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LIMPOPO Ieader NUMBER 10 SUMMER 2006

DISPATCHES FROM THE UNIVERSITY OF LIMPOPO

THE FALL AND RISE OF AN AFRICAN UNIVERSITY: Powerful new leadership at the University of Limpopo

RADIOACTIVITY: Deepening the gaze of medical science Our Lost Alumni competition: WE HAVE A WINNER!


LETTERS TO THE EDITOR

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PREFERENCE WILL BE GIVEN TO SHORT LETTERS. Aim for a maximum of 100 to 150 words or expect your epistle to be edited. Please give contact details when writing to us. No pseudonyms or anonymous letters will be published. ADDRESS YOUR LETTERS TO: The Editor A REQUEST FROM ZIMBABWE

Limpopo Leader

I have found your L i m p o p o L e a d e r a very exciting publication. I am a lecturer at the Zimbabwe Open University (ZOU). How can I subscribe to regularly receive a copy? May I also have the e-mail addresses of Dr Modibo M. Kadalie and the Dean of the Faculty of Education at Limpopo University. Kind regards. Hoping to hear from you soon. Madzviti Jacob Mugabe Zimbabwe. We have supplied the contact details of Dr Kadalie, the radical American political scientist featured in L i m p o p o L e a d e r 4, and Professor Lily Cherian, Indian-born director of Turfloop’s School of Education (see L i m p o p o L e a d e r 7). We are also happy to report that Mr Mugabe is now on the L i m p o p o L e a d e r mailing list.

PO Box 2756 Pinegowrie 2123 South Africa Fax: (011) 782-0335 E-mail: dgrwrite@iafrica.com

UNIQUE IS A DANGEROUS WORD The article Indigenous is Best ( L i m p o p o L e a d e r 9) refers. The generic, botanical name for ‘Bush Tea’ is Athrixia not Athixia. Also, it is an overstatement to claim the ‘product ... with its high antioxidant and low tannins, is unique in the world’. ‘Unique’ is a dangerous word – ‘uncommon’ or ‘unusual’ would be preferable. Forgive me for these criticisms – knowing the names, one’s eyes pick up these faults so readily. Professor K D Gordon-Gray Pietermaritzburg. L i m p o p o L e a d e r apologises for the spelling mistake – and for using the word ‘unique’ in this context.

Dr Mokoko Sebola

WHO EXACTLY ARE THESE MEN? This is a question that many readers were asking when L i m p o p o L e a d e r 9 was published three months ago. Due to a rare production error, in our article entitled Conversations with the University Experts, the captions were reversed. So we’re reprinting the pictures, this time with the right names in the right places. Luckily, both men spoke a lot of sense, so the damage was one of visual identification only. Nevertheless, our apologies to Nkuna and Sebola – and, of course, also to our readers.

Nghamula Nkuna


FOR THE PAST TWO AND A HALF YEARS, REGULAR AS CLOCKWORK, L I M P O P O L E A D E R HAS BEEN PUBLISHED EVERY THREE MONTHS BY THE OFFICE OF THE VICE-CHANCELLOR OF THE UNIVERSITY OF LIMPOPO TO KEEP ITS EXTERNAL CONSTITUENCIES (ALUMNI, GOVERNMENT DEPARTMENTS, BUSINESS, SCHOOLS, FUNDING AGENCIES, AND OTHER UNIVERSITIES IN OTHER PARTS OF THE WORLD) INFORMED ABOUT WHAT IS HAPPENING AT TURFLOOP – AND MORE LATTERLY ON THE MEDUNSA CAMPUS AS WELL. We’re telling you this because you’re holding the 10th issue of one of South Africa’s foremost university magazines. That’s an important milestone. We have promised an index of the well over 100 articles on a wide variety of topics that have appeared so far. In fact, the index has been compiled, and we’re hoping to find the space to publish it shortly. Keeping the index out of this issue are three important groups of stories. Most topical of these surrounds the recent appointment of Professor Mahlo Mokgalong as Vice-Chancellor of the merged University of Limpopo. Although Mokgalong has served as acting and then as interim VC, his final appointment marks a turning point in the troubled recent history of the institution. Now is your opportunity to find out about the quality of man behind the title, and also to ponder the importance of the management team that must now be built around him. L i m p o p o L e a d e r has also turned its attention to the eyes of medical science and the deepening gaze made possible over the past century or so through the harnessing of radioactivity. Visit the departments of radiography, nuclear medicine and oncology for a glance at what is currently available in these fields. There is also coverage of the important allied health sciences of physiotherapy, occupational therapy, speechlanguage pathology and audiology, and finally of optometry and the important community outreach work the Turfloop department is able to couple with its teaching programme. Readers will remember our Lost Alumni competition which we announced in L i m p o p o L e a d e r 7 (Autumn 2006). Well, through the efforts of some of our readers we’ve added to our lists of alumni – and we have a winner! Read all about her – and her prize – on page 32 of this issue. And look out for more competitions next year. Meanwhile, L i m p o p o L e a d e r wishes all its readers a peaceful festive season and a prosperous 2007.

L i m p o p o L e a d e r is published by the Office of the Vice-Chancellor University of Limpopo Private Bag X1106 Sovenga 0727 Limpopo Province South Africa. EDITOR: David Robbins Tel: (011) 792-9951 or 082-787-8099 or dgr write@iafrica.com P R O D U C T I O N M A N A G E M E N T: Gail Robbins DGR Writing & Research Tel: (011) 782-0333 or 082-572-1682 or dgr write@iafrica.com ADVERTISING: Clare-Rose Julius Tel: (011) 782-0333 or 072-545-2366 EDITORIAL COMMITTEE: DK Mohuba (chair man), Dirk Wessels, Nor man Nyazema, Aifheli Gelebe, Daphne Kgwebane, David Robbins, Gail Robbins PHOTOGRAPHS:

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All photograph by Liam Lynch, except the photographs on pages 15, 19 (middle), 20 and the cover photograph by Robby Sandrock D E S I G N A N D L AY O U T: JAM STREET Design (Pretoria) PRINTING: Colorpress (pty) Ltd ARTICLES MAY BE REPRINTED WITH ACKNOWLEDGEMENT. ISSN: 1812-5468

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NEXT ISSUE THE PROVINCE OF LIMPOPO IS TO GET A BRAND NEW HOSPITAL BEFORE THE END OF THE DECADE. At a cost of around R1-billion, it’ll be state-of-the-art and will be linked to the full Medical School being established as part of the University of Limpopo. What will it look like? Where will it be built? For answers don’t miss L I M P O P O L E A D E R 11, out early next year. Also featured will be a new mining initiative at the university that could soon bring engineering training to the province for the first time. And there’ll be lots more besides.


IN THIS ISSUE cover picture: The newly appointed Vice-Chancellor Professor NM Mokgalong.

page 4: Radioactivity: deepening the gaze of medical science.

page 6: Radiography: where it all began. From Wilhelm Röntgen to the CAT scan and beyond.

page 8: The secrets of nuclear medicine. Using radio isotopes to study the physiology of the human body.

page 10: Hi-tech cancer treatment at polokwane. Radiation is delivered by an accelerator that can be likened to a powerful X-ray machine.

page 13: The fall and rise of an African university.

page 14: From the edge of chaos to a new beginning. As seen by DK Mohuba, a man who lived through it all.

page 16: A visionary leader emerges from the ranks. Professor Mahlo Mokgalong – from a tough generation of South Africans – an examination of the man and of his vision.

page 21: The future demands a powerful team. Dr Matata Mokoele outlines the human requirements for successful institutional management.

page 24: Doctors and nurses aren’t the only health professionals: Physiotherapy. A walkabout in this important department on the Medunsa campus.

page 26: Doctors and nurses aren’t the only health professionals: Dedicated to occupational therapy. OT looks at human beings holistically and treats them accordingly.

page 28: Doctors and nurses aren’t the only health professionals: Speech and hearing are communication essentials. There’s real commitment in the Department of Speech-Language Pathology and Audiology.

page 30: Doctors and nurses aren’t the only health professionals: Passionate about optometry outreach. The optometry clinic on the Turfloop campus serves two purposes – teaching and community outreach.

page 32: L i m p o p o L e a d e r ’ s great ‘help and win’ alumni search competition. The winner and the prize.


Radioactivity:

DEEPENING THE GAZE OF MEDICAL

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SCIENCE HERE’S A NEW SLANT ON AN OLD COMPUTER TERM. Change what-you-see-is-what-you-get to whatyou-see-is-what-you’ve-got and Wysiwyg becomes a convenient handle for us as we explore the rapidly expanding world of diagnostic imaging. That’s the ability to see inside the body without cutting it open. Ever since 1895 when Wilhelm Röntgen took the first X-ray photographs of his wife’s hand, revealing the bone structures that lay beneath the skin, doctors and other health professionals have relied heavily on various highly sophisticated machinery that can produce increasingly detailed images not only of bones and other anatomical features, but also of organs, arteries and veins, and of course the brain. From the early days of simple X-rays, and thanks to the pioneering work of Marie Curie and others on radioactivity, we’ve progressed to CT and MRI scanning on the anatomical side of things, and also to the gamma cameras used in nuclear medicine. Latest offering is PET (positron emission tomography) imaging which goes even deeper than the gamma cameras in examining the physiological functioning of organs. Now there are machines that combine PET and CT imaging to achieve a co-registration between anatomical and physiological images. Inevitably enough, the latest of these advances, specifically those on the physiological imaging side, have gone beyond mere image production and entered the field of treatment as well. This is the background. Now let’s visit three key departments in this field that are attached to the University of Limpopo. The first two – Radiography and Nuclear Medicine – are situated on the Medunsa campus. The third is the Oncology Unit housed inside the sprawling Polokwane Hospital, one of the teaching hospitals used by the university’s medical students.

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Deepening the gaze of medical science

RADIOGRAPHY – WHERE IT ALL BEGAN

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APPROPRIATELY, IN THE CORRIDOR OF MEDUNSA’S RADIOGRAPHY DEPARTMENT HANGS A PHOTOGRAPH OF GERMAN PHYSICIST, WILHELM CONRAD RÖNTGEN, THE FATHER OF X-RAY TECHNOLOGY. The framed picture was presented to the Radiography Department at the 10th World Congress of Radiographers in Singapore in 1994, the year of South Africa’s first democratic elections and almost a century since Röntgen made his famous 1895 breakthrough. ‘As one would expect,’ says Titus Moalusi, ‘great strides have been made in the field of diagnostic imaging since then. But the basic X-ray is the foundation, and of course this basic X-ray technology is still very widely used.’ Moalusi is head of Radiography at Medunsa, and he readily agrees that it’s difficult to imagine what doctors would do without those ghostly-looking images of our broken bones, patches on the lungs, and all manner of other views of what is happening in the mysterious darkness under our skins. Pretoria-born Moalusi, after a lifetime in radiography, is well qualified to talk about these things. ‘My mother and aunt were both nurses, and after matric I worked as a clerk in our local hospital in Atteridgeville. I had always been interested in imaging, this idea of being able to see inside the body. While working at patient reception, I actually did a course in diagnostic radiography – and I was hooked. So I applied to go to Pelonomi Hospital – that’s in Bloemfontein’s Botshabelo township – that was offering a two-year national diploma in radiography. Pelonomi was attached to Universitas, the big teaching hospital in Bloemfontein, so standards were high.’ There he learned the basics of his profession. The principle of electromagnetic radiation of short wavelengths being passed through human tissue to examine its internal structure, he mastered. Then came the ability to capture the results on film, and all the considerations allied to this procedure. As he himself explains: ‘Say for example a patient

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is sent for an X-ray of his skull. To get an adequate photograph, you have to know what the doctor is looking for. So the radiographer has to know his anatomy to be able to produce the most useful projections. This boils down to the way in which the patient is positioned. And this in turn leads to the whole question of patient care while’s he’s in the X-ray room. Then you have to know how the machine works, and how it’s capabilities can be used to get the desired projections. There’s also the film: how it’s made, the varying capabilities of fast and slow film, and how it’s processed in the darkroom. In fact, a thorough knowledge of photography is essential.’ Moalusi shows some horrific X-ray images of a human head with the blade of a knife running right through it. One X-ray has been taken from the front, another from under the chin. By combining both images it is possible to pinpoint the exact position of the knife. ‘All this,’ he says, ‘can be classified under conventional radiography. But there’s a great deal more to medical imaging than Röntgen’s original contribution.’ The extremely wide world of computer-based digital technology, and other advances, has revolutionised radiography in recent decades. Moalusi lists the most important new techniques. • Computed Axial Tomography. Commonly known as the CAT or CT scan, this technology is currently in its seventh generation and offers images of sliced planes of the selected part of the body (often the brain). ‘The basic principle of this technology,’ Moalusi explains, ‘involves digetising an image received from a slit scan projection of the partient’s body and then back-projecting the image through mathematical algorithms.’ • Magnetic Resonance Imaging (MRI) uses machinery that looks similar to a CT unit. ‘However,’ says Moalusi, ‘because MRI uses magnetism and radio frequencies to create diagnostic sectional images of the body, the internal construction is quite different.


Picture of Wilhelm Röntgen The phenomena that permit MRI are based on magnetism and radio frequencies that are applied according to the principles of nuclear physics and quantum mechanics.’ • Ultrasonography is a diagnostic tool that involves directing high-frequency sound waves at tissues in the body to generate images of anatomical structures. Pregnant women will be familiar with the images of their unborn babies that are projected through a television monitor. Ultrasonography is also called sonography and echocardiography when it is used to image the heart. • Flouroscopy is another technique for obtaining ‘live’ X-ray images. The radiologist (specialist doctor) uses a switch to control an X-ray beam that is transmitted through the patient and then strikes a fluorescent plate that is coupled to an image intensifier that is in turn coupled to a television camera. Moalusi explains that Flouroscopy is often used to observe the digestive tract after barium swallows or enemas. • Digital Subtraction Angiography is used to examine the vascular system in the sopecified part of the body. It involves the injection of a dye into the vascular system and then eliminating images of bone and soft tissue structures from a diagnostic image, leaving only the dye-filled blood vessels for unimpeded examination.

Titus Moalusi

The students who pass through the Radiography Department are all medical registrars training to become specialist radiologists. There are currently 70 of them, all being taught by a staff of six (Moalusi included), and rotating through three teaching hospitals, the Dr George Mukhari Hospital to which Medunsa is attached, and the Mankweng and Polokwane hospitals in Limpopo. Moalusi has always taken the teaching side of his duties seriously. After his training at Pelonomi, he returned to Kalafong Hospital in Atteridgeville where for two years he concentrated on angiographic work. Then in 1980 he came to Medunsa as a junior lecturer ‘because I wanted to teach’. He put his effort where his mouth was, completing a Higher Education Diploma through Unisa in 1981, and then tackling a Bachelor’s degree in education through Wits several years later. His efforts paid off. He was promoted to senior lecturer and then to head of department in 1992, a position he’s held ever since. Note: The Dr George Mukhari Hospital has recently installed a R12-million CT machine with a 64-slice spiral. MRI facilities are available at Polokwane Hospital where Medunsa’s students regularly rotate.

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Deepening the gaze of medical science

THE SECRETS OF NUCLEAR MEDICINE

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WHEN ASKED TO PROVIDE A LAYMAN’S DEFINITION OF NUCLEAR MEDICINE, THE ACTING HEAD OF THE NUCLEAR MEDICINE DEPARTMENT AT MEDUNSA, DR NISCHAL SONI, THOUGHT FOR A MOMENT AND THEN SAID: ‘WE USE RADIO ISOTOPES, IN A SAFE AND CONTROLLED MANNER, TO DIAGNOSE AND TREAT A WIDE VARIETY OF CONDITIONS.’ He provided a little more detail by explaining that the fundamental departure from the imaging techniques used in radiology – X-rays, ultrasonography, angiography, and so on – was that these radiological techniques provided anatomical images (in other words, what organs look like), while nuclear medicine reveals the physiology or the functioning of these organs. ‘In short,’ Soni says, ‘we complement radiology. Nuclear medicine goes immediately beneath the external appearance of internal organs.’ How is this achieved? The key is in the use of radio isotopes which are most commonly injected into the peripheral vascular system. As the selected isotope finds its way into a specific (or targeted) organ and begins its process of decay, photons are released which are then imaged by a gamma camera over a period of time. Soni: ‘Let me give a little more detail. Our most commonly used isotope is called Technetium Pertechnetate. We extract this radio isotope from an in-house generator. It can be used on it’s own, but most often we use it in combination with other compounds to make it more organ specific. Yes, the isotopes are radioactive. We are protected from the generator by a series of lead bricks built up around it and we can see what we’re doing through special screens of protective glass. But it’s important to reassure your readers. Nuclear medicine makes use of doses of radioactive material that usually offer less exposure than the average X-ray or CT scan.’

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The doses that are used for paediatric patients are adjusted according to body weight. In adults, a standard dose is usually used. This dose incorporates patient gender, age and weight, and then juxtaposes this with the level of exposure required to achieve the required imaging . Soni provides an example of how the nuclear medicine technology generates a result. ‘We do a lot of work on the thyroid,’ he explains. ‘Since the thyroid needs iodine to function effectively, we use an isotope (Technetium Pertechnetate) which is an iodine analogue. Therefore the amount of isotope taken up by the thyroid is an indication of its functioning. Very simply put, if the amount is normal we can deduce that the function is normal. Abnormalities of uptake indicate abnormalities of function. The images acquired by the gamma camera are essentially raw data. We then need to process this data through special software to make it more meaningful and to help us arrive at a more exact diagnosis.’ What has drawn a young man like Nischal Soni into the complexities of nuclear medicine? To some non-specialist people, it might even appear to be an obscure cul-de-sac in the labyrinth of mainstream medical science. But not to Soni. ‘I wanted to do something a bit different,’ he explains. ‘I wanted a newer field in which to begin my career, one with a real potential for growth.” When one looks at some of the developments taking place within nuclear medicine, it’s not too difficult to see Soni’s reasoning. For a start, it’s a relatively new field in South Africa. And there are two areas in particular where swift advances are being made. The first is in the field of diagnostics. It’s already been stated that the gamma cameras used in nuclear medicine provide images of the physiology or functioning of organs in the body; while conventional radiology provides anatomical images – in other


Dr Nischal Soni words, the structure of the organ. It doesn’t take a great deal of imagination to realise the value of having both views in one. This would enable doctors to begin to correlate anatomical characteristics with physiological dysfunction never before possible. And this is what is happening. Soni explains. ‘About ten years ago, a new technique was developed that was capable of going somewhat deeper into physiological imaging than the original gamma cameras used in nuclear medicine. This technique is known as positron emission tomography or PET, and the necessary technology has only just arrived in South Africa. Its main role is in oncology, and through this revolutionary new imaging modality doctors have managed to detect the recurrence of cancers at very early stages, how cancers spread and how they respond to therapy. ‘Now,’ says Soni, ‘medical scientists have succeeded in combining the PET technology with the latest CT technology into one machine. The result is Multi-modality or Fused imaging – with anatomical and physiological information provided simultaneously. Easy to see how such advances could capture the imagination of a young doctor looking for something ‘a bit different’ and ‘with a real potential for growth’. Soni was born in Pietermaritzburg. He completed

his schooling there and then went to the University of the Western Cape, hoping to train as a dentist. But after completing his first year in the basic sciences, he decided to switch to medicine. This decision brought him to Medunsa, where he qualified as a doctor in 2000. He did his housemanship at Dr George Mukhari Hospital, his community service at Mankweng Hospital adjacent to the Turfloop campus in Limpopo, and then worked for a year in paediatrics in Pietermaritzburg’s public hospitals. He returned to Medunsa and entered the world of nuclear medicine in 2004. The second area in this branch of medical science where rapid advances are being made is in the use of radio isotopes for therapy. ‘Techniques for the treatment of certain thyroid conditions are well established,” says Soni. ‘We are now also able to treat the pain associated with certain cancers that have spread to bone, and for severe arthritic pain. And advances are being made with regard to providing treatment for specific tumours as well. But mainly, here at Medunsa, we have specialised in thyroid treatment. Nuclear medicine is a young and vibrant specialty that is wide open for further research and development.’

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Deepening the gaze of medical science

HI-TECH CANCER TREATMENT AT POLOKWANE HOSPITAL

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‘ONCOLOGY IS THE SCIENCE OF CANCER,’ SAYS DR DANIEL DU PLESSIS, ‘AND IT’S HEAVILY DEPENDENT ON INTERDEPARTMENTAL CO-OPERATION, AND HAS AN INTIMATE RELATIONSHIP WITH RADIOLOGY. Indeed, the most sophisticated radiation treatment apparatus, like the equipment we’ve got here at Polokwane Hospital, can be likened to a very clever and extremely potent X-ray machine.’ Du Plessis works in the Department of Clinical and Radiation Oncology. In fact, he runs the oncology clinic, and he explains what happens there. ‘Oncology is a tertiary level service and we do not usually see patients at primary level. Patients with suspected or confirmed cancer are directed to us from colleagues (outpatients, wards, general practitioners, outlying hospitals, oncology nurses, etc). ‘The first thing we do, if it hasn’t been done already, is to confirm the diagnosis – most often with the histology of the affected part. Histology is the study of tissue. We say: oncology is histology! We wouldn’t be able to move without it. So if the patient arrives without a histology report, we start with that. Very often it requires only fine needle aspiration (FNA) – a technique by which we draw out a small amount of tissue from a suspicious lump or other manifestation. This is then sent to the pathology laboratory for microscopic examination. Sometimes additional tests are required. But only after we know the histology – in other words, the tumour type – can we move onto the next step.’ This entails the doctor working out a treatment plan. The plan could involve surgery, radiation treatment or chemotherapy, or it could involve combinations of all three of these treatments. ‘We explain cancer treatment to our patients by comparing it to a porridge pot that has got a bit burned. How do we clean it? The first thing to do is to scrape out the majority of the burned porridge. That’s the surgery. Next you can scour the pot to take away the finer remnants of the porridge. That’s the radiation therapy. And only after that you put in soap and water

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Dr Daniel du Plessis to do a final clean. That’s the chemotherapy. ‘Of course,’ he goes on, ‘there are variations on this general pattern. If the cancer has spread right through, there’s almost no point for surgery. And we must remember that the human body can take just so much radiation. The body has a memory, and when it’s had its quota, the radiation or chemotherapy will do more harm than good. In fact, radiation is actually carcinogenic (cancer causing).’


It’s difficult not to be reminded of Marie Curie, the Polish scientist working in France in the early decades of the 20th century who was jointly responsible for the discovery of radioactivity, thus explaining the X factor that the father of X-ray technology, Wilhelm Röntgen, had stumbled upon less than a decade earlier. After a lifetime of experimentation and research, she died of leukaemia (cancer of the blood) that had been caused by long-term levels of exposure to radiation that exceeded her capacity to cope with it. ‘We administer the necessary chemotherapy to patients here at the clinic,’ Du Plessis explains. ‘We only have an administration locale, which makes it extremely awkward sometimes. We really need proper oncology wards, and we’ve initiated a fundraising plan to rectify the situation. (see inset: Money for a Cancer Ward). For the radiation, we’ve got some of the most modern equipment in South Africa right here at Polokwane Hospital.’ In a nutshell, the radiation unit comprises a simulator and two accelerators – that apparatus that Du Plessis had described as ‘very clever and extremely potent X-ray machines’ – set in their own concrete bunkers to avoid radioactive seepage and contamination, and also a special facility for administering brachytherapy to patients with tumours such as oesophageal and cervical cancer. The head of Clinical and Radiation Oncology, Dr Francis Ooko, explains the brachytherapy procedure. ‘The radioactive material is positioned on the end of a wire that is then inserted into the body (through the mouth or vagina) and brought into direct contact with the tumour for localised radiation. The simulator, in its own room and remotely controlled, is in fact a CT scanner that is modified not only to get a fix on the position of of the tumour in the

normal way but also to assist in designing the most appropriate treatment plan. This entails calculating the type, direction and shape of the radiation beam, its intensity and duration, the fine-tuned combinations of which are checked by physicists attached to the department, before these electronic orders are transmitted, via a control room, to the accelerators in their concrete bunkers. In the bunker the patient is placed in position under the machine. The heavy lead door is closed. The accelerator delivers the treatment, monitored by staff in a the sophisticated control room. There are two accelerators in the radiation unit, a facility that was installed only a few years ago at a cost of some R30-million. Speaking of the old days of cobalt and radium treatment, Du Plessis remarks that medical science had begun by hitting at the cancer fly with a tennis racket. ‘Now we’re down to using a fly swotter. Treatment is more appropriate and effective. Fifty percent of our patients we cure.’ Du Plessis (now 51) began his career as a technician in the post office, so he’s reasonably at home with the hi-tech aspects of oncology. ‘I only began my medical training at 28. Then I travelled quite extensively, only coming home in 1998. I explored various disciplines, without finding my niche and then I ended up in Polokwane in 2000. I’ve come to terms with my work here now.’ He and the Kenyan-born Ooko stand at the latest point of a medical radiology tradition that stretches all the way back to Curie and Röntgen before her. The potentially deadly radioactivity that the latter stumbled upon and the former defined has now been increasingly effectively harnessed to the treatment humanity’s most dreaded disease.

MONEY FOR A CANCER WARD IN THEIR DETERMINATION TO ESTABLISH A FULLY EQUIPPED CANCER UNIT FOR POLOKWANE, DRS JOHN MCCUTCHEON (CEO MANKWENG HOSPITAL) AND DANIEL DU PLESSIS REQUESTED THE HOSPITAL BOARD TO APPROACH THE LIKES OF NELSON MANDELA, OPRAH WINFREY, MARK SHUTTLEWORTH, BILL GATES, RICHARD BRANSON, ET AL. ‘The need is acute,’ they say. ‘At the moment, there’s nowhere for patients to overnight after chemotherapy, and there’s certainly nothing like a hospice facility where patients can be given terminal care.’ The fundraising plan – a target of R10-million is mooted – has received the blessing of the hospital board and provincial health authorities, and a legally constituted fund is soon to be established. What is needed is a complex that houses male and female facilities, with, for example, isolation areas for leukaemia patients whose immune systems are collapsing and also for people being treated with radioactive medicines prescribed by nuclear medicine specialists. Male and female hospice facilities are also needed, as are consulting rooms and a dispensing area for the make-up of chemotherapy doses. ‘We’ll also be approaching big business in South Africa – anyone in fact who would like to become involved,’ says Du Plessis, who can be contacted for more information on drdjdp@lycos.com

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THE FALL AND RISE OF AN AFRICAN UNIVERSITY THE UNIVERSITY OF THE NORTH (NOW LIMPOPO) HAS HAD A TEMPESTUOUS PAST. ITS ORIGINS IN THE LATE 1950S WERE ROOTED IN SOUTH AFRICA’S APARTHEID PAST. Dr Hendrik Verwoerd himself chose the site on the farm Turfloop in pursuance of his separate development vision for the country. By the 1980s, despite the permanent presence of military units, the campus had become a politically ‘liberated zone’, with far-reaching academic and institutional consequences. In 1997, a university employee, Christopher White, published his doctoral thesis under the title From Despair to Hope: the Turfloop Experience. Listen to his description of the institution at that time: ‘The University of the North is at an exciting time in its history. It is an institution that has witnessed the anguish of conflict, of deep-seated alienation, distrust and the dilemma of an identity crisis. Power struggles and conflict still prevail, as the University leadership attempts to marry the claims of the statutory and nonstatutory, the academic and the administrative, the student and the teacher, and the University and the broader community ... As the University grapples with inherent fears and the consequences of change, it should consider the consequences of no change at all. Society is undergoing fundamental change ... Change is the price of survival. If the system has come to rest at the edge of chaos, an environmental jolt might push it into the abyss of chaos under an avalanche of enforced change. The University should take up the challenge to become a leader in higher education at the cutting edge of change rather than being forced into unplanned change.’ By the end of the 1990s, Turfloop came close to being closed down. Gradually, however, and with immense difficulty, the University of the North (and now in combination with Medunsa the University of Limpopo) has taken Christopher White’s advice. The three interviews that follow give an indication of this difficult passage. They chart the progress of an institution that is now taking charge of its own destiny. They also give an indication of the flavour of the future.

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The fall and rise of an African university

FROM THE EDGE OF CHAOS TO A DK Mohuba has lived through it all ‘I STUDIED AT TURFLOOP IN THE 1980S,’ SAYS DK MOHUBA, NOW THE DIRECTOR OF MARKETING AND COMMUNICATIONS AT THE UNIVERSITY OF LIMPOPO. ‘Life was very turbulent. There were always soldiers and policemen on the campus. The majority of students were highly politicised. But we still managed to cope with our studies. ‘First, I did a BA degree, majoring in languages and social sciences, then a teacher’s diploma. Finally, I tackled a Bachelor of Education and taught for some years at the then Modjadji College of Education. But in 1994 I was back at Turfloop, working in the then Department of Development and Public Affairs with events management and media relations as a Senior Public Relations Officer. While his student days had been steeped in the intoxication of the political struggle, his early years on the staff had been characterised by deteriorating institutional conditions. The post-1994 years had been characterised by sweeping changes to tertiary education, and not a few PDIs (previously disadvantaged institutions; in other words universities that had served those population groups which were not white and had tended to be under-financed) floundered and came close to being shut down. ‘We were supposed to be following a transformation agenda,’ Mohuba explains, ‘including a radical overhaul of academic programmes. We were facing the necessity to fit our programmes into a national picture, in short to justify our continued existence, but nobody in the university community could agree on anything. The student structures, the staff associations and labour unions – everyone seemed to be confused about transformation. There was a huge amount of vested interest and hidden agendas. Also, student numbers were dropping, most of the residences were empty, and the university was experiencing serious financial problems. In fact, we were in real trouble on almost every front.’

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On the wall of Mohuba’s Turfloop office are portraits of three men: Nelson Mandela, who served as Chancellor of the University of the North in the 1990s; Chabani Manganyi, former Vice-Chancellor , who then became the first national Director-General of Education; and Njabulo Ndebele, who served as ViceChancellor for a five-year term in the late 1990s and is now the Vice-Chancellor at the University of Cape Town. It was after Ndebele had left, Mohuba said, indicating the portrait on his wall, that the crisis came to a head. Vice-Chancellors came and went with alarming rapidity, either leaving or being suspended by the University Council. Student numbers had declined from 15 000 to 6 000; and the university employed three times as many support staff as they employed academics. One impact of all this was a financial near disaster. By 2001, the university was R70-million in the red, Staff morale could hardly have been lower, and the public image was rock bottom. ‘By that time we needed a Messiah,’ Mohuba recalls. ‘There were persistent rumours that the university would be permanently shut down. Finally, the various interest groups on campus formed a delegation to the Minister of Education (Kadar Asmal), requesting the appointment of an independent assessor to sort out the mess the university was in. The minister obliged, and the assessor’s report led directly to the dissolution of Council and the appointment, in 2001, of an administrator with wide-reaching powers.’ The University of the North had reached its lowest ebb; it had also reached the beginning of its ascent to a new normality. The administrator selected for the job was Professor Patrick Fitzgerald, erstwhile Director-General of Environmental Affairs and Tourism. He brought with him a small team of experts to take control of finances, human resources and legal matters. He acted promptly, and his actions cut deep.


NEW BEGINNING Mohuba: ‘While the financial structures were being overhauled, Fitzgerald began to restructure academia into the three faculties and ten schools that exist today. There were staff cuts and departmental closures, and the administrator’s legal expert was kept busy with the frequent litigation that followed. The ratios between academic and support staff were brought back to a more normal one-to-one; and the rather bloated Faculty of Arts underwent a painful process of departmental shutdowns. Fitzgerald’s actions, often considered ruthless, upset many people, but they also saved this university from oblivion – and almost immediately they brought a level of stability to a campus that had been at war with itself for many years.’ Mohuba mentions four key administrator measures that brought the institution back onto an even keel: • The administrator acted like a dictator with concentrated powers, but he was also persuasive enough to take most people along with him on his course to transformation. • Financial systems at every level were rationalised and tightened. • The administrator introduced an incentive scheme that provided subsidies for the brightest school leavers and resulted in dramatic increases in both the quality and numbers of students. • A marketing and communications strategy was introduced that dealt directly with the flagging image of the university. This last measure, of course, directly impacted on Mohuba’s work as spokesperson for the university. He acknowledges the influence that three men in particular have made on his career. ‘The first was Professor Njabulo Ndebele. He gave me the foundation of my knowledge and a firm understanding of the importance of positive public relations. Then there was the administrator, Professor Patrick Fitzgerald, who made money available and brought in

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an external agency to help us begin the process of improving the university’s image. The third man is Professor Mokgalong. I have worked with him since he was a senior lecturer in Zoology; then as deputy dean; then as executive dean of the new rationalised Faculty of Science, Health and Agriculture; then as acting and interim VC; and now, finally, as officially appointed Vice-Chancellor of the University of Limpopo for at least the next five years. He’s always been easy to work with. He still is. But on top of everything, he’s a strategic thinker of high distinction.’ Mohuba contemplates the 12 turbulent years of his career on the Turfloop campus, from the times of the illustrious men adorning the wall of his office to the ascendancy of the university in more recent times. He says: ‘Yes, of course there have been frustrations. There have been major challenges. I’ve learned a huge amount – but, no, I’ve never believed, even in the darkest days, that this institution was a hopeless cause.’

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The fall and rise of an African university

A VISIONARY LEADER EMERGES FROM At its meeting on the 22 August 2006, the Council of the University of Limpopo resolved that Professor N Mahlo Mokgalong be appointed as the first substantive Vice-Chancellor and Principal of the University of Limpopo. The appointment marks the end of a long period of instability and change in the affairs of the University of the North and the Medical University of Southern Africa. According to the media release announcing the news, ‘this Council decision was made mindful of the need for strong management and leadership to guide the University of Limpopo in confronting the many challenges facing the higher education sector. The University of Limpopo has to respond to numerous directives and policy initiatives ... as well as to take the merger (between UNIN and Medunsa) to the next level whereby a Medical Faculty is established in Limpopo’. But who exactly is this man in the hot seat, and what is his vision? The following pages provide some crucial answers.

Professor Mahlo Mokgalong believes it is Africans themselves who must drive their own future.

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THE RANKS MOKGALONG THE MAN HE’S FROM A REMARKABLY TOUGH GENERATION OF SOUTH AFRICANS. Consider the following list of names: Cyril Ramaphosa, Frank Chikane, Matthews Phoza, Danisa Baloyi, Yvonne Mokgoro, Mokgadi Mailulu. These key figures in the struggle against apartheid and in post-1994 South Africa were all studying on the Turfloop campus at the same time as Mahlo Mokgalong. ‘I was very rapidly politically educated,’ he remarks with a smile. ‘It was a way of life on the campus. We attended after-hours classes in political education, and we all belonged to SASO (the South African Students Organisation). During my first year on campus, 1972, the SASO national president was Onkgopotse Tiro, and he too was a student at Turfloop. He was later (in May 1972) expelled for his political activities. The early 1970s also marked the height of our awareness of the Black Consciousness movement that had started in America. We used to do Black Power salutes when we greeted each other.’ These admissions jar slightly against Mokgalong’s current reality. The newly appointed Vice-Chancellor of one of South Africa’s most complex universities dresses in dark suits and is always quietly polite. But his underlying strength, only occasionally glimpsed, was without doubt forged in those heady and dangerous student days. As with many others, the temper of the times in the 1970s and 1980s forced high levels of commitment and maturity early onto his young shoulders. Mokgalong was born in 1954 at Ga-Masemola, a rural village on the road between Lebowakgomo and Jane Furse in Sekhukhuneland. His father was a school principal and his mother managed a family shop. The village has grown substantially since the 1950s, but barefooted children still play among the dwellings.

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‘I grew up in a family which held education in high esteem,’ says Mokgalong, knowing well enough that even then the course of his life was being set. For his own education, he went to live with an aunt at nearby Schoonoord. Remarkably, at the small primary school there one of his earliest friends was a boy called Malegapuru Makgoba who in 2005 was appointed Vice-Chancellor at the University of KwaZulu Natal. To start their high school careers, both boys were sent to Hwiti High School where their new school was within walking distance of the Turfloop campus. No doubt because of this proximity, the boys enjoyed the then rare advantages of being taught by graduate teachers. ‘But the campus buildings were a constant reminder to us of the possibilities that the future held,’ Mokgalong recalls. ‘We used to go onto campus to the sports fields. We were herded along under escort like a flock of sheep. But we never went into the university proper. It was only later, as a student, that I entered a laboratory for the first time in my life and had my first glimpse of an actual microscope.’ It was after matriculating that the two friends from Sekhukhuneland went their separate ways. Makgoba travelled down to Durban to study medicine. Mokgalong gained admittance to Turfloop where he tackled a BSc Biological Sciences degree. In spite of the plentiful political distractions of the time, he cruised through his first degree and added Honours and Master’s qualifications in quick succession. By 1977, he had joined the university staff as a research assistant, and was promoted to lecturer not long after he began work on his doctorate in parasitology. ‘My research activities took me to many countries,’ Mokgalong recalls, ‘but I spent most of my time abroad in Finland and also at the Institute of Parasitology in St Albans in England. I spent several three to six month blocks at the Institute, and I loved every moment of it. I saw myself as a scientist and

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The fall and rise of an African university

A VISIONARY LEADER EMERGES FROM THE RANKS I saw this as my life. I was happy where I was.’ Fate was soon to intervene, however. The great change in Mokgalong’s career began innocuously enough. After he had been awarded his doctorate, he was asked to become deputy dean of Turfloop’s Faculty of Sciences. Not long afterwards, the dean (Professor Mbudzeni Sibara) was seconded to an outreach campus that had been established in the old homeland of QwaQwa, and Mokgalong found himself in the position of acting dean. ‘I could see what was happening and I said to myself: let me give it my best shot because I don’t want to see this university fail. Events moved rapidly, and after the academic restructuring under the control of the administrator, I was appointed Executive Dean of the new Faculty of Sciences, Health and Agriculture. But after not much more than a year, I found myself as acting VC of the University. I took over from the administrator – who’s powers had been absolute – so the task was like trying to guide this bruised institution in a transition from military back to civilian rule. We had to re-establish virtually all the structures of governance.’ To complicate matters, the merger between the University of the North and Medunsa was announced in December 2002 and planned to take effect at the start of 2005. So Mokgalong’s rise to the top position in the merged University of Limpopo began in 2003 and culminated with his appointment in August of 2006. ‘In the late 1990s, everyone was disillusioned and unhappy. I interacted with all the constituencies. Throughout my years as acting and intermin VC, it’s not that there weren’t protests, strikes, and all the rest of it. But I think that what makes a leader is being able to ride the waves. And through all the upheavals – not least those surrounding the merger – I made a point of not keeping any grudges. After each storm had passed, we were therefore able to pick up the pieces and carry on – for the common good.’ This sense of ‘the common good’ runs powerfully through Mokgalong’s perception of leadership, and his perceptions of the future. The common good requires effort to achieve, it requires teamwork, but above all it requires taking responsibility. Listen to

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Mokgalong’s take on what it means to be African. ‘Of course, I’m optimistic about Africa. The continent is still going through a recovery process after colonial rule. But I believe it is Africans themselves who must drive the future. We need to get our acts together. If we keep blaming colonialism – and apartheid – we won’t get anywhere. Colonialism and apartheid are dead. We have to meet the challenges for ourselves. That’s what it means to be African: accepting responsibility for our continent.’ Mokgalong, one of Limpopo’s brightest sons, lives in Polokwane with his wife (a medical doctor) and their two children.

MOKGALONG’S VISION (The following excerpts are taken from Professor Mokgalong’s presentation to the Council committee responsible for choosing the new Vice-Chancellor of the University of Limpopo.) THE VISION of the new University is informed by the recent restructuring of South Africa’s higher education institutions through mergers and rightsizing. In December 2002, the Minister of Education announced cabinet’s decision to merge the University of the North and the Medical University of Southern Africa. In addition, the new institution was mandated to become one of the three flagship institutions to be created out of previously disadvantaged universities. Cabinet’s decision further requires all institutions involved in mergers to prepare institutional operating plans that will give effect to the direction that these institutions will take over the next three to five years. This presented the University of Limpopo with an opportunity to craft a new vision suitable for a flagship premier African university. The new vision of which I was the architect and now the prime driver ... seeks excellence and global competitiveness. The University has consciously chosen to focus on rural problems within the larger community we serve. This is not to pretend that African rural problems are unique, but rather to focus intellectual energy, financial and material resources to address hitherto largely neglected


problems of the rural poor, who the world over have been neglected by universities and other knowledge producers. It is our intention to develop a high-calibre world-class research institution. We should engender a mentality worldwide where, when students want to research rural issues, the University of Limpopo should be their first port of call. Our new motto is ‘the University of Limpopo for human and environmental wellness in a rural context: finding solutions for Africa’. Perhaps it is germane that one should reflect how the higher education landscape has transformed worldwide in the 21st century. Gone are the days when academics were cloistered in their ivory towers, dreaming about the stars and the heavens with scant regard to the material conditions of the ‘paying’ public. All over the world, governments and other higher education funders want to get a return on their investment. They want research that is targeted at solving day-to-day material needs of society. While stargazing may help develop and harness radio and optics technology that may be applied to ground and interplanetary travel, most payers want to solve the more pressing needs of the here and now. The University has chosen the latter path. This should not be interpreted to mean that we shy away from innovation and knowledge creation, but rather that such efforts will be targeted. The University’s focus areas as it seeks to exploit its rural setting are: • Mineral and natural resource exploitation is a logical priority in a province bestowed with abundant mineral wealth and natural resources. • Tourism flows naturally from the diverse cultural and natural heritages in the province. • Environmental protection and sustainability while exploiting the natural resources is important for the province. In particular, water utilisation and agriculture are crucial in this regard. • People development is paramount. We need to nurture and enhance the intellectual and operative skills of our people to enhance their quality of life away from the tedium of subsistence farming and toiling labours.

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The fall and rise of an African university

A VISIONARY LEADER EMERGES FROM THE RANKS

In order to realise this vision, we have re-engineered academic administration structures and academic structures. We have adopted a lean administration which should free our otherwise limited financial and human resources to concentrate on the University’s core business of scholarship, research and training. In promoting and advancing the new vision, we should be mindful of the challenges facing the institution. The first is that our rural location militates against the recruitment and retention of high quality academics. To overcome this, a number of incentives are planned which include not only financial rewards but also the beefing up of the research platform and the improvement of recreational facilities for staff and students. We have already attracted significant funding from a variety of sources; and we have created a focused Africa Research Hub to promote and co-ordinate multi-disciplinary research and community service efforts. Secondly, the University has in the past attracted students from deprived communities who have not been adequately prepared for tertiary education. To improve the situation, we have tightened up our admissions policy and are increasing our support and development systems for students and academic staff alike. Thirdly, the challenge of financial sustainability is receiving special attention. Government subsidies are simply no longer enough. We have therefore developed a strategy to maximise the contributions from our traditional funders, while at the same time planning a structured approach to philanthropic organisations and individuals for targeted funding.

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We are starting to form and nurture smart partnerships with other higher education institutions in the country, in Africa, and globally. Partnerships are also being forged with the corporate and NGO worlds, and our efforts are supported by in-house systems devised to exercise tight controls on the money flowing into the University from these sources. The merger pocess between the former University of the North and Medunsa is the most complex and highly charged of all the mergers. When I was appointed Interim Vice-Chancellor, I had just stabilised the Turfloop campus which for nearly a decade had been plagued with administrative and financial instability, and then faced a dysfunctional Medunsa campus. We have managed to stabilise Medunsa as well; and we are currently on the verge of solving the complex problems surrounding the establishment of the primary healthcare training site in Polokwane. The University of Limpopo is determined to build a modern and comprehensive medical training facility to bring the resultant health services and trained professionals to the people of Limpopo. In conclusion, I have demonstrated the ability to steer this institution out of several serious crises. I have also presented a comprehensive and innovative vision that is Africa centred and rural development focused. I have already started the implementation process which I believe I should now be given the opportunity to execute.

(As is now well known, Professor Mokgalong has been given that opportunity, and the University of Limpopo seems set for take off.)


The fall and rise of an African university

THE FUTURE DEMANDS A POWERFUL TEAM DR MATATA MOKOELE DEFINES THE ESSENTIAL RAW MATERIAL NEEDED IN THE MANAGEMENT TEAM THAT WILL BE BUILT AROUND THE NEW VICECHANCELLOR OF THE UNIVERSITY OF LIMPOPO. Advertisements for applications to fill the posts of his deputies appeared in mid-October. Then there are the executive deans for the four faculties into which the merged university has been divided. They’ll be appointed early in 2007. Dr Matata Mokoele, the University’s Interim Human Resources Executive, fills in some of the detail. ‘The three deputy VCs will have special portfolios of responsibility,’ he explains, ‘the first in the field of academic affairs and research, the second in student and corporate affairs, and the third in finance and administration.’ The academic faculties will cover the humanities, the general and applied sciences, management and law, and of course the health sciences including full medical school facilities. In total, then, seven key players. Seven members of one of the most important management teams for development in Limpopo Province. ‘There can be no doubt that our new Vice-Chancellor, Professor Mokgalong, is a man with a vision,’ says Mokoele. ‘His interpersonal skills are exceptional: his style is to rehabilitate rather then to kick people when they’re down. This is undoubtedly the man we need. Now we must build a team around him of similar quality so that he is freed from day-to-day management to be the figurehead, spending an important part of his time forging new partnerships in this country and around the world, developing networks and raising funds.’ Mokoele provides a template for the kind of people he and the University Council are looking for to fill the posts of deputy vice-chancellors.

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Dr Matata Mokoele wants to plough something back into the university that made him what he is.

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The fall and rise of an African university

THE FUTURE DEMANDS A POWERFUL TEAM – Dr Matata Mokoele defines the essential raw material Relevant experience for each specific post will be essential, at least ten years of it in a university setting. Relevant qualifications are also important. For example, the finance and administration vice-chancellor will need to be a chartered accountant (or similar) as well as holding a doctoral degree. Doctoral degrees are minimum requirements for the other vice-chancellors as well. ‘We’re looking,’ says Mokoele, ‘for individuals of high integrity, with outstanding academic and leadership ability in higher education institutions. We’re looking for people who are ambitious and creative, who are well travelled, who know how to lead and inspire. Most importantly, though, they should share and be inspired by the vision and mission of the University of Limpopo.’ It’s worth repeating this as it appeared in the newspaper advertisements calling for applications for the three positions. The vision of the University is to be a leading African university, epitomising excellence and global competitiveness, addressing the needs of rural communities through innovation. Mokoele refers to the difficulties surrounding the merger, and particularly the medical school relocation issue, as an example of a situation where creative and innovative management action needs to be applied. The newly appointed VC has already summed up the situation when he told the Appointments Committee of the University Council: ‘The relocation issue has been the most trying aspect of the merger process, with Medunsa staff not only reluctant, but actively resisting, if not sabotaging the process.’ Mokoele adds: ‘What could senior management do differently here to achieve our vision and mission? Yes, of course the merger and the relocation have been gazetted. But should we slavishly follow the letter of the gazette notice? What can we creatively do to facilitate this painful process and to achieve the desired end in terms of the University’s vision and mission, that end being the creation of a full medical school in Limpopo?’ Mokoele’s office is situated on the top floor of the clinical pathology building on the Medunsa campus. He says thoughtfully: ‘Quite frankly, from the point of

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view of the successful management of our human resources, the sooner we move out of here the better. But the first step is the filling of these key posts.’ It’s quite clearly what he was brought into the University to achieve: to successfully manage its diverse human resources. He’s a reserved man, but at the same time he exudes confidence and a sense of reasoned perspective. He’s also committed to the task at hand. ‘It’s always been my wish,’ he asserts, ìto return to my roots, and to plough something back into the university – this new University of Limpopo – that made me what I am.’ Mokoele was born and grew up in Hammanskraal, not far north of Pretoria. His parents were both from what is now Limpopo Province, so perhaps it was not surprising that he went to the then University of the North where he completed a BA in administration, majoring in political science and public administration. After a stint in the South African Department of Foreign Affairs, he went to America (in 1991), enrolling for a Masters in human resource development at Bowie State University in Maryland. He then completed additional postgraduate research in adult learning and human resource development at the Virginia Polytechnic Institution and State University, being awarded his doctorate in 1997. Throughout this period he worked as a consultant for various large corporations, including Reach and Teach in New York where he became the manager of a community development project in Blouberg in the then Northern Province. He returned to South Africa at the end of 1997, to take up a position as deputy director of human resource development with the Independent Electoral Commission, where he was actively involved in training, performance and career development. After several more years of what he refers to as ‘the rapid accumulation of experience’ he was ready to take on the challenge of the swiftly mutating University of Limpopo. ‘I will always cherish this opportunity of making something strong out of these old institutions. Yes, definitely, I believe we can achieve our vision: to become a world-class African university.’


Doctors and nurses aren’t the only health professionals

PHYSIOTHERAPY

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‘SPORT HAS BECOME A BIG THING IN SOUTH AFRICA – NOT LEAST BECAUSE OF THE LOOMING SOCCER WORLD CUP IN 2010 – AND OUR STUDENTS ARE INCREASINGLY INVOLVED. We’ve had our students involved in athletics at Olympic level, and the Bafana Bafana physiotherapist was trained in this department.’ This is Nomathemba Taukobong speaking. She’s head of the Department of Physiotherapy on the Medunsa campus of the University of Limpopo. ‘That’s the glamorous part: the sports. As a result, a lot of people think we’re simply masseurs. Of course, we’re trained to do that, but our real role is in relation to pathological conditions.’ Asked to explain the differences between physiotherapy and the allied discipline of occupational therapy, Taukobong replies: ‘The difference is in the names. Occupational is related to an activity; it changes the environment and the tools. Physio concentrates on the body. Even so, there are quite a lot of overlaps. For example, occupational therapy might provide a prosthesis or other aid and teach the client how to use it. Physiotherapy will use exercises and other treatments to develop the muscles and dexterities needed to maximise its use.’ The other treatments are numerous – electrotherapy, radiation by laser, ultraviolet and infrared lamps, ultrasound, shortwave – and are delivered by a variety of hi-tech machines. But, having said that, Taukobong insists that ‘using our hands is the big thing in physiotherapy’. Drugs are very rarely used, but often the machinery listed above is used in conjunction with physical manipulation and exercises custom-designed for the needs of individual clients. ‘So of course we need to make a thorough assessment of the injury,’ she says. ‘Remember, we’ve done anatomy, which helps us to know what functions

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Nomathemba Taukobong have been lost and what have been retained. It’s on that basis that we work out an appropriate treatment.’ Taukobong began her original physiotherapy training under the then Madikoti College of Education based at the Ga-Rankuwa (now George Mukhari) Hospital. Training was taken over by the recently


Physiotherathy students from left: Kulani Mogotsi, Kabo Baldwin Chimela, Machawe Mamba (therapist) and Danny Matlou (patient) established Medunsa in 1978, when Taukobong was in her first year. After graduating, she worked at the Waverley Sanitorium in Germiston where she concentrated on chest work and cerebral palsied children. Then she moved to Baragwanath Hospital in Soweto for a short spell. She also worked at the Rand Mutual Hospital run by the Chamber of Mines in Johannesburg where she gained specialised experience in spinal cord injuries. Then it was back to Ga-Rankuwa, and from there she finally joined the staff of Medunsa. In 1998 she completed her master’s degree through Pretoria University. In 1998 she was promoted to senior lecturer. And in 2003 she became head of physiotherapy. ‘I’m passionate about my profession,’ she says. ‘I want to see more people qualify. To me, being HOD was exciting because it gave me the opportunity to prove that black physiotherapists can be as good anyone else’. She’s also passionate about her country. In 1993, she went to the United States to work in the West Jefferson Hospital in New Orleans. I wanted experience of physiotherapy outside of South Africa. I found I was more ‘hands-on’ than my American counterparts. I also found that I knew more than they did. But then 1994 came around; the elections loomed; and I got too excited to stay away any longer. ‘I came back specifically to vote,’ Taukobong admits. ‘I wanted to make my cross and experience

the new South Africa. I’ve travelled quite a lot since then. I serve on the board of Physiotherapy, Podiatry and Bio-kinetics under the Health Professions Council of South Africa; and I’ve been to Tanzania, Holland, Spain and Australia on physiotherapy business. But it’s always great to come home.’ ‘Home’ is a house in Pretoria – and of course her Physiotherapy Department at Medunsa. Here there are more than 160 students in various stages of qualifying with BSc Physiotherapy degrees under the guidance of Taukobong’s staff of eight. There are also 17 students doing postgraduate studies. ‘I’ve already said that some of our students end up in quite glamorous positions in the world of sport. Not a few others have found their way overseas – our degrees are acceptable all over the world. Some are working in special schools, and some are employed in the public hospitals. But they tend not to stay in the public service long. The salaries are too low. So many find their way into private practice. But wherever people end up, there’s no doubt about one thing: it’s a deeply rewarding profession because it is first and foremost about helping people to overcome their disabilities and to be more themselves.’ Finally, but more as an afterthought than as a piece of relevant information about her department, Taukobong adds: ‘Oh, by the way, I’m currently doing my PhD on community-based rehabilitation.’

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Doctors and nurses aren’t the only health professionals

DEDICATED TO OCCUPATIONAL THERAPY

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ALFRED RAMUKUMBA CAME TO MEDUNSA FOR THE FIRST TIME AS A YOUNG MAN IN 1980. He had been born and attended school in Venda, and he had come south because he was keen to pursue a career in the field of occupational therapy (OT). He began to study for a three-year diploma, but soon converted to a full Bachelors of OT, a degree that was conferred upon him in 1983. For the next few years he worked in a number of hospitals in the then northern Transvaal, before returning to the George Mukhari Hospital next door to Medunsa. After a year, in 1988, he joined the Medunsa department as a lecturer. And fifteen years after that, in July 2003, he was appointed head of Medunsa’s OT Department – a position he still holds. He obtained a Master degree in Philosophy of Adult Education and Training from Rand Afrikaans University in 2001. He’s also the immediate past president of the Occupational Therapy Association of South Africa, and he’s recently been appointed to the executive management team of the World Federation of Occupational Therapists, as the co-ordinator of the Education and Research Programme. In addition, he is the vice-chairperson of the Health Professions Council of South Africa Board for Occupational Therapy, Medical Orthotics/Prosthetics and Arts Therapy. ‘Most of my working life has been in the field of OT in psychiatry and mental health,’ Ramukumba (now 47) says, ‘but my interest in all aspects of this fascinating profession remains unabated.’ There are a lot of aspects to consider. Ramukumba explains OT by describing occupational therapists as professionals who help people who are ill, injured or disabled to function independently in whatever they do in the three main ‘occupation performance areas’. These are: personal management, the area of work, or in the case of children the areas

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of play and learning; and finally leisure activities. The helping process begins with an assessment of the person in need, usually called the client. This is done via four basic methods: observation; standardised tests; structured assessment techniques; and finally specific assessment activities. ‘A fundamental question that the assessment must answer,’ says Ramukumba, ‘is what do clients most want or need to do? In young clients, there’s a corollary to the basic question, and that is: at what stage of development is the client? People at different stages of development have different needs. So it’s crucially important that the assessment takes this into consideration and only then can appropriate interventions be designed.’ There are four pillars involved in the building of any treatment regime, and they relate to four primary skills that the OT must acquire. To more fully understand these skills, we can look at an example. Injured in a road accident, a client is partially paralysed and confined to a wheelchair – and he has a badly damaged right hand with several fingers missing. • The first pillar of the treatment is the selection of activities that the client must master to lead a useful and independent life. Obviously, his previous occupation and stage of development are important factors. • The second pillar is the analysis of the activities selected. Let’s assume that the client was a journalist who did a lot of writing with a pen. What muscles will be required to do that with what is left of his right hand. What are the cognitive and psychological impacts that might need to be addressed? • The third pillar is the grading of activities to simpler or more complex, either permanently or as stages through the treatment.


Alfred Ramukumba

• The fourth pillar is the adaptation of activities and equipment. For example, it may be desirable to adapt worktop and storage-unit heights to facilitate ease of working. Or it may be necessary to adapt the rules of a sport to accommodate the client or to adapt the equipment; for example making a squash racket handle thicker so it is easier to grasp by someone with an injured right hand. ‘But the treatment we provide extends far beyond the physical needs,’ Ramukumba explains. ‘Because occupational therapists view human beings holistically, the clients’ psychosocial needs are always considered. Undergraduate training equips students to work in both the physical and psychiatric fields of practice. Trainees are encouraged to work in rural areas, and training occurs in hospitals like Mankweng and Thabamoopo outside Polokwane.’ In addition, the OT department at Medusa campus maintains close contact with community centres in the adjacent peri-urban areas of Soshanguve, Mabopane and Winterveld.. ‘Students in their final year spend six weeks in the community centres and clinics where they see individual

clients and do general community work,’ says Ramukumba. ‘ Here at Medunsa campus we have taken a conscious decision to train graduates who are generalists and who can work at all levels of health care. But we are especially interested in the primary health care level because our aim is to expand OT services into the rural areas where, usually, the need for OT is much more acute than in town.’ In Ramukumba’s department there are currently 138 students across the four years of the Bachelor’s degree in OT. Ramukumba has also launched a student/staff exchange programme with a Swedish institution, Jönköping University, and he’s also exploring the possibility of establishing staff exchanges with Tumaini University and Kilimanjaro Christian Medical College in Tanzania where Medunsa is helping to upgrade the level of tuition. Ramukumba’s level of commitment is everywhere evident, but perhaps nowhere more so than in this final comment. ‘In spite of being HOD here, I still supervise our final-year students. I want to keep in touch with the realities on the ground. I also want to maintain my clinical skills.’

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Doctors and nurses aren’t the only health professionals

SPEECH AND HEARING: COMMUNICATION ESSENTIALS

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WORKMEN HAVE BEEN PAINTING IN THE DEPARTMENT OF SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY ON THE MEDUNSA CAMPUS OF THE UNIVERSITY OF LIMPOPO. Is that so unusual? It is when you learn that this isn’t routine maintenance. Instead, it’s a departmental initiative utilising a grant obtained from the Professional Provident Society. This is the first clue to the level of commitment to be found here. There are others. Dr Sandra du Plessis is head of the department. She speaks enthusiastically of combining community development with high quality training for future speech-language therapists and audiologists. Indeed, the two are linked. As she explains: ‘The practical component of the courses does provide very necessary services to the community, with practical training taking place in a variety of contexts such as mainstream schools, schools for learners with special needs, old-age homes, private practices, hospitals, as well as in our own speech-language and hearing clinic.’ Students and staff are as enthusiastic as Du Plessis – and as committed. One group of first-year students talks about ‘very interesting course work’ and ‘exciting’ options for the future. Of the nine, two are from Gauteng, three from Limpopo, three from the Free State and one from the Eastern Cape. A lecturer is demonstrating a R120 000 handheld screener used for the detection of hearing defects. The students handle the apparatus with care, their young faces absorbed as they take in new knowledge. Asked what they would like to do once they had qualified, a few said immediately: ‘private practice, for the money’. Others thought they might like to stay in academia. Two boys from the Free State said they wanted to work in state hospitals in their home areas.

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One of the male students asks: ‘Why are there no male lecturers in this department?’ The lecturer in attendance replies promptly, saying that there had always been a gender imbalance in the speechlanguage pathology and audiology professions. In South Africa, there had also been a severe racial imbalance. ‘You do realise that your own group here is helping to rectify both imbalances.’ The student’s faces are thoughtful as they see themselves in this way in a broader context. They nod. The Department of Speech-Language Pathology and Audiology is one of Medunsa’s youngest. It was established only in 2001. The student count already stands at 66, and the aim, says Du Plessis, is to double that number in the next few years. ‘The need is certainly great,’ she says. ‘According to international statistics, between seven and ten percent of populations have communication disorders and are in need of the therapies we provide here. The need may be even greater here, in rural and periurban settings, but our estimate is that we’re seeing only a quarter of those who actually need us.’ Du Plessis gathers her staff – for the most part young and enthusiastic women – into a conference room to describe their fields of expertise. ‘We deal,’ she says by way of introduction, ‘with human communication and any associated abnormality or pathology. Through communication, we exchange ideas and information, and this exchange can occur in different formats: by means of speaking, writing or through the use of a common system of signs or behaviour. Obviously, an individual’s hearing ability, or her or his awareness and perception of sound, is also of the utmost importance, and we play a role in maintaining this part of the communication process.’ The lecturing staff fills in the detail.


Nghamula Nkuma

From right, anti-clockwise: Dr Sandra du Plessis, Motshana Phohole, Lizzy Maketa, Carmen Milton, Carina Avenant, Prasha Sooful, Debbie Prinsloo On the speech-language side, therapists encounter all types of developmental or acquired disorders, and also speech motor disorders resulting from strokes or functional abnormalities. The lecturers speak of articulation problems and fluency problems (like stuttering), and post-operative speech disorders. On the language side, the situation is often complicated by premature birth or the presence of different genetic syndromes. But one also comes across another imbalance. As one lecturer puts it: ‘Previously, speech-language therapists dealt only in English and Afrikaans. Now the awareness of multilingualism has become extremely important since many schoolaged learners receive their schooling in a language other than their mother tongue.’ Therapists on the audiology side will work with organic disorders, functional hearing disorders, central auditory disorders, and developmental or acquired disorders of hearing which might necessitate other modes of communication (like sign language). The loss of hearing in the aged and the fitting of hearing aids forms an important aspect of the work. Audiologists will also become involved in such

conditions as attention deficit disorders where the problem is often related to the processing of the auditory message in the brain. An important part of the diagnostic process in audiology is the soundproof booth fitted with audiometers that present sounds to each ear as hearing thresholds are recorded. Most treatments relating to hearing disorders are based on the results of such tests. A new audiological booth, worth R80 000 and donated by Old Mutual, was opened in the department in August 2006. ‘August was also Better Hearing Month,’ Du Plessis explained, ‘and thanks to sponsorship from two hearing aid companies, we hosted eight retired citizens. Ear, Nose and Throat (ENT) specialists from Dr. George Mukhari Hospital examined and dewaxed their ears. We took them to the ENT department in the medical school for an examination. Then we gave them a full hearing test and made ear moulds for hearing aids. They looked exhausted at the end of it, but they thoroughly enjoyed it, too, I think.’ In these ways – as in the repainting of walls and ceilings in the department – the commitment to excellence in the realm of human communication goes on.

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Doctors and nurses aren’t the only health professionals

PASSIONATE ABOUT OPTOMETRY OUTREACH IT’S NO WONDER THAT THE DIRECTOR OF CLINICS IN THE OPTOMETRY DEPARTMENT ON THE TURFLOOP CAMPUS OF THE UNIVERSITY OF LIMPOPO IS SO PASSIONATE ABOUT COMMUNITY OUTREACH. It’s because he knows from personal experience what a huge difference a helping hand can make. Letsoela Motingoe is a friendly and enthusiastic man, and he speaks candidly about his childhood in the Free State. ‘I was born near Bultfontein, a small town 100 km north of Bloemfontein. My mom and dad couldn’t read and write. My brother was considerably older than me. He had joined the church. In fact, he finally became a dominee in the Dutch Reformed Church. He was the one who put me in school and kept me there – and then sent me to university.’ Thanks to his brother’s persistence and his own efforts, Motingoe qualified at Turfloop as an optometrist. ‘The department was really small then,’ he recalls. ‘There were only three final-year students in 1984: I was one; my girlfriend (now my wife) was the second; and a friend of mine was the third. These days, there are over two hundred students in the department, fifty-five of them currently doing their fourth and final year. The department has certainly grown phenomenally.’ It is with senior students of different levels that Motingoe, as director of clinics, now has most to do. He organises them into groups and sends them into the rural villages surrounding Turfloop. Here they do visual screening on the general populace. Sometimes as many as 100 students are involved. ‘It’s great to see them setting off in university transport,’ says Motingoe. ‘They wear ties and white

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coats. They carry their own personal diagnostic set comprising a retinoscope and ophthalmoscope, as well as trail frames with the usual set of 158 lenses. I have to control the numbers going on these trips simply because everyone wants to come along.’ Motingoe points to Transnet’s Phelophepa Health Train (which provides optometry services, among others, to many remote areas throughout South Africa) as providing evidence of the dual success of the Turfloop outreach programme. ‘When the train stops at Polokwane station,’ he says, ‘there are no crowds of would-be patients to meet it. This is because we go so regularly into the rural areas. Not only to the villages, but also to schools and clinics and hospitals. We also send our students to work on the train. Do you know that overseas optometry students frequently telephone to ask to join the train. It shows you the excellence of our students’ exposure to optometry in the real world. The better the exposure through outreach, the better the training, while at the same time remote communities are being serviced.’ After the visual screening in the villages, those with defective vision (usually about 40% of the total) are transported to the optometry clinics on the Turfloop campus. Motingoe describes the most common disorders: • Refractive error, as in myopia (shortsightedness), hyperopia (farsightedness with problems close up), and presbyopia (age-related close eyesight impairment). • Pathology or anatomical abnormality. The two major pathologies encountered in rural Limpopo are cataracts and vernal conjunctivitis. It is estimated that at least 15 000 people per province are in need of cataract operations in South Africa.


Letsoela Motingoe with his Optometry students (from back,anti-clockwise), Witness Shuma (patient), Welcome Hlanze (clinician), Melusi Sibeko (patient), Ketsotlhekaene Sereeco (clinician) Vernal conjunctivitis (a browning of the whites of the eyes) is most common among young black boys under 15 years of age. • Combinations of refractive errors, pathologies and anatomical abnormalities. The outreach and clinic services provided by the Optometry Department are free, and patients in need of spectacles are referred to nearby Mankweng Hospital where a free state service is in operation. But there are constraints that are beyond the ability of departmental budgets to resolve. Motingoe says ‘Our clinics coping with this sizeable flow of patients are squatting between the residences and we really need our own building now. We’ve already raised R100 000 to this end, but of course we need a lot more.’ Funds are also required to replace the department’s mobile optometry clinic. ‘The caravan, filled with expensive optometry equipment, that served this function is grounded as it can no longer take the battering of untarred rural roads,’ Motingoe explains. ‘And even our outreach programme, although generously supported by the University, requires

additional funding. Here, too, we’ve been successful in raising R25 000. Anyone interested in helping people to see better and in bolstering the already sterling work being done by the department should contact Motingoe on letsoelam@ul.ac.za ‘I love this university very much,’ he says. ‘I was a student here, and now a teacher. Between those periods I have worked in private practice in Bloemfontein, Maseru (Lesotho) and Mafikeng, and I’ve lectured at the Wits Technikon. And even though I will soon be leaving to take up a position in a big company in Randburg, I’ll always remember my times here. This institution has provided me with crucially important rungs in my career ladder.’ This theme of indebtedness is continued when he refers again to the influence his brother has had on his life. ‘I must tell you that I’ve had the opportunity to give back. I’ve helped with the education of three of his children, one of whom is now a doctor, another a high school science teacher, and the third a nurse. Just so, I will never forget my alma mater, the University of Limpopo, and especially its new focus on rural African problems and community outreach.’

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Winner of the Alumni ‘Help & Win’ competition!

Olga Sebeela

JUST A REMINDER THAT IN L I M P O P O L E A D E R NO 7, THE AUTUMN ISSUE OF 2006, A COMPETITION WAS LAUNCHED TO LOOK FOR LOST ALUMNI. Even though many thousands of University of Limpopo Alumni are on our mailing list, we know that many more thousands have slipped through the net. We asked our L i m p o p o L e a d e r readers to help us find these LOST ALUMNI; or to send in the contact details of friends and neighbours who would enjoy subscribing to L i m p o p o L e a d e r , and thereby they would stand a chance to win a mystery prize via a lucky draw. Olga Sebeela is that lucky person!

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Her colleagues say she is very good at talking to people, both young and old, but now Olga Sebeela will be talking to the animals too. On being notified of her lucky draw prize, Olga said, ‘What a lovely surprise this is! At first I thought it was a joke!’ A special long weekend at Ingwe Lodge in Mpumalanga awaits Olga and her partner. Their prize includes travel, accommodation, all meals, two game drives and an exciting bush-walk a day. Olga is the senior clinical psychologist at Pelonomi Regional Hospital in Bloemfontein, having graduated from Medunsa in 2004 with an MSc in Clinical Psychology. She was born and spent her early years in Mangaung in Bloemfontein. After matriculating from Moroka High School in Thaba Nchu, Olga achieved a BA and a University Education Diploma (U.E.D) from

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Vista University, followed by her Honours degree in Psychology from Free State University. Olga’s connection with people started at an early age when she was a counsellor at Hodisa Technical School. L i m p o p o L e a d e r is a great magazine, Olga says. ‘I look forward to each issue and read it from cover to cover’. She particularly likes the style of writing which she says, ‘flows easily, is not too academic, but understandable and informative’. She also enjoys the articles on research and career opportunities offered by the University of Limpopo. ‘This year has been a very sad one for me’, Olga said. ‘I have lost a number of close family members, so this unexpected break is like a blessing, the best thing that has happened to me this year’. More alumni should send the names, addresses and contact numbers of ex-fellow students to L i m p o p o L e a d e r so that they, too, can receive this prestigious magazine.

INGWE LODGE Ingwe Lodge has generously provided the prize to our winner of the ‘great “Help & Win” competition’. We thank Ingwe Lodge for this fantastic opportunity for one of our readers. Please do visit their website on www.ingwelodge. co.za and you’ll be tempted to book your own long weekend away in the gorgeous South African bush.


Ingwe Game Lodge – African charm, gracious living and the fun of a bush experience. Tel: +27 13 752 6572 Fax: +27 13 752 2526 Email: ingwelodge@global.co.za Website: www.ingwelodge.com


Secure your future

Physiotherapy students from left: Fortunate Lebape (patient on table) Evelyn Ralebona, Esther Makhananesa, Precious Maripane and Olivia Keetse with Nomathemba Taukobong, head of the Department of Physiotherapy

Tsireledzani vhumatshelo hanu Tihlayiseleni vumundzuku bya n’wina Sireletsa bokamoso bja gago Verseker jou toekoms Vikela ikusasa lakho v

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UNIVERSITY OF LIMPOPO Telephone: (015) 268 9111


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