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02 March 2022 | Story Prof Anthony Turton | Photo Supplied
Prof Anthony Turton, Affiliated Professor in the Centre for Environmental Management at the University of the Free State (UFS), writes that in the face of the typhoid outbreak, we need to renew our trust in science, but also wake up and smell the coffee.

Opinion article by Prof Anthony Turton from the Centre for Environmental Management, University of the Free State .
The recent news has been dominated by so many things that an important signal has been drowned out by the noise. That small signal is the announcement by the NICD that typhoid has been identified in parts of the country, so the prudent approach is to boil the water coming from taps. While this is an important development, it needs to be placed into context.  For starters, the NICD is a credible institution, so anything they say must be taken seriously. This issue brings three important factors into clear focus. Let us unpack each of these in order to gain greater perspective. 

The issue of trust 

The first is the issue of trust. This is a global phenomenon, most notably associated with social media that has enabled each person to theoretically have access to the entire quantum of our cumulative knowledge as an apex species on planet earth. In an instant, each person has the capacity to become an expert on a given topic. We have seen this playing out in the COVID-19 space, most notably as the efficacy of the vaccination programme has been questioned. While it is great that so much information is available to everyone instantly, it is also a problem, because unless the individual is trained to filter out the noise, they are rapidly overloaded with stuff that causes them to panic. In South Africa this has an added dimension, driven by the findings of the Zondo Commission, which in general indicate a severe trust deficit between government and the general population. Seen in this light, it is highly likely that the typhoid issue will fall directly into that chasm of trust and serve to widen it even further. This needs to be dealt with in our collective best interest, because panic serves nobody in a constructive way. Therefore, the first part of my core message is that we must avoid the urge to become instant experts by deferring the scientific facts to the scientific professionals. Sadly, science has been a victim of this trust deficit, so my voice might be lost in the howling gale of discontentment. 

The problem of deteriorating water quality

The second is the problem of deteriorating water quality. In this regard, we are on absolutely solid ground, because we know – without fear of contradiction – that our water quality has been on a downward trajectory for some time. If we are looking for a pivotal moment, we might consider the acid mine drainage decant that first hit the public attention in 2002. Amid a flurry of activism and a media frenzy, we have the sad reality, two decades later, that absolutely nothing has been done about this matter. Highly acidic mine water, rich in a dissolved cocktail of metals that include uranium, arsenic, cadmium, and mercury, have continued to flow into our rivers and dams in mining areas of the country. But more importantly, we have also witnessed the systematic collapse of our wastewater infrastructure, which has accelerated over the past decade; this is best epitomised by the unsuccessful attempt of the SANDF to prevent the flow of raw sewage into the Vaal River at Emfuleni. Two billion rand later, we are no closer today to finding a solution than we were a decade ago. The numbers are staggering. As a nation, we produce over five billion litres of raw sewage every day. The latest credible calculation of that flow indicated that about 4,2 billion litres were being discharged daily into our rivers in an untreated format. That represents a tsunami of human waste inundating our rivers and dams, without respite, for more than a decade. 

This is probably our biggest single challenge as a nation. In my professional opinion, this is a national security issue, because it impacts negatively on the lives of each citizen daily. It is destroying the economy from within by damaging the health of the individual, without them even knowing about it. You see, in sewage return flows, we find every substance that is ever dispensed in the retail sector. Think of the pharmaceutical industry. Imagine how much medication is sold each day by major pharmacies countrywide. Every item sold ends up in the sewage stream in a partially metabolised format. These include antibiotics, antiretrovirals, antidepressants, oestrogen used for contraception, and Viagra used to keep an aging population happy. So, we need to think of the sewage streams being discharged into our rivers and dams as thousands of tons of medication, still viable even in its partially metabolised form, to which we are exposing trillions of pathogenic microbes that are flourishing in the warm nutrient-rich waters. Think of this as a boot camp for microbes, because lazy and weak ones are destroyed by the low concentration of antibiotics, leaving only the stronger ones to flourish. In short, our boot camp for microbes is producing the next generation of multidrug-resistant pathogens. It is happening right before our eyes.  Simply think about this logically and draw your own conclusion if you choose to mistrust science for reasons of your own.  Does it make sense to allow the discharge of more than four billion litres of sewage daily into our rivers and dams, without anticipating some form of unintended consequence?  

Our ability to cope as a nation

The third is the issue of our ability to cope as a nation. Here is where it gets really interesting, because at the very time when we are facing multiple risks to our economic well-being – COVID-19, unemployment, capital flight, energy crisis, corruption, to name but a few – we also need to be at our peak performance when it comes to finding solutions. We can say, with a high level of confidence, that our capacity to reach consensus on the way to solve the complex problems we are facing, is probably at an historic low (and deteriorating). In fact, we can say that there is an inverse relationship between our need to find consensus on a viable way ahead, and our capacity to generate the very consensus on which our survival as a species depends. This sounds a little dramatic, but I am using it to illustrate the point that globally, our capacity to unite in the face of a single common threat – climate change – is being eroded by many forces. These include the deficit of trust in government (point one noted above), the growing mistrust of science (exacerbated by the COVID-19 pandemic and the manifest as social pushback from the anti-vaxxers and the climate change denialists), and the increased sense of helplessness that each person is confronted with.

All of these are manifested in the typhoid issue. While typhoid is clearly a bad thing, we need to place it in context. Just as the COVID issue has shown us, the fatalities are relatively few, and while tragic to the individual families impacted, seen through the lens of logic and reason, this is not a show-stopper. What it does is highlight the issue of our failing sewage infrastructure. We can no longer simply accept that incompetent politicians can muddle their way through a growing crisis. We have to hold them accountable. We must convert the rising sense of rage into the high-octane rocket fuel of change. We need to say enough is enough. Now is the time that we demand technically competent people be appointed into specialist jobs, and then held fully accountable. We need to depoliticise the deployment of cadres, for that policy has brought us the failing infrastructure we see in Eskom, PRASA, municipal wastewater systems, and many other failed SOEs. 

In the face of the typhoid outbreak, we need to renew our trust in science, but also wake up and smell the coffee by realising that we cannot simply discharge billions of litres of acidic mine water and raw sewage into our rivers and dams, without encountering unintended consequences. Those consequences might just be deadly.

News Archive

Research contributes to improving quality of life for cancer patients
2016-11-21

Description: Inorganic Chemistry supervisors  Tags: Inorganic Chemistry supervisors

Inorganic Chemistry supervisors in the Radiopharmacy
Laboratory during the preparation of a typical complex
mixture to see how fast it reacts. Here are, from the left,
front: Dr Marietjie Schutte-Smith, Dr Alice Brink
(both scholars from the UFS Prestige
Scholar Programme), and Dr Truidie Venter (all three
are Thuthuka-funded researchers).
Back: Prof André Roodt and Dr Johan Venter.
Photo: Supplied

Imagine that you have been diagnosed with bone cancer and only have six months to live. You are in a wheelchair because the pain in your legs is so immense that you can’t walk anymore – similar to a mechanism eating your bones from the inside.

You are lucky though, since you could be injected with a drug to control the pain so effective that you will be able to get out of the wheelchair within a day-and-a-half and be able to walk again. Real-life incidents like these provide intense job satisfaction to Prof André Roodt, Head of Inorganic Chemistry at the University of the Free State (UFS). The research, which is conducted by the Inorganic Group at the UFS, contributes greatly to the availability of pain therapy that does not involve drugs, but improves the quality of life for cancer patients.

The research conducted by the Inorganic Group under the leadership of Prof Roodt, plays a major role in the clever design of model medicines to better detect and treat cancer.

The Department of Chemistry is one of approximately 10 institutions worldwide that conducts research on chemical mechanisms to identify and control cancer. “The fact that we are able to cooperate with the Departments of Nuclear Medicine and Medical Physics at the UFS, the Animal Research Centre, and other collaborators in South Africa and abroad, but especially the methodology we utilise to conduct research (studying the chemical manner in which drugs are absorbed in cancer as well as the time involved), enhances the possibility of making a contribution to cancer research,” says Prof Roodt.

Technique to detect cancer spots on bone
According to the professor, there are various ways of detecting cancer in the body. Cancer can, inter alia, be identified by analysing blood, X-rays (external) or through an internal technique where the patient is injected with a radioactive isotope.

Prof Roodt explains: “The doctor suspects that the patient has bone cancer and injects the person with a drug consisting of an isotope (only emits X-rays and does no damage to tissue) that is connected to a phosphonate (similar to those used for osteoporosis). Once the drug is injected, the isotope (Technetium-99m) moves to the spot on the bone where the cancer is located. The gamma rays in the isotope illuminate the area and the doctor can see exactly where treatment should be applied. The Technetium-99m has the same intensity gamma rays as normal X-rays and therefore operates the same as an internal X-ray supply.” With this technique, the doctor can see where the cancer spots are within a few hours.

The same technique can be used to identify inactive parts of the brain in Alzheimer patients, as well as areas of the heart where there is no blood supply or where the heart muscle is dead.

Therapeutic irradiation of cancer
For the treatment of pain connected with cancer, the isotope Rhenium-186 is injected. Similar to the manner in which the Technetium-99m phosphonate compound is ingested into the body, the Rhenium-186 phosphonate travels to the cancer spots. Patients thus receive therapeutic irradiation – a technique known as palliative therapy, which is excellent for treating pain. A dosage of this therapy usually lasts for about two months.

The therapy is, however, patient specific. The dosages should correspond with the occurrence and size of cancer spots in the patient’s body. First, the location of the cancer will be determined by means of a technetium scan. After that, the size of the area where the cancer occurs has to be determined. The dosage for addressing total pain distribution will be calculated according to these results.

Technique to detect cancer spots on soft tissue
Another technique to detect cancer as spots on bone or in soft tissue and organs throughout the body is by utilising a different type of irradiation, a so-called PET isotope. The Fluor-18 isotope is currently used widely, and in Pretoria a machine called a cyclotron was produced by Dr Gerdus Kemp, who is a former PhD graduate from the Inorganic Research Group. The F-18 is then hidden within a glucose molecule and a patient will be injected with the drug after being tranquillised and after the metabolism has been lowered considerably. The glucose, which is the ‘food' that cancer needs to grow, will then travel directly to the cancer area and the specific area where the cancer is located will thus be traced and ‘illuminated’ by the Fluor-18, which emits its own 'X-rays'.

In the late 80s, Prof Roodt did his own postdoctoral study on this research in the US. He started collaborating with the Department of Nuclear Medicine at the UFS in the early 90s, when he initiated testing for this research.

Through their research of more than 15 years, the Inorganic Group in the Department of Chemistry has made a major contribution to cancer research. Research on mechanisms for the detection of cancer, by designing new clever chemical agents, and the chemical ways in which these agents are taken up in the body, especially contributes to the development in terms of cancer therapy and imaging, and has been used by a number of hospitals in South Africa.

The future holds great promise
Prof Roodt and his team are already working on a bilateral study between the UFS and Kenya. It involves the linking of radio isotopes, as mentioned above, to known natural products (such as rooibos tea), which possess anti-cancer qualities.

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