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Dr. S. Radovanovic: Warns that tattoos can bring you infections

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Consultant dermatologist Dr Spasoje Radovanovic gives an exclusive insight into life as a dermatologist and how he treats those in his care.

Tell us your background.

I was born in Serbia where I started and finished all my education – primary, secondary, medical school and specialization. I have been practicing as a dermatologist for over 20 years.

 

What do you find is the most common skin complaint from your patients?

Most dermatologists will probably agree that the majority of our work-load falls into two categories. The first is inflammatory skin disorders such as eczema, psoriasis and acne. The second is skin cancer and skin lesions (lumps and bumps).

 

Talk about patients with a psychological problem.

The skin and mind is a hugely interesting and expanding area. We are really becoming aware how closely these two are linked and most dermatologists will group this into largely two areas – there are skin diseases that can be associated with psychological distress; such as acne and psoriasis – and then there are psychiatric disorders that can manifest with skin problems; such as trichotillomania and dermatitis artefacta. The approach to dealing with these is, on the whole, different. The first group are likely to benefit from talking therapies and often as the skin is controlled, the distress also improves. The second group may need some input from other medical specialties as well as a dermatologist. Personally, I think it is important to ask patients how their skin disease affects their daily life. I have had patients with acne becoming socially isolated, or patients with hand psoriasis wearing gloves even under hot conditions, or not wanting to go swimming, or not wanting to wear skirts. When the skin is good, these challenges can often be taken for granted. But skin disease can cause huge psychological morbidity and if you don’t ask the question, people may not necessarily volunteer quite what an impact their skin is having on their general well-being. If I have ongoing concerns, then I would recommend review by a clinical psychologist.

 

Reports indicate that skin cancer is on the rise in the Sub Saharan countries including Botswana, especially Melanoma. Why do you think this is the case?

Incidence of skin cancer has increased all over the world especially in developing countries because of the damaged ozone layer in the atmosphere. In fact a recent report by the World Health Organisation (WHO) estimates that 21–87% of the general population in developing countries has skin disease. The sun changed the spectrum and more UV (ultra-violet) radiation now comes to the earth surface.

Why is sunlight harmful to our skin (despite popular belief that dark skin is not affected by the sun’s harmful rays)? How exactly does the sun affect our skin?

Sun radiation is divided in three parts according to the energy it carries: IR (infrared), Visible Light, and UV (ultraviolet). Only UV radiation is harmful. It carries enough energy to produce ionisation of different molecules in the skin. Ions are chemically active and interact with genetic material of skin cells, to produce mutations. The nature of X-rays is similar to UV radiation, but carries even more energy. In other words UV radiation is “softer” than X-rays but still poses danger.

 

What beauty trend have you seen over the course of your career that you wish would go away?

Definitely tattooing, it may transmit all diseases that may be transmitted with needles (e.g. Hepatitis B, HIV, Syphilis), and it may even cause allergy due to the injected paint.

What is the one anti-aging myth you wish everyone would stop believing?

A long time ago, when I was young, doctors recommended the sun as healthy for the skin and general health. Suntanned and bronze models advertise cosmetic products. Some still believe in it.

 

What do you find the most rewarding about the work you do?

I prefer to treat real diseases than cosmetic problems. It sounds like a cliché, but it is an honour and a privilege to be a doctor.  People see you at their most vulnerable and share intimate details of their lives.  To be able to make a difference, however small it maybe, is a unique position to be in and not one I take for granted.  There is nothing more satisfying than being able to diagnose, treat, and reassure others. 

And what are the challenges?

The hardest part of the job is delivering bad news, such as telling someone they have metastatic cancer.  There needs to be a balance between providing reassurance and an honest discussion regarding prognosis, particularly if it is bleak. There is still no easy way to do this. 

Do patients always follow the advice you give them?

I think the crux of answering this is based on making sure I try my hardest to establish good rapport with those I am treating. I think if you trust your doctor, you are much more likely to stick to a treatment plan that they recommend.  People have busy lives and what tends to happen is that people may ease off their treatment plan when their skin improves. It’s all about developing a practical, happy medium that improves the patient but causes minimal interference with their life.

 

On a basic level, what skills does your job demand?

If a doctor were a computer, it would have a slow processor and a large hard drive. Doctors just have to be hard working, no special skills needed.

 

How is the job market/demand in the dermatology field? How do you think it will develop over the next five years?

American statistics say that 30,000 people need one dermatologist. Now there are only five (5) dermatologists in Botswana. This is a prospective job for young doctors.

 

 

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Cops are not monsters – Matlapeng

Yvonne Mooka

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Crime becomes easier to fight when members of the society and the police work together, says Sejelo Police Station Commander Superintendent Mogomotsi Matlapeng.

“Police of today go to the people. We want them to see that we are not fighting them but fighting crime, hence we want to join hands with them,” said the police boss, who joined the police station this year in May from Broadhurst Police station in Gaborone.

He said that gone are the days when police officers were feared by members of the community. Supt. Matlapeng is likeable among members of his staff and the community of Kanye. He has won the hearts of many villagers in a short period of time because of his efforts to take the police station to the people.

Under him, Sejelo Police was awarded Station Community Policing award for this year by the Botswana Police Service. “We go to the people and address their issues. As a philosopher and a perfectionist myself, I believe that community policing is the way to go. “We go to schools and speak to teachers on certain issues relevant to the students. Our clusters also visit local wards to teach parents about pressing matters pertaining to crime,” he said.

Other than stock theft, the police station has recorded relatively low crime statistics. The station covers Kanye Kgosing ward, Moshana, Gasita and Selokolela.

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Murder convict, Masilo not going down without a “fight”

Keletso Thobega

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Thabo Masilo did not cringe when Judge Abednigo Tafa found him guilty of murder this past Thursday. Masilo stood erect staring ahead as if in a trance.

There was not a mutter in the courtroom when Justice Tafa stated that Masilo had intentionally murdered former St. Joseph’s College learner Tshepang Motlhabane on 16 November 2012 in Phase 4 Gaborone. In his ruling, Tafa argued that Masilo could not claim that he was acting in self defence when he had stabbed Tshepang three times. Masilo had through his lawyer Kgosi Ngakayagae insisted that Tshepang was his lover and he had stabbed her following an altercation because she had grabbed him by the balls when he had demanded his phone and P100 he had borrowed her.

Post mortem results show that Motlhabane had three wounds and died from a vein rupture. “If it was indeed self-defence, he would have not stabbed the deceased three times in different places. It is without a doubt that the accused had come to the house with the intention to commit an offence but faced with resistence from his victim, he decided to stab her,” said the judge.
He however dismissed the robbery charge.

It remains a mystery how Masilo gained entry into the property, which had a high wall and alarm system. Curious members of the public, relatives and friends of Tshepang as well as relatives of Masilo flocked Court Room 5 of Lobatse High Court for the ruling. The courtroom was so packed that some people sat at the back on the floor.

Masilo, who has lost a lot of weight, seemed to suffer a ‘leaky bladder’ as he went to the bathroom several times, escorted by prison officers. At one point during the long ruling, Masilo stopped proceedings, and through his lawyer Ngakayagae, complained that there were certain people in the courtroom taking pictures of him.

These people were seen by him only. The ruling that was read over nearly two hours painted a sad ending for the little girl who sustained wounds above the eye, on the chest and died a day after the attack. Tshepang is said to have at one point said to a nurse and relative: A lo boleletse mama gore ke a swa (Did you tell my mother that I am dying). Information provided by medical personnel indicates that she had lost a lot of blood.

Tafa read statements by 13 witnesses including Security System officers, police officers, a forensic expert, nurse, doctor, a relative and a photojournalist. All corroborated that the girl had been attacked and had locked herself in her bedroom from her assailant, who was much later found in hiding in the house. Masilo had claimed that he and the deceased were dating and he had loaned her P100 and his Nokia phone. However, when he visited her and asked that she return the money, a fight ensued and she held him by the testicles.

This, he claimed, led to him taking a kitchen knife and stabbing her in self-defence because she did not want to let go of him. Tafa said that this version of events was questionable and noted that only the accused and deceased were in the house at the said time and it would be difficult to determine exactly what had happened. He however said that there was no doubt that Masilo had killed Motlhabane.

He also noted that Masilo’s actions showed guilt as he had hidden in the ceiling of the house when he heard Security Systems personnel breaking into the house, and had also claimed to have drunk poison. He said if it was not his intention to kill Tshepang; he would have cooperated with the security officers and asked them to help Tshepang promptly.

Following the ruling, Masilo’s lawyer Ngakayagae asked for a date to be set for submissions on extenuation, saying that they would present three witnesses. The date was set to 7 February 2019 at the Gaborone High Court.

Masilo, who is already serving 15 years for robbery and rape, appears to come from a decent home. Many of his relatives were in court to offer moral support. His mother, who appeared agitated, has been by his side from day one. Considering that the family is paying one of the best lawyers in the country, it is safe to say that money is not a problem.

Although Masilo has already been found guilty, the fight appears to be for a more lenient sentence as he faces the hangman’s noose. Outside court, different camps spoke in hushed tones discussing the ruling. The mother of the late Tshepng looked sombre and frail. It is clear that the pain has not left her.

Shying away from flashing cameras and curious glances, she briefly said she was pleased Masilo had been found guilty but refused to comment further. An unidentified family representative chipped in that they were happy with the ruling. Quizzed on how they felt about Masilo she said: “We have forgiven him because we are Christians. But we are glad that justice will be served.”

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