Why I Write

At first it was easy to answer this question. I said that I wrote because I could not speak (a curious answer from a garrulous person) - because as a black person, an outsider in Britain, I somehow did not have the right to speak. When health visitors or shopkeepers spoke to me in pidgin they constructed for me the choice of silence, of replying in their pidgin, or of replying in a caricatured voice of Her Majesty. Never in my own. My license to speak as a teacher or to speak in the domestic domain never transferred to that of the public, to the arena outside the immediate classroom or the home. This silence rendered me ineffective within institutions, marked me as an outsider and writing seemed to offer a way out of it. I have always tried to write, as a child and as a student but never sustained it. There is a huge leap between having the potential to write - most literate people do - and actually producing a text, an act which also always depends on material conditions

The chief is a chief through the people: Using Rule 7(1) to test the authority of a chief to litigate on behalf of his people

This note discusses the judgement handed down by the North West High Court in Mafikeng in an interlocutory application in the matter of the Royal Bafokeng Nation (RNB) vs the Minister of Rural Development and Land Affairs and Others. The application was brought by several ‘sub’-communities under the jurisdiction of the RBN, challenging the latter’s authority to litigate on their behalf. This application relates to a growing tension between the political authority of traditional leaders and the fundamental right of their ‘subjects’ to speak for themselves. It may be argued that the judgement represents an important step beyond the established frame of this discussion in the North West courts, namely which representative traditional structure is the proper one, to a question as to the duty upon those structures to comply with customary requirements of broad consultation and consent. In the event, it demonstrates the potential substantive significance of a procedural formality such as regulated by Rule 7(1)

In search of Tommie

Short story set in South Afric

Weight gain in hospitalised low birth weight (LBW) premature infants receiving breast milk or breast milk with human milk fortifier in the Nelson Mandela Bay Health District

Rationale: Worldwide, hospitals with premature units have one generalised objective, i.e. to achieve postnatal growth and body composition similar to that of a normal foetus of similar gestational age. Optimal nutrition leads to optimal neurodevelopment and breastfeeding (BF) is known as the golden standard for infant nutrition. Human breast milk (BM) has significant value for preterm and term infants and is of special benefit to HIV infected mothers. Maternal supplementation is provided as part of the standard protocol in certain hospitals in the Eastern Cape province to those mothers who breastfeed their low birth weight (LBW) infants after delivery. human milk fortifier (HMF) is a nutritional supplement that is added to expressed breast milk for feeding preterm infants in order to meet their high energy and protein needs and therefore supporting the recommended growth velocity of 10g/kg/day-15g/kg/day. Some hospitals within South Africa provide HMF to preterm infants as part of their standard nutritional protocol in order for the infant to gain weight if BM only failed to produce adequate results. To date, little to no South African studies support or discourage the use of HMF for LBW infants. This study aimed to describe the effect of maternal supplementation compared with breast milk with HMF, or a combination of maternal supplementation and breast milk with HMF, on growth velocity in hospitalised LBW premature infants within the Nelson Mandela Bay health district. The proposed study design followed a longitudinal, observational, descriptive study in a cohort of LBW infants. The study was analytical using quantitative empirical data. Study participants were selected, by using convenience sampling, at Dora Nginza Hospital, Zwide between October 2015 and August 2016 (ethics approval: EC_2016RP27_564). Quantitative data on anthropometric measurements was collected from study participants. Primary care givers provided written informed consent. Registered nurses were trained and performed anthropometrical measurements according to standardised methods. A structured questionnaire was completed by the principal reasarcher as a source of data collection. Numerical data was described using means and standard deviations. Chi squares were used to describe the associations between maternal risk factors and birth weight outcomes. ANOVA was used to determine the relationship between growth velocity and the various supplementation groups. A sample size of 91 LBW preterm infants and mother pairs were entered into this study. The majority of mothers, 64% (n=58) fell in the age category of 20-35 years old. Of the total maternal sample (n=88), 35% (n=31) were classified in the at risk age category, i.e. 36years old. Out of the total infant sample (n=91), 65% (n=59) was classified as VLBW, 22% was LBW and 22% (n=20) was ELBW. No statistically significant association was found between infant growth velocity and maternal risk factors. The group receiving BM with HMF had a mean growth velocity of 19.75 g/kg/day (SD=6.45) that was statistically significantly (p<0.05) more than the other groups. The maternal supplementation only group and the maternal supplementation and BM fortification group showed mean growth velocities of 12.26 g/kg/day (SD=5.41) and 12.29 g/kg/day (SD=6.97) respectively. A post hoc test was done between growth velocity in the supplementated groups and the length of hospital stay. These results reveal that the group receiving BM with HMF had a significantly (p<0.05) shorter mean length of hospital stay of 11.29 days (SD=7.02), compared with the group on the combination of maternal supplementation and BM with HMF. In this study, infants receiving HMF with BM showed the highest growth velocity with the shortest hospital stay before discharge. In this group, infants were already receiving an adequate BM intake of 150-180 ml/kg/day prior to participation in the study. This meant that the HMF group consisted of more stable preterm infants compared to the rest of the supplementated groups. However, a large proportion of participants in the maternal supplementation group also showed adequate to good growth velocity. The researcher recommends the implementation of maternal supplementation only, as standard of care for all hospitalised lactating women. Furthermore, timeous addition of HMF to expressed BM is necessary for infants with growth velocities <15 g/kg/day. This may save costs to the hospital as the use of HMF allowed for better weight gain and earlier discharge

Poverty and respectability in early twentieth-century Cape Town

Cape Town's black population of the early twentieth century actively pursued lifestyles that might be described as respectable. But respectability was expensive, and poverty —characterised by poor housing, ill health and shortened lifespans — stood in the way of some of its most essential elements: cleanliness, sexual restraint, sobriety, and the creation of nuclear and gendered households. Black respectability, therefore, could not simply replicate that of the dominant white bourgeoisie. Most challenging was the development of rampant black criminality, often seen by contemporary observers as the result of the failure of black women to realise respectable households. Even attempts on the part of the state to create respectable citizenries floundered, partly because these initiatives were incompatible with the policies of racial segregation. The state and the dominant bourgeoisie put their faith in the black elite as the standard-bearers of respectability, but the reality was that the respectability of the ‘superior’ class was frequently indistinguishable from those below, a consequence of the fact that the boundary between these classes was highly porous

A profile of adult acute admissions to Lentegeur Psychiatric Hospital, South Africa

Introduction: The Western Cape Province has the highest documented lifetime prevalence of common mental disorders in South Africa. To ensure the efficient, equitable and effective distribution of current resources, there is a need to determine the profile of patients seeking psychiatric treatment. Aim: The aim of this study was to describe patients admitted to the Acute Adult Admissions Unit at Lentegeur Hospital (LGH) which is situated in Mitchells Plain, Cape Town. Methods: This retrospective study involved an audit of all patients (18–60 years of age) admitted between 01 January 2016 and 30 June 2016. Results: A total of 573 adult psychiatric patients were profiled. The median age of the cohort was 29 years. The majority of patients (63%) were educated to the secondary level. Only 12% of patients were employed and 37% received disability grants. More than 90% of cases presented with psychotic symptoms. Of these, 28% presented with first episode psychosis. Of all patients, 20% were referred with manic symptoms and 7% with depressive symptoms. Many patients (62%) used substances in the period leading up to admission. Significantly more males (73%) used substances compared to females. Cannabis was the most widely used substance (51%), followed by methamphetamine (36%). Violence was a contributing factor to 37% of admissions. A total of 70 patients (13%) tested positive for HIV, while 49 (9%) tested positive for syphilis. Conclusion: We found the average patient requiring admission to be a young urban male who would likely have a secondary level (grades 8–12) education, but be unemployed. This patient would also likely be a user of illicit substances, would present psychotic and would likely display violent behaviour prior to referral. Substance use and a propensity for violence were identified as significant factors that influence the likelihood of admission. We invite planners in the Department of Health, as well as other stakeholders, to take heed of this burgeoning crisis and to implement specific strategies for addressing these problems before the effectiveness of mental health services as a whole is further undermined

Illicit drug use and violence in acute psychosis among acute adult admissions at a South African psychiatric hospital

Background and objective: The prevalence of mental illness and illicit substance use has increased markedly in South Africa\u2019s Western Cape Province, over the last 2 decades; potentially increasing demand for psychiatric care. This paper describes the demographic and substance use profile of patients admitted to Lentegeur (LGH), the largest of the four psychiatric hospitals in the Province. Methods: Medical records, patient interviews and other clinical notes were used to collect data on demographics, illicit substance use, violent behaviour and utilization of rehabilitative services for patients (n=535) admitted to LGH between 1 August 2012 and 31 January 2013. Results: Majority of admissions were male (65.6%) and younger (69.8% &lt; 35 years) compared to females (62.6% &gt;35 years). Overall, 255 (49%) used an illicit substance, (24% females and 63% males). Majority of substance users were youth (18\u201335 years) in both males (83.1%) and females (73.8%). Cannabis and methamphetamine were the most popular drugs in males (56.3% and 34.9%) and females (17.9% and 16.2%) with the highest rates being among the youth. Violence was common among both men (60.7%) and women (40.8%); among the violent, 67% of males and 35.6% of female used substances. Only 5.5% of drug users utilized formal drug rehabilitation services. Conclusion: Substance use and violence were high, yet only a small proportion of the patients utilised available drug rehabilitation services. This may have implications on psychotic relapses, morbidity and subsequent pressure on financial resources within the health care system. Efforts are needed to maximise utilisation of existing rehabilitative resources for these patients

Little perpetrators, witness-bearers and the young and the brave: towards a post-transitional aesthetics

The aesthetic choices characterizing work produced during the transition to democracy have been well documented. We are currently well into the second decade after the 1994 election - what then of the period referred to as the 'second transition'? Have trends consolidated, hardened, shifted, or have new 'post-transitional' trends emerged? What can be expected of the future 'born free' generation of writers and readers, since terms such as restlessness, dissonance and disjuncture are frequently used to describe the experience of constitutional democracy as it co-exists with the emerging new apartheid of poverty? Furthermore, what value is there in identifying post-transitional aesthetic trends?DHE

Hyper-compressions: The rise of flash fiction in “post-transitional” South Africa

Blair, P. (2020). Hyper-compressions: The rise of flash fiction in “post-transitional” South Africa', The Journal of Commonwealth Literature, 55(1), 38-60. Copyright © 2018. Reprinted by permission of SAGE Publications.This article begins with a survey of flash fiction in “post-transitional” South Africa, which it relates to the nation’s post-apartheid canon of short stories and short-short stories, to the international rise of flash fiction and “sudden fiction”, and to the historical particularities of South Africa’s “post-transition”. It then undertakes close readings of three flash fictions republished in the article, each less than 450 words: Tony Eprile’s “The interpreter for the tribunal” (2007), which evokes the psychological and ethical complexities, and long-term ramifications, of the Truth and Reconciliation Commission; Michael Cawood Green’s “Music for a new society” (2008), a carjacking story that invokes discourses about violent crime and the “‘new’ South Africa”; and Stacy Hardy’s “Kisula” (2015), which maps the psychogeography of cross-racial sex and transnational identity-formation in an evolving urban environment. The article argues that these exemplary flashes are “hyper-compressions”, in that they compress and develop complex themes with a long literary history and a wide contemporary currency. It therefore contends that flash fiction of South Africa’s post-transition should be recognized as having literary-historical significance, not just as an inherently metonymic form that reflects, and alludes to, a broader literary culture, but as a genre in its own right