The Iowa Department of Health and Human Services on Monday confirmed the death of a middle-aged eastern Iowa resident from Lassa fever.

The individual had recently returned from travel to West Africa, where it is believed the person contracted the virus, the state health department said.

The U.S. Centers for Disease Control and Prevention is working to confirm the diagnosis of Lassa fever, the state health department said. The CDC said it assesses the risk to the general public to be extremely low.

Lassa fever is a viral disease common in West Africa, but rarely seen in the United States.

There have been eight travel-associated cases of Lassa fever in the United States in the past 55 years, according to the Iowa health department.

In West Africa, the Lassa virus is carried by rodents and spread to humans through contact with urine or droppings of infected rodents.

About 100,000 to 300,000 cases of Lassa fever and 5,000 related deaths occur in West Africa each year, according to the CDC.
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Islamabad — Pakistan and neighboring Afghanistan simultaneously launched fresh vaccination campaigns against polio Monday amid a resurgence in cases in the only two countries globally where the virus continues to be endemic and paralyze children. 

The World Health Organization reported 64 polio infections this year: 41 from Pakistan and 23 from Afghanistan, up from six each in both countries in 2023.

Pakistani officials said the weeklong house-to-house nationwide campaign that was rolled out Monday enlists 400,000 polio workers, who aim to vaccinate over 45 million children under five against the paralytic disease.

“This is Pakistan’s third nationwide campaign this year, launched in response to the alarming increase in polio cases across 71 districts,” said Ayesha Raza Farooq, the prime minister’s point-person for polio eradication.

More than half the infections in 2024 are located in southwestern Balochistan province, which sits on the Afghan border and is “facing an intense transmission” of the poliovirus. The southern province of Sindh has recorded 12 cases this year, while other regions in Pakistan, a country of more than 240 million, have reported the remaining cases, according to Pakistan’s polio eradication program.

Anwarul Haq, the coordinator of the National Emergency Operations Center for Polio Eradication, urged parents to cooperate with health teams in protecting their children against the crippling disease, stressing that there is no cure for polio. “With the threat at an all-time high, we must act as one nation to keep our children safe through vaccination,” he stated.   

Local and WHO officials attribute the resurgence of poliovirus in Pakistan to vaccine boycotts in rural areas stemming from the false propaganda that these initiatives are a Western plot to sterilize Muslim children.

Additionally, anti-state militants in violence-hit districts bordering Afghanistan occasionally attack vaccinators and their police escorts, suspecting them of spying for the government. The violence has resulted in the deaths of dozens of polio workers and police personnel, including at least two vaccinators and seven police members killed this year.

Afghanistan 

Meanwhile, health officials in Taliban-led Afghanistan announced Monday the opening of a three-day polio-vaccination campaign, saying it aims to reach 6.2 million children under five in 16 of the country’s 34 provinces. The target areas are primarily located close to the border with Pakistan.

The latest round of this year’s anti-polio campaign in Afghanistan began after nearly a two-month delay because Taliban authorities abruptly halted house-to-house vaccine deliveries in the southern province of Kandahar without publicly stating any reason. Instead, de facto Afghan authorities stressed the need to conduct vaccinations for children from site to site and mosque to mosque.

In a report released last month, an independent monitoring board of the Global Polio Eradication Initiative believed that the Taliban’s action had stemmed from their “administration’s concerns about covert surveillance activities.” The report quoted Taliban officials as explaining that their leadership is living in Kandahar and has concerns about their security.

Kandahar, regarded as the unofficial capital of Afghanistan under Taliban rule, is where the militant group’s reclusive supreme leader, Hibatullah Akhundzada, resides and governs the country through his decrees based on his strict interpretation of Islam.

The Taliban chief has banned most Afghan women from public and private sector workplaces and barred girls from receiving an education beyond the sixth grade.

WHO officials say eradicating polio in Afghanistan requires comprehensive integration of large migrant populations into the vaccination program. They say it is also crucial to reach out to groups that refuse vaccination and establish a female public health workforce dedicated to the polio initiative to tackle multiple challenges facing polio-eradication efforts in the impoverished country.
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LOS ANGELES — McDonald’s announced Sunday that Quarter Pounders will again be on its menu at hundreds of its restaurants after testing ruled out beef patties as the source of the outbreak of E. coli poisoning tied to the popular burgers that killed one person and sickened at least 75 others across 13 states.

The U.S. Food and Drug Administration continues to believe that slivered onions from a single supplier are the likely source of contamination, McDonald’s said in a statement. It said it will resume selling the Quarter Pounder at affected restaurants — without slivered onions — in the coming week.

As of Friday, the outbreak had expanded to at least 75 people sick in 13 states, federal health officials said. A total of 22 people had been hospitalized, and two developed a dangerous kidney disease complication, the Centers for Disease Control and Prevention said. One person has died in Colorado.

Early information analyzed by the FDA showed that uncooked slivered onions used on the burgers “are a likely source of contamination,” the agency said. McDonald’s has confirmed that Taylor Farms, a California-based produce company, was the supplier of the fresh onions used in the restaurants involved in the outbreak, and that they had come from a facility in Colorado Springs, Colorado.

McDonald’s pulled the Quarter Pounder burger from menus in several states — mostly in the Midwest and Mountain states — when the outbreak was announced Tuesday. McDonald’s said Friday that slivered onions from the Colorado Springs facility were distributed to approximately 900 of its restaurants, including some in transportation hubs like airports.

The company said it removed slivered onions sourced from that facility from its supply chain on Tuesday. McDonald’s said it has decided to stop sourcing onions from Taylor Farms’ Colorado Springs facility “indefinitely.”

The 900 McDonald’s restaurants that normally received slivered onions from Taylor Farms’ Colorado Springs facility will resume sales of Quarter Pounders without slivered onions, McDonald’s said.

Testing by the Colorado Department of Agriculture ruled out beef patties as the source of the outbreak, McDonald’s said.

The Department of Agriculture received multiple lots of fresh and frozen beef patties collected from various Colorado McDonald’s locations associated with the E. coli investigation. All samples were found to be negative for E. coli, the department said.

Taylor Farms said Friday that it had preemptively recalled yellow onions sent to its customers from its Colorado facility and continues to work with the CDC and the FDA as they investigate.

While it remains unclear if the recalled onions were the source of the outbreak, several other fast-food restaurants — including Taco Bell, Pizza Hut, KFC and Burger King — pulled onions from some menus in certain areas this week.

Colorado had the most illnesses reported as of Friday, with 26 cases. At least 13 people were sickened in Montana, 11 in Nebraska, 5 each in New Mexico and Utah, 4 each in Missouri and Wyoming, two in Michigan and one each in Iowa, Kansas, Oregon, Wisconsin and Washington, the CDC reported.

McDonald’s said Friday it didn’t pull the Quarter Pounder from any additional restaurants and noted that some cases in states outside the original region were tied to travel.

The CDC said some people who got sick reported traveling to other states before their symptoms started. At least three people said they ate at McDonald’s during their travel. Illnesses were reported between Sept. 27 and Oct. 11.

The outbreak involves infections with E. coli 0157:H7, a type of bacteria that produces a dangerous toxin. It causes about 74,000 infections in the U.S. annually, leading to more than 2,000 hospitalizations and 61 deaths each year, according to CDC.

Symptoms of E. coli poisoning can occur quickly, within a day or two of eating contaminated food. They typically include fever, vomiting, diarrhea or bloody diarrhea and signs of dehydration — little or no peeing, increased thirst and dizziness. The infection is especially dangerous for children younger than 5, people who are elderly, pregnant or who have weakened immune systems.
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The good news: You will get a glorious extra hour of sleep. The bad: It’ll be dark as a pocket by late afternoon for the next few months in the U.S. 

Daylight saving time ends at 2 a.m. local time next Sunday, Nov. 3, which means you should set your clock back an hour before you go to bed. Standard time will last until March 9 when we will again “spring forward” with the return of daylight saving time. 

That spring time change can be tougher on your body. Darker mornings and lighter evenings can knock your internal body clock out of whack, making it harder to fall asleep on time for weeks or longer. Studies have even found an uptick in heart attacks and strokes right after the March time change. 

“Fall back” should be easier. But it still may take a while to adjust your sleep habits, not to mention the downsides of leaving work in the dark or trying exercise while there’s still enough light. Some people with seasonal affective disorder, a type of depression usually linked to the shorter days and less sunlight of fall and winter, may struggle, too. 

Some health groups, including the American Medical Association and American Academy of Sleep Medicine, have said it’s time to do away with time switches and that sticking with standard time aligns better with the sun — and human biology. 

Most countries do not observe daylight saving time. For those that do — mostly in Europe and North America — the date that clocks are changed varies. 

Two states — Arizona and Hawaii — don’t change and stay on standard time. 

Here’s what to know about the twice yearly ritual. 

How the body reacts to light 

The brain has a master clock that is set by exposure to sunlight and darkness. This circadian rhythm is a roughly 24-hour cycle that determines when we become sleepy and when we’re more alert. The patterns change with age, one reason that early-to-rise youngsters evolve into hard-to-wake teens. 

Morning light resets the rhythm. By evening, levels of a hormone called melatonin begin to surge, triggering drowsiness. Too much light in the evening — that extra hour from daylight saving time — delays that surge and the cycle gets out of sync. 

And that circadian clock affects more than sleep, also influencing things like heart rate, blood pressure, stress hormones and metabolism. 

How do time changes affect sleep? 

Even an hour change on the clock can throw off sleep schedules — because even though the clocks change, work and school start times stay the same. 

That’s a problem because so many people are already sleep deprived. About 1 in 3 U.S. adults sleep less than the recommended seven-plus hours nightly, and more than half of U.S. teens don’t get the recommended eight-plus hours on weeknights. 

Sleep deprivation is linked to heart disease, cognitive decline, obesity and numerous other problems. 

How to prepare for the time change 

Some people try to prepare for a time change jolt by changing their bed times little by little in the days before the change. There are ways to ease the adjustment, including getting more sunshine to help reset your circadian rhythm for healthful sleep. 

Will the U.S. ever get rid of the time change? 

Lawmakers occasionally propose getting rid of the time change altogether. The most prominent recent attempt, a now-stalled bipartisan bill named the Sunshine Protection Act, proposes making daylight saving time permanent. Health experts say the lawmakers have it backward — standard time should be made permanent. 
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washington — A NASA astronaut who was hospitalized upon return from the International Space Station for an unspecified medical condition was released Saturday in “good health,” the U.S. space agency said. 

The four-member Crew-8 mission splashed down off the coast of Florida early Friday after nearly eight months aboard the orbital laboratory.   

NASA did not reveal which of the astronauts was hospitalized nor the reason, citing medical privacy.   

However, it said in a blog post that the crew member has returned to the Johnson Space Center in Houston “in good health and will resume normal post-flight reconditioning with other crew members.”   

On its way back to Earth, the SpaceX Dragon executed a normal re-entry and splashdown, and recovery of the crew and spacecraft was without incident, NASA said.   

But during routine medical assessments on the recovery ship, an “additional evaluation of the crew members was requested out of an abundance of caution,” it added, without elaborating. 

NASA astronauts Matthew Dominick, Michael Barratt and Jeanette Epps, and Roscosmos cosmonaut Alexander Grebenkin were all flown to Ascension Sacred Heart Pensacola.   

Three were subsequently released, while one remained at the hospital “under observation as a precautionary measure.” 
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CAPE CANAVERAL, Florida — A NASA astronaut was taken to the hospital for an undisclosed medical issue after returning from a nearly eight-month space station stay extended by Boeing’s capsule trouble and Hurricane Milton, the space agency said Friday.

A SpaceX capsule carrying three Americans and one Russian parachuted before dawn into the Gulf of Mexico just off the Florida coast after undocking from the International Space Station at midweek. The capsule was hoisted onto the recovery ship where the four astronauts had routine medical checks.

Soon after splashdown, a NASA astronaut had a “medical issue” and the crew was flown to a hospital in Pensacola, Florida, for additional evaluation “out of an abundance of caution,” the space agency said in a statement.

The astronaut, who was not identified, was in stable condition and remained at the hospital as a “precautionary measure,” NASA said.

The space agency said it would not share details about the astronaut’s condition, citing patient privacy.

The other three astronauts were discharged and returned to NASA’s Johnson Space Center in Houston.

It can take days or even weeks for astronauts to readjust to gravity after living in weightlessness for several months.

The astronauts should have been back two months ago. But their homecoming was stalled by problems with Boeing’s new Starliner astronaut capsule, which came back empty in September because of safety concerns. Then Hurricane Milton interfered, followed by another two weeks of high wind and rough seas.

SpaceX launched the four — NASA’s Matthew Dominick, Michael Barratt and Jeanette Epps, and Russia’s Alexander Grebenkin — in March. Barratt, the only space veteran going into the mission, acknowledged the support teams back home that had “to replan, retool and kind of redo everything right along with us … and helped us to roll with all those punches.”

Their replacements are the two Starliner test pilots Butch Wilmore and Suni Williams, whose own mission went from eight days to eight months, and two astronauts launched by SpaceX four weeks ago. Those four will remain up there until February.

The space station is now back to its normal crew size of seven — four Americans and three Russians — after months of overflow.
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BERLIN, Germany — Close to 200 countries are scheduled to negotiate a new climate finance target for the Global South at the U.N. Climate Change Conference, or COP29, in Baku, Azerbaijan, in November.  

Dubbed the “Finance COP,” next month’s conference is expected to see focused discussions on a New Collective Quantified Goal on Climate Finance, or NCQG. It defines a new target for monetary support from historic emitters – mostly countries in the Global North – to address climate needs in poorer countries.    

Surging climate needs  

In 2009, countries including the United States and the European Union agreed to contribute $100 billion collectively each year by 2020, but an OECD report showed that they struggled to meet that goal over the years. Worse still, much of the climate finance came in the form of loans, which critics say have piled more pressure on developing countries already drowning in debt.    

The new negotiations come after a spate of extreme weather conditions intensified by human-caused climate change. July, for instance, witnessed the three hottest days ever recorded. Scientists said in an article on BioScience that as fossil fuel emissions reached an all-time high, the Earth is on track for 2.7 degrees Celsius warming by 2100, far above the 1.5 degrees Celsius target established in the 2015 Paris Agreement.   

To combat the burgeoning crisis, developing countries will now need more than $100 billion a year, with estimates ranging up to $6 trillion by 2030. Even that does not sufficiently cover measures to adapt to already inevitable climate change, according to a 2021 U.N. report. 

Conference host Azerbaijan in July launched the Climate Finance Action Fund with an initial goal of raising $1 billion from fossil-fuel producing countries and companies. 

Nations are likely to reach a compromise at the lower end of a NCQG goal, according to Irene Monasterolo, professor of climate finance at the Utrecht University. 

“These results of the negotiations may not be able to address the current need for climate finance in low-income countries, which are massively affected already now by climate risk,” Monasterolo told VOA. “The focus so far has been mostly on mitigation [reducing emissions] projects and measures, while adaptation investments are lagging behind.”   

Adaptation finance   

While adaptation finance has gone up over the years, mitigation still accounts for the majority of current climate finance, the OECD report revealed. Monasterolo said the scale of adaptation finance ultimately depends on mitigation efforts.    

“We don’t see bold plans for mitigation that would be needed to achieve the 1.5 degrees Celsius target, including the Global North. We have instead some issues of policy reversal and some major economies and polluting countries like the U.S. stepping back and in Europe,” she added.    

“The science is clear. To limit global warming to below 2 degrees Celsius compared to pre-industrial times, we need to drop production, extraction, use of fossil fuels and related carbon activities and focus on renewables, and low-carbon activities should go up. But that’s not happening. In the latest geopolitical crisis, we increased our dependency on fossil fuels.”  

The wars in the Middle East and Russia have put energy security at risk, according to the International Energy Agency. While a record high level of clean energy came online last year, emissions from the energy sector also broke records.    

Another reason for low adaptation finance, Monasterolo said, is the complexity of assessing climate risks. “We need to work on how to integrate forward-looking climate risk into investors and financial authorities’ models. Market-based approaches based on past data are a poor proxy of what could happen in the near future with ongoing climate change.”   

Loss and damage fund   

At COP28 in Dubai last year, countries agreed to set up a voluntary fund for historic emitters to pay for the damage caused by climate disasters in vulnerable developing countries. Western countries also called for large emitters like China to contribute. Negotiators are expected to continue the discussion at COP29.    

For now, it remains unclear whether the loss and damage fund will be included in the new NCQG, according to Karoliina Hurri, researcher at the Center on Climate Politics and Security at the Finnish Institute of International Affairs. 

The fund “is defined as voluntary, so it’s not based on the same categorization of developed and developing countries. … Some developed countries argue that the loss and damage fund is not part of the mandate and should be negotiated separately from this.”  

Looming NDCs   

As countries are slated to declare new and more ambitious national green goals by February 2025, COP29 is expected to be a big push.   

“I am afraid we won’t see ambitious enough NDCs [national determined contributions], but I think this is really important at this COP, especially the discussion of how to ensure the [recommended] outcomes of last year’s Global Stocktake, and the discussion about transitioning away from fossil fuels,” Hurri explained. 

Hurri said many countries said they would lead by example to announce goals aligned with the 1.5 degrees Celsius warming goal. “But at the same time, nations can decide for themselves what the alignment means. This clarifies how difficult it is to reach the NDC.”   

At COP28, countries signed a historic deal to start transitioning away from polluting fossil fuels. Hurri said, however, it remains to be seen how the phases translate into actions. “Do we see, for example, schedules of roadmaps on how this process is planned on the national level?”   

Pivotal US election   

The U.S. election results could have a large impact on the implementation of potential negotiation results, including cooperation measures with the world’s biggest emitting nation, China, according to Hurri. 

“I have not seen very detailed climate policy arguments from either of the candidates, although we know that they have very different views on climate change. … We know what happened last time during President [Donald] Trump’s term that the U.S. decreased financial contribution for climate,” she said.    

COP29 will also mark the first cooperation talks between the new envoys from the United States and China — John Podesta and Liu Zhenmin. They had a working group meeting in Beijing in early September, in which they agreed to host a summit on methane and non-carbon greenhouse gases during the climate conference.   

“While the U.S. election might not influence the cooperation at this year’s COP, the election outcome can have an influence on the credibility of their cooperation in the long term on a high level,” Hurri said.   
…

Four astronauts returned to Earth on Friday after a nearly eight-month space station stay extended by Boeing’s capsule trouble and Hurricane Milton.

A SpaceX capsule carrying the crew parachuted before dawn into the Gulf of Mexico just off the Florida coast after undocking from the International Space Station mid-week.

The three Americans and one Russian should have been back two months ago. But their homecoming was stalled by problems with Boeing’s new Starliner astronaut capsule, which came back empty in September because of safety concerns. Then Hurricane Milton interfered, followed by another two weeks of high wind and rough seas.

SpaceX launched the four — NASA’s Matthew Dominick, Michael Barratt and Jeanette Epps, and Russia’s Alexander Grebenkin — in March. Barratt, the only space veteran going into the mission, acknowledged the support teams back home that had “to replan, retool and kind of redo everything right along with us … and helped us to roll with all those punches.”

Their replacements are the two Starliner test pilots Butch Wilmore and Suni Williams, whose own mission went from eight days to eight months, and two astronauts launched by SpaceX four weeks ago. Those four will remain up there until February.

The space station is now back to its normal crew size of seven — four Americans and three Russians — after months of overflow.
…

Maulana Tayyab Qureshi, the top cleric in Pakistan’s Khyber Pakhtunkhwa Province, has seen up close the devastating effects of polio.

Two of his own kin were once paralyzed, victims of a scourge that has been vanquished worldwide yet refuses to go away from Pakistan and neighboring Afghanistan.

“Had their parents not neglected [to have their children vaccinated], their children wouldn’t be disabled today,” Qureshi said of his relatives.

As the chief khateeb, or Friday prayer leader, of the northwestern province, Qureshi preaches this message at every opportunity — Friday sermons at his 17th century Mahabat Khan Mosque in Peshawar, Eid prayers when upward of 40,000 people congregate, meetings with village elders.

“I’m very clear cut: I tell them, it’s free. It doesn’t cost you anything. Why don’t you take it seriously?” Qureshi said in an interview with VOA.

Qureshi is not the only Pakistani cleric advocating vaccination. Several renowned scholars have issued decrees in its support, with a notable shift in attitudes. Vaccine hesitancy, an intractable obstacle to eradicating polio, has waned, he said.

A once infamous bastion of vaccine resistance outside Peshawar has now embraced immunization.

“The fatwas have had a great impact,” Qureshi said.

Yet, as Pakistan and Afghanistan seek to eradicate polio, misinformation remains a key hurdle. While immunization rates are generally high in both countries, pockets of resistance persist along the border, jeopardizing eradication efforts.

To counter vaccine misinformation, public health officials increasingly have turned to influential clerics like Qureshi. As the trusted voices within their communities, these religious leaders play a crucial role in dispelling harmful myths and misconceptions about vaccines, experts say.

“The best way to fight through this is empowering trusted voices in communities to push back on it and provide real information,” said Kai Ruggeri, a Columbia University health policy professor who has written about vaccine disinformation.

The stakes are high. Afghanistan and Pakistan are the only countries where polio remains endemic. And as World Polio Day arrives this year, there are renewed concerns over their ability to eliminate the disease.

The neighboring countries were once on the brink of going polio-free. But persistent insecurity coupled with cross-border movements has fueled a resurgence.

Pakistan has recorded 40 cases and Afghanistan at least 20, this year. This marks a significant increase from the six cases each reported last year.

A setback came last month when more than 1 million Pakistani children missed vaccinations, and Afghanistan’s Taliban briefly suspended immunization campaigns.

Oliver Rosenbauer, a spokesman for WHO’s polio eradication program in Geneva, noted that misinformation is not the only obstacle to eliminating polio; a lack of infrastructure, insecurity and population density also contribute.

“The important point is the polio virus doesn’t care why a child is not vaccinated,” Rosenbauer said in an interview. “It’s very, very good at finding that unvaccinated child.”

Polio, a crippling disease that can lead to paralysis and death, has long been eradicated globally thanks to universal immunization efforts. For most people around the world, polio is a distant memory or even a relic of history.

But in Afghanistan and Pakistan, the disease remains a stark reality despite significant progress in recent decades. Its scars are visible to those who look, Rosenbauer said.

“It’s a disease that parents still see,” he said. “If you walk around Karachi or Kabul, you’ll still see people with polio on the streets.”

This “respect for the disease” explains why vaccine hesitancy remains around 1.5% in Afghanistan and Pakistan, significantly lower than many Western countries.

Yet in densely populated areas, such as the border regions of Afghanistan and Pakistan, lingering resistance can prevent efforts to eradicate the virus.

Leading the charge against the vaccine, militants on both sides of the border have waged violent attacks on polio workers and their escorts. Their claim that the vaccine program violates Islamic law and is used for surveillance has fueled resistance.

Hundreds have been killed in both Pakistan and Afghanistan.

In January, at least five policemen were killed and more than a dozen injured in a major attack on polio teams and security personnel in northwestern Pakistan.

According to the Emergency Operations Center in Khyber Pakhtunkhwa, militants have carried out 21 attacks against polio teams and security escorts in Pakistan this year.

Mainstream clerics have pushed back.

In 2019, prominent Islamic scholars from Afghanistan and Pakistan declared the polio vaccine safe and Sharia-compliant. They stressed the “moral duty” of parents to have their children vaccinated.

In 2022, the al-Azhar University, the Sunni Muslim world’s most prestigious institution of religious education, warned against decrees banning the polio vaccine in Pakistan.

Last month, nearly 200 renowned religious scholars in Khyber Pakhtunkhwa declared support for polio vaccination.

Qureshi, the chief khateeb of KP, was among them.

The scholars “took a strong stand not only regarding the polio vaccine but all health measures by the ministry of health,” Qureshi said.

Across the border, Taliban health officials are waging their own campaign against vaccine misinformation even as attacks on health workers, often claimed by ISIS, have persisted.

Ehsanul Haq Hanafi, a cleric and senior official in the health ministry, understands the clergy’s influence in Afghan society.

“People listen to the ulema and accept what they say,” Hanafi said in an interview with VOA.

Among the myriad misconceptions about the vaccine, he said, some Afghans believe it corrupts morals or causes sterility. Others think it can accelerate puberty, he said.

“This is unscientific and baseless disinformation,” he said.

To combat this, Hanafi travels around the country to meet with locals and mullahs to convince the skeptics. While some clerics remain opposed, most accept the vaccine once its benefits are explained, he said.

“We can’t convince 100% of the people, but 80% agree with us and have their children vaccinated,” Hanafi said.

VOA’s Ihsan M. Khan contributed to this article.
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Snakebites are classified as a neglected tropical disease by the World Health Organization. In South Africa and other countries in the region, there are numerous barriers to getting the antivenom necessary to save limbs and lives. But scientists are working to make antivenom cheaper, safer and easier to produce. Kate Bartlett reports from Johannesburg. Camera: Zaheer Cassim
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