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29 April 2022 | Story André Damons
Dr Asha Malan
Dr Asha Malan, Head of the division for Vascular Surgery in the Faculty of Health Sciences at the University of the Free State (UFS), is the first woman vascular surgeon to head an Academic Unit in South Africa and the youngest Head of Vascular Surgery.

Dr Asha Malan, Head of the division for Vascular Surgery in the Faculty of Health Sciences at the University of the Free State (UFS), is not only one of just seven qualified female vascular surgeons in the country; she is also the first female vascular surgeon to head an academic unit in South Africa and the youngest Head of Vascular Surgery yet.

Dr Malan says she is honoured to represent women in the field of Vascular Surgery – a historically male-dominated field. One of her main objectives now is to attract more women to this field. In 2020, she was simultaneously appointed the Acting Head of the Department for General Surgery when Dr Nicholas Pearce became the head of the Universitas Academic Hospital COVID-19 Task team. 

“To be very honest – I had not previously thought about this (being the first female to head a unit for Vascular Surgery). I have always been of the opinion that if I achieve something in life, it should be because I worked hard enough for it and was blessed with God-given opportunities.  This was one of the life lessons taught to me by my two amazing parents. 

“It is an absolute privilege to be in this position at such a young age. I have been in the fortunate position where hard work indeed paid off and to a large extent, I was incredibly lucky. I believe my age counts in my favour – I am keen to learn (which is a daily exercise) and take on new opportunities. I am still ‘naïve’ enough to dream big and market my dream of offering state-of-the-art vascular surgical care for all,” says Dr Malan.  

Passion for Vascular Surgery
According to her, she has been granted opportunities to develop her skills by visiting units in other countries including Switzerland, Belgium and Germany. Later this year she is off to the Netherlands, France and the US to build on this and teach these skills locally. 

Dr Malan is passionate about vascular surgery and calls it one of the most beautiful types of surgery. She decided to become a medical doctor at school when her Biology teacher, Mrs Em Volschenk, triggered an appreciation for the workings of the human body.

It is her obsessive and perfectionist personality that attracted her to vascular surgery. The love to fix things, she calls it.

“I have always gained great joy from making something cleaner, neater and better. Medicine, and more in particular, surgery, provides you with the absolute privilege to do so for the human body. Vascular surgery is one of the most beautiful types of surgery. It is neat and clean, but at the same time challenging. It provides the opportunity to perform surgery on any part of the body and develop your surgical skills. 

“In addition, it makes you calm and comfortable in high-stress situations.  The most tiring part of vascular surgery is, however, not the physical strain nor the hours, but the intense planning it requires – it is in some aspects like the engineering of surgery – you sometimes have to come up with solutions to problems that no textbook will contain. It is currently one of the fastest growing surgical subspecialties worldwide due to the innovation happening within the field. It is a way of thinking and I love every moment,” states Dr Malan.

She is well aware of the responsibility that comes with this important position and feels honoured to pave the way forward. Says Dr Malan: “I am currently one of only two female consultant surgeons in the Department of General Surgery and I strongly believe we bring a unique perspective. We also have a particular leadership style that is inclusive and encouraging – contributing to an environment where others can grow and strengthen the Department.”

Not many women in surgery
According to Dr Malan, surgery historically has a bad name due to the hours and demands of the job. Surgeons need to be available almost all the time – a schedule that fails to conform to the traditional expectations of women. This is even more so for vascular surgery, as many of our patients require emergency care that does not respect “working hours”. On the other hand, says Dr Malan, she believes most women possess the ability to multitask efficiently.

“Not only can we do a number of things at once, but can also do them well. Females have mastered the art of balancing the demands of both their work- and personal-lives more and more and society is generally more receptive to this as well. This provides a definite advantage to not only function, but flourish in the field of surgery and vascular surgery.”

The first step to get more women involved in this field, says Dr Malan, is to show it can be done.  Females are featuring in surgical leadership roles worldwide on an increasing front and prominent role models are key to igniting interest and self-belief. 

Harvard University Surgical Leadership Programme
Dr Malan graduated from the Harvard University Surgical Leadership Programme in April this year and says it was an amazing experience to liaise with colleagues in leadership roles within their respective surgical departments across the globe. It was an honour to represent the University of the Free State in this capacity.

According to her, Prof Francis Petersen, UFS Rector and Vice-Chancellor, was instrumental in retaining her for the university after she qualified as a vascular surgeon. She received offers from other universities and private practice, but was keen to stay on as she envisaged a career in academics. “I had a dream of building a nationally recognised quality Vascular Surgery Unit that not only excels in clinical service delivery, but also in undergraduate- and postgraduate-training – this vision was already developing as we performed the first complex endovascular aortic repair in a state hospital in South Africa in 2019. Prof Petersen made time to listen to my dream and initiated the process for me to start realising it.”

She would like to give credit to her predecessors, particularly Prof Renald Barry who has been a mentor to her and with whom she had the privilege of operating until last year. In addition, she would like to thank her colleagues in the Department of Surgery and Vascular Surgery, who continue to inspire her every day.

News Archive

Inaugural lecture: Prof Robert Bragg, Dept. of Microbial, Biochemical and Food Biotechnology
2006-05-17



Attending the inaugural lecture were in front from the left Prof Robert Bragg (lecturer at the Department of Microbial, Biochemical and Food Biotechnology) and Frederick Fourie (Rector and Vice-Chancellor).  At the back from the left were Prof James du Preez (Departmental Chairperson:  Department of Microbial, Biochemical and Food Biotechnology) and Prof Herman van Schalkwyk (Dean: Faculty of Natural and Agricultural Sciences). Photo: Stephen Collett
 

A summary of an inaugural lecture delivered by Prof Robert Bragg at the University of the Free State:

CONTROL OF INFECTIOUS AVIAN DISEASES – LESSONS FOR MAN?

Prof Robert R Bragg
Department of Microbial, Biochemical and Food Biotechnology
University of the Free State

“Many of the lessons learnt in disease control in poultry will have application on human medicine,” said Prof Robert Bragg, lecturer at the University of the Free State’s (UFS) Department of Microbial, Biochemical and Food Biotechnology during his inaugural lecture.

Prof Bragg said the development of vaccines remains the main stay of disease control in humans as well as in avian species.  Disease control can not rely on vaccination alone and other disease-control options must be examined.  

“With the increasing problems of antibiotic resistance, the use of disinfection and bio security are becoming more important,” he said.

“Avian influenza (AI) is an example of a disease which can spread from birds to humans.  Hopefully this virus will not develop human to human transmission,” said Prof Bragg.

According to Prof Bragg, South Africa is not on the migration route of water birds, which are the main transmitters of AI.  “This makes South Africa one of the countries less likely to get the disease,” he said.

If the AI virus does develop human to human transmission, it could make the 1918 flu pandemic pale into insignificance.  During the 1918 flu pandemic, the virus had a mortality rate of only 3%, yet more than 50 million people died.

Although the AI virus has not developed human-to-human transmission, all human cases have been related to direct contact with infected birds. The mortality rate in humans who have contracted this virus is 67%.

“Apart from the obvious fears for the human population, this virus is a very serious poultry pathogen and can cause 100% mortality in poultry populations.  Poultry meat and egg production is the staple protein source in most countries around the world. The virus is currently devastating the poultry industry world-wide,” said Prof Bragg.

Prof Bragg’s research activities on avian diseases started off with the investigation of diseases in poultry.  “The average life cycle of a broiler chicken is 42 days.  After this short time, they are slaughtered.  As a result of the short generation time in poultry, one can observe changes in microbial populations as a result of the use of vaccines, antibiotics and disinfectants,” said Prof Bragg.   

“Much of my research effort has been directed towards the control of infectious coryza in layers, which is caused by the bacterium Avibacterium paragallinarum.  This disease is a type of sinusitis in the layer chickens and can cause a drop in egg product of up to 40%,” said Prof Bragg.

The vaccines used around the world in an attempt to control this disease are all inactivated vaccines. One of the most important points is the selection of the correct strains of the bacterium to use in the vaccine.

Prof Bragg established that in South Africa, there are four different serovars of the bacterium and one of these, the serovar C-3 strain, was believed to be unique to Southern Africa. He also recently discovered this serovar for the first time in Israel, thus indicating that this serovar might have a wider distribution than originally believed.

Vaccines used in this country did not contain this serovar.  Prof Bragg established that the long term use of vaccines not containing the local South African strain resulted in a shift in the population distribution of the pathogen.

Prof Bragg’s research activities also include disease control in parrots and pigeons.   “One of the main research projects in my group is on the disease in parrots caused by the circovirus Beak and Feather Disease virus. This virus causes serious problems in the parrot breeding industry in this country. This virus is also threatening the highly endangered and endemic Cape Parrot,” said Prof Bragg.

Prof Bragg’s research group is currently working on the development of a DNA vaccine which will assist in the control of the disease, not only in the parrot breeding industry, but also to help the highly endangered Cape Parrot in its battle for survival.

“Not all of our research efforts are directed towards infectious coryza or the Beak and Feather Disease virus.  One of my Masters students is currently investigating the cell receptors involved in the binding of Newcastle Disease virus to cancerous cells and normal cells of humans. This work will also eventually lead to a possible treatment of cancer in humans and will assist with the development of a recombinant vaccine for Newcastle disease virus,” said Prof Bragg.

We are also currently investigating an “unknown” virus which causes disease problems in poultry in the Western Cape,” said Prof Bragg.
 
“Although disinfection has been extensively used in the poultry industry, it has only been done at the pre-placement stage. In other words, disinfectants are used before the birds are placed into the house. Once the birds are placed, all use of disinfectants stops,” said Prof Bragg.

“Disinfection and bio security can be seen as the ‘Cinderella’ of disease control in poultry.  This is also true for human medicine. One just has to look at the high numbers of people who die from hospital-acquired infections to realise that disinfection is not a concept which is really clear in human health care,” said Prof Bragg.

Much research has been done in the control of diseases through vaccination and through the use of antibiotics. “These pillars of disease control are, however, starting to crumble and more effort is needed on disinfection and bio security,” said Prof Bragg.

Prof Bragg has been working in close co-operation with a chemical manufacturing company in Stellenbosch to develop a unique disinfectant which his highly effective yet not toxic to the birds.

As a result of this unique product, he has developed the continual disinfection program for use in poultry. In this program the disinfectant is used throughout the production cycle of the birds. It is also used to ensure that there is excellent pre-placement disinfection.

“The program is extensively used for the control of infectious diseases in the parrot-breeding industry in South Africa and the product has been registered in 15 countries around the world with registration in the USA in the final process,” said Prof Bragg.

“Although the problem of plasmid mediated resistance to disinfectants is starting to rear its ugly head, this has allowed for the opening of a new research field which my group will hopefully exploit in the near future,” he said.

 

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