SoPH BULLETIN
The School of Public Health (UWC) Newsletter
February 2010
Congratulations on your Promotion to Full Professor
Thandi Puoane!
Professor Puoane tells what this recognition means to her and the challenges she has had to
overcome…
It has been a long winding journey with each bend having
its own challenges. I was born in Malelane, Mpumalanga
Province. I am the eldest of 6 children. I have two sons and
one grandchild.
To fulfill part of our culture as the eldest child, I stayed
with my grandmother in KZN where I completed my
primary school. Growing with my grandma was a
challenge. I had to walk to school for over an hour,
crossing rivers, meaning that after heavy rain there was no
school. Grandma never had a watch, she could tell the
time by looking at the sun. I never got to school before the
bell rang for the first period of school. We never had
electricity and I don’t remember studying or reading in any
of the days. At the completion of primary school I moved
to a boarding school for my high school education.
I always wanted to study further. So after graduating from
high school I went for training as a nurse at Chris Hani
(the former Baragwaneth) Hospital. After completing my
Prof. Thandi Puoane
nursing training I moved to Mpumalanga, Kabokweni hospital to work as a nursing sister.
Meanwhile, I enrolled with the University of South Africa (UNISA) where I obtained the
following qualifications: (1) B(Cur) with Community Health nursing education as majors, (2) BA
with Psychology and sociology as majors, and (3)Diploma in nursing administration. I then
worked at the college of nursing, and in the process of studying I became motivated to study for
the masters in Public Health. In 1991 I was awarded a scholarship to study MPH at the
University of California, Berkeley, USA where I majored in Epidemiology and Biostatistics.
Bearing in mind that few were allowed to take mathematics at the high school level, one of the
challenges I was faced with was studying biostatistics without a mathematics background. I
spent 95% of my time memorising formulas, working out problems in order to get a pass mark.
In addition, assignments had to be typed and I had never touched a computer before coming to
the graduate school. I had to buy a computer and type papers for the whole night. “Where there
is a will there is a way”.
Being a single-parent to a teenager and a toddler in a foreign country without any family support
was one of the biggest challenges. However I managed with the help of my nephew who came to
join us. After graduating with a Masters degree in public health (MPH), I was funded by the
United Nation to study further. I graduated in 1997 with Dr PH.
Looking for a job was a challenge as I did not want to go back to nursing. A friend from Cape
Town got me a long list of people working in Nutrition related projects. I did not know any of
the names. I kept the list for a month and one day I decided to randomly select a name from the
list to initiate contact. And yes, I chose the name of David Sanders! So I initiated communication
with him and ended up at the School of Public Health in February 1998.
After being a graduate student in a developing country and working with health problems in
developed world, coming back home to the problems of development in my country was also a
challenge. My first research project included working with severely malnourished children. My
subsequent research projects put this topic on the back-burner and I had forgotten about it, but
I loved it. It is still one of the projects I’m passionate about.
Since I was on a contract post at UWC, after a year I accepted a permanent position at the MRC
in 1999. While working at the MRC I missed Public Health related research and interacting with
students. When a permanent post (lecturer) became available at the SOPH in 2002 I applied
and got accepted. In 2003 I was promoted to senior lecturer. In 2005 I was rated as a researcher by
the National Research Foundation (NRF) and in 2006 I was promoted to Associate professor, and now
to full professor in 2010.
What I enjoy most about my work is writing and putting my thoughts on paper. I have written
several publications. The two areas of research that I am passionate about are improving the
management of severe malnutrition and primary prevention of Non-communicable diseases.
Most of my publications are in these two areas.
Working at the School of Public Health is a great and rewarding experience. The environment
has been conducive to growth and development. In spite of the workload, engaging in research
areas of interest became an incentive to do more. The achievements and the promotion would
not have been possible without the support of all the SOPH staff members and my family
After hard and productive work, it was time for me to take a sabbatical during 2009. Half of the
time was spent working on research projects and writing up the research. Four manuscripts
have been submitted to peer review journals. Three have been accepted and are in press, one is
still under review. Two book chapters (one book chapter published and one in progress).
Now that I’m back I’ll continue working on three main projects namely: Improving severe
malnutrition, PURE, Community Health workers project (Ovations), Motivational Interviews. I
will continue with student supervision and PhD co–ordination.
Hi,
My name is Chelsea Whalen, and I am from Seattle University in Washington
State. I am interning here with Ehi, working with the PURE study until the end
of March. In Seattle I am doing my undergraduate in Biology, and
considering a future in Public Health. I have enjoyed my work here
thus far, and hope to gain a firm understanding of PURE before I
leave. This is my first time in South Africa, and I am enjoying it. I am
hoping to do a little traveling while I am here as well, mainly some
shorter trips. If you have any suggestions of what I must see close
by, please let me know. My e-mail is [email protected]. I look
forward to meeting all of you.
Launch of Interdisciplinary Centre of Excellence for Sport
Science and Development
The new interdisciplinary Centre of Excellence for Sport Science and Development (ICESSD) was
launched at the University of the Western Cape on December 7, 2009.
The Centre will promote sport as a powerful tool for development, health, wellbeing and social
change through high quality research and combining the areas of sports, health sciences,
community development and wellness to advance the physical, social and economic development
and wellbeing of South African and African communities.
Conducting
productive
research
activities
and
teaching and training the
next generation of sport
leaders will be among the
functions of the Centre.
High performance sports
services will be pro-vided to
emerging elite athletes and
coaches from tradition-ally
underserved communities.
Community outreach will be
at the forefront of the project
through the establishment of
an inter-and multidisciplinary
community service programme.
UN Special Advisor on Sport for Development and Peace, Mr. Wilfried
Lemke (second from right) with Prof. Ratie Mpofu, Prof. Marion Keim
and guest speakers from Germany, Belgium and South Africa at the
ICESSD launch
The focus will be on youth development, health and wellness, professional development, talent
identification, coaching assistance, liaising with federations, sport clubs, schools, community
organisations, the provision of holistic community sport leader programmes, internships and
participatory research opportunities.
The Centre stems from the VLIR/ Dynamics of Building a Better Society initiative and is endorsed by
the United Nations Office on Sport for Development and Peace. It has a number of partners from the
African and European continent such as Uganda, Tanzania, Namibia, Mozambique, Belgium and
Germany.
PROFILE ON SOPH INITIATIVES AND PROJECTS
DELPHE
(DEVELOPMENT PARTNERSHIP IN HIGHER EDUCATION)
IN AFRICA
COLLABORATION BETWEEN SOPH AND THE DEPARTMENT
OF APPLIED SOCIAL SCIENCES (DASS) AT LONDON
METROPOLITAN UNIVERSITY
By Ruth Stern,
Coordinator of the DELPHE Collaboration
DELPHE, (Development Partnership in Higher Education) is a
British Council funded 3 year scheme. It involves collaboration
between a UK university and a university in a low/middle income
country, aiming at academic support. In practice this involves 2
exchange visits for 2 people to each other’s institutions per year
Dr Ruth Stern
We have just commenced the second year. Our objective is to use the collaboration to support
the revisions of 3 of SOPH’s MPH modules: Health, Development and Primary Health Care;
Health Promotion; and Health Management. We are also using the opportunity to undertake a
needs assessment/review into the appropriateness of the distance learning materials for SOPH.
An obvious additional benefit is the opportunity to spend time with colleagues teaching similar
courses in a completely different context and using different approaches (DASS does not, as yet,
run distance learning courses. All their courses are contact teaching sessions, taught at the
university.) We are also learning about the similarities. London Metropolitan University has a
significant number of African students and staff, and many of the issues raised are very similar.
What we have done so far:
Lucy Alexander is leading the needs assessment.
So far, she has held consultations with local
health services experts; and run focus groups and
interviews with students in Cape Town, Namibia
and Zambia.
Two of us from SOPH, Ruth Stern and Suraya
Mohamed,
visited
London
Metropolitan
University in May 2009, where we taught on the
DASS Masters health promotion courses, and
visited some of the programmes that DASS
supports. The two DASS staff to visit SOPH
Suraya Mohamed (SoPH) teaching at DASS
were Eileen O’Keefe and Jo Skinner. They contributed to the Summer and Winter Schools
respectively, and gave us useful feedback and new ideas.
The February and March 2010 visits:
The main priorities for year 2 will be the Health Management Module and the continuation of
the needs assessment. Ruzanna Gevorgyan, who teaches Health Management and Social
Epidemiology at DASS, will visit SOPH this month to work with Verona Mathews on the Health
Management II module. She also plans to sit in on some sessions of the Measuring Health and
Disease Summer School short course. Verona will visit London in March to continue this work.
She will also teach on the DASS Health Management Course, spend time with relevant staff and
visit relevant initiatives. Ruth Stern will accompany both Ruzanna and Verona on their
respective visits, and she will begin work with Lucy on tracking the social determinant content
across the modules.
Simukai Shamu’s PhD Study
Title: The dynamics of Intimate Partner
Violence (IPV) and the risk of HIV among
pregnant women in Zimbabwe.
The study aims to assess the associations among
IPV, pregnancy and HIV among attendees of
public antenatal care in Harare. Feminist
perspective and Social Learning Theory will be
used to examine how gender inequality influences
behaviour roles, HIV infection and violence in
relationships. The study will test the hypothesis
that IPV is associated with HIV status, disclosure
of HIV status, childhood abuse, forced first sex,
and pregnancy among currently pregnant women
attending public antenatal care.
Simukai Shamu
Two thirds of the world’s HIV
positive people live in SubSaharan Africa. A growing body
of literature reports interlinkages between HIV infection
and Intimate Partner Violence
(IPV). However, there is limited
information on intimate partner
violence among HIV positive
pregnant women and
contrasting evidence on violence
after disclosing HIV status to a
partner. Intimate partner
violence and the risk that it
poses for HIV infection among
pregnant women are not
researched in Zimbabwe.
Study Design: A prospective cohort study
design will be used. A total of 2660 pregnant
women, both HIV positive and HIV negative, will
be recruited at the time of their first antenatal
visit and interviewed at baseline/recruitment and
after six months (after birth). Existing
instruments designed and cross-culturally
validated to measure and describe IPV and sexual
risk in a sensitive way will be merged to form a
combined questionnaire. Focus group discussions
will be conducted with pregnant women prior to
the interviews to ensure that the combined
questionnaire is locally appropriate and relevant.
After pilot testing, women will be interviewed on
two occasions to capture the relationship
dynamics and possible changes in IPV during
pregnancy and particularly after possible
disclosure of HIV status. HIV status and
pregnancy outcome will be ascertained through
clinic records and applied in the analysis of the
data subsequently. Interviewers and focus group
facilitators will be blinded to the HIV status of all
the pregnant women.
Analysis of results: Quantitative data will be
double-entered into Epi Info and processed by
SAS. Main outcome variable will be self reported
disclosure of HIV status to the partner (and other
people) and incidence of IPV and will be analysed
using multivariate logistic regression models and
odds ratios at 95% confidence levels. Qualitative
data will be transcribed verbatim from the audiotapes and themes will be formulated around the
study objectives.
CENTRE FOR HIV AND AIDS RESEARCH
To Receive VLIR Post-Doctoral Scholar
Dr Thomas Achia from Kenya is one of the first group of scholars to be
awarded a Post-Doctoral Scholarship under the university-wide
VLIR/DBBS Programme of UWC. Dr Achia will spend two years at the
Centre for HIV and AIDS Research working in close collaboration with
Centre Director Prof. Christina Zarowsky on a programme of research
and publication. Both the Centre and SoPH will benefit from the presence,
collaboration and contribution of Dr Achia.
POST-DOCTORAL WORK AT UWC
Following the successfully completion of my PhD (Mathematical Statistics) research work in
2006, I embarked on rigorous reengineering from a theoretically basic research oriented
statistician to a more useful and applied research methods specialist.
A lot of the current research problems that I
have encountered have required statistical
expertise but have also need strengths in other
areas of mathematics as well. The application
ordinary and partial differential equations to
the modeling of simple and even large
dynamical systems is an area where more than
mere statistical expertise is needed. While
consulting for CDC-Kenya on a mathematical
modeling exercise to establish trends in the HIV
epidemic in Nyanza, Kenya, I used the
Estimation and Projection Package (EPP) and
Dr Thomas Achia
the Spectrum modeling software to estimate various health indicators of the pandemic. I have
also worked for the Kenyan chapter of the International Aids Vaccine estimating the impact of a
vaccine, if one is available in 2020, on various epidemiological and socio-demographic
parameters. Each of these projects involved the use of compartmental models, mathematical
modeling approach that solves systems of differential equations.
Opportunity provided by the Post-Doc
I envision the post-doc at UWC as an excellent opportunity to work for a considerable period of
time with researchers from other discipline and as a chance to enrich my understanding of their
perspectives on issues.
Contributing to the Vision of the Centre
In the short period that I have served as a lecturer at the School of Mathematics, University of
Nairobi, I have been instrumental in linking the academic rigor of mathematics/statistics to
applied research. I have overseen and support the establishment of student based research
projects that are relevant and useful to society. I have also supported the effective running of the
medical statistics program that is currently producing excellent graduates. In regard to
contribution to the vision of the centre, I would bring to UWC 3 key strengths: teaching/training
expertise (and experience); a sound statistical foundation and an excellent mathematical
modeling background.
Teaching
I have a 13 year experience of teaching at the University of Nairobi during which time I have
gained strength and expertise in the preparation of teaching materials and in the dissemination
of knowledge. Having taught spatial statistics courses to medical statistics students at the
University and brought it into the mainstream curriculum at the university, I envision offering
training to students, statisticians, epidemiologist and other researchers at UWC researchers on
the use of various spatial statistics techniques and software, especially open-source software’s
like R and WINBUGS. I would also contribute significantly and be willing to support training of
student and researchers on aspects modeling (both statistical and mathematical).
Spatial Statistics
Spatial statistical analysis, a branch of statistics that is notably absent from mainstream
statistical theory and is usually offered only as an elective course, if offered at all, to statisticians
and researchers at universities. The techniques and statistical methods, though useful, remain
underutilized and relatively unknown. There is, however, a growing interest in statistical
methods for the analysis of spatially referenced data in a wide variety of fields, including the
analysis of public health data. As a member of the UWC HIV/AIDS research team, I would
participate in research that links spatially referenced exposure information to HIV (and/or other
disease) data. I would also use spatial point patterns analysis techniques to identifying
disease (in this case HIV) clusters in data. I also envision possibilities of using geospatial
techniques to detect disease hotspots and to use spatial regression methods to link spatially
referenced exposure information and HIV (or any other disease) data.
SOPH IN ASSESSMENT MODE DURING 2010
by Shun Govender
External Assessment of the School of Public Health
During the latter half of 2010 the School of Public Health(SoPH) will undergo a quality review
by external reviewers appointed by the Senate Academic Planning Committee of UWC. The last
such review of the School was conducted in 1999. In line with international trends to make
public higher education institutions more accountable and efficient and to ensure the quality of
service provision, the purpose of such external assessments of the University’s institutions is:
‘to demonstrate (based on a “fitness for purpose approach”) that in terms of their selfdetermined mission, goals and educational service provisions, and with the resources at their
disposal, they are providing education of adequate quality’.
(Source: Policy Document for Academic Reviews, Senate Academic Planning Committee, UWC, 2001)
The output from the Review Committee will be a report, highlighting issues and making
recommendations. This in turn will be discussed with SoPH by the Vice Rector (Academic) with
a view to implementation over an eighteen-month period.
Internal Process of Critical Reflection
During 2010, the SoPH will also engage in an internally driven process of critical reflection and
strategic planning. Annual strategic planning forms a normal part of the planning process of the
work of the School. This year however, the process of strategic thinking and planning will be
informed by in-depth reflection and discussions about the direction and future trends that
public health research and teaching is taking at global, regional and local levels.
Prof Uta Lehmann, Director of SoPH points out that this process of reflection should be guided
by questions such as the following:
What does our field and discipline look like at the moment?
Where the cutting edge/where is it likely to move?
How are we located in relation to the field?
How do we want to locate ourselves in the medium- to long-term (e.g. do we want to
become more mainstream, or do we see our 'niche' somewhere on the edge of the main
discipline)?
What do we need to do/set in motion to strengthen and consolidate and/or shift our
location and position?
It is hoped that this discussion will engage the whole School over several months. The views of
external experts and practitioners in the fields of public health, development and related
disciplines will be canvassed. A one day public discussion on the future of public health will be
held in March this year. The contributions emanating from this wider process of deliberation
and reflection will feed into the School’s own planning process.