Discharge of water containing waste emanating from land to the marine environment: A water quality management perspective

The National Water Act, 1998 (Act 36 of 1998) mandates the Department of Water Affairs and Forestry to manage all water containing waste (wastewater), which emanates from land-based sources and which directly impact on the marine environment. These sources include sea outfalls, storm water drains, canals, rivers and diffuse sources of pollution. To date there are many places where wastewater is being discharged into the sea. More than forty sea outfalls are formalised through authorisations issued in terms of the old Water Act, 1956 (Act 54 of 1956) and the National Water Act, 1998 (Act 36 of 1998). In order to protect water quality, effluent standards were applied under the old Water Act to discharges into the water resource. However, the National Water Act, 1998 follows a receiving water quality objectives approach recognising differences in the assimilative capacity of different resources. Both approaches have the same main objective namely to maintain the resource at a quality fit for use by other users. The same principle applies to discharges to the marine environment. In addition, South Africa, as a signatory to a number of international Conventions and treaties such as the London Convention, is committed to certain requirements pertaining to the disposal of waste at sea. To meet such requirements, a very clear policy on what could be allowed for discharge to sea is required for South Africa. Such a policy should be very clear on what is allowed, why it is allowed and the conditions that apply for such discharges in order for this country to retain international credibility. In this paper the authors provide a concise discussion on: • The development of an operational policy providing the strategic view on marine disposal, as well as the goal, basic principles, ground rules and management framework that will be applied to the discharge of land-derived wastewater to the marine environment; and • Overview of procedures to guide authorities and managers in terms of the administrative and institutional responsibilities in dealing with land-derived wastewater discharges to the marine environment of South Africa.br> Water SA Vol. 30 (5) 2005: pp.56-6

Food Waste Within South Africa and Saudi Arabia

The food waste reduction potential within the countries of the Middle East and Africa is large and understudied. Countries in the region are faced with food security and sovereignty issues, with over 50% of food imported in some countries. Due to the many differences in this region, this chapter highlights the state of food waste in two prominent countries: South Africa and Saudi Arabia. Both South Africa and Saudi Arabia have their own food waste challenges and solutions. This chapter summarises the current state of food waste research in each country, and reports the estimated volumes of food waste in South Africa and Saudi Arabia along with any notable policy developments

Recommendations for Haemodynamic and Neurological Monitoring in Repair of Acute Type A Aortic Dissection

During treatment of acute type A aortic dissection there is potential for both pre- and intra-operative malperfusion. There are a number of monitoring strategies that may allow for earlier detection of potentially catastrophic malperfusion (particularly cerebral malperfusion) phenomena available for the anaesthetist and surgeon. This review article sets out to discuss the benefits of the current standard monitoring techniques available as well as desirable/experimental techniques which may serve as adjuncts in the monitoring of these complex patients

Limits of agricultural greenhouse gas calculators to predict soil N2O and CH4 fluxes in tropical agriculture

Acknowledgements This work was undertaken as part of the CGIAR Research Program on Climate Change, Agriculture and Food Security (CCAFS), which is a strategic partnership of CGIAR and Future Earth. This research was carried out with funding by the European Union (EU) and with technical support from the International Fund for Agricultural Development (IFAD). The UN FAO Mitigation of Climate Change in Agriculture (MICCA) Programme funded data collection in Kenya and Tanzania. The views expressed in the document cannot be taken to reflect the official opinions of CGIAR, Future Earth, or donors. We thank Louis Bockel of the UN FAO Agricultural Development Economics Division (ESA) for his comments on an earlier draft of the manuscript.Peer reviewedPublisher PD

A breath of relief: High-flow nasal oxygen in a resource-limited setting.

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Primary health care facility infrastructure and services and the nutritional status of children 0 to 71 months old and their caregivers attending these facilities in four rural districts in the Eastern Cape and KwaZulu-Natal provinces, South Africa

Objective: To assess primary health care (PHC) facility infrastructure and services, and the nutritional status of 0 to 71-month-old children and their caregivers attending PHC facilities in the Eastern Cape (EC) and KwaZulu-Natal (KZN) provinces in South Africa. Design: Cross-sectional survey. Setting: Rural districts in the EC (OR Tambo and Alfred Nzo) and KZN (Umkhanyakude and Zululand). Subjects: PHC facilities and nurses (EC: n = 20; KZN: n = 20), and 0 to 71-month-old children and their caregivers (EC: n = 994; KZN: n = 992). Methods: Structured interviewer-administered questionnaires and anthropometric survey. Results: Of the 40 PHC facilities, 14 had been built or renovated after 1994. The PHC facilities had access to the following: safe drinking water (EC: 20%; KZN: 25%); electricity (EC: 45%; KZN: 85%); flush toilets (EC: 40%; KZN: 75%); and operational telephones (EC: 20%; KZN: 5%). According to more than 80% of the nurses, problems with basic resources and existing cultural practices influenced the quality of services. Home births were common (EC: 41%; KZN: 25%). Social grants were reported as a main source of income (EC: 33%; KZN: 28%). Few households reported that they had enough food at all times (EC: 15%; KZN: 7%). The reported prevalence of diarrhoea was high (EC: 34%; KZN: 38%). Undernutrition in 0 to younger than 6 month-olds was low; thereafter, however, stunting in children aged 6 to 59 months (EC: 22%; KZN: 24%) and 60 to 71 months (EC: 26%; KZN: 31%) was medium to high. Overweight and obese adults (EC: 49%; KZN: 42%) coexisted. Conclusion: Problems regarding infrastructure, basic resources and services adversely affected PHC service delivery and the well-being of rural people, and therefore need urgent attention.Keywords: primary health care facilities; nutritional status; children; caregivers’ rural; South Afric

Limits of agricultural greenhouse gas calculators to predict soil N\u3csub\u3e2\u3c/sub\u3eO and CH\u3csub\u3e4\u3c/sub\u3e fluxes in tropical agriculture

Demand for tools to rapidly assess greenhouse gas impacts from policy and technological change in the agricultural sector has catalyzed the development of \u27 GHG calculators\u27-simple accounting approaches that use a mix of emission factors and empirical models to calculate GHG emissions with minimal input data. GHG calculators, however, rely on models calibrated from measurements conducted overwhelmingly under temperate, developed country conditions. Here we show that GHG calculators may poorly estimate emissions in tropical developing countries by comparing calculator predictions against measurements from Africa, Asia, and Latin America. Estimates based on GHG calculators were greater than measurements in 70% of the cases, exceeding twice the measured flux nearly half the time. For 41% of the comparisons, calculators incorrectly predicted whether emissions would increase or decrease with a change in management. These results raise concerns about applying GHG calculators to tropical farming systems and emphasize the need to broaden the scope of the underlying data

An Optimal Diagnostic Strategy for Tuberculosis in Hospitalized HIV-Infected Patients Using GeneXpert MTB/RIF and Alere Determine TB LAM Ag.

The diagnosis of tuberculosis (TB) in HIV-infected patients is challenging. Both a urinary lipoarabinomannan (LAM) test (Alere TB LAM) and GeneXpert-MTB/RIF (Xpert) are useful for the diagnosis of TB. However, how to optimally integrate Xpert and LAM tests into clinical practice algorithms remain unclear. We performed a post hoc analysis of 561 HIV-infected sputum-expectorating patients (median CD4 count of 130 cells/ml) from a previously published randomized controlled trial evaluating the LAM test in hospitalized HIV-infected patients with suspected TB. We evaluated 5 different diagnostic strategies using sputum culture as a reference standard (Xpert alone, LAM alone, sequential Xpert followed by LAM and vice versa [LAM in Xpert-negative patients and Xpert in LAM-negative patients], and both tests concurrently [LAM + Xpert]). A cost-consequence analysis was performed. Strategy-specific sensitivity and specificity, using culture as a reference, were similar with the Xpert-only and sequential and concurrent strategies. However, when any positive TB-specific test was used as a reference, the incremental yield of LAM over Xpert was 29.6% (45/152) and that of Xpert over LAM was 75% (84/11). The incremental yield of LAM increased with decreasing CD4 count. The costs per TB case diagnosed were similar for the sequential and concurrent strategies ($1,617 to$1,626). In sputum-expectorating hospitalized patients with advanced HIV and access to both tests, concurrent testing with Xpert and LAM may be the best strategy for diagnosing TB. These data inform clinical practice in settings where TB and HIV are endemic