful country you will see that its contagious and soon you will also be a firm believer of Hakuna Matata
The dreamy African Sunsets on these beautiful shores ensure memorable moments for honeymoon couples and romantic getaways. The beaches are safe so it’s a great location for family holidays and your young ones will not be bored at all.
The Kenyans have over the past few years done a lot to improve the perception of Kenya, with the government funding training projects aimed specifically at the hospitality and tourism industry, thus you will find entire communities involved in the process as well as being depended on the proceeds that stem from this. Being the undiscovered gem, or rather “next big thing” the beaches on this beautiful coast are one of a kind along the Indian Ocean strip, proudly claiming its spot along the likes of, Mauritius, Zanzibar and Madagascar. If like many of us you are up in arms when it comes to peak season availability and price when you would like to book popular places like Zanzibar and Mauritius. The Coastal resorts make for a healthy alternative that won’t leave your bank account in intensive care for the foreseeable future. Neptune Village is a perfect example setting the standard for beach resorts and the Kenyan tourism industry in general. Situated in Diani Neptune Village is an allinclusive resort. Ideally located on a strip of beach that stretches with Kilometers of soda white sand complimented with the bright turquoise (Neptune) blue water. Coconuts, tropical fruit and cocktails on the beach whilst working on your tan can be your life day after the day when you book your holiday at Neptune Village For South Africans, a flight from OR Tambo to Mombasa is a mere 6 hours and 35 mins away. Diani beach is situated 45kilometers (1 hour and 15 mins’ drive) from Mombasa airport. It’s easy to getaway for just a few days as Kenya airways have flights that depart daily at different times of the day.
Do you remember those salt water swimming pools in Zanzibar? This one is fresh my dear.
The animation team ensures that guests are entertained and you can expect anything from Fashion shows to themed dinner evenings to African acrobats to name but a few. Rooms are beautifully decorated and come with all the amenities that you would expect from such a beautiful establishment. You have the choice of 7 room categories with some being Sea facing and others Garden facing. The award-winning spa 5 Senses Sea treats your 5 senses to an extraordinary experience to ensure that you are left relaxed and rejuvenated. The spa has 4 massage rooms an independent swimming pool as well as two Jacuzzis. Treatments range from hair removal to facials and pedicures. With so much to do Neptune Village is a great option for your Kenya beach experience. Diani beach itself is situated an hour away from the Tsavo national park so you can book a game drive whilst you are on the beach. It’s such a diverse and wonderful country you will ask yourself why have people forgotten?
MOTORING
New Cars in SA It’s time to check out some of the new car models available in SA. There’s a lot to be excited about across the spectrum. Here are some of the cars you can expect to see on the road.
Audi Q2 The Audi Q2 represents Audi’s response to the growing popularity of small crossovers premium compact family car market. The Q2 is scheduled to arrive in South Africa in the middle of 2017. This newcomer will be offered with a 1.4 litre turbo petrol engine with 110 kW and 250 Nm of torque, a 6-speed manual or a 7-speed dual clutch automatic transmission. An 85 kW/200 Nm 1.0-litre turbo petrol engine will be introduced later, followed by a 2.0-litre turbo diesel.
Alfa Romeo Giulia The arrival of the Alfa Romeo Giulia in the first quarter of 2017 is one to look out for. The Giulia offers will be led by the Giulia Quadrifoglio with its 375 kW/600 Nm 2.9-litre twin turbocharged V6 engine mated with an 8-speed automatic transmission. This version will be offered in both Launch and Race editions and buyers can also go for the 2.0-litre turbo petrol engine in Base, Super and Super Lux trim, with 150 kW and 330 Nm of torque using an 8-speed auto box.
Honda CR-V An all-new version of the CR-V is on its way to SA during the second half of 2017. The redesign appears to have changed it from a demure people carrier into something more sleek and attractive. It rides on a stretched version of the new Civic platform and is claimed to be more spacious and more upmarket inside. Engines have yet to be decided for our local market, but 1.5-litre turbo petrol and 2.4-litre naturally aspirated petrol derivatives may on offer here.
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Renault Duster Oroch 2017 promises to be a big year for the French automaker as it will be launching a raft of new products across all segments. There’s something for everyone here, ranging from entry-level to commercial. The Renault Duster Oroch bakkie is worth keeping an eye out for. It’s also likely to see the international reveal of the new RenaultSport Megane.
5th-generation Discovery The 5th-generation Discovery will be a highlight of 2017. Over and above significant off-road ability matched with impressive on-road refinement, the Disco will offer generous loading capacity. With all the rear seats down it is said to offer 2 406 litres of space. Loads of off-roading tech and connectivity systems have been crammed into the new Discovery. You can even fold down the rear seats via an app on your phone.
Chevrolet Cruze The new and lighter Chevrolet Cruze compact sedan will hit South African shores in the third quarter of 2017 with larger dimensions and comprehensive safety specifications. Engines will include a 1.4-litre turbo petrol engine with 110 kW and 245 Nm of torque, as well as a 1.6-litre turbo diesel option. In terms of transmissions, a 6-speed manual or 6-speed manual will drive the Cruze’s front wheels.
Nissan Navara The Navara leisure bakkie will also arrive early in 2017. The mine feature is the Navara’s new independent rear suspension setup, which greatly improves ride comfort substantially. Engines have yet to be confirmed but a new 2.3-litre turbo diesel unit (a replacement for the current 2.5-litre powerplant) could be on the cards.
MOTORING
CAR OF THE YEAR 2017 OPEL ASTRA
Designed, engineered and built to be the best driver’s car in the world.
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pel and compact class cars - this exceptional success story starts with the Kadett in 1936 and will be continued with the new Opel Astra, the eleventh generation of an Opel compact class car. So far, 24 million Kadett and Astra compact class models have left the plants. The world premiere of the Opel star at the 2015 Frankfurt Motor Show marked the start of a new chapter in the history of OPEL. The new Astra is based on a completely new lightweight vehicle architecture, is powered exclusively by latest-generation engines and enables ultra-modern connectivity via smartphone integration and personal connectivity and service assistant Opel OnStar. The new Astra is up to 200 kilograms lighter than its predecessor and its athletic design shows this immediately. The dimensions have shrunk but spaciousness and comfort have
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been increased considerably. A member of the completely new engine portfolio can be found under the hood of each new Astra with outputs ranging from 70 kW/95 hp to 147 kW/200 hp. The diesel and petrol engines with a displacement range from 1.0 to 1.6 litres all have three things in common: they combine highest efficiency with excellent responsiveness and running smoothness - the latest-generation Opel turbo diesels are known as whisper diesels for good reason. The new Astra with the 74 kW/100 hp 1.4-liter all aluminium gasoline engine under the hood will be available at a very affordable price. The 77 kW/105 hp three-cylinder 1.0 ECOTEC Direct Injection Turbo. When combined with Easytronic 3.0, the automated manual gearbox, the new Astra only emits 96 grams of CO2 per kilometre and consumes a mere 4.2 litres of petrol per
MOTORING 100 kilometres in the combined cycle, making it one of the leading gasoline cars in the compact class in fuel economy and eco-friendliness. The completely new 1.4 ECOTEC Direct Injection Turbo will make its debut in the new Astra. The four-cylinder unit is available with outputs of 92 kW/125 hp or 110 kW/150 hp and delivers maximum torque of up to 245 Nm. It is from the same family as the smaller but nonetheless powerful three-cylinder engine and simultaneously brings less weight into the car thanks to its all aluminium construction. Depending on the output, fuel consumption can be reduced to 4.9 litres per 100 kilometres (114 g/km CO2). The 1.6 ECOTEC Direct Injection Turbo with 147 kW/200 hp and an impressive 300 Nm of torque (with overboost) will be the most powerful gasoline engine available for the Astra. Mid-range acceleration from 80 to 120 km/h in fifth gear is completed in just 7.5 seconds, with a maximum speed of 235 km/h. The 1.6 CDTI is available in three outputs ranging from 70 kW/95 hp to 100 kW/136 hp and offers maximum torque of 320 Nm. In com-
bination with the standard six-speed manual transmission, CO2 emissions are always below 100 grams per kilometre. The current efficiency champion of the new Astra family is the 81 kW/110 hp model, with fuel consumption a mere 3.4 litres and CO 2 emissions of 90 grams. Three transmission types are available for the new Astra: five and six-speed manual transmissions, the automated manual transmission Easytronic 3.0 and an especially low-friction six-speed automatic transmission. The sixspeed automatic transmission is available in combination with the 110 kW/150 hp 1.4 litre turbo gasoline engine and with the 100 kW/136 hp 1.6 CDTI. However, the outstanding efficiency proposed by the new Astra is not only linked to the innovative power train technologies. Thanks to ultra-modern production methods and highquality materials, it reaches an excellent level of quality, attributes that also have a positive impact on the total cost of ownership, where the new Astra also sets the standard in its class.
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MOTORING
LEXUS LC 500 The LC500 is the most focused sports car that Lexus has produced since the LFA super car. Ostensibly a competitor to the likes of the BMW 6 Series, the LC looks to marry Lexus' sporting pedigree with the brand's reputation for refinement, supreme occupant comfort and luxury. The LC500 is likely to arrive in SA by July 2017.
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FASHION
PLAN YOUR WINTER WARDROBE WITH THIS YEAR’S COLOUR GUIDELINE AND By: LEMANJA MEARS GARMENT CHECKLIST
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his year fashion gurus from London, Paris, Milan & New York agreed to make use of the Pantone Colour Institute’s fashion colour report as the foundation that designers and fashion houses have based their recommended winter colours on for your wardrobe this winter. These nine colours were specifically chosen by the Pantone Colour Institute to resemble a unity of strength, confidence and complexity. Blue is still the new black, followed by earth tones and exuberant vibrant colours. All of the carefully selected colours work together against the contemporary turbulent life and bring about more tranquillity & optimism against the back drop colours of a grey winter’s day. • In the lead is Riverside, a cool and calming shade of blue in between navy blue and vibrant cobalt blue. It has some sense of confidence and tenacity to it, yet with that feeling of excitement, sophistication and a bit of mystery. • Followed by Airy Blue: icy, cobalt & navy blues that creates an air of freedom, tranquillity and weightlessness • Sharkskin in third position is a great pairing
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colour. Grey pallets (bright or muted shades) have worked their way to the forefront of the winter colours for the past decade and are here to stay • Aurora Red is a bold RED with some sensual and warm undertones, not as bold as burgundy though and not as vibrant as crimson either. According to the Pantone’s Institute, this bold red statement gets the metaphorical blood of the palette pumping.
FASHION
• Warm Taupe hands out a “high five” to the rest of the winter colours as it can be matched with any one of these nine winter statement colours. This is a reassuranceemanating colour that whispers words like: trust, organic and grounded • The warm and welcoming shade of muted pink, that the Pantone Colour Institute has called Dusty Cedar arrives as one of the best winter 2017 colour trends that warms our hearts • For the utmost elegance, sophistication and swag add a tad of Lush Meadow - not too much I must warn you or you might end up looking like a leprechaun. Even so, the fashion gurus swear that it puts the spell of sophistication and charm on you. To me however this one is still a bit of a gamble. • Add some exotic and zesty touches to any outfit with the recommended Spicy Mustard • For those having a soft spot for earthy shades, Potter’s Clay is the best recommendation this year with its strong foundation and lovely hybrid of brown and russet orange.
Winter wardrobe check list combined with “must have” clothing suggestions by Glamour • Winter sleep wear; warm cotton fleece or silky satin • Sheep skin slippers • Aurora red super sized scarf • Warm Taupe leather boots • Warm Taupe leather belt • Camel brown maxi coat • Riverside Puffer jacket • Denim jacket • Fun velvet platforms • Sharkskin strong shoulder blazer • White, “old-school” trainers • Potters clay high waisted wide leg trousers • “One shoulder statement” long sleeve tops • Spicy mustard dramatic sleeve top • Perfect vintage jeans • Dusty cedar lacy top • Khaki winter jackets and dresses • Bold stripe knitted dresses
WILDLIFE PHOTOGRAPHY
Photo Safari
By: Natasha Bertram Photos: By Dr Landi Lombard
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aking my camera on safari is the way I see it and not going on safari with my camera tagging along. If you’re serious about the quality of your photos then your own comfort comes second to the main objective and that objective is getting the best possible photos. However it is important to remember the wildlife photography rule number one, we are the guests in the equations, always handle the animals with respect. Rule number two, you’re dealing with WILD LIFE, it is just as important to be safety conscious, don’t endanger yourself to get a good photo.
Lion cubs playing in the Etosha National park near Wolfsnes waterhole (Canon 7D Sigma 150-500mm lens)
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WILDLIFE PHOTOGRAPHY Here are some tips to increase the success rate of you photo safari. • Protection: Protect your expensive lenses and camera equipment against dust, bumps, water and scratches. • Make a list: Don’t arrive at your destination and realise that you have forgotten half the equipment. This includes your own personal equipment. Things like water bottles, warm clothing, hats, sunscreen, sunglasses, as well as medical stuff. Nothing worse than trying to take photos with a blinding headache or with no protection against those pesky mosquitoes. • Know your camera: Know how to adjust your camera settings between focus points or focus modes without taking your eye off the viewer • Know how high you can push your camera’s ISO setting without sacrificing picture quality. • Burst mode: This mode continuously takes pictures as long as the shutter button is depressed. More frames per second increases your chances of capturing the perfect moment. • Shoot some photos at a wider angle to get in more of the subjects surroundings. Don’t get stuck in the perfect focus trap with hundreds of photos just getting the face of the animal into perfect focus. • Shutter speed freezes the action of the subject in movement. With slow animals 1/1000 second will be OK. With flying birds you might need 1/2000 second and faster. • Telephoto lenses: The longer the lens the more photos you can take without disturbing the animals, but the more susceptible the camera is to movement, with long lenses even the slightest movement can cause blurred photos. So keep it steady and use as fast a shutter speed as possible without losing quality. Use a bean bag or tripod for a steady base. • Don’t forget to charge your camera battery and don’t leave the SD card at home. Take extra batteries and SD cards along if possible.
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Main picture: This African Bull Elephant appears to be a statue come to life. The white coating on him is mud he has squirted on to keep him cool. Photo taken in the Etosha National park at Goas water hole
Black-backed jackal cub in Kgalagadi National Park
A Waterbuck giving the camera the eye. Photographed in the Kruger National park
Young African baboon getting ready hitch a taxi ride on his mother back in the Kruger National park
Male Cheetah seen in Kgalagadi National park. These cats can run more than 100km/h
A lioness captured in the middle of a lazy yawn after a afternoon nap. Photo taken in the Kruger National park close to Jones dam
WATERFORD 4X4 By Henk Mulder
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aterford trail with Hendrick Coffee. The trail is situated on the farm Waterford in the Northern Cape province where Hendrik Coffee’s grandfather lived. Just off the R64 connecting Groblershoop with Griekwastad. For a Green Kalahari red sand experience this is the place to be. There are steep up-and-down tracks along the dunes and Hendrik says to get up those, you need an approach speed of close to 120km/h, but luckily not all are that rough and tough and mostly there is a way to bypass the track if you didn’t want to punish your car. It takes about 5 hours to cover the complete trail of 33km/h including a rest stop. Down the dunes and on the level, second gear was possible, but for the most part, vehicles remained in first gear. You do get stuck, but that is what it is all about and this is usually caused by a lack of momentum because of being overly cautious. Contrary to what we originally thought, the trail is more than just lots of sand. It winds through a hilly and sometimes mountainous country-side. Most of these roads were originally made to access fences and other farm related activities. The environment is unexpectedly green. The grasses are pretty, and every now and then you get a beautiful view of the landscape and the trail ahead. Hendrik’s contact details: 071 868 5528. If he does not answer just leave a message. He is probably out of signal range.
4X4 Vehicles Lining up for inspection before they set-off for the day
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tough uphill portunity to tackle the Everybody got the op s enge and not so tough chall
Hendrik, re commends a 0.8 b against shar p turns at th ar tyre pressure, but w at low press arns ures as tire come off th s can e rim
the varicussing enge is d d n all rn a nest ch their tu p of the waiting o a t s e t s h t ia g to hus 4X4 ent egies on gettin t a r t s s u o
Cool heads prevail and the co-driver has to help navigate and as well as hang on. This is a great family outing
Setting
Getting enough forward momentum is crucial when climbing the sandy uphill tracks
up cam
p for th
e evenin
g
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TRAVEL - NORTH WEST
Thabaledi which means Mountain of the Stars in Tswane Thabeledi welcomes you to the heart of the African Bushveld. Beautiful dawns rising over the silhouetted thorny bushveld offers breath-taking views of the not-to-distant Waterberg mountains.
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s you embark on your daily activity you may encounter various species: Steenbok, Grey Duiker, Warthog, Impala, Nyala, Kudu, Hartebeest, Blue Wildebeest, Eland, Zebra, Gemsbuck, Blesbuck and Giraffe. Thabaledi is a bird-watchers paradise right on the door-step of your chalet – day or night. Some spectacular species as: Helmeted Guineafowl, Swansens Franklin, Red Winged Starling, Red & Yellow Billed Hornbills, Red Chested Coocoo, Woodlands Kingfisher, Violet Woodhoepoe, Longtailed Shrike, African Paradise Flycatcher, Black Shouldered Kite, and many many more. Twilight evenings, sitting by the lodge sees you experiencing the extraordinary sounds of the bushveld: jackal calling in the distance, the beautiful kri-trrrrr of the strikingly vibrant blue Woodland Kingfisher as they dive into the pool. As the night falls, you take your seat upon our game viewer and your anticipation of encountering the abundant bushveld nightlife starts to overwhelm you, you realise – as you
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slowly exit the lodge you are engulfed by the green eyes of the Impala and Nyala watching your every move. Further along your evening drive you could encounter nocturnal species such as: Caracal, Jackal, Porcupine, Genet, Brown Hyena and maybe a rare glimpse of our illusive resident leopard. After such an alluring day you retreat to your luxury air-conditioned chalet to relax in your private lapa feeling the ambiance of the fire. Our Lodge Offers • Reception • Thabaledi Shop • Bathrooms • Sunrise Deck • Games Room • Thabaledi Bar • 2 Swimming Pools • Boma – Hire options • Sunset Deck • Conference Area Contact Information: Game Lodge Managers • • • • • • • •
Cindy-lee Stoltz +27 (0) 84 754 7137 Fransua Stoltz +27 (0) 71 043 5255 Coordinates S 25°11’55’’ E 27°37’28’’ Website: www.thabaledi.com info@thabaledi.com
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he Game Lodge offers an unique four star lodge experience in the fauna and flora rich Northwest Province in South Africa. This privately owned, luxurious lodge is nestled along the N12 Treasure Route and offers its guests an unforgettable experience through their tailored Bona Bona Game Lodge hospitality in true African comfort. The lodge can accommodate 119 guests in-house. Guest can enjoy mouth-watering cuisine next to the homely fireplace on cold winter nights. Bona Bona Game Lodge offer a wide range of activities for business travellers as well as families seeking a well-deserved break. The predator drives, game drives and encounters with rare species such as sable, rhino and buffalo will make your stay at Bona Bona Game Lodge an unforgettable experience. All staff are handpicked and well trained to ensure their slogan ‘Pure African Comfort’ becomes a reality. Bona Bona Game Lodge has an impressive track record of more than 10 years. They recently invested a remarkable amount into their infrastructure and facilities, thereby assuring they stay abreast with the highest standards and the needs of clients. All meat and other fresh produce used are organic and guests with halaal requirements are catered for. Wind down and pamper yourself at
our spa. Our treatments promises an African experience in style, for you to rejuvenate and to indulge in complete relaxation. The spa treatment menu includes a full range of body and beauty treatments by one of our highly trained and experienced therapists. Indulge in a 60 minute Hot Stone Massage or rejuvenate while having an Anti-aging facial. Bookings are essential and couples and children are catered for. Our wine cellar is an experience in its own as no detail was overlooked in planning and furnishing it. The nostalgia of a true ancient cellar fills the romantic atmosphere. This remarkable game lodge is closely situated to Klerksdorp and Potchefstroom where the well-known Nampo agricultural exhibition and Aardklop festival take place. It is approximately 2 hours’ drive from Johannesburg and the entire family can be entertained in this secure and safe farm environment. Bona Bona has a compressed gravel landing strip and heli-services are available should you need to fly during your stay. Contact Information: General Info and Bookings: T: +27(0)18 451 1188 071 674 9969 / 072 908 5730 E: info@bonabona.co.za
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TRAVEL - NORTHERN CAPE
Augrabies Falls National Park
Augrabies Falls National Park: he 56 metre high main falls that cascade into the granite abyss of the Orange River Gorge are unmistakably the top attraction here. Easily accessed through an extensive network of boardwalks (some are wheelchair friendly) the falls are now illuminated at night. Few sights are as awesome or sound as deafening as the water thundering Augrabies Waterfall when the Orange River is in full flood. Take time to explore the rest of the park by driving to scenic viewpoints with descriptive names of this rocky region like Moon Rock, Ararat and Echo Corner. Although not prolific, giraffe, klipspringer and Hartmann’s mountain zebra can be seen scattered across the Park. Accommodation: Family chalets, a gorge cottage and campsites.
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Contact Information: RESERVATIONS+27 12 428 9111 www.sanparks.org/parks/augrabies/ Email reservations@sanparks.org
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Mokala National Park T
he isolated dolerite hills give the place a calming feeling of seclusion. A big surprise awaits you when you pass through the hills and are confronted by the large open sandy plains towards the north and west of the Park. Drainage lines from the hills form little tributaries that run into the plains and drain into the Riet River. Mokala is a Setswana name for a Camel Thorn (Kameeldoring) These trees occur in dry woodland and arid, sandy areas and are one of the major tree species of the semi-desert regions of Southern Africa. This immensely important species has a great range over the Northern Cape and varies from a small, spiny shrub barely 2m high, to a tree up to 16m tall with a wide, spreading crown. The Camel Thorn is an incredible resource to both wildlife and humans who survive in often harsh conditions characteristic of this area. Traditionally, the gum and bark have been used by local tribes to treat coughs, colds and nosebleeds. Some even use the roasted seeds as a coffee substitute. Mokala is an important area for the regeneration of valuable species and is home to, amongst other species, Black Rhino, White Rhino, Buffalo, Tsessebe, Roan Antelope, Sable Antelope, Giraffe, Gemsbok, Eland, Zebra, Red Hartebeest, Blue
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Wildebeest, Black Wildebeest, Kudu, Ostrich, Steenbok, Duiker and Springbok. Accommodation: Family chalets, luxury chalets, a tree house and campsites Facilities Conferences and Weddings Restaurant & Curio Shop Luxury executive & family suites Self-catering bungalows Self-catering chalets Enviro Centre Camp Sites Activities Nature Walks Stargazing Swimming Competent Field Guides Wildlife Photography Fly Fishing Mountain bike, Trail runs Rock Art Game drives Eco-Tours School Tours
Contact Information: RESERVATIONS+27 12 428 9111 www.sanparks.org/parks/mokala/ Email: reservations@sanparks.org
TRAVEL - KIMBERLEY
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TRAVEL - NORTH WEST
Iwamanzi Private Game Lodge
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Iwamanzi – Means: “place of the falling waters.”
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his magnificent reserve is 12 000 acres large consisting of savannah, bush veld and riverine areas, with hills and gorges, mountains and valleys. The 5 luxury chalets are built in the gorge above the rumbling waters of the Selons river. Our five luxury chalets, each with a private wooden deck, all have en-suite bathrooms fitted with a bath and shower. A mini bar fridge, tea and coffee station, and storage facilities are standard features in each chalet. The lodge also has three bush rooms ( to accommodate additional guests). Tasty meals are prepared by our chef in an Italian and South African way. Good South African wines are also available. Our daily rate at Iwamanzi includes : welcome drinks on arrival, full luxurious accommodation in our chalets, three tasty meals prepared by our in- house chef, snacks , sundowners and two game activities per day( game drives/walks). The area is home to many different antelope, sable, nyala, bushbuck,
kudu,impala, red hartebeest, gemsbuck, and other species like warthog, zebra, brown hyena, buffalo, giraffe, wildebeest, buffalo and 250 different bird species. We do game drives and bush walks, guided fishing, clay pigeon shooting, private lunches at our big waterfall, romantic dinners at the river lapa. Come, relax & unwind at Iwamanzi Private Game Lodge in an ideal bush hide away, privately situated for your indulgence. Contact and General Information: +27 14 549 2371 +27 14 940 0036 Emergency Number +27 14 549 2248 info@iwamanzi.com Koster North West South Africa In The Area Pilanesberg- 90 km Sun City- 90 km Elephant Back Safaris - 90 km Cradle of Humankind- 70km Lesedi Cultural Village- 90 km
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TRAVEL - WESTERN CAPE
Maison Chablis Franschhoek
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his tranquil Georgian-style boutique Bed & Breakfast in the heart of dream-destination Franschhoek, just an hour out of Cape Town, is highly sought-after and rated “Upper four-star Luxury” by The Portfolio Collection. Frequented by local celebrities, business people and discerning south african and international travellers this well-appointed, exclusive establishment is surrounded by majestic mountains and positioned within strolling distance of the quaint historic Franschhoek village centre, with its delightful street cafes, award-winning rest restaurants, museums and galleries and within easy reach of walking and horse trails. Maison Chablis is also an easy drive to many of the Capes celebrated wine estates, world-class golf courses and unspoiled beaches. Whatever you are in the mood for, the knowledgeable
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staff will point you in the right direction with tailor-made suggestions. Maison Chablis is surrounded by ancient oak trees which are set in a secluded, manicured garden featuring a pristine swimming pool. Guests can be assured of quiet luxury where one can completely unwind from the hustle and bustle of frenetic city life. Each of the newly-renovated and beautifully decorated, eight contemporary bedrooms feature an en-suite bathroom, top of the range furniture and décor, luxury embroidered linen and individual DSTV. A sumptuous breakfast is served every morning in the gorgeous sun-filled breakfast room and is included in the valuefor-money rates. Guests will be well looked after with attention-to-detail service and a very special brand of warm and caring Cape hospitality. Owner James Calderwood will ensure your stay is a memorable and peaceful one.
They have recently opened Maison Chablis Annexe (Superior Double Luxury Suite & Patio ). The Annexe which is at 13 Berg Street just next door to the Maison Chablis Guest House and is a beautifully furnished Superior Double Luxury suite that has 45 sqm of space, making it spacious and comfortable for you to enjoy your time in the charming Franschhoek village. The unit, together with the private patio, which allows you direct street access makes it easy to come and go as you please. Enjoy a chilled glass of your favourite beverage on the sun filled patio or relax in the garden and swimming pool area, enjoying the fabulous mountain views.
Contact Information Maison Chablis: Mr James Calderwood Maison Chablis Guest House Tel: + 27 (0) 21 876 2366 LOCUM LIFESTYLE
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PHARMACY
Dispensing errors – what to do By: Dulaine Stander
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inston Churchill once said: “All men make mistakes, but only wise men learn from their mistakes.” In researching material for this article, this was one of the most profound quotes on mistakes I found. As healthcare professionals, we are all too conscious of the effect that errors have on the lives of our patients.
In an industry where errors can have deadly effects, it is wise to be prepared for this eventuality. The ostrich approach is not an option in this case. It could lead to devastating loss, not only for a patient. It could mean the end of your professional career and impact your personal life as well.
At the 2016 SAPC Pharmacy Conference, APC Vice President Douglas Defty said the increase in complaints could be due to patients being more aware or being encouraged to lodge complaints against pharmacists. He said medication dispensing errors occurred due to the wrong dose being dispensed (30%); the wrong technique of dispensing (12%); the wrong drug being dispensed (12%); patients missing doses (7%); the wrong dose times (7%); and patients being given drugs when they have a known allergy (6%). Dispensing errors are usually the result of a failure in process. The more complicated the process or system is, the higher the risk for error, especially if the process is
dependent on human interpretation and actions. The initial fight-or-flight response we have when we realize we’ve made an error is to somehow hide it or cover it up. This emotional, fear-based response is absolutely the wrong thing to do. Concealing an error may not only exacerbate potential harm to the patient by delaying appropriate care, but also prevent the organization from identifying and addressing system issues that can cause future errors. The way in which the patient is communicated with, and engaged with throughout the process is absolutely critical. You might refer to this as the “bedside-manner” of the pharmacist.
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PHARMACY As soon as you realize an event has occurred, immediate action and analytical thinking are necessary. It’s important to avoid blaming others for your mistakes because you may lose the loyalty and respect of your colleagues and coworkers. Your primary responsibility as a professional is to take care of the patient. Swift action is critical, so identify any actualized and potential adverse reactions as soon as possible to prevent any adverse effect from occurring or worsening. As a pharmacist in South Africa, it is not only wise to be prepared for the financial implication of a medical malpractice lawsuit; it is a SAPC requirement as well. South Africa is an increasingly litigious society, and the inception of the Consumer Protection Cct has made the public even more aware of their rights as consumers. In the last 5 years, the incidence of medical malpractice lawsuits has increased 900%. When looking at this, it is critical for the pharmacy owner, pharmacists as well as support personnel to ensure that their professional indemnity insurance cover is sufficient. This should cover the pharmacist in the event of a malpractice suit that is the result of a dispensing error. If you do have cover, it is important to understand exactly what it covers you for. It should cover for medical malpractice suits where the patient holds the professional person liable for actual or perceived loss. Similar to car insurance that does not cover speeding fines; the indemnity insurance will not pay for any disciplinary sanctions instituted against you in the event of a guilty verdict at a SAPC hearing. “Pharmaceutical Society of South Africa (PSSA) Head of Public Affairs Lorraine Osman said the Minister of Health, Aaron Motsoaledi, had hosted a medicolegal summit to discuss patient safety, the management of claims, the impact of litigation on the recruitment of
specialists and justice for patients after his department budgeted R24.9 billion for medical malpractice claims across the public sector in 2015. In 2013/14 the state paid out R498 million rand in legal costs for malpractice cases.” (Pharmaciae, 2016) So how do we prevent error and what do we do in the event of an error occurring. If the subject is approached academically, one could say that all the regulations and rules (including GPP and GMP rules) currently governing every aspect of our industry is designed to reduce and eliminate the risk of errors occurring. Defining and implementing the Standard Operating Procedures (SOPs) as set out in the Good Pharmacy Practice manual is a good first step in reducing the risk of dispensing errors. Ensuring all dispensers and support staff are aware of the SOPs is also a critical part. Inevitably, despite our best intentions, errors are made. It is only in the event of errors that we identify the source of the failure in the system or process. So documentation and investigation of dispensing errors are critical. This includes “near-misses” where the error is found before it reaches the patient. It is important to review the errors along with the SOPs describing the process. Investigating and classifying dispensing errors: A helpful classification of any error, problem or issue is to look at the following: System failure: i.e. computer failure/poor software design etc. Process failure: insufficient clarity of processes or process caused the error or Human error: insufficient training, unfair pressure, working out of scope of practice Once an error has been classified, it becomes easier to focus on the solution, and identifying steps to prevent the same error from occurring again. Some guidelines in root cause analysis Root cause analysis is a buzzword in the world of business analysis, and something LOCUM LIFESTYLE
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not all pharmacists may have encountered. The truth of the matter is that we, as pharmacists perform root cause analysis in our professional engagement with our patients on an ongoing basis. The cough that your patient presents with is not merely a cough until you understand the full history of the patient and the cough. Most often, it is due to a cold but sometimes the cough is a side effect of the ACE-inhibitor that the patient is taking. Analysing dispensing errors should be approached in the same manner. Understand the history and the circumstances that led up to the error occurring. Methodologies to consider are: Five why’s: the actual cause of an issue, problem or error is usually discoverable within 5 why’s. • I.e. I dispensed expired medicine – why? Because I assumed that all medicine picked by the assistant would be within the expiry date • Why did the assistant bring expired medicine? Because it was on the shelf. • Why was it on the shelf? Because we haven’t done any cycle counts to rotate stock • Why did we not do cycle counts? Because it was not specifically clarified that this process should happen on a monthly basis. Another helpful tool is to design a factor template. A factor template is a table that has 2 columns. The left column defines the factors that could influence dispensing, and the right column is an open area to enter the events relating to that factor that could have caused the error or incident. Below is an example from a hospital pharmacy in the UK, and while not all factors would be applicable to every type of pharmacy, it does provide a very good example of a factor table, and how it can be used to analyse an error.
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It is recommended that this forms part of the initial error reporting template. Factors That May Lead to Medical Errors: Type of Factor Example: Institutional/regulatory: A patient on anticoagulants received an intramuscular pneumococcal vaccination, resulting in a hematoma and prolonged hospitalization. The hospital was under regulatory pressure to improve its pneumococcal vaccination rates. Organizational/management A nurse detected a medication error, but the physician discouraged her from reporting it. Work environment: Lacking the appropriate equipment to perform hysteroscopy, operating room staff improvised using equipment from other sets. During the procedure, the patient suffered an air embolism. Team environment: A surgeon completed an operation despite being informed by a nurse and the anesthesiologist that the suction catheter tip was missing. The tip was subsequently found inside the patient, requiring reoperation. Staffing: An overworked nurse mistakenly administered insulin instead of an antinausea medication, resulting in hypoglycemic coma. Task-related: An intern incorrectly calculated the equivalent dose of long-acting MS Contin for a patient who had been receiving Vicodin. The patient experienced an opiate overdose and aspiration pneumonia, resulting in a prolonged ICU course. Patient characteristics: The parents of a young boy misread the instructions on a bottle of acetaminophen,
causing their child to experience liver damage. The role of peer reviews The thought of going through a peer review is daunting for even the most experienced pharmacist. But this need not be the case if it is approached correctly. The purpose of the peer review is to understand what similar professionals would have done in similar circumstances, and then make a recommendation on corrective action. The details of the event should be shared and discussed in detail to understand exactly what lead up to the error, and the panel of peers should recommend corrective action. An objective view of the facts are always valuable, as the persons involved in the error might lose sight of the lessons learnt while focussing on the fall out of the error.
prevented simply because there is a focus on reporting these. It creates a culture of vigilance, and this prevents errors from occurring. Regular reviews of all errors should be done as well. The pharmacy manager/ owner should review all errors reported on a quarterly basis to understand if there are any trends. The review should include a classification of the root cause of the error as well as an area of impact. E.g. dispensing expired medicine is firstly a failure during the checking procedure before handing the medicine over to the patient but the root cause of the problem is actual failure to properly control and rotate pharmaceutical stock. Correcting the root problem will inevitably prevent similar errors from occurring in future.
Conclusion: Making a mistake is bad but not confronting it is worse. Correct your error(s) by making sure minimal or no harm is done by addressing the problem right away. Once the error is under control, The role of the pharmacy manager/owner: follow the policies of your organization so It is crucial for the pharmacy manager/ the error can be understood and learned owner to create a culture of safety to from as a means of preventing a similar ensure that professional staff has the occurrence from happening in the future. courage to report any errors made, selfdiscovered as well as reported by patients, Lastly, don’t dwell on your mistake; be sure without fear of the consequences. A to learn from it so that you don’t repeat it. system of documenting and reporting Do everything in your power to right your should be standard practice in all wrong and then move on. pharmacies. Many times, errors are LOCUM LIFESTYLE
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HEALTH
FOODS, DRINKS & ACTIVITIES TO AVOID DURING PREGNANCY By: LEMANJA MEARS
A
fter doing intense research I have compiled a list of foods, drinks & activities to avoid while being pregnant. It is not written with the intent to create fear or pile onto your stress levels, quite the opposite in fact. If you follow this basic guideline you will have peace of mind that you are eliminating potentially harmful factors from your pregnancy. Some stress during your pregnancy is normal but if it becomes constant, the effects on you and your baby could be lasting. Susan Andrews, PhD, a clinical neuropsychologist suggests that reducing your stress levels during pregnancy is in fact beneficial for the mother and the baby’s health. Susan is the author of the book Stress Solutions for Pregnant Moms: How Breaking Free From Stress Can Boost Your Baby’s Potential. She also explains in her book that constant stress could alter your body’s stress management system, causing it to overreact and trigger an inflammatory response.
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Inflammation, in turn, has been linked to poorer pregnancy health and developmental problems in babies. “There is some data to show that higher chronic stressors in women and poor coping skills to deal with those stressors may be associated with lower birth weight and with delivering earlier,” says Ann Borders, MD, MPH, MSc, and a Gynaecologist in the obstetrics and gynaecology department at the North Shore University. She also adds that chronic stress may also contribute to subtle differences in brain development that might lead to behavioural issues as the baby grows. As you can see there are absolutely no benefits in increasing your stress levels during your pregnancy. Now take a deep breath, kick off your shoes, relax on the couch and read our recommended guideline listing the important things to avoid while pregnant. If you enjoy reading this article, send me an email at lemanja@ locumlifestyle. co.za and share your thoughts. FOODS TO AVOID: • Uncooked seafood (no sushi ladies); under cooked poultry & raw meat holds the risk of contamination with coli form bacteria, toxoplasmosis & salmonella • Cold meats can be contaminated with listeria, which can cause a miscarriage. • Deep sea fish like swordfish & king mackerel most likely contain high mercury levels. • Smoked seafood - risk of listeria.
• Raw oysters, mussels and under cooked shell fish can lead to algae related infections that are associated with red tides • Raw eggs and foods containing raw eggs risk of salmonella. • Soft cheeses such as Brie; Camembert, Roquefort, Feta, Gorgonzola, and Mexican style cheeses that include queso blanco and queso fresco, unless they clearly state that they are made from pasteurized milk may contain listeria. • Unpasteurized milk & refrigerated pate’s can also contain listeria. • Avoid caffeine especially during the first trimester and there after limit your intake as some believe it can aid miscarriage. • Never consume ANY alcohol during your pregnancy as this can lead to fatal alcohol syndrome. • Wash all fruits and vegetables carefully, Pesticides on it can cause toxoplasmosis. • Unpasteurized juices can lead to food poisoning. EXERCISES TO AVOID Exercise during pregnancy is healthy and it has been noted that women who exercise during their pregnancy experience shorter labour and deliver healthy babies with strong heart beats. The key is in selecting moderate activities. A mild and regular exercise routine during pregnancy will not harm your baby, instead it is good for both, you and your growing child. LOCUM LIFESTYLE
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HOWEVER THE FOLLOWING EXERCISES SHOULD BE AVOIDED:
OTHER ACTIVITIES TO AVOID DURING YOUR PREGNANCY:
• Heavy weight training can cause serious injury to your abdomen • Avoid normal yoga, instead opt for prenatal yoga classes instead • Never exercise while lying on your stomach • Taking up running or jogging - only serious athletes may run or jog during pregnancy after consulting their doctor first • Cycling is no longer safe and your growing stomach might interfere with keeping your balance • No high impact aerobics • Swimming, skiing, volleyball, horse riding can be dangerous during this time • No rigorous workouts
• • • • • • • • • • •
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Changing your cat’s litter box Playing with large or excitable dogs Handling amphibians and reptiles Overeating Sun tanning Gymnastics Scuba diving Dieting for weight loss Live virus immunization Frequent exposure to loud noises Postpone the amusement park visit until after your baby is born • Avoid sauna’s, steam rooms or hot baths as it could lead to birth defects • Cosmetic surgery • Chemical hair dyes
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