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Health care
Those who took part in the community engagements are: From left Dr Kamo Mothibi from the UFS, Irene Mokgadi from CUT, Dr Mosebi Thejane (UFS), Ahlume Nkumbesi (UFS), Dr Lebogang Mogongoa (CUT), Minnie Mbokazi (UFS), Dr Happy Phage (CUT), Dr Phindile Shangase (UFS) and Teboho Mhlanga from the Free State Department of Health. Seated in from are Meshack Mothupi, driver from CUT, and Sipho Zulu (UFS).

The Division of Public Health at the University of the Free State (UFS) together with the Central University of Technology (CUT), and the Free State Department of Health’s Disability Unit, held community engagements recently by visiting rehabilitation services in Bloemfontein. 

These engagements were part of the co-funded project: Capacity building for the use of implementation science in various typologies in low- and middle-income countries for the prevention and/or management of the quadruple burden of disease. This was phase two in this project with the last phase including a symposium that is expected to take place on 1 April on the UFS Bloemfontein Campus.

Qhomane Mhlanga, a representative from the Free State Department of Health who is actively involved in this project, and her team, identified rehabilitation services for a case study. They also identified stakeholders to be visited during this community engagement in order to gather information on their engagement with Mangaung University of the Free State Community Partnership Programme (MUCPP). The team also visited stakeholders at the Phelang Disability Home, Carel du Toit Special School, and the Department of Education (Inclusive Education). 

 

Research to improve health care service

Dr Phindile Shangase from the Division of Public Health, and Principal Investigator at UFS, says the purpose of community visits was to engage service providers on the implementation strategies. This includes analysing alignment of implementation strategies with the policy (National Rehabilitation Policy 2000, Free State Rehabilitation Policy Guidelines, Framework and Strategy for Disability and Rehabilitation Service in South Africa 2015-2020) as well as identifying facilitators and barriers to implementation.

“It is the intention of the Division of Public Health, UFS to continue collaborations with stakeholders in implementation science research to improve health care service delivery and outcomes. The Division of Public Health also intends to add postgraduate research studies on implementation science in the near future.

“The visit to the clinic sought to establish the services provided by the rehabilitation unit, the referral system, and how the unit collaborates with external stakeholders to enhance the service. We gained knowledge of categories of healthcare professionals in rehabilitation services, e.g., occupational therapists, physiotherapists, speech and language therapists, audiologists, orthotists and prosthetists, rehabilitation doctors, optometrists, community rehabilitation workers. Some of these professionals are not available in the facilities visited,” says Dr Shangase. 

It was identified that, she continues, early hearing screening services for children are not available at healthcare facilities. Early hearing screening helps identify hearing defects which could be managed early to avoid complications that lead to hampered education and poor quality of life.


Outcome of engagements

Before the community outreach began, the UFS/CUT team, in collaboration with the Department of Health, convened to discuss strategies for navigating the Implementation Science project. The meeting focused on identifying key stakeholders and developing approaches essential for the project's success, drawing insights from the Department of Health's Mangaung Metro implementation science case study. 

The team identified five primary approaches for the project: Health, Education, Livelihood, Social, and Empowerment. Additionally, the discussion highlighted both the barriers and enablers related to each approach, which are crucial for ensuring effective project implementation and sustainable outcomes. Free State rehabilitation policy guidelines document was also applied to evaluate the case study.

According to Dr Shangase, the outreach will help with drafting of an intervention plan to address policy implementation gaps identified. The information gathered will assist in commissioning further research to improve health outcomes. “The intention is to collaborate with the Department of Health to work on past research outputs, presented during research day conferences, for implementation in healthcare facilities. Newly identified research areas will also prompt projects in healthcare facilities, led by the academic partners, UFS, Division of Public Health as well as the Department of Health Sciences, CUT.”

News Archive

To tan or not to tan: a burning issue
2009-12-08

 Prof. Werner Sinclair

“Some evidence exists which implies that sunscreens could indeed be responsible for the dramatic rise in the incidence of melanoma over the past three decades, the period during which the use of sunscreens became very popular,” says Prof. Werner Sinclair, Head of the Department of Dermatology at the University of the Free State. His inaugural lecture was on the topic Sunscreens – Curse or Blessing?

Prof. Sinclair says the use of sunscreen preparations is widely advocated as a measure to prevent acute sunburn, chronic sun damage and resultant premature skin aging as well as skin malignancies, including malignant melanoma. There is inconclusive evidence to prove that these preparations do indeed achieve all of these claims. The question is whether these preparations are doing more harm than good?

He says the incidence of skin cancer is rising dramatically and these tumours are induced mostly by the ultra-violet rays.

Of the UV light that reaches the earth 90-95% belongs to the UVA fraction. UVC is normally filtered out by the ozone layer. UVB leads to sunburn while UVA leads to pigmentation (tanning). Because frequent sunburn was often associated with skin cancer, UVB was assumed, naively, to be the culprit, he says.

Exposure to sunlight induces a sense of well-being, increases the libido, reduces appetite and induces the synthesis of large amounts of vitamin D, an essential nutritional factor. The use of sunscreen creams reduces vitamin D levels and low levels of vitamin D have been associated with breast and colon cancer. Prof. Sinclair says the 17% increase in breast cancer from 1981 to 1991 parallels the vigorous use of sunscreens over the same period.

Among the risk factors for the development of tumours are a family history, tendency to freckle, more than three episodes of severe sunburn during childhood, and the use of artificial UV light tanning booths. He says it remains a question whether to tan or not. It was earlier believed that the main carcinogenic rays were UVB and that UVA merely induced a tan. The increase in UVA exposure could have severe consequences.

Prof. Sinclair says the UV light used in artificial tanning booths consists mainly of pure UVA which are highly dangerous rays. It has been estimated that six per cent of all melanoma deaths in the UK can be directly attributed to the use of artificial tanning lights. The use of an artificial tanning booth will double the melanoma risk of a person. “UVA is solely responsible for solar skin aging and it is ironical that tanning addicts, who want to look beautiful, are inflicting accelerated ageing in the process,” he says.

On the use of sunscreens he says it can prevent painful sunburn, but UVA-induced damage continues unnoticed. UVB blockers decrease vitamin D synthesis, which is a particular problem in the elderly. It also prevents the sunburn warning and therefore increases the UVA dosage that an individual receives. It creates a false sense of security which is the biggest problem associated with sunscreens.

Evidence obtained from the state of Queensland in Australia, where the heaviest and longest use of sunscreens occurred, boasted the highest incidence of melanoma in the world. A huge study in Norway has shown a 350% increase in melanoma for men and 440% for women. This paralleled the increase in the use of UVB blocking sunscreens while there was no change in the ozone layer. It did however, occur during that time when tanning became fashionable in Norway and there was an increase especially in artificial tanning.

Prof. Sinclair says: “We believe that sunscreen use does not directly lead to melanoma, but UVA exposure does. The Melanoma Epidemic is a reality. Sunscreen preparations are not the magical answer in the fight against melanoma and the irresponsible use of these preparations can worsen the problem.”

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt.stg@ufs.ac.za
7 December 2009

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