Sensitive crypto risk detection
Extreme bacteria vs mixed metals in the e-waste era Dismantling cancer cells with a cannabis derivative and laser light Vulnerable tree species yields potential diabetes treatment How allopathic and traditional medicines collide MAY 2024
April 2024
UJ recognised as one of South Africa’s premier universities for Science, Engineering, and Hospitality, by Quacquarelli Symonds (QS) World University Rankings by Subject.
March 2024
UJ retains its position as the highest producer of research outputs in SA.
January 2024
UJ climbs globally in University Ranking by Academic Excellence (URAP).
Madibeng Building on the UJ Auckland Park Kingsway Campus (Photo by Olivier Maurin)
Dear Reader,
I am delighted to introduce to you the second issue of our Magazine, an exciting showcase of impactful projects dedicated to the betterment of society. These projects highlight the dedication of UJ researchers from across our faculties who are committed to making a tangible difference in society.
We start off this issue with research tackling a major challenge in volatile investments such as cryptocurrencies.
Prof Jules Mba from the UJ School of Economics introduces a promising new technique to assess financial investment portfolio vulnerability to extreme price swings, also known as tail risk. The technique is particularly relevant for cryptocurrency investments and institutional investors, such as pension funds.
Next, we look at an environmental issue that computing and mobile devices contribute to. ‘Exploding mountains’ of e-waste are generated every year around the world. Much e-waste ends up in landfills, where their toxic materials can leak into groundwater. Prof Lukhanyo Mekuto from UJ Chemical Engineering leads research on ‘extreme bacteria teams’ recovering metals from powdered e-waste, which uses far less energy and water than conventional e-waste recycling methods.
In human health, researchers at the UJ Laser Research Centre explore ways to ‘neatly’ dismantle rogue cells causing various cancers. Prof Heidi Abrahamse leads a continuing early-stage exploration of light therapy
techniques. In this issue, she leads a study where the plant derivative hypericin and gold nanoparticles can make cancer cells grown in the laboratory much more sensitive to dying in a controlled way from simultaneous cannabidiol (CBD) treatment.
Meanwhile, plant extracts can be effective treatments for many illnesses. Prof Mthokozisi Simelane from UJ Biochemistry leads research on a promising plant derivative to treat diabetes. It is a compound isolated from a very popular tree for African traditional medicine, which is highly vulnerable in the wild. Prof Simelane works with the UJ Technology Transfer Office to develop the compound into a complimentary medicine.
The use of traditional medicines sourced from indigenous plants is widespread globally. However, patients do not inform physicians about their use of traditional medicine during consultation. Dr. Lindiwe Gumede of UJ Medical Imaging and Radiation Sciences interviewed physicians in South African hospitals and identified a lack of explicit protocols that would prompt patients to disclose their use of traditional medicines.
Happy reading!
Yours sincerely, Prof Sarah Gravett Deputy Vice-Chancellor: Research & Innovation (Acting)
Photo by Gregor Röhrig
CONTENTS
See how UJ researchers explore solutions for volatile investments and the Sustainable Development Goals (SDGs) in the May 2024 issue of the Research & Innovation @ UJ.
CRYPTO INVESTMENTS
– A promising technique to better assess portfolio vulnerability to extreme price swings, also known as tail risk.
RECYCLING E-WASTE FOR METALS
– “Team extreme bacteria” recovers metals from powdered computer electronics, using much less energy and water than conventional methods.
CANNABIDIOL FOR CANCER CELL DESTRUCTION
– Combined with light therapy, gold nanoparticles and a plant extract, a promising way to neatly dismantle cancer cells in the laboratory.
AFRICAN TREE FOR DIABETES TREATMENT
– A compound from a popular but vulnerable tree in traditional medicine is being developed into complimentary medicine.
TRADITIONAL MEDICINE VS ALLOPATHIC MEDICINE
– Building a bridge over the silence about traditional medicines at hospitals. 3 6 10 13 17
Sensitive crypto risk detection
Since the first cryptocurrency was introduced in 2008, thousands more have been introduced, says Prof Jules Mba from the UJ School of Economics.
As of November 2023, over 21,000 crypto currencies exist, of which over 16,0000 are actively traded on more than 600 cryptocurrency exchanges, according to crypto asset price tracking website CoinMarketCap.
Despite the bewildering array of cryptocurrencies to choose from, the single biggest objection to these alternative forms of digital money is still in play: The extreme price swings these currencies are prone to.
That is on top of the risk from the collapse of multiple crypto currencies and exchanges, which started in 2011 and surged from 2017 onwards, adds Mba.
Conventional approaches to investment portfolio risk tend to not adequately capture the extreme price swings – also known as tail risk – associated with cryptocurrencies.
Interconnected losses in stressed markets Something needs to change before cryptocurrency investments can be managed along with conventional asset classes by institutional investors, for pension funds for example. Resilient portfolios require more informed decisions than what is provided by traditional risk assessments.
A new, more sensitive model to detect tail risk, even for crypto investments
In a recent study Prof Mba confirmed that cryptocurrencies inherently hold a greater risk of unexpected large losses compared to traditional investments. He also introduces a promising new technique to assess portfolio vulnerability to tail risk. The technique is particularly relevant for cryptocurrency investments and institutional investors.
“The research proposes a Conditional Value-at-Risk (CoVaR) estimation via vine copula and APARCH-DCC models. CoVaR captures the potential losses an asset may incur given that other related assets experience stresses beyond a certain threshold,” says Prof Mba via email.
“By modeling the time-varying dependence structure between assets using vine copulas and multivariate volatility with APARCH-DCC, the research aims to provide a more accurate assessment of CoVaR to account for complex interconnectedness within financial portfolios during periods of market distress”, he continues.
Beyond average returns and volatility
Institutional investors usually focus on average returns and volatility. However, this traditional approach is inadequate for the tail risk inherent in cryptocurrencies and other very volatile investments.
Using the vine copula-APARCH technique makes improved portfolio construction possible. It yields deeper insights into how specific assets contribute to overall portfolio downside risk during periods of market stress.
When wealth managers are deciding on optimal asset allocations, the technique can help them take tail risk into account and construct diversified baskets.
It yields a more informed view of the risk-return tradeoff when including cryptocurrencies. Using the technique can make possible more robust portfolios that capture cryptocurrency upside, while managing the potential for disproportionate losses.
Finding GMV exposure
The Global Minimum Variance (GMV) strategy is a very common approach used by institutional investors such as pension funds to construct their bond and equity portfolios. It aims to minimize risk by allocating more heavily to assets with lower volatility and correlation.
CoVaR was shown to be sensitive to portfolio allocation strategies in the study. The new CoVaR technique showed that GMV would result in the most vulnerable portfolio in terms of tail risk.
In other words, an objective approach such as GMV may unintentionally increase exposure to tail risk events. By not considering downside aspects beyond variance, GMV portfolios can end up more sensitive to market crises.
Interconnected risk
In the study, Mba went further and also presented the Delta CoVaR technique, a variation of CoVaR.
CoVaR is a systemic risk measure, looking at the portfolio risk conditional on an asset on its own.
In contrast, Delta CoVaR quantifies how much that individual asset contributes to the overall systemic risk of the interconnected portfolio. It shows the impact or change on the portfolio caused by the distress of the single asset.
Assessing interconnected asset risks is crucial for portfolio management, valuation of collateralized debt, and stress-testing bank balance sheets.
Decisions on stability rather than rankings
While Delta CoVaR quantifies individual asset impact on the interconnected portfolio, it proved overly dependent on portfolio construction strategy during the study.
CoVaR remained steadier across optimizations, making it preferable for comparing opportunities or monitoring flagship mandates over time.
This means CoVaR is probably a better core metric for risk modeling toolkits and can fill a need for consistent risk insights. The CoVaR technique can assist institutional investors in reconsidering decisionmaking solely on rankings sensitive to minor strategy tweaks, when stability is key to robust decision-making.
Photo by Therese van Wyk
Prof Jules Mba from the UJ School of Economics.
A vine copula is a graphical model to understand how multiple factors affect something such as the growth of an investment portfolio. In particular, it is useful to understand the complex connections between these factors. Instead of treating all the factors as one big complex problem, it breaks them down into smaller, simpler pairs. It then analyzes how each pair influences each other.
APARCH provides a more refined risk assessment by incorporating factors like long memory (past events influencing future volatility) and skewness (the tilt of the distribution of price movements). In addition, good news (price increases) often create a smaller impact than bad news (price drops).
APARCH captures this “leverage effect” where negative events can trigger larger swings in volatility.
DCC can help identify situations where traditionally correlated assets might become less connected or even move in opposite directions. This can provide opportunities for investors to capitalize on market inefficiencies.
The combined APARCH-DCC model captures both conditional volatility and dynamic correlations. This method provides a more nuanced picture of portfolio risk, especially for those containing cryptocurrencies.
Use of Artificial Intelligence in this article
Google Gemini Large Language Model (LLM) was used by Therese van Wyk to summarize extracts from the research study as a first rough draft.
Extreme Bacteria Mixed Metals
in the e-waste era
UJ researchers get extreme bacteria to chomp through powdered e-waste to recover valuable metals, instead of burning it – and identify a promising ‘team extreme’
Instead of sending old computers and other e-wastes straight to the trash can, an emerging low-energy process can reduce demand for landfill space and harm to the environment – and recover some valuable metals at the same time.
In a recent study, UJ researchers used a two-step process with three different types of bacteria to extract metals such as nickel, copper, zinc and manganese from powdered printed circuit boards (PCBs) which originated from obsolete computer sets. They found that the size of the PCB particles affects how well the metals can be extracted.
This research suggests that grinding circuit boards into smaller particles can improve the efficiency of metal extraction using bacteria. However, there might be a trade-off for some metals like copper, lead, and tin, which seem to be easier to extract from larger particles.
Prof Lukhanyo Mekuto from the Department of Chemical Engineering led the study.
Metals from ground-up computers
The PCBs for this study were removed from old computers. The researchers ground up the PCB boards into a powder. Then they sifted the powder into five ‘streams’, i.e. into five particle size ranges.
They wanted to see if it is possible to separate out metals according to particle size ranges, even before the bacteria could bioleach the e-waste powder. The better this works, the easier it will be for any future commercialscale operation to be efficient and cost-effective.
In so doing, this study tackles a question that hasn’t been well-studied before: how grinding and pulverizing e-waste affects the recovery efficiency of different metals in relation to their particle sizes.
In their analysis, they found that copper and tin dominated the largest particle size range of 500 to 710 micrometers in size. However, both metals were most efficiently recovered in the particle size range of 38 to 150 micrometers.
Tin was the most valuable metal considering its commodity price per tonne in the study, followed by nickel and copper.
Microbial room service
For the first step in the process, the researchers treated a mix of three kinds of extreme bacteria to ‘five-star room service’, so they would make enough copies of themselves to remove metals out of the PCB powder later.
‘Room service’ consisted of generous amounts of the iron and sulphur these extreme bacteria eat to stay alive, and some other compounds to help them multiply. True to their nature, their environment was highly acidic at pH 1.8. This is more acidic than than lemon juice which has a pH ranging from 2.0 to 2.5.
By using three kinds of extreme bacteria in a more resilient ‘consortium’ the UJ researchers went beyond previous studies that used single types of bacteria or fungi to recycle metals from e-waste.
Once the three main members of team bacteria had made enough copies of themselves, the researchers added the PCB particles to the ‘bacteria soup’. This is the second step of the bioleaching process in the study. Each particle size range was added into a ‘separate soup pot’, to see to what extent specific metals are recovered from larger or smaller PCB particle size ranges.
Valuable mountains
Old computers, tablets, mobile phones and chargers are just some of the exploding mountains of e-waste generated every year. Most e-waste ends up in landfills, where their toxic materials can leak into ground water; or get shipped to developing countries where workers in informal recycling operations are particularly at risk, often lacking proper protection.
At the same time, e-waste can contain valuable resources like gold, copper, rare earth elements and other metals.
Acidithiobacillus Caldus
Acidithiobacillus ferrooxidans Leptospirrillum ferriphilum
Images: AI images generated by Google Gemini, prompted by Therese van Wyk and Lukhanyo Mekuto
Burn it
One way of recycling objects containing various metals is to grind them to a powder, heat them up till they melt, and then separate them afterwards. This process is called pyrometallurgy and it is widely used for metals recycling. The catch is that it needs enormous amounts of energy for keeping furnaces heated for extended periods.
As an example, copper which is used extensively in PCBs, has a melting point of around 1085°C.
Another widely used process is hydrometallurgy. This uses less energy than pyrometallurgy, but the overall energy and water bill is still very high for metals mining or metals recycling. This process also results in the formation of excess slurry (or mud) which can be a serious problem.
Let bacteria do it
But there is another way, which uses a fraction of the energy and water. It works at mild, even ambient temperatures. In this way, bacteria eat through powdered metals ore or powdered e-waste to ‘liberate’ the metals inside powdered rock or man-made material particles.
This process is called bioleaching, and it is used extensively in the global copper mining industry, where heaps of powdered ore are sprayed down with bacteria to extract the copper.
Bioleaching is a great candidate process for extracting metals from e-waste, but only a few small commercial operations exist so far. There are many puzzles to be worked out before bioleaching will be a viable option to recycle e-waste at industrial scale. However, valuable metals can occur at much higher concentrations in
by
e-waste than in average mined ore, which may help commercial develop ment along.
Team extreme
One of the key contributions of this study is that so many of the bioleaching bacteria managed to stay alive in the truly extreme conditions of the process – partly created by the bacteria themselves. Using a mix of bacteria dominated by three carefully selected species with overlapping abilities contributed to this.
As an example, two of the three dominant bacteria species generate sulphuric acid while they chomp through iron, effectively lowering the pH of their environment while recovering metals. During bioleaching, the bacteria also must survive strong toxins present in e–waste, which is another challenge for commercial–scale bioleaching in recovering metals.
Liberating commodities from waste
After 10 days of bioleaching, team bacteria had ‘liberated’ several metals from the PCB powder. In terms of recovery efficiency, the process best recovered iron (95.3%) and manganese (86.2%).
Photo
Therese van Wyk
From left to right: UJ Honours students Mr Tisetso Modiba and Mr Thandumusa Wela, Prof Philiswa Nomngongo from UJ Chemical Sciences and Prof Lukhanyo Mekuto from UJ Chemical Engineering.
In terms of commodity prices, the bioleaching was most effective for nickel, where 61.9% of the metal was recovered after 10 days from PCB particles sized 38 to 150 micrometers.
On 27 March 2024, nickel had a three-month contract closing price of USD 16,640 per tonne on the London Metal Exchange.
Nickel was added to the USA Critical Minerals list for the first time in 2022 for its use in large-capacity batteries. Nickel is not on the EU list of critical minerals but will be ‘monitored closely’ due to ‘growth in demand for battery raw materials.’
In second place was copper, recovered at 68.2% by the bacteria after 10 days of bioleaching from PCB particles sized 38 to 150 micrometers. Copper was also the most abundant in the PCB particles.
On 27 March 2024, copper had a three-month contract closing price of USD 8,862 per tonne on the London Metal Exchange. Other metals recovered were aluminium, lead, tin and zinc.
Next metal
Current research which is being done is focused on the use of different extreme bacteria which can operate at different temperatures up to 65 °C. This work is meant to check if the temperature plays a positive role in the extraction efficiency of the metals.
Also, future research is focused on using different sources of e-waste, such as spent batteries and obsolete solar panels, for the extraction of metals from these sources.
Research Article
2024 Recycling
Use of Artificial Intelligence in this article
Google Gemini Large Language Model (LLM) was used by Therese van Wyk to ‘translate’ extracts from the research study to plain English and to provide summarised answers to contextual questions.
Dismantling cancer cells with a cannabis derivative and laser light
Laser light with hypericin and simultaneous CBD administration delivers promising results on hormoneresponsive cancer cells in the laboratory
Light therapy using the plant derivative hypericin and gold nanoparticles can make cancer cells cultured in a laboratory much more sensitive to dying ‘neatly’ from simultaneous cannabidiol (CBD) treatment, researchers from the University of Johannesburg have found.
The light therapy in the study is known as photodynamic therapy (PDT).
The combination of processes caused a ‘neat and controlled’ cancer cell death called apoptosis in most of the cancer cells. This was the result of very low concentrations of compounds and PDT used in the laboratory experiments.
The researchers used a staining technique (immunofluorescence) on the cancer cells which indicated that the combination treatment caused apoptosis.
Prof Heidi Abrahamse, Prof Blassan P. George and Dr Dimakatso Mokoena from the Laser Research Centre (LRC) at the Faculty of Health Sciences, University of Johannesburg, conducted the study. Abrahamse is Director: Laser Research Centre and the SARChI Chair: Laser Applications in Health.
Photodynamic therapy (PDT) is a clinically approved, minimally invasive and targeted approach to cancer treatment. Using PDT, researchers aim to destroy cancer cells while minimizing harm to healthy tissue.
Researchers around the world are studying the effectiveness of various combinations of CBD and other natural compounds with PDT.
In future, effective medical CBD-PDT treatments for cancer with fewer side effects, and more economical than current chemotherapies and cancer surgery, may be possible.
Cannabidiol and lasers
For this study, the researchers used MCF-7 breast cancer cells. MCF-7 is a hormone-responsive cell line frequently used in cancer research.
In the final series of experiments for this study, they ‘dosed’ the MCF-7 breast cancer cells with CBD and applied PDT at the same time.
To do this, they introduced a nontoxic chemical compound called a photosensitizer (PS) to the petri dish the cancer cells were grown in. Cancer cells absorb the PS more readily than healthy cells do. In this study, they used hypericin attached to the surface of the gold nanoparticles as a PS.
For the PDT, they shone a visible laser on the cells after administering the PS and observed the cellular changes 12 hours post-irradiation. When the laser light hits the PS inside the cancer cells,
the PS gets activated, a bit like a switch being flipped on. In the activated state, the PS becomes a ‘tiny, controlled explosion’ inside the cancer cell.
Squeezing through
The researchers used hypericin as a PS in this study, because it is sensitive to visible laser light and acts as an effective ‘controlled cellular explosion switch’. However, it has a limited ability to move across cell membranes. It needs a ‘carrier molecule’ to get it inside cancer cells more effectively.
This research formed part of Dr Dimakatso Mokoena’s doctoral thesis. Photo supplied.
Prof Heidi Abrahamse (Left) and Prof Blassan P George (Right). Prof Abrahamse is Director: Laser Research Centre and the SARChI Chair: Laser Applications in Health. Photo: Therese van wyk.
This is where the gold nanoparticles come in. These particles are roughly 50,000 to 100,000 times smaller than a human hair is wide.
Gold nanoparticles are good at squeezing through the walls of blood vessels (endothelial membranes) that feed cancer cells, because they are so small.
As a result, the gold nanoparticles can ‘carry’ more hypericin PS into cancer cells. If there is more PS inside a cell, the PS-PDT ‘cellular explosion’ works better, and the cancer cell is more likely to die.
Next steps
To fully understand how this treatment (Hypericin-gold nanoparticle PDT with CBD) works in deep tumors, more research is needed. A closer look at the genes and proteins affected by the treatment is the next step.
It is also necessary to note that the majority of cellular and molecular mechanisms in CBD and other cannabis derivatives are not fully understood. These also need to be investigated alone and in combination therapy.
Research article
2024 Cells
Neat cell death vs messy
Apoptosis is the goal for cell death in effective cancer therapies. This process dismantles the cancer cell in a neat and controlled way. It also minimizes damage to surrounding healthy tissue. Crucially, the cell membrane of the dying cell remains intact. This prevents the leakage of cellular components that cancer cells might use to spread.
Necrosis is another form of cell death. This is very messy in comparison to apoptosis. It is more like an uncontrolled demolition, and it damages the cancer cell membrane. The damage then makes inflammation of surrounding tissues possible, and the spread of cellular components that can spread cancer.
Cannabidiol (CBD) is a derivative from the Cannabis sativa plant but does not alter mood, perception, or behavior. It does not cause hallucinations, euphoria, or sedation.
CBD is abundant, easily accessible, and nontoxic to normal cells. Numerous retail outlets around the world sell purified CBD oil, and numerous physicians already prescribe CBD oil for a variety of health conditions.
Many studies by other researchers have shown that cannabinoids (such as cannabidiol) can influence processes crucial for maintaining a healthy balance within the human body.
Cannabinoids positively influence the rate at which cells divide and create new copies of themselves; the movement of individual cells from one location to another; the process of forming new blood vessels from existing ones; and programmed cell death (apoptosis), a neat and natural process that eliminates old, damaged, or unwanted cells.
Hypericin is a naturally occurring compound found in plants. It is a promising photosensitizer (PS) for PDT due to its strong ability to absorb light, particularly in the red spectrum. It appears to have some degree of selectivity for tumor cells.
Once activated by light during PDT, hypericin can efficiently generate reactive oxygen species (ROS) within cells. These ROS are highly damaging molecules that can kill cancer cells. Some research indicates that hypericin can make chemotherapy less effective.
Use of Artificial Intelligence in this article Google Gemini Large Language Model (LLM) was used by Therese van Wyk to translate extracts of the research article into plain English as a first rough draft, and to summarise background information for side-bar stories.
Vulnerable tree species yields potential diabetes treatment
A chemical compound from a tree poached for traditional medicine is being developed into a complimentary treatment for diabetes
images from Wikipedia (Manie van der Schijff).
Warburgia salturaris tree.
Photo by Therese van Wyk
Single-crystal X-ray structure of iso-mukaadial acetate characterised by Prof Simelane
In the street markets in Southern Africa, some items are high on the shopping lists of people who use traditional medicines. These have been used by various cultures in a region stretching from South Africa to Malawi.
Amazwecehlabayo, isibhaha, manaka, molaka, mulanga, shibaha, muranga, pepperbark... are some of the names for the dried bark, stems and roots from mature Warburgia salturaris trees.
There are many reasons parts of this tropical species are such popular remedies. Traditionally, these have been used to treat a variety of illnesses, including common colds, blocked sinuses, coughs and malaria.
Traditional healers would mostly harvest sustainably from the protected tree species. However, with more people in cities, harvesting by poachers would leave mature trees without bark, and the trees died as a result.
At one stage, the species was listed as Endangered by the International Union for Conservation of Nature (UICN). Since then, several Southern African cultivation and conservation projects have been successful enough to pull the species back to IUCN Vulnerable status in 2021. Some commercial nurseries cultivate the tree for the gardening industry as well.
However, the number of mature trees in the wild is estimated to be as low as 2500 individuals by the IUCN and declining. The biggest threat to the species remains the illegal harvesting of bark from mature trees, including in nature conservancies.
From bark to animal trials
Walburgia salutaris trees contain several active chemical compounds in their leaves, roots and bark. Some of these have been developed into commercial products. The chemical compound iso-mukaadial acetate was first isolated and described by Prof Mthokozisi Simelane and co-authors in research published in 2018.
Credits: CC BY images from Wikipedia / Manie van der Schijff.
Prof Simelane is a researcher in the Department of Biochemistry within the UJ Faculty of Science.
The compound is a drimane sesquiterpene found in the bark of Warburgia salutaris trees. That study showed that the compound has potential for treating malaria.
In 2019, Simelane started investigating the compound for potential diabetes treatments as well. The researchers grew muscle cells in the laboratory and induced diabetic conditions in them. Then they treated the cells with the compound.
The cells showed an increased ability to take up glucose, which is crucial for diabetes management. The results also showed that the compound may be able to reduce the breakdown of carbohydrates to sugars during digestion in humans.
In 2023, Simelane published a follow-up study where the compound was used to treat rats with induced diabetes. In the study, some blood cell issues caused by diabetes appeared to be improved by the compound. The compound also helped with blood sugar control and insulin levels in rats when administered in lower doses.
Weight gain for diabetics
While many people wish to lose weight, some people living with diabetes really need to gain weight to maintain their health. The research shows that isomukaadial acetate may be a potential treatment to improve body weight in humans.
“Diabetes can cause weight loss or gain, depending on the type of insulin a patient takes and their blood sugar levels,” says Simelane. “When a patient is first diagnosed with diabetes, they may lose weight quickly due to this symptom. The body may also burn fat and muscle for energy when it doesn’t have enough insulin to get glucose from the blood into cells, which can cause a loss in body weight.”
Product development
Currently, Simelane and his team are working on the product development of iso-mukaadial acetate as a complimentary medicine for the treatment of diabetes in South Africa.
They are working with the UJ Technology Transfer Office’s (TTO) Dr Phumuza Langa who coordinates the commercialisation aspects of the project. The Intellectual Property (IP) aspects are managed by the TTO’s Ms Ruwaida Mohideen.
“Our team is conducting animal studies to gather further data about the effects, safety profile, and efficacy of the compound,” says Simelane. “This data will be used in our submission to the South African Health Products Regulatory Authority (SAHPRA) to comply with the requirements for complementary medicine.”
Sustainable sourcing
To develop the compound fully into a viable commercial complementary medicine, the researchers need sustainable sources of it. While the bark from mature trees is the most popular with users of
traditional medicines from the tree, that source is also the most threatened.
A commercial grower in South Africa is currently supplying Simelane’s team with Warburgia plants, he says. Their sourcing process guarantees that each batch of botanicals meets the standards for research, in terms of quality requirements and research ethics.
The company has a bioprospecting permit, which is required in South Africa for commercial product development from traditional medicines using indigenous plants.
Advancing indigenous knowledge
In a deeply rural area of South Africa’s KwaZulu-Natal province, Warburgia salutaris trees still grow naturally. Traditional healers have harvested the trees for their bark for centuries to treat the villagers. Some of Simelane’s post-graduate students hail from the area.
Simelane’s research team with the assistance of the UJ TTO plan to establish a research centre in a village in the area. “We plan to cultivate Walburgia salutaris plants at the centre, and conduct further research on the species,” says Simelane. “We will focus on cultivation techniques, habitat restoration, and community engagement to foster a deeper understanding and appreciation for the plant’s significance.
“We will also explore the plant’s many medicinal properties in collaboration with experts in complementary medicine. Our primary goal is to ensure the continued existence of this plant for future generations, while also harnessing its potential for the advancement of complementary medicine,” concludes Simelane.
More about the tree species
South African National Biodiversity Institute (SANBI)
International Union for Conservation of Nature (UICN) Red List
The biggest Southern African Conservation Project Research Articles
2023 Planta Medica; 2019 Biomolecules; 2018 Malaria Journal.
Use of Artificial Intelligence in this article
Google Gemini Large Language Model (LLM) was used by Therese van Wyk to translate the results of research articles into plain English as background information.
How allopathic
Dr Lindiwe Gumede in the imaging room where she trains UJ students. Dr Gumede is from the UJ Department of Medical Imaging and Radiation Sciences. Photo: Therese van Wyk.
Building a bridge over the silence about traditional medicines at hospitals
You were angry
One of the physicians in the study told Gumede about a mother who brought a very sick, dehydrated baby to the hospital. When the doctor asked the mother about the child, she just said the child got ill but was evasive about having given the child some form of medication, traditional or otherwise.
“I remember having a patient when I was still in [an eastern suburb of greater Johannesburg]. The child was unconscious,” said the physician in the research interview.
“The child had herbal intoxication like they’ve given an overdose of some herbal drug. That child was going to the ICU. The mother kept on denying it [use of traditional medicine]. I was upset.
“I’m like this child... dark things like secretions that I’m like, this is traditional medication. The child ended up going to ICU in [one of the big Johannesburg hospitals].
The child stayed there for a month and was discharged.
“Then the mother came looking for me... I’m like, why?
... No, Doctor, you were right, and I want to confess, but at that time, I could not disclose because I could see you were angry.
“But I was like I, at least that the child is been saved. Because I was telling you that if we don’t know what the child was given, how will we help? “
Banned healers
For a very long time, traditional healers in South Africa were prohibited by law from practicing. In 1957, the apartheid-era government passed the Witchcraft Suppression Act. Sixty years later under democratic government, the Traditional Health Practitioners Act of 2007 formally established the industry.
Says Gumede: “While the traditional healers were banned, they had to operate in hiding.”
Trying to heal baby
Says Gumede: “Even if the family stays within walking distance of a clinic, a family is going to try the family remedies first. For example, the family may administer a traditional enema using lukewarm water.
“This can be effective and safe when done by an experienced person, usually an elder in the family. But it can go wrong when the required experience is not there, especially when traditional medicine is included.”
With babies a few months old, a family member may perform a healing ritual called kukipha inyoni on the child. More often, the family will take the child to an experienced traditional healer who specialises in this ritual.
”The traditional healer may instruct the guardian to administer imbiza, a mixture of cooked herbs, to the child with specific dose measurements,” says Gumede. “But there is no way of knowing what active ingredients in the medicinal plants entered the baby’s bloodstream, and how it may interact with the allopathic medicine from the hospital.”
Missing on the form
In general, when a patient is booked for a procedure in theatre, for example, they must disclose all medication they use when they complete the pre-procedure documents.
At the hospitals where Gumede interviewed physicians, the questions on the forms were not specific to traditional medicine. Rather, the questions dealt with using over the counter (OTC) medicines sold in pharmacies and supermarkets.
At community clinics, physicians would ask ‘are you taking any other medication’ but also wouldn’t ask specifically about traditional medications, she adds.
Some of the physicians interviewed for the study shared that the hospitals could be less restrictive. It would be helpful to allow patients to freely disclose their use of traditional medicines.
A safe environment
Some of the physicians interviewed for the study shared how they encouraged patients and parents of child patients to disclose their use of traditional medicines.
One doctor emphasized creating a safe environment: “Ok. First, when I consult with a patient, I want the patient to feel safe and confident; when the patient is with me, I want the patient to trust me because I’m
Plants used as traditional medicine in South Africa, from top to bottom: Hoodia gordonii, pineapple flower (Eucomis autumnalis) and Aloe ferox.
here to help, not to harm; and once the patient trusts you, I believe it will be easy for the patient to disclose.”
Another doctor echoed this: “Uh, we’d like patients to fully disclose because we don’t want them to be hiding anything from us. So, we’d like to provide an environment in which a patient feels very safe to disclose and is not judged by whatever treatment they’re using, but ultimately, we’d like patients to give us full disclosure about what they’re using because it affects how we manage them further.”
Better questions
Beyond a safe environment, it is still necessary to ask direct, non-prejudiced questions, Gumede discovered.
Said one physician: “However, if you ask the patient directly, they will not disclose unless they believe you are receptive. If I’m curious, I’ll tell the patient that most of my patients take traditional medications. So, when they know they are not the only ones using traditional medicine, they reveal it. But if I simply asked, they would not reveal.”
Patient choice
Once the physician knows about the traditional medicines the patient is using, there is still the question of how willing patients may be to choose between traditional and allopathic medicines for their treatment.
“The physicians agreed that patients who use traditional and allopathic medicines concurrently cannot be pressured just to use their prescribed allopathic medicine if they believe their traditional meds to be useful for them. They felt it necessary to support patients in choosing the treatment that best suited them,” says Gumede.
As one physician declared during a research interview: “I used to be autocratic before I went to get my speciality, but not anymore. I no longer use that method; instead, I simply allow the patient to make their own decision because, at the end of the day, it is the patient’s choice. I can’t make the patient do anything.”
Another doctor said: “Let’s say a patient comes in for an acute illness and they don’t necessarily have any chronic conditions, and I have no reason to suspect any other chronic illnesses, I don’t usually have a problem with that [referring to the use of traditional medicines].”
Patient responsibility
While respecting patient choice, the physicians also emphasised that patients need to take responsibility for the outcomes of their choices, where use of traditional medicines is concerned.
“We should not pass judgment on patients based on their choices. We must recognise that patients have the right to choose their treatments. We should also remind patients that their rights come with responsibilities. On the other hand, we have a responsibility to protect the patients and maintain our commitment to patient autonomy,” said one physician in the study.
Medical training
The training of physicians in South Africa is grueling, and includes some material about alternative medicines, usually acupuncture and homoeopathic medicine. However, the traditional medicine used by most people in South Africa is not included, says Gumede.
Physicians in the study talked about not ‘knowing what happens on the other side,’ meaning outside hospital walls, when a traditional healer diagnoses or treats a patient.
“I believe if information about common traditional medicines used by patients is included in the training of physicians, it would be easier to facilitate transparent cross-practice communications between physicians and traditional healers. Collaboration like that can go a long way to ensure better patient outcomes,” says Gumede.
The research article
2023 BMC Complimentary Medicine and Therapies
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