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09 November 2023 | Story André Damons | Photo SUPPLIED
UFS experts give presentations on hospital-acquired infections at Africa Health
From left (bottom) Samantha Mc Carlie, Prof Robert Bragg and Caroline Bilen. (Back) Hugo La Reserve (from PMB Health and Safety) and Dr Noor Zakhura (from Free State Department of Health) at the Africa Health Exhibition.

It was recently discovered that bacteria are capable of growing inside bottles of disinfectants, hand sanitisers and antiseptics. These cleaning products, which are actively used in South African hospitals, are doing more harm than good by contaminating the environment they are designed to clean. Upon testing, some of these contaminated bottles harbouring harmful microorganisms were still actively in use in hospitals and instead of killing microorganisms, the contaminated cleaning solutions were spreading pathogens throughout the hospital with their use. 

This is according to Samantha Mc Carlie from the Department of Microbiology and Biochemistry at the University of the Free State (UFS). She, with her promotor, Prof Robert Bragg, were part of a workshop at the Africa Health Exhibition – the biggest gathering of health care professionals in South Africa and Africa. This was held at Gallagher Estate, Midrand, from 17 to 19 October 2023. 

Increasing mortalities in health-care setting

In a workshop titled: “Developing and sustaining safe health-care environments”, they were part of the main presenting panel, together with Caroline Bilen from the Compass Health Consultancy in Dubai 

Prof Bragg, whose main research is in disease-control, first in the agricultural industry, and now human health, started off the session by highlighting the problems with the increasing mortalities in the health-care setting. He presented data indicating that in the not too distant future, deaths from hospital-acquired infections would be the leading cause of human deaths. “This problem is rapidly growing as most of the pathogens which people contract while in hospital are now resistant to antibiotics, making them very difficult to treat,” he explained.

He used an analogy from San Tzu from the book The Art of War to explain why humankind is losing the war against the microbes. “San Tzu stated that if you know yourself and know your enemy, you will be victorious in every battle. On the other hand, if you do not know yourself or the enemy, you will be defeated in every battle. He pointed out that we do not know the enemy and we do know ourselves (or rather the weapons we have to defeat the enemy) and for this reason we are being defeated,” according to Prof Bragg. 

He continued: “We know the names of the different pathogens causing diseases, but do we really understand them? The answer to that must be ‘no’. A typical example is people are using ethanol-based or chlorine-based products to disinfect and then they wonder why there are increasing problems with Clostridioides difficile infections. If we knew the enemy, we would know that this bacterium producers endospores  and chlorine and ethanol-based disinfectants do not inactivate bacterial endospores, and so will not kill this bacterium,” said Prof Bragg. 

He stated that a major concern for hospitals is that they are currently unaware of whether the disinfectants they are using are effective against the pathogens in their hospital. It is assumed that their cleaning products are working but no testing is being done.

Bacterial resistance to disinfectants

Mc Carlie, in her presentation, highlighted the development of bacterial resistance to disinfectants and why this is important in the health-care setting. She pointed out that the standards for the registration of disinfectant products is based on the use of reference strains of bacteria.

“Bacteria found in hospital environments often exhibit significantly greater resistance to disinfectant compounds compared to the standard strains used for product testing. The presence of these resistant bacteria can result in microbial growth and contamination within containers of disinfectants, hand sanitisers, and antiseptics intended for hospital cleaning purposes. Instead of effectively eliminating microorganisms, these contaminated products inadvertently spread these resilient bacteria throughout the hospital environment, contributing to overall contamination,” said Mc Carlie.

She also discussed the consequences of using incorrectly diluted disinfectant products at concentrations that will not be effective against resilient hospital pathogens. 

Prof Bragg finished the session with a discussion on the solutions to the current problem and highlighted the need for a paradigm shift in medicine. “The current paradigm, since the discovery of antibiotics, has been treatment. As we are entering into a post-antibiotic era, this paradigm of treatment needs to change to one of ‘prevention’. The old saying ‘Prevention is better than cure’ has never been more true.”

He concluded by discussing various options which could be used when focus is placed on biosecurity for the prevention of hospital-acquired infection; including the installation of UV lights, monitoring of the laundry process, correct disinfecting of surfaces, using products with proven efficacy against the pathogens isolated from the different health-care setting and finally, the use of antimicrobial bedside privacy curtains.

The workshop ended with a panel discussion on biosecurity and the efforts needed to reduce the ever-increasing numbers of hospital-acquired infections. It is hoped that the message of this workshop will have a significant impact on the reduction of hospital acquired infections. 

Click to view documentProf Bragg's presentation.

Click to view documentMc Carlie's presentation.

News Archive

Media: ANC can learn a lesson from Moshoeshoe
2006-05-20


27/05/2006 20:32 - (SA) 
ANC can learn a lesson from Moshoeshoe
ON 2004, the University of the Free State turned 100 years old. As part of its centenary celebrations, the idea of the Moshoeshoe Memorial Lecture was mooted as part of another idea: to promote the study of the meaning of Moshoeshoe.

This lecture comes at a critical point in South Africa's still-new democracy. There are indications that the value of public engagement that Moshoeshoe prized highly through his lipitso [community gatherings], and now also a prized feature in our democracy, may be under serious threat. It is for this reason that I would like to dedicate this lecture to all those in our country and elsewhere who daily or weekly, or however frequently, have had the courage to express their considered opinions on pressing matters facing our society. They may be columnists, editors, commentators, artists of all kinds, academics and writers of letters to the editor, non-violent protesters with their placards and cartoonists who put a mirror in front of our eyes.

There is a remarkable story of how Moshoeshoe dealt with Mzilikazi, the aggressor who attacked Thaba Bosiu and failed. So when Mzilikazi retreated from Thaba Bosiu with a bruised ego after failing to take over the mountain, Moshoeshoe, in an unexpected turn of events, sent him cattle to return home bruised but grateful for the generosity of a victorious target of his aggression. At least he would not starve along the way. It was a devastating act of magnanimity which signalled a phenomenal role change.

"If only you had asked," Moshoeshoe seemed to be saying, "I could have given you some cattle. Have them anyway."

It was impossible for Mzilikazi not to have felt ashamed. At the same time, he could still present himself to his people as one who was so feared that even in defeat he was given cattle. At any rate, he never returned.

I look at our situation in South Africa and find that the wisdom of Moshoeshoe's method produced one of the defining moments that led to South Africa's momentous transition to democracy. Part of Nelson Mandela's legacy is precisely this: what I have called counter-intuitive leadership and the immense possibilities it offers for re-imagining whole societies.

A number of events in the past 12 months have made me wonder whether we are faced with a new situation that may have arisen. An increasing number of highly intelligent, sensitive and highly committed South Africans across the class, racial and cultural spectrum confess to feeling uncertain and vulnerable as never before since 1994. When indomitable optimists confess to having a sense of things unhinging, the misery of anxiety spreads. It must have something to do with an accumulation of events that convey the sense of impending implosion. It is the sense that events are spiralling out of control and no one among the leadership of the country seems to have a handle on things.

I should mention the one event that has dominated the national scene continuously for many months now. It is, of course, the trying events around the recent trial and acquittal of Jacob Zuma. The aftermath continues to dominate the news and public discourse. What, really, have we learnt or are learning from it all? It is probably too early to tell. Yet the drama seems far from over, promising to keep us all without relief, and in a state of anguish. It seems poised to reveal more faultlines in our national life than answers and solutions.

We need a mechanism that will affirm the different positions of the contestants validating their honesty in a way that will give the public confidence that real solutions are possible. It is this kind of openness, which never comes easily, that leads to breakthrough solutions, of the kind Moshoeshoe's wisdom symbolises.

Who will take this courageous step? What is clear is that a complex democracy like South Africa's cannot survive a single authority. Only multiple authorities within a constitutional framework have a real chance. I want to press this matter further.

Could it be that part of the problem is that we are unable to deal with the notion of "opposition". We are horrified that any of us could become "the opposition". In reality, it is time we began to anticipate the arrival of a moment when there was no longer a single [overwhelmingly] dominant political force as is currently the case. Such is the course of change. The measure of the maturity of the current political environment will be in how it can create conditions that anticipate that moment rather than ones that seek to prevent it. This is the formidable challenge of a popular post-apartheid political movement.

Can it conceptually anticipate a future when it is no longer overwhelmingly in control, in the form in which it currently is and resist, counter-intuitively, the temptation to prevent such an eventuality? Successfully resisting such an option would enable its current vision and its ultimate legacy to our country to manifest itself in different articulations of itself, which then contend for social influence.

In this way, the vision never really dies, it simply evolves into higher, more complex forms of itself. If the resulting versions are what is called "the opposition" that should not be such a bad thing - unless we want to invent another name for it. The image of flying ants going off to start other similar settlements is not so inappropriate.

I do not wish to suggest that the nuptial flights of the alliance partners are about to occur: only that it is a mark of leadership foresight to anticipate them conceptually. Any political movement that has visions of itself as a perpetual entity should look at the compelling evidence of history. Few have survived those defining moments when they should have been more elastic, and that because they were not, did not live to see the next day.

I believe we may have reached a moment not fundamentally different from the sobering, yet uplifting and vision-making, nation-building realities that led to Kempton Park in the early 1990s. The difference between then and now is that the black majority is not facing white compatriots across the negotiating table. Rather, it is facing itself: perhaps really for the first time since 1994. It is not a time for repeating old platitudes. Could we apply to ourselves the same degree of inventiveness and rigorous negotiation we displayed up to the adoption or our Constitution?

Morena Moshoeshoe faced similarly formative challenges. He seems to have been a great listener. No problem was too insignificant that it could not be addressed. He seems to have networked actively across the spectrum of society. He seems to have kept a close eye on the world beyond Lesotho, forming strong friendships and alliances, weighing his options constantly. He seems to have had patience and forbearance. He had tons of data before him before he could propose the unexpected. He tells us across the years that moments of renewal demand no less.

  • This is an editied version of the inaugural Moshoeshoe Memorial Lecture presented by Univeristy of Cape Town vice-chancellor Professor Ndebele at the University of the Free State on Thursday. Perspectives on Leadership Challenges In South Africa

 

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