Pioneering ‘new science’ in Masiphumelele

At the age of five, 20% of children in Masiphumelele are already infected with tuberculosis (TB). When these children enter high school, about half are infected with TB. By the time they become young adults, the infection rate has increased to roughly 80%.

That’s the reality for the community of over 23 000 residents in the heart of Cape Town’s “deep south”, home to the University of Cape Town’s (UCT) Desmond Tutu HIV Foundation (DTHF) Masiphumelele research site.

Known commonly as the “Masi site”, it is also now home to the new Aerobiology TB Research Facility, officially launched on 20 February, which will focus on the study of the transmission of these TB organisms with a view to finding ways to halt the spread of the disease.

While these percentages relate specifically to research in Masiphumelele schools, there is nothing to suggest that this community is exceptional. Rather, the figures are an indicator that similar TB infection results will likely be recorded in township schools throughout the Western Cape.

Emeritus Professor Robin Wood, chief executive officer of the DTHF and director of the Desmond Tutu HIV Centre (DTHC), an accredited research centre within UCT’s Health Sciences faculty, said at the launch that poor socio-economic conditions are one of the big drivers of TB transmission.

Research shows that the triple challenge of poverty, inequality and unemployment is most pronounced in townships in South Africa.

“So we have a major burden of TB,” said Wood, who is also a full member in UCT’s Institute of Infectious Disease and Molecular Medicine (IDM).

“This will allow clinicians and scientists to study each individual organism to try and develop ways in which to control TB in communities such as Masiphumelele.”

He explained that researchers at the new facility specialise in capturing the organisms in the air exhaled by patients, and “putting [the data] on to matrices which we can then look at very carefully.”

This allows clinicians and scientists to study each individual organism to try and develop ways in which to control TB in communities such as Masiphumelele.

Part of the research involves measuring the amount of air individuals exchange with each other, for example. Wood said he exchanges about 25 litres a day whereas the children and adolescents studied swap approximately 300 litres per day.

In a place like Pollsmoor Prison, Wood estimates swapping is between 1 000 and 2 000 litres per day.

“And that increases the chances of disease being transmitted,” he explained, adding that the centre researchers are effectively measuring the number of organisms in the air that are being exchanged.

A history of collaboration

Professor Linda-Gail Bekker, deputy director at the DTHC, chief operating officer at the DTHF and a member of the IDM, told guests at the launch there is a 20-year relationship between clinicians, scientists and the Masiphumelele community.

The relationship dates back to 1999 when the staff at the Desmond and Leah Tutu Clinic began providing HIV care to Masiphumelele residents. That clinic is still situated in the community.

They then raised funds to build  a dedicated research clinic, the Desmond and Leah Tutu Research Centre, adjacent to the public clinic. This was opened in 2004 - the year that the DTHF was established and opened at UCT’s Faculty of Health Sciences campus. In 2011 an adjacent youth centre was built, providing upwards of 4 000 young people with a space to hang out, eat, read and access the internet.

Bekker also conveyed “support and love” from DTHF and DTHC patron Anglican Archbishop Emeritus Desmond Tutu and his wife Leah Tutu.

“He is our role model for the work we do,” she said.

While the launch was about the facility and the work it will enable, it was also a celebration of interdisciplinary research, and IDM director Professor Valerie Mizrahi spoke of working with “giants in the field of medical research” like Bekker and Wood.

She praised Wood for his leadership, saying that as a polymath he understands the many fields at work, and is never intimidated by what he doesn’t know. This kind of leadership, she said, is key to interdisciplinary and now transdisciplinary research on the TB project.

“There’s a merging of social responsiveness and basic research. It brings these together, making it impossible to distinguish [between them].”

“We are actually creating and pioneering new science here in Masiphumelele ... new science, the aerobiology of tuberculosis that brings together state-of-the-art single cell microbiology.

 “There’s a merging of social responsiveness and basic research. It brings these together, making it impossible to distinguish [between them].”

UCT Vice-Chancellor and guest of honour Professor Mamokgethi Phakeng cut the red ribbon, officially opening the facility.

She told guests the occasion made her extremely proud, first off because of what the facility will be able to do in the fight against TB.

“Imagine a future where we can talk about Masi as a place where TB used to be a problem,” she said.

She also praised the “friendship that has grown” between researchers and the communities of Masiphumelele and Ocean View.

“The people of Masi and Ocean View have helped us in many ways. I want to acknowledge the important role [they] have played in … shaping the way we work here and how this work reaches different individuals and families.”

Commending her colleagues at the DTHF for their attention to community needs, Phakeng said UCT increasingly recognises that the “university lives in the community and the community lives in the university”.

“It’s in moments such as this one that I wish I could call all of South Africa to come and witness … what we mean when we say the work that we do responds to the context that we live in.

 “We are not just the best on the continent; we work hard to be the best for the continent.”

Addressing the DTHC, DTHF and IDM teams, she added: “You didn’t come to Masiphumelele because it’s fashionable. You were driven by the questions that you wanted answers to, and the questions that you wanted answers to are pertinent to the continent.”