MDF Magazine Newsletter Issue 55 April 2018
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Autumn <strong>Issue</strong> <strong>55</strong><br />
<strong>April</strong> <strong>2018</strong><br />
R25.00 incl. VAT<br />
Cycle Challenge<br />
Muscle Riders<br />
“Walk/run for<br />
those who can’t”<br />
Suzanne Glover<br />
living with<br />
SMA<br />
"Don't be limited by your challenges.<br />
Challenge your limits"
DF<br />
<strong>Magazine</strong><br />
05 <strong>MDF</strong> notice board<br />
06 National news<br />
07 MD information<br />
11 Disability information<br />
MD INFORMATION<br />
07 Friedreich’s ataxia<br />
09 Stem cells – what are they, and could they be a potential<br />
therapy?<br />
11 SARS disability tax credits<br />
Events<br />
13 Akasia Athletic Club Fun Walk<br />
14 Telkom 947 Cycle Challenge – Muscle Riders 2017<br />
People<br />
18 Peter Neville: Charcot-Marie-Tooth disease<br />
19 Moving up in six questions: An interview with<br />
Rianna Davis<br />
20 Suzanne Glover on living with SMA Type 2<br />
22 Don't be limited by your challenges<br />
Regular Features<br />
28 The View from Down Here<br />
29 Doctor’s corner<br />
30 Sandra’s thoughts on … Uncertainties in life<br />
Research<br />
24 Potential treatment for CMT<br />
24 IBM trial at University College London<br />
25 Preliminary results from FSHD trial<br />
25 Genome editing corrects mutation in new Duchenne<br />
mouse model<br />
C O N T E N T S<br />
Published by:<br />
Muscular Dystrophy Foundation of SA<br />
Tel: 011 472-9703<br />
Fax: 086 646 9117<br />
E-mail: national@mdsa.org.za<br />
Website: www.mdsa.org.za<br />
Publishing Team:<br />
Managing Editor: Pieter Joubert<br />
Copy Editor: Keith Richmond<br />
Publishing Manager: Gerda Brown<br />
Design and Layout: Divan Joubert<br />
Cover photo of Bernadette Francois by Robert Scott<br />
Future <strong>Issue</strong>s:<br />
August <strong>2018</strong><br />
(Deadline: 29 June <strong>2018</strong>)<br />
The Muscular Dystrophy Foundation<br />
of South Africa<br />
We are a non-profit organisation that supports<br />
people affected by muscular dystrophy and<br />
neuromuscular disorders and that endeavours to<br />
improve the quality of life of its members.
From The<br />
Due to the rising costs of printing and postage, the National Office is no longer<br />
in a position to print and distribute physical copies of the magazine. It will now<br />
be available only as an e-magazine.<br />
In this issue you will read of personal stories and awareness events. As usual<br />
you will also find MD information and research articles. In order to keep our<br />
readers interested and updated, we will continue to share information and<br />
stories of interest with you. Please share your stories and let us know what you<br />
would like to read about in the magazine.<br />
Timothy Tebow, a professional baseball outfielder, was born in the Philippines<br />
to Christian missionaries. Tebow says his main goal is to live a life he will<br />
be proud of decades from now. He has started the Tim Tebow Foundation,<br />
fighting for those who can’t. He asked the following questions: What are you<br />
fighting for? What are you going to be known for? What is your legacy? Is whatever you are fighting for worth<br />
it? Are you going to stand for something in this life? When I read about his foundation it made me realize that<br />
our foundation has the same values. We want to give a message of hope to families and every person affected<br />
by muscular dystrophy. We’ve got to bring Faith, Hope and Love every day to everything we get in contact with.<br />
Share a message of hope with every single person. If we don’t do it now, when? Will you one day say that you<br />
brought about Faith, Hope and Love and it was worth it?<br />
People should focus on a person’s ability to have a positive impact on this world. We would not have been<br />
able to accomplish our mission to assist affected members without the support of caring people and generous<br />
donors over the years. We hope that you will consider becoming involved with our organisation through prayer<br />
and our fundraising initiatives to change the lives of those affected with muscular dystrophy. We will continue<br />
to do our utmost to support all people affected with muscle-wasting conditions. With your support we can make<br />
a difference!<br />
As Denzel Washington says in his book A Hand to Guide Me (Meredith Books, 2006):<br />
At the end of the day, it’s not about what you have or even what you’ve accomplished. … It’s about who you’ve<br />
lifted up, who you’ve made better. It’s about what you’ve given back.<br />
Regards<br />
Pieter Joubert<br />
gcnetwork<br />
genetic counselling • making sense of genetics<br />
What is genetic counselling?<br />
Genetic counselling is a medical service that provides you with<br />
information about genetics to help you understand the impact of<br />
a genetic condition on your life, and assist you with making<br />
informed personal and medical decisions.<br />
Genetic counsellors: Suretha Erasmus and Noelene Kinsley<br />
Website: www.gcnet.co.za<br />
Telephone: 010 595 1005<br />
Email: info@gcnet.co.za<br />
Cell phone: 082 375 1118 (Suretha Erasmus)<br />
Address: Northcliff Medical Centre, Suite 104, 1<strong>55</strong> Beyers Naude Drive, Northcliff<br />
4
Subscription and contributions to<br />
the magazine<br />
We publish three issues of <strong>MDF</strong> <strong>Magazine</strong><br />
a year and you can subscribe online<br />
to the magazine or by calling your nearest<br />
branch.<br />
If you have any feedback on our<br />
publications, please contact the<br />
National Office by e-mail at national@<br />
mdsa.org.za or call 011 472-9703.<br />
Get all the latest news on the fight<br />
against muscle-wasting conditions and<br />
the latest research updates. It is our<br />
editorial policy to report on developments<br />
regarding the different types<br />
of dystrophy but we do not thereby<br />
endorse any of the drugs, procedures<br />
or treatments discussed. Please consult<br />
with your own physician about any<br />
medical interventions.<br />
If you are interested in sharing your<br />
inspirational stories, please let us know<br />
and we'll be in touch to discuss this with<br />
you.The Foundation would love to hear<br />
from affected members, friends, family,<br />
doctors, researchers or anyone interested<br />
in contributing to the magazine.<br />
Articles may be edited for space and<br />
clarity.<br />
<strong>MDF</strong> SA database<br />
If you know people affected by muscular<br />
dystrophy or neuromuscular<br />
disorders who are not members, please<br />
ask them to contact us so that we can<br />
register them on our database. If we do<br />
not have your current e-mail and postal<br />
address, please contact your branch so<br />
that we can update your details on our<br />
database.<br />
How can you help?<br />
Branches are responsible for doing<br />
their own fundraising to assist members<br />
with specialised equipment. Contact<br />
your nearest branch of the Muscular<br />
Dystrophy Foundation of South<br />
Africa to find out how you can help<br />
with fundraising events for those<br />
affected with muscular dystrophy.<br />
Fundraising<br />
Crossbow Marketing Consultants (Pty)<br />
Ltd are doing invaluable work through<br />
the selling of annual forward planners.<br />
These products can be ordered<br />
from Crossbow on 021 700-6500. For<br />
enquiries contact the National Office by<br />
e-mail at national@mdsa.org.za or call<br />
011 472-9703.<br />
<strong>MDF</strong> ::<br />
<strong>MDF</strong> support information<br />
For more information about the Muscular Dystrophy Foundation, the benefits of<br />
being a member and details on how to become a member, call your nearest branch.<br />
CAPE BRANCH (Western Cape,<br />
Northern Cape & part of Eastern<br />
Cape)<br />
E-mail: cape@mdsa.org.za<br />
Tel: 021 592-7306<br />
Fax: 086 535 1387<br />
Address: 3 Wiener Street, Goodwood,<br />
7460<br />
Banking details: Nedbank, current<br />
account no. 2011007631,<br />
branch code 101109<br />
GAUTENG BRANCH (Gauteng,<br />
Free State, Mpumalanga, Limpopo<br />
& North West)<br />
E-mail: gauteng@mdsa.org.za<br />
Website: www.mdfgauteng.org<br />
Website: www.muscleriders.co.za<br />
Tel: 011 472-9824<br />
Fax: 086 646 9118<br />
Address: 12 Botes Street, Florida Park,<br />
1709<br />
Banking details: Nedbank, current<br />
account no. 1958323284<br />
branch code 192841<br />
Pretoria Office<br />
E-mail: swpta@mdsa.org.za<br />
Tel: 012 323-4462<br />
Address: 8 Dr Savage Road, Prinshof,<br />
Pretoria<br />
KZN BRANCH (KZN & part of<br />
Eastern Cape)<br />
E-mail: kzn@mdsa.org.za<br />
Tel: 031 332-0211<br />
Address: Office 7, 24 Somtseu Road,<br />
Durban, 4000<br />
Banking details: Nedbank, current<br />
account no. 1069431362<br />
branch code 198765<br />
General MD Information<br />
Cape Town<br />
Lee Leith<br />
Tel: 021 794-5737<br />
E-mail: leeleith@mweb.co.za<br />
Gauteng<br />
Pieter Joubert<br />
Tel: 011 472-9824<br />
E-mail: gauteng@mdsa.org.za<br />
General Support Group Gauteng<br />
East Rand<br />
Zigi Potgieter<br />
Cell: 082 499 9384<br />
E-mail: z.kerstholt@gmail.com<br />
Duchenne MD<br />
Cape<br />
Win van der Berg (Support Group)<br />
Tel: 021 <strong>55</strong>7-1423<br />
Penny Cato<br />
Tel: 021 671-8702<br />
KZN<br />
Maxine Strydom (Support Group)<br />
Tel: 031 762-1592<br />
Cell: 083 290 6695<br />
Gauteng<br />
Jan Ferreira (Support Group – Pretoria)<br />
Tel: 012 998-0251<br />
Estelle Fichardt<br />
Tel: 012 667-6806<br />
Christine Winslow<br />
Cell: 082 608 4820<br />
Charcot Marie Tooth (CMT)<br />
Hettie Woehler<br />
Cell: 084 581 0566<br />
E-mail: hettie@leefvoluit.co.za<br />
Facioscapulohumeral (FSHD)<br />
Francois Honiball<br />
Tel: 012 664-3651<br />
Barry Snow<br />
Cell: 083 66 66 270<br />
E-mail: barry.snow@worleyparsons.<br />
com<br />
Friedreich Ataxia (FA)<br />
Linda Pryke<br />
Cell no: 084 405 1169<br />
Nemaline Myopathy<br />
Adri Haxton<br />
Tel: 011 802-7985<br />
Spinal Muscular Atrophy (SMA)<br />
Zeta Starograd<br />
Tel: 011 640-1531<br />
Lucie Swanepoel<br />
Tel: 017 683-0287<br />
Spinal Muscular Atrophy (Adult<br />
SMA)<br />
Justus Scheffer<br />
Tel: 012 331-3061<br />
E-mail: justusscheffer@gmail.com<br />
5
National<br />
First of its kind outside the<br />
borders of the United States<br />
By Gerda Brown<br />
We are happy to announce that on 27 October 2017, the Muscular Dystrophy<br />
Foundation of South Africa (MDSA) awarded the status of Global Certified<br />
Duchenne Care Center to the Red Cross War Memorial Children’s Hospital in Cape<br />
Town. This certification is the first of its kind outside the borders of the United<br />
States and confirms that the Duchenne-specific patient care and services provided<br />
at this centre are provided in agreement with international standards. To retain the<br />
certification, the Red Cross Hospital must satisfy the MDSA that the agreed level of care is being maintained. We are hopeful<br />
that, with this recognition, South Africa will now have access to early therapeutic interventions as part of Duchenne clinical<br />
trials. In the past, South African clinics were not considered viable due to the perception that we had limited resources.<br />
During August and September 2016 the Muscular Dystrophy Foundation was fortunate in hosting representatives from Parent<br />
Project Muscular Dystrophy (a Duchenne-specific organisation based in the United States) to present lectures about Duchenne<br />
muscular dystrophy to our South African families and clinicians. Parent Project Muscular Dystrophy (PPMD) is recognised<br />
around the world as the leader in the Duchenne community. Because of their efforts, families affected by Duchenne have<br />
better access to state-of-the-art care information and research. This visit led to the neuromuscular service, based at Red Cross<br />
War Memorial Children’s Hospital, to apply for certification by the PPMD as a Certified Duchenne Care Center.<br />
Muscular dystrophy (MD) is the name given to a group of more than 70 different neuromuscular disorders causing progressive<br />
wasting and weakness of the muscles. Each type presents differently and with its own levels of complexity. The prognosis<br />
varies according to the type of MD and the speed of progression. Some types are mild and progress very slowly, allowing<br />
normal life expectancy, while others are more severe and result in functional disability and loss of the ability to walk. The<br />
disorders are usually inherited, with the defective gene being passed on from one generation to the next. However, MD can<br />
also occur in families where there is no prior history of the condition.<br />
Duchenne muscular dystrophy (Duchenne) is the most serious neuromuscular genetic disorder diagnosed in childhood.<br />
Because the Duchenne gene is found on the X-chromosome, it primarily affects boys. Duchenne results in progressive<br />
loss of strength and is caused by a mutation in the gene that<br />
encodes for dystrophin. Because dystrophin is absent, the<br />
muscles gradually break down. The progressive muscle<br />
weakness leads to serious medical problems, particularly<br />
issues relating to the heart and lungs. Young men with<br />
Duchenne typically lose the ability to walk between the ages<br />
of 10 and 14 years and live only into their late twenties.<br />
About the Muscular Dystrophy Foundation of South Africa (www.mdsa.org.za)<br />
The Muscular Dystrophy Foundation of South Africa is a registered non-profit organisation consisting of a National Office<br />
and three branches which operate in the nine provinces of South Africa. The Foundation was founded in 1974 by Mr and Mrs<br />
Walker, who at the time had a son affected with Duchenne Muscular Dystrophy. The Foundation was established with the aim<br />
of reaching out to other parents and families in a similar situation and to support research into this disease with the ultimate<br />
goal of finding a cure.<br />
About the Global Certified Duchenne Care Center Program<br />
Created by Parent Project Muscular Dystrophy (PPMD) in the US, the Global Certified Duchenne Care Center (CDCC)<br />
Program offers a path forward for global neuromuscular patient advocacy groups to certify Duchenne Care Centers within<br />
their own countries. Patient advocacy groups, operating within their own country and under the guidance of Parent Project<br />
Muscular Dystrophy’s Certified Duchenne Care Center Program, grant certification to local Duchenne Care Centers that meet<br />
the high standards set forth by this program. Learn more online at EndDuchenne.org/CareCenters.<br />
6
Friedreich’s Ataxia<br />
MD<br />
What is Friedreich's ataxia?<br />
Friedreich's ataxia (also called FA or FRDA) is a rare inherited<br />
disease that causes nervous system damage and movement<br />
problems. It usually begins in childhood and leads to<br />
impaired muscle coordination (ataxia) that worsens over time.<br />
The disorder is named after Nicholaus Friedreich, a German<br />
doctor who first described the condition in the 1860s.<br />
In Friedreich’s ataxia the spinal cord and peripheral nerves<br />
degenerate, becoming thinner. The cerebellum, part of the<br />
brain that coordinates balance and movement, also<br />
degenerates to a lesser extent. This damage results in<br />
awkward, unsteady movements and impaired sensory<br />
functions. The disorder also causes problems in the heart and<br />
spine, and some people with the condition develop diabetes.<br />
The disorder does not affect thinking and reasoning abilities<br />
(cognitive functions).<br />
Although rare, Friedreich’s ataxia is the most common form<br />
of hereditary ataxia. Both male and female children can<br />
inherit the disorder.<br />
What are the signs and symptoms?<br />
By the US National Institute of Neurological Disorders and Stroke<br />
Most individuals with Friedreich’s ataxia tire very easily and<br />
find that they require more rest and take a longer time to<br />
recover from common illnesses such as colds and flu.<br />
The rate of progression varies from person to person.<br />
Generally, within 10 to 20 years after the appearance of<br />
the first symptoms, the person is confined to a wheelchair,<br />
and in later stages of the disease individuals may become<br />
completely incapacitated.<br />
Friedreich's ataxia can shorten life expectancy, and heart<br />
disease is the most common cause of death. However, some<br />
people with less severe features of Friedreich's ataxia live<br />
into their sixties, seventies, or older.<br />
How is Friedreich's ataxia diagnosed?<br />
A diagnosis of Friedreich's ataxia requires a careful<br />
clinical examination, which includes a medical history and a<br />
thorough physical exam, in particular looking for balance<br />
difficulty, loss of proprioception (joint sensation), absence of<br />
reflexes, and signs of neurological problems. Genetic testing<br />
now provides a conclusive diagnosis. Other tests that may<br />
aid in the diagnosis or management of the disorder include:<br />
Symptoms typically begin between the ages of 5 and 15<br />
years, although they sometimes appear in adulthood and<br />
on rare occasions as late as age 75. The first symptom to<br />
appear is usually gait ataxia, or difficulty walking. The ataxia<br />
gradually worsens and slowly spreads to the arms and the<br />
trunk. There is often loss of sensation in the extremities,<br />
which may spread to other parts of the body.<br />
Other features include loss of tendon reflexes, especially in<br />
the knees and ankles. Most people with Friedreich's ataxia<br />
develop scoliosis (a curving of the spine to one side), which<br />
often requires surgical intervention for treatment.<br />
Dysarthria (slowness and slurring of speech) develops and<br />
can get progressively worse. Many individuals with later<br />
stages of Friedreich’s ataxia develop hearing and vision<br />
loss.<br />
Other symptoms that may occur include chest pain, shortness<br />
of breath, and heart palpitations. These symptoms are the<br />
result of various forms of heart disease that often accompany<br />
Friedreich's ataxia, such as hypertrophic cardiomyopathy<br />
(enlargement of the heart), myocardial fibrosis (formation of<br />
fiber-like material in the muscles of the heart), and cardiac<br />
failure. Heart rhythm abnormalities such as tachycardia (fast<br />
heart rate) and heart block (impaired conduction of cardiac<br />
impulses within the heart) are also common.<br />
About 20 percent of people with Friedreich's ataxia develop<br />
carbohydrate intolerance and 10 percent develop diabetes.<br />
• electromyogram (EMG), which measures the electrical<br />
activity of muscle cells,<br />
• nerve conduction studies, which measure the speed with<br />
which nerves transmit impulses,<br />
• electrocardiogram (ECG), which gives a graphic presentation<br />
of the electrical activity or beat pattern of the heart,<br />
• echocardiogram, which records the position and motion of<br />
the heart muscle,<br />
• blood tests to check for elevated glucose levels and vitamin<br />
E levels, and<br />
• magnetic resonance imaging (MRI) or computed tomography<br />
(CT) scans, tests which provide brain and spinal cord<br />
images that are useful for ruling out other neurological<br />
conditions.<br />
How is Friedreich's ataxia inherited?<br />
Friedreich's ataxia is an autosomal recessive disease,<br />
meaning individuals only develop symptoms if they<br />
inherit two copies of the defective FXN gene, one from their<br />
father and one from their mother. A person who has only one<br />
abnormal copy of the gene is called a carrier. A carrier will<br />
not develop the disease but could pass the gene mutation<br />
on to his or her children. If both parents are carriers, their<br />
children will have a 1 in 4 chance of having the disease and<br />
a 1 in 2 chance of inheriting one abnormal gene that they,<br />
in turn, could pass on to their children. About one in 90<br />
Americans of European ancestry carries an abnormal FXN<br />
gene.<br />
7
MD<br />
In 1996, an international research team identified the<br />
Friedreich’s ataxia gene on chromosome 9. The FXN gene<br />
codes for production of a protein called "frataxin." In the<br />
normal version of the gene, a sequence of DNA (labeled<br />
“GAA”) is repeated between 7 and 22 times. In the defective<br />
FXN gene, the repeat occurs over and over again – hundreds,<br />
even up to a thousand times.<br />
This abnormal pattern, called a triplet repeat expansion, has<br />
been implicated as the cause of several dominantly inherited<br />
diseases, but Friedreich's ataxia is the only known recessive<br />
genetic disorder caused by the problem. Almost all people<br />
with Friedreich's ataxia have two copies of this mutant form<br />
of FXN, but it is not found in all cases of the disease. About<br />
two percent of affected individuals have other defects in the<br />
FXN gene that are responsible for causing the disease.<br />
The triplet repeat expansion greatly disrupts the normal<br />
production of frataxin. Frataxin is found in the energyproducing<br />
parts of the cell called mitochondria. Research<br />
suggests that without a normal level of frataxin, certain cells<br />
in the body (especially peripheral nerve, spinal cord, brain<br />
and heart muscle cells) cannot effectively produce energy and<br />
have been hypothesized to have a buildup of toxic byproducts<br />
leading to what is called “oxidative stress.” It also may lead<br />
to increased levels of iron in the mitochondria. When the<br />
excess iron reacts with oxygen, free radicals can be produced.<br />
Although free radicals are essential molecules in the body's<br />
metabolism, they can also destroy cells and harm the body.<br />
Can Friedreich's ataxia be cured or treated?<br />
As with many degenerative diseases of the nervous<br />
system, there is currently no cure or effective treatment for<br />
Friedreich's ataxia. However, many of the symptoms and<br />
accompanying complications can be treated to help<br />
individuals maintain optimal functioning as long as possible.<br />
Doctors can prescribe treatments for diabetes, if present; some<br />
of the heart problems can be treated with medication as well.<br />
Orthopedic problems such as foot deformities and scoliosis<br />
can be corrected with braces or surgery. Physical therapy may<br />
prolong use of the arms and legs. Advances in understanding<br />
the genetics of Friedreich's ataxia are leading to breakthroughs<br />
in treatment. Research has moved forward to the<br />
point where clinical trials of proposed treatments are<br />
presently occurring for Friedreich’s ataxia.<br />
What services are useful to Friedreich's ataxia<br />
patients and their families?<br />
therapists, and speech therapists to help deal with some of the<br />
other associated problems.<br />
What research is being done?<br />
Researchers are optimistic that they have begun to understand<br />
the causes of the disease, and work has begun to develop<br />
effective treatments and prevention strategies for Friedreich's<br />
ataxia. Scientists have been able to create various models<br />
of the disease in yeast and mice which have facilitated<br />
understanding the cause of the disease and are now<br />
being used for drug discovery and the development of novel<br />
treatments.<br />
Studies have revealed that frataxin is an important mitochondrial<br />
protein for proper function of several organs. Yet in<br />
people with the disease, the amount of frataxin in affected<br />
cells is severely reduced. It is believed that the loss of frataxin<br />
makes the nervous system, heart, and pancreas particularly<br />
susceptible to damage from free radicals (produced when the<br />
excess iron reacts with oxygen). Once certain cells in these<br />
tissues are destroyed by free radicals they cannot be replaced.<br />
Nerve and muscle cells also have metabolic needs that may<br />
make them particularly vulnerable to this damage. Free<br />
radicals have been implicated in other degenerative diseases<br />
such as Parkinson's and Alzheimer's diseases.<br />
Based upon this information, scientists and physicians have<br />
tried to reduce the levels of free radicals, also called oxidants,<br />
using treatment with "antioxidants." Initial clinical studies in<br />
Europe suggested that antioxidants like coenzyme Q10,<br />
vitamin E, and idebenone may offer individuals some limited<br />
benefit. However, recent clinical trials in the United States<br />
and Europe have not revealed effectiveness of idebenone in<br />
people with Friedreich’s ataxia, but more powerful modified<br />
forms of this agent and other antioxidants are in trials at this<br />
time. There is also a clinical trial to examine the efficacy of<br />
selectively removing excess iron from the mitochondria.<br />
Scientists also are exploring ways to increase frataxin<br />
levels through drug treatments, genetic engineering and<br />
protein delivery systems. Several compounds that are directed<br />
at increasing levels of frataxin may be brought to clinical<br />
trials in the near future.<br />
Article online at: https://www.ninds.nih.gov/Disorders/Pa-<br />
tient-Caregiver-Education/Fact-Sheets/Friedreichs-Ataxia-<br />
Fact-Sheet<br />
Genetic testing is essential for proper clinical diagnosis, and<br />
can aid in prenatal diagnosis and determining a person’s<br />
carrier status. Genetic counselors can help explain how<br />
Friedreich's ataxia is inherited. Psychological counseling and<br />
support groups for people with genetic diseases may also help<br />
affected individuals and their families cope with the disease.<br />
A primary care physician can screen people for complications<br />
such as heart disease, diabetes and scoliosis, and can<br />
refer individuals to specialists such as cardiologists, physical<br />
8
Stem Cell<br />
Stem cells – what are they, and could they be a<br />
potential therapy?<br />
A mouse muscle fibre showing dystrophin protein<br />
(red), nuclei (blue) and a satellite cell (green). Image<br />
courtesy of Dr Bruno Doreste, University College London.<br />
Stem cells are considered to have great potential for treating<br />
numerous health conditions. We hope this article will help<br />
you understand more about stem cells, and about where<br />
research is in developing a stem cell therapy for musclewasting<br />
conditions.<br />
What are stem cells?<br />
Our bodies are made up of many different types of cells that<br />
are specialised to perform particular functions. For example,<br />
the individual fibres that make up our muscles are specialised<br />
for muscle contraction.<br />
Stem cells are distinct from other cells in our body in that<br />
they are unspecialised. They have the ability to develop<br />
into many different types of cell through a process called<br />
‘differentiation’. They are also able to self-renew, which means<br />
they can keep dividing and producing identical copies of<br />
themselves. These properties therefore make them attractive as<br />
a potential therapeutic option for muscle-wasting conditions.<br />
Stem cells are important in early life and growth, as they<br />
develop into the cells that make up all of our tissues<br />
and organs. But their role doesn’t end there. They are<br />
continually working throughout our lives to ensure we<br />
have all the cells we need. They are essential to the<br />
maintenance of tissues such as skin, gut and blood that<br />
undergo continuous turnover. They are also vital in maintaining<br />
muscle, which can be built up according to the body’s<br />
needs and can often get damaged during physical exertion.<br />
Types of stem cell<br />
By Muscular Dystrophy UK<br />
There are two main types of stem cell found naturally inside<br />
the body:<br />
• embryonic stem cells – as their name suggests, these<br />
stem cells originate from an embryo. They supply new<br />
cells to the embryo as it grows and develops into a baby.<br />
Embryonic stem cells are pluripotent, which means they<br />
can develop into any type of cell.<br />
• adult (somatic) stem cells – these not only supply new<br />
cells as a person grows but also replace cells that get<br />
damaged. Somatic stem cells are multipotent, which means<br />
they can only change into certain cell types. For example,<br />
muscle stem cells (satellite cells) specialise into muscle<br />
cells. However, research has found that some adult stem<br />
cells are more versatile than previously thought. Stem cells<br />
from blood vessels (mesoangioblasts) and even from fat<br />
tissue (adipose stem cells) are capable of becoming muscle<br />
cells under certain growth conditions (see figure 1 below).<br />
Figure 1: Satellite cells are adult stem cells found inside our muscle. They specialise into immature muscle cells called<br />
myoblasts, which fuse together to form myotubes. These myotubes align to form mature muscle fibres. This entire process,<br />
which is highly regulated, requires different signals to trigger each step.<br />
It is also possible to manufacture stem cells in the<br />
laboratory by adding a cocktail of ‘reprogramming’ factors<br />
to specialised cells such as skin cells. These specialised cells<br />
then convert to induced pluripotent stem (iPS) cells, which<br />
can subsequently be converted into any type of cell. iPS cells<br />
are similar to embryonic stem cells in this way.<br />
From a therapeutic perspective, iPS cells can be produced<br />
from a patient’s own cells, which makes them useful<br />
tools for studying the treatment of human diseases. And,<br />
because they’re made from a person’s own cells, they can be<br />
used to create cells that can be transplanted back into the<br />
person without the risk of immune rejection. For example,<br />
iPS cells from someone with a genetic muscle-wasting<br />
condition could be genetically ‘corrected’ outside of the body<br />
using a gene therapy or genome-editing approach, allowed to<br />
differentiate into healthy muscle cells, which are then<br />
transplanted back into the body (see figure 2 below).<br />
9
Stem Cell<br />
Figure 2: Making healthy muscle cells from patient skin cells<br />
Stem cells and muscle wasting<br />
Stem cells found in skeletal muscle are called satellite cells<br />
and their function is disrupted in some muscle-wasting<br />
conditions. This is because the muscle gets damaged<br />
easily and there is a continuous cycle of muscle<br />
degeneration and regeneration. The satellite cells<br />
cannot keep up with the demand for new muscle fibres and<br />
eventually become exhausted and ineffective, which<br />
ultimately leads to muscle wasting.<br />
The underlying genetic mutation can also directly affect<br />
satellite cell function. For example, the mutation that causes<br />
facioscapulohumeral muscular dystrophy (FSHD) leads to<br />
the activation of a protein called DUX4, which is toxic to<br />
satellite cells. The loss of dystrophin in Duchenne muscular<br />
dystrophy may also affect the division of satellite cells.<br />
Stem cell therapy<br />
Stem cell therapy is the transplantation of stem cells into<br />
patients, using either their own cells or those of a donor.<br />
This therapy has the potential to benefit people with musclewasting<br />
conditions, as it could encourage the growth of new<br />
muscle fibres in damaged muscle. However, to date, no stem<br />
cell therapy has been proven effective in treating musclewasting<br />
conditions. There have been few clinical trials, which<br />
have unfortunately been unsuccessful. One of the main<br />
reasons is the difficulty in delivering these cells to the<br />
muscle.<br />
Researchers need to overcome several challenges before<br />
stem cell therapy could become an approved treatment for<br />
people with muscle-wasting conditions. These include:<br />
• growing large volumes of stem cells in the laboratory,<br />
without losing their regenerative properties<br />
• finding a suitable delivery mechanism, so that the stem<br />
cells reach all of the affected muscle<br />
• improving the integration of stem cells into muscle<br />
(engraftment), so that they can successfully make new<br />
muscle cells<br />
• preventing the body’s immune system from rejecting the<br />
transplanted stem cells.<br />
Transplanting a patient’s own stem cells is one way to<br />
reduce the risk of immune rejection. However, for genetic<br />
conditions such as muscular dystrophy, the underlying<br />
genetic mutation would still affect these cells and they may<br />
not function as well as stem cells from a healthy person. This<br />
means that a combination of gene and cell therapy may be<br />
required, by genetically correcting the stem cells in the<br />
laboratory before transplantation.<br />
Alternatively, researchers could use donor or embryonic stem<br />
cells. However, as with an organ transplant, there’s a risk of<br />
immune rejection of the introduced cells. In this situation,<br />
there would need to be careful matching of the donor, and<br />
the recipient may need to take immunosuppressive drugs.<br />
On the Internet, you may come across clinics around the<br />
world offering stem cell therapies; it’s important to remember<br />
that almost none of these are approved. There is currently<br />
only one stem cell therapy approved by the US Food and<br />
Drug Administration (FDA), which targets certain blood<br />
disorders. The European Medicines Agency (EMA) has also<br />
approved one that helps to repair part of the eye after injury.<br />
It is extremely important to test investigational products such<br />
as stem cell therapies in clinical trials and for regulators to<br />
assess them. This ensures the safety of patients, by only<br />
using drugs or treatments that are effective.<br />
Future research<br />
Although there is a lot of ongoing stem cell research for<br />
muscle-wasting conditions, there is no consensus over<br />
which type of stem cell has the most potential as a therapy.<br />
Researchers are investigating a number of different types of<br />
stem cell, and each has its own pros and cons.<br />
Satellite cells – which are found naturally inside the muscle<br />
– might seem an obvious choice for a stem cell therapy but<br />
there are a number of issues with them. When grown outside<br />
the body, satellite cells lose their regenerative capacity and<br />
so do not form large amounts of muscle when transplanted.<br />
They also rely on the host muscle environment to function<br />
properly, so they may only have limited effectiveness in a<br />
dystrophic muscle.<br />
At a recent scientific workshop in Paris, international experts<br />
discussed cell therapy for muscle-wasting conditions, and<br />
how to move the field forward. This important meeting was<br />
organised and hosted by the French muscular dystrophy<br />
association, AFM-Téléthon, with some financial contribution<br />
from Muscular Dystrophy UK and Action Duchenne. When<br />
the scientific report is available, detailing outcomes from the<br />
meeting, we will write a lay summary for you.<br />
Article from the Research section of the Muscular Dystrophy<br />
UK website at: http://www.musculardystrophyuk.org/<br />
progress-in-research/news/<br />
10
Disability<br />
Have a disabled child?<br />
Here’s how to get SARS disability tax credits<br />
(Reprinted from the website of parent24) By Carin Bevan<br />
Disclaimer: This article is aimed at providing general<br />
information only, and should not be seen as financial<br />
or tax advice. For advice about your family’s specific<br />
circumstances and tax claims, please consult SARS<br />
or a tax consultant that is registered with the South<br />
African Institute of Tax Professionals (SAIT).<br />
If you have a child with a disability, you’ve probably<br />
felt the pinch of those extra medical and educational<br />
expenses. But did you know that you could deduct<br />
some of those expenses from your tax?<br />
Who may claim the SARS disability benefits?<br />
In order to qualify for SARS’ disability tax credits, your<br />
child’s condition has to meet certain criteria.<br />
SARS sees a disability as a specific impairment that<br />
has a significant effect (or limitation) on your daily life.<br />
• This could be a physical, sensory (visual or hearing),<br />
communication, intellectual, or mental impairment.<br />
• The condition has to be long term, in other words<br />
likely to last for more than one year.<br />
• The condition must have been confirmed by<br />
a relevant, registered medical practitioner.<br />
• The condition must meet SARS’ specific minimum<br />
criteria (found on this form).<br />
• If the effects of the condition remain moderate to<br />
severe even after the maximum amount of<br />
treatment or therapy, SARS considers it a<br />
disability. But if treatment does have some<br />
effect, it could be seen as a physical impairment<br />
rather than a disability. In this case, you may still<br />
qualify for tax credits, though not to the same extent.<br />
Let’s look at some examples. If your child was<br />
diagnosed with Down syndrome, you don’t<br />
automatically qualify for tax benefits. This is because<br />
the condition in itself does not impact her daily life and<br />
abilities. However, the physical impairments, speech<br />
impediments or intellectual disabilities associated with<br />
the syndrome may qualify.<br />
Another example: if your child has a visual impairment,<br />
but a pair of good glasses helps him function with only<br />
mild limitations, SARS considers his condition as a<br />
physical impairment and not a disability. But if glasses<br />
or therapy have no effect and he still struggles to<br />
perform basic tasks that could be a disability.<br />
What are these benefits?<br />
There are two parts to the tax benefits: an additional<br />
medical expenses tax credit, and a deduction of<br />
expenses directly related to the disability.<br />
Additional medical expenses tax credit<br />
There are limits to how much money taxpayers can<br />
claim back for medical expenses. When one of your<br />
dependents has a disability, the amount you can claim<br />
back is higher – not just for your child with the disability,<br />
but for the entire family. This could mean a significant<br />
refund at the end of the tax year.<br />
Expenses directly related to disability<br />
You can also deduct a portion of expenses directly<br />
related to your child’s disability from your total taxable<br />
income.<br />
These expenses could include salaries for<br />
carers; training courses for parents; the purchase,<br />
insurance and maintenance of aids and prosthetics;<br />
alterations to your home or car to accommodate<br />
your child’s special needs; the training and care of<br />
service animals; specialised therapy and much more.<br />
If your child has special educational needs, there are<br />
a lot of possible deductible expenses. For example:<br />
• School fees — If your child goes to a special<br />
education school, you could deduct anything above<br />
the amount that you would have paid for your<br />
neighbourhood school.<br />
• Travel costs — If the closest special education school<br />
is more than 10 km from your home, you might be<br />
able to claim travel expenses.<br />
• Private tutors or facilitators — If your child needs a<br />
facilitator, these costs could also be deducted.<br />
SARS has published a long list of qualifying<br />
expenses.<br />
It’s important to remember that each child’s case is<br />
unique, and that tax law can get very complex. Just<br />
because something is on SARS’ list doesn’t mean you<br />
can automatically claim it: it has to be directly relevant<br />
to your child’s case. The opposite is also true: just<br />
because something is not on the list doesn’t mean you<br />
can’t claim it. You can deduct anything that SARS sees<br />
as essential to your child’s condition.<br />
11
How do you claim?<br />
Step 1: Complete the form<br />
Download form ITR-DD and take it to a registered medical<br />
practitioner qualified to treat your child’s disability. If<br />
you’re not sure who to speak to, ask your family doctor<br />
or paediatrician for a referral. Do keep in mind that you<br />
may need to pay a fee to get your form completed.<br />
If your child’s disability is confirmed as permanent or<br />
long term, you only need to renew this form once every<br />
five years. If it is seen as temporary, you’ll need a new<br />
one every year.<br />
Keep the form in a safe place. You won’t automatically<br />
submit it to SARS, only when it is required as part of<br />
an audit.<br />
Step 2: Fill in your tax form<br />
When the next tax filing season arrives, you’ll find these<br />
questions on your form:<br />
“Are you, your spouse or any of your qualifying children<br />
a person with a disability?”<br />
“If ‘Yes’, has the disability been confirmed by a duly<br />
registered medical practitioner as prescribed?”<br />
If you’re confident that your paperwork is in order, tick<br />
yes. On efiling, your form will now include the relevant<br />
fields where you fill in your deductions.<br />
Remember:<br />
1. Get a tax specialist<br />
While the process may seem straightforward, it’s not<br />
always the case. “We are finding that SARS is becoming<br />
more and more sticky about claims,” warns SAIT<br />
registered tax consultant Liza Southern. A good tax<br />
specialist can help you keep your claims relevant and<br />
above board, make sure your paperwork’s in order, and<br />
help you deduct expenses you otherwise wouldn’t have<br />
thought of.<br />
2. All paperwork must be in the tax claimer’s name<br />
“Make sure that all medical documents (receipts and<br />
invoices) are in the name of whoever is claiming,”<br />
advises Liza. In other words, if you’re the one<br />
claiming an expense, make sure the invoice is not in<br />
your spouse’s name.<br />
3. Keep all receipts<br />
Keep receipts for your entire family’s out-of-pocket<br />
medical expenses. Remember, you get the additional<br />
medical expenses tax credit for you and all your<br />
dependants, not just for your child with the disability!<br />
4. Keep records<br />
Keep a detailed record of your expenses. If you’re<br />
going to claim travel expenses, for example, you’ll have<br />
to keep accurate records of kilometres.<br />
5. You may be able to claim retrospectively<br />
This means that if you’ve had medical expenses<br />
related to your child’s disability in previous tax years but<br />
perhaps didn’t know about the tax benefits, you could<br />
claim back for up to three previous years as well. But,<br />
warns Liza, you’ll still need the ITR-DD form for those<br />
three years, which means you’ll have to get a specialist<br />
to fill in the form retrospectively.<br />
Article online at: http://m.parent24.com/parent24/Family/Finance_Legal/have-a-disabled-child-heres-how-toget-sars-disability-tax-credits-20170905<br />
Suppliers of Medical<br />
Equipment<br />
CE Mobility<br />
Phone: 0860 236624<br />
Johannesburg, Cape Town, Durban,<br />
Port Elizabeth, Pretoria & Rivonia<br />
Website: www.cemobility.co.za<br />
Impact Medical Supplies<br />
Phone: 011 469-1750<br />
E-mail: impactmed@worldonline.<br />
co.za<br />
Website: www.impactmedical.co.za<br />
Clinical Emergencies<br />
Phone: 011 443-9093<br />
E-mail: clinical@icon.co.za<br />
Website: www.clinicalemergencies.<br />
co.za<br />
Solutions Medical<br />
Phone: 021 592-3370<br />
Website: 12 www.wheelchairs.co.za<br />
Medmedical<br />
Phone: 011 640-5262<br />
Website: www.medmedical.co.za<br />
Medop cc<br />
Phone: 011 827-5893/4/5<br />
Website: www.medop.co.za<br />
Wheelchairs on the Run (Pty) Ltd<br />
Phone: 011 9<strong>55</strong>-7007<br />
Website: www.wheelchairs-ontherun.<br />
co.za<br />
Radical Mobility<br />
Phone: 011 664-6069<br />
E-mail: www.radicalmobility.com<br />
Hands on Lifts (Pty) Ltd<br />
Phone: 011 918-7060/1<br />
E-mail: lynn@handsonlifts.co.za<br />
Website: www.handsonlifts.co.za<br />
Chairman Industries<br />
Phone: 011 624-1222<br />
Website: www.chairmanind.co.za<br />
Flybrother SA<br />
Phone: 011 425-4300<br />
Cell phone: 084 777 5105<br />
Website: www.flybrothersa.co.za<br />
Jessen Dakile (Pty) Ltd<br />
Phone: 011 793-6260<br />
Website: www.jessendakile.co.za<br />
Sheer Mobility<br />
Phone: 021 <strong>55</strong>2-<strong>55</strong>63<br />
Cell phone: 082 926 5414<br />
Website: www.sheermobility.co.za<br />
Shonaquip<br />
Phone: Cape Town 021 797-8239<br />
Phone: Pretoria 012 665-1211<br />
Phone: Port Elizabeth 079 524-4350<br />
E-mail: nina@shonaquip.co.za<br />
Website: www.shonaquip.co.za<br />
Botlhale Ke Katlego Trading (Pty) Ltd<br />
Phone: 083 424 7231<br />
Website: www.bkktrading.co.za
“Walk/run for those who can’t”<br />
Getting active to raise funds and awareness for people living<br />
with neuromuscular disorders<br />
By Anri Human<br />
What began as a casual conversation<br />
during a breakfast run to assist<br />
children living with neuromuscular<br />
disorders culminated in a full-blown<br />
fundraising project. Initiated by Anri<br />
Human and Naomi Janse van<br />
Rensburg and with the keen support<br />
of the executive committee of the<br />
Akasia Athletic Club and the club<br />
members, the project “Walk/run for<br />
those who can’t” was born.<br />
Members of the Akasia Athletic Club<br />
were asked to raise funds for the<br />
Muscular Dystrophy Foundation<br />
Gauteng by asking others to sponsor<br />
them per kilometre (when running<br />
the Bestmed Tuks race on 17<br />
February) or to donate an amount<br />
to this worthy cause. The <strong>MDF</strong><br />
is a non-profit organisation that<br />
provides support to people<br />
living with neuromuscular disorders,<br />
and the <strong>MDF</strong> Gauteng branch is<br />
responsible for members with<br />
neuromuscular disorders in<br />
Gauteng, North West, Mpumalanga,<br />
Limpopo and Free State. Therefore,<br />
the needs of these members<br />
regarding specialised equipment<br />
and motorised wheelchairs are<br />
numerous, but the resources are<br />
very limited.<br />
Akasia club supported this as their<br />
social responsibility project for<br />
<strong>2018</strong>, and in the process I realised<br />
that the club members and people<br />
in the northern side of Pretoria have<br />
huge hearts! The Akasia club usually<br />
makes a donation to a selected<br />
charity on an annual basis, and this<br />
year the executive committee,<br />
under the leadership of Pieter Luyt<br />
and Tommy Breedt, decided to<br />
donate R20 000 to <strong>MDF</strong> Gauteng.<br />
Over and above this donation, 27<br />
Akasia club members worked<br />
really hard and raised an additional<br />
amount of approximately R16 000<br />
through sponsorships, EFT and<br />
cash payments.<br />
After many hours of hard work,<br />
the day finally arrived! The Tuks<br />
Bestmed race at the High<br />
Performance Centre of the<br />
University of Pretoria took place<br />
on Saturday, 17 February. On race<br />
day it was great seeing so many<br />
runners wearing the blue T-shirts<br />
with the slogan “Walk/run for those<br />
who can’t”, with the red <strong>MDF</strong> and<br />
green Akasia logos.<br />
Some of the Akasia club members<br />
ran with their club tops but with an<br />
<strong>MDF</strong> logo pinned to the shoulder<br />
in order to raise awareness for this<br />
cause. Some of the children with<br />
neuromuscular disorders, their<br />
parents, Pieter Joubert, Robert Scott<br />
and Mulanga Kharidzha of <strong>MDF</strong><br />
Gauteng joined us for the event.<br />
Interacting with other athletes and<br />
getting to know some of the staff<br />
and members of <strong>MDF</strong> Gauteng,<br />
including little Lian van Eyk and his<br />
parents, who completed the 10 km<br />
race, was a highlight. It was such a<br />
joy to see Lian’s beaming face, although<br />
his parents did most of the<br />
hard work.<br />
A word of thanks to the <strong>MDF</strong><br />
members who distributed information<br />
leaflets and magazines on the<br />
day to athletes and others attending<br />
the event. Education is power, and if<br />
we can make the public more aware<br />
of neuromuscular disorders, the war<br />
is halfway won. We believe that we<br />
did raise some awareness since<br />
other clubs also showed interest in<br />
this fundraising event, and we trust<br />
that the money raised can assist in<br />
making life better for many with<br />
neuromuscular disorders.<br />
Thank you to each and every one<br />
who contributed, in whichever way,<br />
to make this day a success. No<br />
contribution went unnoticed. These<br />
acts of kindness reminded me of<br />
the following words by Anne Frank:<br />
“How wonderful it is that nobody<br />
need wait a single moment before<br />
starting to improve the world.”<br />
For a small club like Akasia, with<br />
fewer than 70 members, this was<br />
really a wonderful achievement.<br />
Thank you to every member of the<br />
club who improved the world of<br />
children living with neuromuscular<br />
disorders. I am proud to be part<br />
of this club and to be associated<br />
with the wonderful people from the<br />
<strong>MDF</strong>.<br />
Lastly, we would like to challenge all<br />
other running clubs to support this<br />
initiative or to host their own events<br />
to raise money for the <strong>MDF</strong>.
Events<br />
Telkom 947 Cycle Challenge<br />
Muscle Riders 2017<br />
By Robert Scott<br />
The morning of Sunday, 19 November 2017 had<br />
begun. It was still dark, but we were all making<br />
our way to the big event of the day. The time<br />
had come to show everyone what the Muscle<br />
Riders were made of!<br />
This day marked a notable journey for a young<br />
boy named Ludick Fouche, 8 years old and<br />
affected with Duchenne muscular dystrophy. He<br />
was to be pulled in a chariot for 94.7 km with<br />
Angelos Frantzeskos at the helm, flanked by a<br />
wall of other Muscle Riders. The trip was not<br />
going to be easy, but this dynamic duo had a<br />
spirit that could not be broken.<br />
The Muscle Riders were ready, Angelos and<br />
the chariot were ready, and most of all our little<br />
champion Ludick was ready.<br />
Everyone watched the clock, and at 8:16 am the<br />
Muscle Riders took off!<br />
14<br />
We watched as they disappeared into the<br />
distance, and then we turned our attention to<br />
our phones, on which we could carefully track<br />
the riders’ progress as the race went on.<br />
At midday we made our way to the finish line to<br />
welcome our heroes home.<br />
Over the hill they came, including Angelos and<br />
Ludick with the Muscle Riders surrounding<br />
them.<br />
Applause rang through Riversands Commercial<br />
Park as they crossed the finish line in a time of<br />
4 hours and 32 minutes, the very first chariot<br />
across the line. They had done it!<br />
We could not be more proud of the Muscle<br />
Riders of 2017, and our hearts are full of pride<br />
for everything that was achieved.<br />
Thank you to all the Muscle Riders – we could<br />
not have done it without you.
Events<br />
15
FUNKYTOWN,<br />
Jeffreys Bay<br />
By Hilton Purvis<br />
The town of Jeffreys Bay is home of the best<br />
right-hand surf break in the world! The village lies<br />
80 km west of Port Elizabeth midway between the<br />
Gamtoos and Kromme rivers, and the two estuaries<br />
of the Kabeljous and Seekoei rivers. International<br />
surfers flock to catch the legendary waves at<br />
surfing spots named Kitchen Window, Tubes,<br />
Super Tubes, Point and Albatross, each possessing<br />
its own unique magic.<br />
In this, a paradise of sunshine, aloes, dolphins,<br />
shells, perfect points and classic reefs, surfers<br />
and others who found it hard to leave such an<br />
idyllic spot have turned Jeffreys Bay into a<br />
year-round fun place to be. Jeffreys Bay is the home<br />
of thriving surf shops, hand-crafted leather shoes<br />
and shell art industries. The surf culture clothing<br />
shops are synonymous with Jeffreys, and all their<br />
clothes depict scenes in the Bay. Jeffreys is also<br />
the hub of the calamari industry of the Eastern Cape<br />
and is thus in the fortunate position of being able to<br />
supply visitors with this delicacy in abundance.<br />
16<br />
Gotta make a move to a town that's right for me<br />
Town to keep me movin'<br />
Keep me groovin' with some energy<br />
Well, I talk about it, talk about it<br />
Talk about it, talk about it<br />
Talk about, talk about<br />
Talk about movin'<br />
Gotta move on<br />
Won't you take me to<br />
Funkytown<br />
Gotta make a move to a town that's right for me<br />
Town to keep me movin'<br />
Keep me groovin' with some energy<br />
Well, I talk about it, talk about it<br />
Talk about.<br />
Lipps Inc. in their 1979 song "Funkytown"<br />
above might have been describing our desire<br />
to travel and explore, or they might have been<br />
describing the town of Jeffreys Bay. With this in mind<br />
it comes as little surprise that one should encounter<br />
self-catering accommodation named FunkyTown<br />
in the middle of this rather unusual Garden Route<br />
town. What is surprising is that FunkyTown is not<br />
only wheelchair accessible but also furnished from<br />
what looks like an IKEA interior decor catalogue!<br />
Nestled within the little streets near the centre of the<br />
town, this clean, ultramodern, minimalist establishment<br />
offers a communal kitchen, dining and lounge<br />
areas with an external pool deck, and, as with most<br />
tourist businesses these days, free WiFi.<br />
The ground-floor wheelchair accessible room<br />
is spacious and well appointed with a small<br />
kitchenette, work area and large, accessible en suite
athroom with a roll-in shower. Access from the<br />
secure grassed parking area and into the building is<br />
manageable with assistance, but once inside<br />
everything is perfectly level and accessible.<br />
If you are looking to explore the town of Jeffreys Bay<br />
or require a springboard into Port Elizabeth or the<br />
Addo Elephant National Park, FunkyTown should be<br />
on your shortlist of accommodation enquiries.<br />
FunkyTown, Jeffreys Bay<br />
Cell: +27 (0)76 625 0816<br />
Landline: +27 (0)42 293 3860<br />
GPS: S 34.051504; E 24.921219<br />
Website: www.funkytown.co.za<br />
E-mail: info@funkytown.co.za<br />
ACCESSIBLE HOLIDAY ACCOMMODATION<br />
The following establishments offer more wheelchair accessible accommodation which has been used and<br />
evaluated by a member of the <strong>MDF</strong>. If you have stayed at a venue and found the accommodation to be<br />
wheelchair accessible, please let us know so that we can add it to our database.<br />
Addo Elephant National Park<br />
www.sanparks.co.za/parks/addo/<br />
Cornerway House, Plettenberg Bay<br />
info@cornerwayhouse.co.za<br />
Excelsior Manor Guesthouse, Robertson<br />
www.excelsior.co.za<br />
FunkyTown, Jeffreys Bay<br />
www.funkytown.co.za<br />
Gubas de Hoek, Robertson<br />
www.gubas-dehoek.com<br />
Makaranga Garden Lodge, Kloof, Durban<br />
www.booking.com/hotel/za/makaranga-gardenlodge.en-gb.html<br />
Mountain Zebra National Park<br />
www.sanparks.co.za/parks/mountain_zebra/<br />
Rocherpan Nature Reserve<br />
www.capenature.co.za/reserves/<br />
Storms River Mouth<br />
www.sanparks.co.za/parks/garden_route/camps/<br />
storms_river/default.php<br />
West Coast National Park<br />
www.duinepos.co.za/<br />
17
People<br />
‘It was a very emotional day’<br />
Peter Neville on volunteering at the Cambridge Town and Gown<br />
Peter Neville, 40, from Newmarket, has Charcot-<br />
Marie-Tooth disease (CMT). He and his partner<br />
Tracie say that they volunteer for Muscular<br />
Dystrophy UK at the Cambridge Town and Gown<br />
10k run because they want to “give something back”<br />
after receiving support from the advocacy team.<br />
He said: “I was diagnosed with CMT in February last<br />
year. I went to the GP with what I thought was carpal<br />
tunnel syndrome years ago and had an operation for<br />
it, but I carried on getting the symptoms. I got sent to<br />
Addenbrook’s hospital for tests and then I was sent<br />
to a neurologist, who said to me straight away that<br />
she suspected I had CMT.<br />
“Looking back, I had all the classic symptoms<br />
before, but I’d never picked up on them. I was<br />
always clumsier than everyone else as a child. The<br />
neurologist later confirmed it was CMT.<br />
She told me that it wasn’t life-shortening but it<br />
was life-changing, and suggested that I speak to<br />
Muscular Dystrophy UK straight away for help.<br />
I called the advocacy team, who advised me to<br />
take things one step at a time and told me what<br />
they could do for me. They managed to get me a<br />
neuromuscular care assistant and an occupational<br />
therapist, which really helped.<br />
“There has been a significant deterioration in<br />
my condition since then. Things sped up quite<br />
quickly over the last 12 months. I used to do a lot of<br />
fishing and I find it much harder to do now because<br />
my mobility is more limited. I had a manual car but<br />
I’ve had to change it for an automatic because it was<br />
too painful to drive.<br />
“I stayed in contact with the advocacy team, and they<br />
wrote to the housing association when we needed a<br />
new place because there wasn’t enough room for a<br />
stairlift where we were living. It’s great to have that<br />
support there for you on the whole journey, from the<br />
moment of diagnosis to dealing with problems that<br />
come up later.<br />
“My partner and I volunteered at last year’s<br />
Cambridge Town and Gown as marshals because<br />
we really wanted to give something back. It was a<br />
very emotional day. There was a child participating<br />
who was blind and was running with his carer. When<br />
you see something like that it makes you realise how<br />
giving people can be. I can’t run, and he can’t see,<br />
but there he was there raising money for people that<br />
he wanted to help.<br />
“People could see me there in the wheelchair and I<br />
think it made them realise how much what they were<br />
doing was helping people like me. It was a really<br />
good atmosphere. We’re looking forward to doing it<br />
again this year – I’m just hoping it doesn’t rain this<br />
time!”<br />
Article online at: http://www.musculardystrophyuk.<br />
org/your-stories/it-was-a-very-emotional-day-peterneville-on-volunteering-at-the-cambridge-town-andgown/<br />
18
People<br />
Moving Up in six questions:<br />
An interview with Rianna Davis<br />
Rianna Davis, 25, has Congenital muscular<br />
dystrophy (CMD). In February 2017, after leaving<br />
university due to difficulties with disability support,<br />
she took part in Muscular Dystrophy UK’s work<br />
experience project Moving Up. Rianna interned<br />
with the Events and Campaigns teams and also<br />
became a spokesperson for the charity, appearing<br />
on BuzzFeed, London Live and speaking in<br />
Westminster about her experiences.<br />
Moving Up interviewed Rianna about her experiences<br />
on the project:<br />
Best part of the placement<br />
All of it!<br />
I’ve particularly enjoyed interacting with people and<br />
the variety of the work. I’ve never been bored.<br />
And the least expected?<br />
I was given an increase in responsibility after one<br />
staff member had time off work. It was quite a step<br />
up and I didn’t realise how much work it is to stay on<br />
top of everything!<br />
Anything you’ve found challenging?<br />
All of it! But in a good way.<br />
When I first came here everything was out of my<br />
comfort zone. I just went for it and asked for help<br />
when I didn’t understand something.<br />
How has the placement helped you with regards to<br />
your future career?<br />
I’m definitely more confident. I have more office<br />
based skills like organisation skills.<br />
Also, I’ve learnt more about disability rights and<br />
the help and support I am entitled to. I am more<br />
aware of something happening to me that shouldn’t<br />
because of my disability and how to deal with it. I’ve<br />
taken part in disability rights employment training<br />
and understand now it’s not just me who doesn’t get<br />
replies to applications.<br />
Advice for someone considering the placement<br />
Just go for it! If you get the opportunity, take up a<br />
split placement between departments. I got to see<br />
the fundraising side and the campaigns side.<br />
Describe the placement in a word<br />
Life-changing [can I say that or does it count as<br />
two?]<br />
Article online at: http://www.musculardystrophyuk.<br />
org/your-stories/moving-up-in-five-questions-an-interview-with-rianna-davis/<br />
19
People<br />
‘I’ve always liked to keep busy<br />
and keep moving’ – Suzanne Glover<br />
on living with SMA Type 2<br />
Suzanne Glover, 24, from County Down, was<br />
diagnosed with SMA Type 2 when she was two<br />
years old. She is a student at Ulster University,<br />
doing a PhD that examines how carers cope with<br />
the challenges of helping people with Duchenne<br />
muscular dystrophy, another muscle-wasting<br />
condition.<br />
She said: “Having SMA is simply life as I know it.<br />
When I was first diagnosed, my mum struggled to<br />
lose the image of the little girl running around in a<br />
party dress. But, over time, we met more families<br />
with SMA and it soon became a new image. One<br />
where a little girl, with a wheelchair called ‘whizzy’<br />
and a fearless attitude defied every challenge.<br />
“It turned out that I was still running around, but it<br />
was just a different kind of running around because<br />
I was in a wheelchair. I still caused the same amount<br />
of havoc!<br />
“Being diagnosed with SMA means that you have<br />
to fight for a lot of things. You have to fight for your<br />
independence.<br />
“Initially, my care package for my undergraduate<br />
degree was turned down for being too expensive<br />
because I needed 24 hour care. It took a lot of<br />
determination to change that, but I got there in<br />
the end. It’s important that people know they have<br />
to keep trying, otherwise they can miss out on<br />
opportunities.<br />
“At the moment I’m studying for my PhD, which<br />
takes up a lot of my time, but I’ve always liked to<br />
keep busy and keep moving. I’d like people to know<br />
that the condition doesn’t affect my mind.<br />
“I’m thankful that SMA gives me the drive to<br />
overcome and achieve.<br />
“The chest infections and the battles to get what I<br />
need from health and social care are tough, but I<br />
believe there is a true spirit that most people with<br />
SMA carry. This spirit gives you determination, focus<br />
and a bright personality. In my case, there’s also<br />
mum behind me, supporting me in the direction I<br />
want to go.”<br />
Article online at: http://www.musculardystrophyuk.<br />
org/your-stories/ive-always-liked-to-keep-busy-andkeep-moving-suzanne-glover-on-living-with-smatype-2/<br />
20
People<br />
"Don't be<br />
limited by<br />
your<br />
challenges.<br />
Challenge<br />
your limits"<br />
By Bernadette Francois<br />
When I want to relax I read, listen to music and<br />
cook. I love cooking not only because I love<br />
good food but also because I find it relaxing and<br />
therapeutic – so the more frustrated I am, the more<br />
elaborate the meal!<br />
My name is Bernadette Francois and I am differently<br />
abled. I am a 45-year-old woman living with spinal<br />
muscular atrophy type 2, which affects my spine<br />
and muscles and means that I am unable to walk. I<br />
have been living with this condition since birth.<br />
I was blessed in that my family never saw my<br />
disability as abnormal, which meant that I attended<br />
“normal schools”, took part in all activities, went<br />
camping and fishing on the rocks with my dad and<br />
worked under cars with him in the backyard with my<br />
very own overalls and tools. My friends also never<br />
saw a problem with picking me up and taking me<br />
wherever they were going and my doing whatever<br />
they did.<br />
I originally lived in Durban but moved to<br />
Johannesburg over 20 years ago. The main reason<br />
for my relocating was that in the early 1990s there<br />
were just no employment opportunities for people<br />
living with disabilities.<br />
I love to learn and am always studying to upskill<br />
myself and learn new things. I studied part-time<br />
while working and have an Advanced Diploma in<br />
Project and Programme Management. I would love<br />
to complete a degree in project management.<br />
I love working in customer service. In 1999 I started<br />
working as a switchboard operator for Alexander<br />
Forbes Financial Services and after a year was<br />
promoted to frontline supervisor, managing the<br />
reception and switchboard areas for a couple of<br />
years. I had the opportunity to attend a management<br />
programme and started working in the call centre<br />
before being promoted to team leader. In 2005 I<br />
joined STANLIB as a call centre team leader and a<br />
year later became the assistant call centre manager.<br />
I currently work in recruitment and will be partnering<br />
someone in this area to start our own agency in the<br />
near future.<br />
I adopted my daughter when she was 3 years old<br />
and she is now 12. She is my passion. I cannot<br />
afford to hire a 24-hour caregiver, so my daughter<br />
has to help me sometimes. This is frustrating for<br />
me. I always need to have someone to assist me as<br />
I cannot reach all the appliances.<br />
Public transport in most areas is not accessible.<br />
Uber is great, but because I use a motorised<br />
wheelchair which is difficult to fold, I have to use<br />
Ubervan, which is not cost effective and also limits<br />
me because there are not as many vans available.<br />
I enjoy using a motorised wheelchair, especially<br />
in shopping malls, because I do not have to stand<br />
in queues for lifts, at paypoints and at banks and<br />
restaurants. More seriously, it gives me the<br />
opportunity to show that a person with a disability<br />
22
People<br />
is capable of achieving whatever they set out to do.<br />
For example, a former neighbour of mine had a<br />
disabled son who was kept indoors and not really<br />
allowed to do anything. One day the mom came and<br />
told me she was so grateful for my attitude because<br />
it had made her realise she did not need to hide her<br />
boy from the world or be so overprotective, and he<br />
was so much happier now that he could go outside.<br />
My wheelchair has to be charged every day for<br />
about eight hours. Every morning I use it to go with<br />
my daughter to school and fetch her again every<br />
afternoon.<br />
People with disabilities are the same as everyone<br />
else and should not be treated any differently. Yes,<br />
some may need assistance or accommodation,<br />
especially in the workplace, but once that is taken<br />
care of we are more than capable of performing like<br />
anyone else, or even better because we feel that we<br />
have to prove ourselves.<br />
My advice to other disabled people is to concentrate<br />
on things that your disability doesn't prevent you<br />
from doing well, and don't regret the things it<br />
interferes with.<br />
Wheelchair Bound<br />
By Bernadette Francois<br />
I was conversing with someone the other day about<br />
a friend who is on maternity leave, the official term<br />
for which is “confinement”. This got me thinking<br />
about the way users of wheelchairs are sometimes<br />
described as “wheelchair bound” or “confined to a<br />
wheelchair”.<br />
On the contrary, my wheelchair is an assistive<br />
device. It does NOT define me in a limiting way.<br />
There is no difference between what I am capable<br />
of doing and what you are capable of doing except<br />
that I can do it from the comfort of my wheelchair,<br />
wearing killer heels, while others walk around complaining<br />
about their sore feet! I can still cook, sing,<br />
dance, swim, exercise, study, work, be a wife, be a<br />
mom, be a friend. I am differently abled, NOT wheelchair<br />
“bound”.<br />
Such terms are very misleading. No wonder people<br />
feel so sorry or “inspired” by people who use<br />
wheelchairs. They think that it must be so HARD for<br />
a wheelchair user to achieve anything.<br />
10 RIGHTS VIOLATIONS<br />
OF SA’S CHILDREN<br />
WITH DISABILITIES<br />
1. EDUCATION<br />
The denial of the right to an education and an<br />
equitable education.<br />
2. ASSISTIVE DEVICES<br />
The denial of the right to assistive devices.<br />
3. EARLY CHILDHOOD DEVELOPMENT<br />
The denial of the right to quality and equitable<br />
ECD services.<br />
4. MARGINALISATION<br />
Their general marginalisation and exclusion from<br />
mainstream society.<br />
5. PROTECTION<br />
Society’s failure to protect them from abuse,<br />
neglect and exploitation.<br />
6. EXCLUSION<br />
Their exclusion from play, recreational, social and<br />
cultural activities.<br />
7. HEALTH and REHABILITATION<br />
The denial of their right to quality and equitable<br />
health and rehabilitative services.<br />
8. JUSTICE<br />
The denial of their right to access justice as the<br />
victims of crime.<br />
9. CULTURAL SUPERSTITIONS<br />
Their alienation, exclusion and stigmatisation<br />
because of cultural superstitions.<br />
10. POVERTY<br />
The denial of their right to be free from poverty.<br />
Next time you want to say “wheelchair bound”, try<br />
to think of a more positive way to describe the<br />
situation. Try not to be confined or bound by your<br />
words!<br />
Good luck!<br />
NCPD Disability Rights Violations DL Flyers March <strong>2018</strong>.indd 1 <strong>2018</strong>/03/1<br />
23
Research<br />
Published: 21/02/<strong>2018</strong><br />
A recent preclinical study has<br />
identified a potential therapeutic<br />
target for Charcot Marie Tooth disease<br />
(CMT). Although this research is in<br />
relatively early stages, it could help to<br />
develop a new treatment.<br />
Our nerve cells communicate with<br />
other cells by sending electrical signals<br />
down their long, thin axons. Within<br />
the axons are rod-like structures called<br />
microtubules, which act a bit like train<br />
tracks. They help to transport cargo,<br />
such as proteins, mitochondria and<br />
vesicles, up and down the nerve cell.<br />
This process of axonal transport is<br />
disrupted in several neurodegenerative<br />
conditions, including some types of<br />
CMT.<br />
The following four articles are from the website of Muscular Dystrophy UK.<br />
Early-stage research identifies potential treatment for CMT<br />
The microtubules in the axon can be<br />
modified by a number of proteins,<br />
which can impact how well they<br />
transport their cargoes. One of these<br />
proteins, an enzyme called histone<br />
deacetylase 6 (HDAC6), has been<br />
shown to modify microtubules, leading<br />
to impaired axonal transport.<br />
Researchers in the lab of Prof Ludo<br />
Van Den Bosch, KU Leuven, previously<br />
found that inhibiting these negative<br />
effects of HDAC6 improved axonal<br />
transport in a mouse model of CMT2F.<br />
In this new study, they investigated<br />
whether this could also be beneficial to<br />
a mouse model of CMT2D.<br />
The researchers treated the CMT2D<br />
mice with an HDAC6 inhibitor called<br />
tubastatin A. They found that this stabilised<br />
the microtubules and improved<br />
axonal transport. This improved nerve<br />
By Jenny Sharpe<br />
health, resulting in greater muscle<br />
function in the mice.<br />
Lead author of the study, Dr Veronick<br />
Benoy, said in a press release:<br />
“These results suggest that disturbed<br />
acetylation of α-tubulin may be a common<br />
hallmark of different forms of<br />
CMT. Moreover, we found a cellular<br />
link between HDAC6 and the diseaseassociated<br />
protein, indicating that<br />
HDAC6 could be linked to CMT disease<br />
pathogenesis and that selective inhibition<br />
of HDAC6 with a drug could<br />
be a beneficial treatment strategy for a<br />
wide variety of CMT patients.”<br />
This study was published in the<br />
scientific journal, Brain.<br />
Article online at: http://www.musculardystrophyuk.org/news/news/earlystage-research-identifies-potentialtreatment-for-cmt/<br />
Orphazyme sponsors IBM trial at University College London<br />
By Jenny Sharpe<br />
Published: 25/01/<strong>2018</strong><br />
Danish biotech company, Orphazyme,<br />
has assumed sponsorship of a phase 2/3<br />
trial assessing the safety and efficacy of<br />
arimoclomal for the treatment of sporadic<br />
inclusion body myositis (sIBM).<br />
The trial has sites at the University of<br />
Kansas Medical Center, USA, and the<br />
Institute of Neurology at University<br />
College London (UCL). The UCL site<br />
is expected to begin recruitment soon;<br />
we will let you know when this starts.<br />
24<br />
MDUK’s Chair, Professor Mike Hanna,<br />
is the principal investigator at the UCL<br />
trial site. He said in a press release:<br />
“Arimoclomol has strong potential<br />
benefit in patients with this disabling<br />
disease. We made the case quite strongly<br />
that arimoclomol should be properly<br />
tested in a large trial, and it is most<br />
exciting that we have now started the<br />
next step in the clinical development.”<br />
The exact cause of sIBM is not fully<br />
understood. Some research suggests<br />
that it is partly caused by certain<br />
proteins being folded incorrectly.<br />
These misfolded proteins accumulate<br />
in clumps inside the muscle, causing<br />
inflammation and muscle damage.<br />
Arimoclomal is an experimental drug<br />
that enhances the cells’ ability to<br />
re-fold proteins. This could help to clear<br />
the toxic clumps in muscles affected by<br />
sIBM. You can read more about arimoclomal<br />
on Orphazyme’s website.<br />
Article online at: http://www.musculardystrophyuk.org/news/news/orphazyme-sponsors-ibm-trial-at-universitycollege-london/
Research<br />
Acceleron announce preliminary results from FSHD trial<br />
By Jenny Sharpe<br />
Published: 31/01/<strong>2018</strong><br />
Acceleron Pharmaceuticals has<br />
announced preliminary results from its<br />
phase 2 trial testing ACE-083 in adults<br />
with facioscapulohumeral muscular<br />
dystrophy (FSHD).<br />
ACE-083 is a drug that inhibits a<br />
family of proteins that negatively<br />
regulate muscle growth (including<br />
myostatin). This approach aims to<br />
build muscle mass and improve muscle<br />
strength.<br />
The trial is split into two parts:<br />
• Part 1 is a dose-escalation study.<br />
This was designed to identify the<br />
highest and safest dose of ACE-083<br />
in adults with FSHD. Participants<br />
were divided into three dose groups<br />
(150mg, 200mg, 250mg), and received<br />
injections of ACE-083 into<br />
either the upper leg (tibialis anterior<br />
muscle), or the upper arm (biceps<br />
brachii muscle).<br />
• Part 2 is a randomised, double-blind,<br />
placebo-controlled study. This will<br />
start once Part 1 is complete. The<br />
best dose from Part 1 will be tested<br />
in Part 2.<br />
Acceleron has released data from the<br />
150mg and 200mg dose groups in Part<br />
1. Overall the drug was well tolerated<br />
and no serious adverse events occurred.<br />
Magnetic Resonance Imaging (MRI)<br />
was used to quantify the volume of<br />
the targeted upper leg or upper arm<br />
muscle. This was carried out before<br />
treatment (the baseline) and three<br />
weeks after the last injection of ACE-<br />
083.<br />
The results showed that ACE-083<br />
increased the volume of the upper<br />
leg by an average of 12.6%, and the<br />
upper arm by an average of 13.2%.<br />
The amount of fat in the leg and arm<br />
muscles also decreased.<br />
While these results are promising, they<br />
are based on a small number of patients<br />
(23 in total) and there was no placebo<br />
to compare against. We also don’t yet<br />
know what effect ACE-083 has on<br />
muscle strength and function. This will<br />
be investigated in Part 2 of the study,<br />
which is due to start in the second<br />
quarter of <strong>2018</strong>.<br />
Dr Matthew Sherman, Chief Medical<br />
Officer of Acceleron, said:<br />
“These data support our decision to<br />
advance to Part 2 of the Phase 2 trial,<br />
which we expect to initiate in the<br />
second quarter of this year. We look<br />
forward to fully exploring functional<br />
outcomes in the larger, placebo-controlled<br />
Part 2 of the trial.”<br />
Article online at: http://www.musculardystrophyuk.org/news/news/acceleron-announce-preliminary-resultsfrom-fshd-trial/<br />
Genome editing corrects mutation in new Duchenne mouse model<br />
By Betty Kao, Royal Holloway University<br />
Published: 23/01/<strong>2018</strong><br />
US scientists have created a new<br />
mouse model of Duchenne muscular<br />
dystrophy (DMD) and treated it with<br />
an improved genome editing technique.<br />
This corrected the dystrophin gene and<br />
protected the muscles from damage.<br />
While the results of this preclinical<br />
study are promising, more research is<br />
needed before genome editing can be<br />
tested in people with Duchenne muscular<br />
dystrophy.<br />
The new mouse model has a deletion<br />
of exon 50, which is one of the most<br />
common mutations causing DMD.<br />
This makes it an important tool for<br />
future DMD research. Previously, most<br />
studies have used the mdx mouse<br />
model, which has a different and less<br />
common mutation.<br />
The exon 50 deletion puts the dystrophin<br />
gene “out of frame”. This means<br />
that exon 49 can’t join up with exon 51,<br />
as the ends of these two exons don’t fit<br />
together (see below). This leads to an<br />
incomplete, faulty dystrophin protein.<br />
To put the gene back ‘in frame’,<br />
Professor Eric Olsen and his team at<br />
the Wellstone Muscular Dystrophy<br />
Research Centre, Texas, designed a<br />
CRISPR/Cas9 tool to make a single cut<br />
near exon 51. This was packaged into<br />
an adeno-associated virus (AAV) and<br />
injected into the bloodstream of very<br />
young mice with the exon 50 deletion.<br />
The CRISPR treatment corrected<br />
the dystrophin gene and increased<br />
dystrophin production in the heart and<br />
muscles of the mice. Different tests<br />
showed that the muscles were healthy<br />
and muscle strength was improved.<br />
This demonstrates that treatment in<br />
very early stages of the condition can<br />
protect the muscles from damage.<br />
When the researchers analysed the<br />
dystrophin gene of the CRISPR-treated<br />
mice, they found that it had been put<br />
in frame by two different mechanisms.<br />
One of these involved exon skipping,<br />
where exon 51 was ‘skipped’ (you can<br />
read more about exon skipping in our<br />
factsheet). This resulted in a dystrophin<br />
protein missing exons 50 and 51.<br />
The other mechanism involved the<br />
insertion of a particular DNA letter<br />
(called adenosine) next to exon 51.<br />
This allowed exon 51 to join up with<br />
exon 49, resulting in a dystrophin<br />
protein missing only exon 50.<br />
No off-target effects were found,<br />
which suggests that the Cas9<br />
scissors were cutting the DNA in the<br />
right place. However further research<br />
is still needed to confirm the long-term<br />
safety of CRISPR/Cas9 and how long<br />
its therapeutic effect might last.<br />
Prof Olson is the founder of Exonics<br />
Therapeutics, which aims to develop<br />
CRISPR/Cas9 for commercialisation.<br />
Article online at: http://www.musculardystrophyuk.org/news/news/genomeediting-corrects-mutation-in-newduchenne-mouse-model/<br />
25
BARRIERS AND CHALLENGES<br />
All people, even people with disabilities, must be able<br />
to fully participate in community life. Even though it<br />
has much improved, people with disabilities still face<br />
challenges when they are out and about.<br />
Attitudinal challenges – stereotyping of people with<br />
disabilities (e.g. Talk slowly and loudly to a person<br />
using a wheelchair)<br />
Physical challenges – stairs and high curbs blocks a<br />
person with a physical disability from entering a<br />
building
Policy challenges – work environments are not<br />
modified to enable disabled persons to do the job they<br />
are hired for<br />
Social challenges – children with disabilities are<br />
less likely to have completed mainstream schooling<br />
compared to peers without disabilities<br />
Transportation challenges – public<br />
transportation may be unavailable or<br />
at inconvenient locations
We all have those light-bulb<br />
moments, instants when everything<br />
becomes perfectly clear and understandable.<br />
They are represented really<br />
well in animated cartoons where the<br />
on-screen character sports a most confused<br />
look on their face, followed by the<br />
proverbial light bulb illuminating above<br />
their head, followed shortly thereafter<br />
by a look which says that the proverbial<br />
penny has dropped, everything<br />
has fallen into place and they fully<br />
understand what has just taken place.<br />
I love light-bulb moments, but sadly<br />
they are all too scarce in the wheelchair<br />
accessibility world. I would like to see<br />
more of them occurring, particularly in<br />
the design offices of architects, property<br />
developers, interior designers and<br />
construction site managers.<br />
We live in an era when access for the<br />
disabled should not be an issue, yet it<br />
continues to be so. This is largely due<br />
to people not having an understanding<br />
of the problem or of how to go<br />
about rectifying it. We have people<br />
designing and constructing buildings and<br />
infrastructure believing that they<br />
know what is required for disabled<br />
access, yet the reality is that they do not<br />
understand the nature of the problem in<br />
the first place. Just recently I had reason<br />
to look for accommodation in one<br />
of our most popular East Coast seaside<br />
resorts. I visited three self-catering<br />
developments, all claiming to be wheelchair<br />
accessible and all exhibiting<br />
wheelchair access signage, yet not one<br />
was accessible to anyone permanently<br />
disabled.<br />
When this anomaly was pointed out<br />
to the owners there was no light-bulb<br />
JUST SIT DOWN<br />
moment. Nothing lit up. No pennies<br />
fell into place. One owner believed<br />
that making the front door accessible<br />
qualified the place as disabled<br />
friendly, whilst another had obviously<br />
purchased a "bathroom kit" of grab rails<br />
believing that merely bolting them<br />
to the wall transformed the bathroom<br />
magically into an accessible unit. They<br />
simply did not understand what was<br />
required. Perhaps, more disturbingly,<br />
they were not particularly interested in<br />
learning what was really needed. They<br />
felt they had made an effort, and that<br />
was enough. The reality was that the<br />
only disabled people who could use<br />
their accommodation would be those<br />
who could stand and walk (albeit just<br />
one or two steps).<br />
Every once in a while, however, there<br />
is a glimmer of hope. I shared in a<br />
light-bulb moment a couple of weeks<br />
ago. I was sitting in a supposedly<br />
wheelchair accessible bathroom<br />
detailing various aspects which made it<br />
a non-wheelchair accessible bathroom.<br />
Items such as the very decorative<br />
designer hand basin (you know, those<br />
currently trendy rectangular wash<br />
trough designs), and the wall mirror<br />
mounted at a height of more than 1.5<br />
metres above the ground, and the hand<br />
shower unit that was at the opposite<br />
end of the shower to the water taps. I<br />
was trying to describe to the gentleman<br />
involved how inaccessible these<br />
items were but could see that he did not<br />
understand the issues from his<br />
standing height of 2 metres. I then<br />
gestured towards the plastic garden<br />
chair which I had retrieved from the<br />
exterior patio to use in the shower that<br />
morning, and I asked him to "just sit<br />
down" for a moment.<br />
In that moment everything fell into<br />
place. The bulb went on. The penny<br />
dropped. I could literally see that look<br />
on his face the moment he understood.<br />
Suddenly the designer hand basin was<br />
at the same level as his chin, and if he'd<br />
wished to wash his hands he needed<br />
to come up with some interesting arm<br />
contortions in order to get his elbows<br />
over the rim and hands into the basin.<br />
Suddenly that easily visible wall mirror<br />
was way above his head and completely<br />
out of view. Equally the hand shower<br />
unit and the water taps were so far apart<br />
that when he sat on a chair he could<br />
access one but not the other.<br />
In fairness to the gentleman involved,<br />
the experience must have had a<br />
profound impact, because when we met<br />
again over a cup of coffee the following<br />
morning the first thing he said to me<br />
was "just sit down"! And in an e-mail to<br />
me a couple of weeks later he referred<br />
to the "just sit down" moment.<br />
It is encounters such as these which<br />
give me hope. Hope that there are<br />
people who have the capacity to grasp<br />
the moment and realise what they<br />
have been missing all along. Hope that<br />
we might be able to reach architects,<br />
property developers, interior designers<br />
and construction site managers. I<br />
feel it is important to reaffirm those<br />
professions because they play a key role<br />
in our inclusion in the broader society.<br />
I would argue that they are perhaps the<br />
most important professions impacting<br />
on our lives, more so than the medical,<br />
health care and technology industries.<br />
Without an accessible environment we<br />
go nowhere.<br />
28
Prof Amanda Krause, MBBCh, PhD MB BCh,<br />
Medical Geneticist/Associate. Professor.<br />
Head: Division of Human Genetics.<br />
National Health Laboratory Service (NHLS)<br />
& The University of the Witwatersrand.<br />
Please e-mail your questions about genetic counselling to national@mdsa.org.za.<br />
What is Friedreich’s ataxia ?<br />
Friedreich’s ataxia (FRDA) is a disease that typically starts before the age of 25 years, but<br />
usually between the ages of 10 and 15 years. The earliest symptoms are loss of co-ordination<br />
with difficulty walking. Patients often notice the development of a very high foot arch. People<br />
with FRDA also develop slurred speech, muscle weakness and visual and hearing difficulties. The weakness often results in severe<br />
curvature of the spine (scoliosis). About two-thirds of affected individuals develop a cardiac muscle problem, termed cardiomyopathy, and about a<br />
quarter develop diabetes.<br />
FRDA is a genetic condition inherited in what is termed an autosomal recessive fashion. This means that an individual with FRDA has two faulty genes,<br />
one inherited from each parent. Their parents are unaffected as they have one faulty and one normal gene, and are so-called ‘carriers’. When parents<br />
are both carriers, each of their children has a ¼ or 25% chance of having FRDA.<br />
The majority of FRDA patients have exactly the same genetic fault – an abnormal repeat expansion in the gene. It is thus relatively straightforward to<br />
confirm the diagnosis.<br />
Although there is no cure for FRDA, there are many ways to assist people living with FRDA. It is important to try to maintain mobility as long as<br />
possible, and to prevent deformities developing with occupational therapy and physiotherapy. Scoliosis should be aggressively treated, especially as<br />
severe scoliosis can impact on heart function. Cardiomyopathy and diabetes can be managed by appropriate specialists. Hearing and visual aids are<br />
also available, if required.<br />
Many therapies for FRDA are under investigation. Many are directed at trying to improve mitochondrial function, as this is severely disturbed in<br />
FRDA. Others are trying to replace the missing protein. There have been some promising results of early trials.<br />
Why is progress so slow on finding a cure for muscular dystrophy?<br />
This is a question people with muscular dystrophy ask frequently. There are many reasons for this. Firstly, there are hundreds of different muscular<br />
dystrophies, each with different characteristics and probably each requiring its own therapy. It is hoped, however, that once significant breakthroughs<br />
are made with one type of muscular dystrophy, developments for other conditions will be achieved more quickly.<br />
Doctor’s<br />
In most muscular dystrophies the muscle structure has been abnormal since conception. Thus, by the time an individual presents with the disease it is<br />
already longstanding, and significant damage or loss of cells has occurred. In addition, it is very hard to build muscle cells after we are born, so any<br />
therapy has to be able to reach all our muscle cells and repair the damaged ones. It is unlikely that we could replace the damaged cells with new ones as<br />
they form very complex structures. Muscle cells are not easy to reach, and each muscle cell would need to be reached separately. This is rather different<br />
from a protein that is deficient in our blood, for example, where the tissue is accessible and the protein does not need to integrate into cell structure but<br />
rather is in solution.<br />
There have been some very important recent advances in therapies for muscular dystrophies.<br />
Although these are not cures, clinical trials have demonstrably slowed disease progression.<br />
Some of these have managed to partially correct the DNA message so that muscle cells<br />
which previously produced only abnormal protein now produce some functional protein.<br />
Many new developments in molecular biology offer a lot of promise regarding genetic<br />
diseases. We can only hope that this promise will be fulfilled sooner rather than later.<br />
29
Sandra’s thoughts on…<br />
......Uncertainties in life<br />
By Sandra Bredell (MSW)<br />
Why do we not notice the good and certainty around<br />
us when everything is going well? Why is it that we<br />
feel paralysed by uncertainty or, put differently, by<br />
insufficient certainty?<br />
Certainty in life does not equal the amount of security<br />
you have in place to protect you and your family. In fact,<br />
nothing is equal to certainty in life, because we cannot<br />
control what happens to us. Life is uncertain and that is<br />
a fact. Changes are bound to happen in our life.<br />
The only way that we can answer the above questions<br />
is to understand where uncertainty stems from. When<br />
we are faced with changes, we feel uncertain about<br />
things in our life and we tend to feel we are “losing<br />
control” over a situation. We start to feel anxious and<br />
panicky because we fear the unknown. This takes us<br />
back to Franklin D. Roosevelt’s famous statement that<br />
the only thing to fear is fear itself (cited by Wallace,<br />
2009).<br />
So now we start to see the pattern: changes –<br />
uncertainty – loss of control – challenges – anxiousness<br />
and panicking – fear. Then we start to fear the<br />
times when changes will happen, and the whole<br />
process starts all over again. Some will refer to this<br />
as a vicious circle, but others will be able to see the<br />
opportunity to tap into their potential, creativity and<br />
strength. Uncertainty is scary, but it is not all bad.<br />
By mastering the fears that go with it, you can turn<br />
uncertainty into a great opportunity for growth. You<br />
might also find it interesting to read Lane Wallace’s<br />
book, Surviving Uncertainty: Taking a Hero’s Journey<br />
(cf. Wallace, ©2010–2015).<br />
Let’s take the water crisis as an example. We could<br />
dwell on all the things that may happen when we<br />
reach Day Zero and how the country would struggle to<br />
recover after that. Instead, we should focus our thoughts<br />
and energy on what we can do daily, weekly and<br />
monthly to avoid Day Zero. This way, we start to feel<br />
more in control, although the uncertainty still exists.<br />
Using the “Maybe” concept or approach can help<br />
us realise that “every situation has multiple possible<br />
outcomes” and therefore that “Maybe something else<br />
could happen” (Carmen, 2017). This can change the<br />
way we think and, by helping us stay in the present<br />
moment, can put us back in the driver’s seat, so to speak.<br />
Maybe this way of looking at situations in life can ease<br />
some of the fears and stresses you face in your own life.<br />
Till next time, stay in the present, focus on what you can<br />
control, keep your faith and take care!<br />
References<br />
Carmen, A. 2017. A survival guide for uncertain times<br />
#3: Positive thinking? Blog, February 10. Psychology<br />
Today. http://www.psychologytoday.com/blog/the-giftmaybe/201702/survival-guide-uncertain-times-3-positive-thinking<br />
Wallace, L. 2009. Surviving uncertainty – a few tips.<br />
The Atlantic, May 22. https://www.theatlantic.com/<br />
national/archive/2009/05/surviving-uncertainty-a-fewtips/18044/<br />
Wallace, L. ©2010–2015. Surviving uncertainty. Lane<br />
Wallace: Writer, Speaker, Consultant. http://www.<br />
lanewallace.com/books/surviving-uncertainty/<br />
30
Cape Branch<br />
Craft Day<br />
On 21 and 28 February <strong>2018</strong> we hosted craft<br />
days for the children with muscular dystrophy.<br />
The children got to build wooden sculptures of<br />
dinosaurs, automobiles, motorbikes and the<br />
Statue of Liberty. We got our creative juices<br />
flowing and had lovely lunches from Spur and KFC.<br />
Special thanks to Mandy and Cameron for all their<br />
help crafting with the children, and for providing<br />
wonderful snack goodie bags for them to take<br />
home.<br />
31
Cape Branch<br />
Crossbow Marketing<br />
Consultants Visit<br />
Since 1988 Crossbow Marketing Consultants<br />
(Pty) Ltd has been assisting us to raise funds<br />
by designing, manufacturing, marketing and<br />
selling various products for and on behalf of<br />
the <strong>MDF</strong>. The income generated by them<br />
allows us to work towards the goals of our<br />
organisation. We truly see this partnership as<br />
essential to our survival.<br />
As a token of appreciation, we took cupcakes<br />
on Valentine’s day to the Steenberg and<br />
Milnerton office of Crossbow to thank all staff<br />
for their hard work and dedication.<br />
Pictured right: Lee Leith, showing<br />
appreciation from <strong>MDF</strong> Cape branch.<br />
Buckets of Love<br />
The Catholic Association has a 20-year history of supplying meals to those in need over the December period.<br />
The children with muscular dystrophy received these beautiful “Buckets of Love” to share with their families<br />
over the festive season.<br />
We would like to thank the Catholic Association for their support.<br />
32
Cape Branch<br />
Valentines Social<br />
This year our adult support group got together to<br />
celebrate the month of love. Thank you to everyone<br />
who joined this lovely social gathering. It was lovely to<br />
share stories about the festive season and celebrate<br />
the new year with you over a cup of coffee. It was with<br />
this lovely gathering that our <strong>2018</strong> Adult Support Group<br />
programme was launched.<br />
Pictured: Sanjay Narshi<br />
Fun at the<br />
Iziko Museum<br />
To end 2017 off with a bang we celebrated<br />
with the Duchenne boys by taking them<br />
to the Iziko Museum in Cape Town. The<br />
morning was filled exploring the fantastic<br />
and awe-inspiring exhibitions of skeletal<br />
remains of a number of different animals,<br />
even including dinosaurs! We were spoilt<br />
with goodie bags from Gift of the Givers,<br />
and each child got to take one home with<br />
them when the day was done.<br />
Members who passed away<br />
It is with great sadness that we bid farewell to Mr Shaun Joon. Our sincere condolences to his family.<br />
We will dearly miss this beautifully determined and kind gentleman, who led by shining example on how<br />
to persevere through difficult circumstances in a kind-hearted manner.<br />
It’s always too soon to say goodbye. It is with very heavy hearts that we say goodbye to Mr Craig<br />
Thomson. Our sincere condolences to his family. We loved to see his gentle smile at our Adult Support<br />
Group outings. All our love and wishes to Craig’s parents, James and Merle.<br />
Our deepest condolences to the Burton family on the passing of their son, Mogamat Noor. Noor’s<br />
gentle patience and warm smile will always be remembered. Your family is in our thoughts.<br />
33
Gauteng Branch<br />
Muscle Riders<br />
appreciation function<br />
By Robert Scott<br />
The annual Muscle Riders appreciation function was<br />
held on Saturday, 18 November 2017 at Crawford<br />
College Lonehill.<br />
The day saw the Muscle Riders from far and wide<br />
converge to meet one another, collect their race packs<br />
and of course the famous Muscle Riders cycle jersey.<br />
Thank you to each and every person who<br />
supported the 2017 cause and all the cyclists who chose<br />
to join the Muscle Riders Team.<br />
Thank you to Jason Greer, the official <strong>MDF</strong> Gauteng ambassador, who was master of ceremonies for the<br />
day, and Dee-Ann Kaaijk from Strike A Pose photography, who agreed to capture the event with some<br />
incredible photographs.<br />
Thank you to the children who took part in the annual<br />
Kiddies Ride on Saturday, 11 November. They also raised<br />
funds for children in need of motorised wheelchairs and had<br />
amazing fun doing it.<br />
The little heroes were Cayden Fourie (aged 5), Ava Rudman<br />
(5), Quintin Fouche (5), Juanru Roodt (4), Beth Van Til (3)<br />
and Dante Fourie (2).<br />
Thank you to our generous sponsors: Mitsubishi Electric,<br />
Spoormaker & Partners, Cool Tech (Pty) Ltd, Eskort Ltd<br />
Princess Crossing, Tru Juice (Pty) Ltd, Paarman Foods,<br />
CE Mobility, John Leamy Insurance, SuperSpar Florida<br />
Junction, and Hollywood Costumes.<br />
Lastly, thank you to Crawford College Lonehill and all the<br />
volunteers who helped make the day an amazing success!<br />
34
Gauteng Branch<br />
Blue Bottle Group<br />
<strong>MDF</strong> Gauteng wishes to express our deep gratitude<br />
and thanks to the Blue Bottle Group.<br />
As part of the Telkom 947 cycle challenge, their<br />
cycle team wore the Muscle Riders logo on their<br />
team kit.<br />
On Monday, 15 January <strong>2018</strong> Pieter Joubert and<br />
Robert Scott received the donation of R25,014 and<br />
there were smiles all around. Thank you Blue Bottle<br />
for your continued support and kindness towards<br />
the Foundation. It means the world to all of us.<br />
Pictured: From left to right, Robert Scott,<br />
Pieter Joubert and Jose Nascimento<br />
Annual WCCS UJ Golf Day<br />
On 8 March <strong>2018</strong> the Annual WCCS UJ Golf Day was held at Jackal<br />
Creek Golf Course. Funds raised will be used to host the annual<br />
World Congress of Chiropractic Students in Sandton. We will receive<br />
a percentage of profit from the chiropractic golf day. We would like<br />
to thank Chase Batty and other students from the University of<br />
Johannesburg for all their hard work with the golf day. This is the<br />
seventh year that we are a beneficiary of fundraising and wish to<br />
thank the WCCS UJ Chapter for caring and their continued support.<br />
Pictured: Ashley Kupfer, Devlin Randal-Smith<br />
& Micah Kupfer<br />
Pictured: Chase Batty, Robert Scott<br />
& Ami-Lee Verwey<br />
35
Gauteng Branch<br />
Tshepo Mahlosi, a<br />
very happy boy<br />
Tshepo Mahlosi, who is 12 years<br />
old and affected with Duchenne<br />
muscular dystrophy, received<br />
his new motorised wheelchair on<br />
Sunday, 11 February <strong>2018</strong>. The<br />
Muscle Riders were proud to see<br />
all the hard work pay off, and<br />
Tshepo is looking forward to many<br />
happy years with his newfound<br />
independence.<br />
Thank You!<br />
My name is Mzwandile du Plessis, from Katlehong. I<br />
would like to thank the Muscular Dystrophy Foundation<br />
Gauteng for the new motorised wheelchair. I am very happy<br />
and wish to thank them for assisting me.<br />
Yours sincerely<br />
Mzwandile du Plessis<br />
36<br />
Clara Moloi says thank you<br />
Muscular dystrophy is a very difficult disease to live with, especially when we keep growing up and it keeps<br />
getting worse. I was born with the type of muscular dystrophy called myotubular myopathy. I’m now in my<br />
mid-thirties and the progression of the disease worsens by the day.<br />
I have short breath and I can’t digest food well due to the deformation of the spine.<br />
Having the Muscular Dystrophy Foundation is a blessing from God. I asked for a cushion from the Foundation<br />
and they referred me to CE Mobility to be assessed for the correct one. The occupational therapist there by<br />
the name of Kat realised that my sitting position was one of the causes of my deformation, and she decided<br />
that we should try a new backrest that has support on the sides to help me to sit up straight and that will<br />
assist with breathing and digesting. The <strong>MDF</strong> helped with the purchase of the backrest and now I’m sitting up<br />
straight, a little better than with the normal backrest, and I’m able to burp without being assisted (like a baby).<br />
Even though I’m not used to sitting straight and it’s painful, I believe that I won’t be using my nebuliser for a<br />
while. Thank you very much <strong>MDF</strong> Gauteng Branch.<br />
Yours sincerely<br />
Clara Moloi
Gauteng Branch<br />
Make Today Count<br />
Tandem Skydiving <strong>2018</strong><br />
Adventure Skydives in Deneysville offers skydiving<br />
with a difference – the fast speed at which you rush<br />
towards the ground due to the thin air in the<br />
Highveld. In the tandem jump, after a quick briefing,<br />
you are good to go, attached to an instructor with a<br />
special harness for two.<br />
A tandem jump will cost you R2,600 and you will also receive a DVD that contains a video and photos taken of<br />
your jump.<br />
Date : Saturday, 18 August <strong>2018</strong> and Sunday, 19 August <strong>2018</strong><br />
Where : Leeukop Farm Airfield, Deneysville (on the Vaal)<br />
Bookings can be made through Robert Scott via email: mdfgauteng@mdsa.org.za<br />
Muscular Dystrophy Workshop<br />
The Muscular Dystrophy Foundation Gauteng is pleased to announce that we will be hosting a<br />
workshop about caring for persons with muscular dystrophy, the handling of them, stretching exercises by a<br />
physiotherapist, and the importance of education by an educational psychologist.<br />
Parents of children and persons affected with any type of muscular dystrophy are encouraged to attend.<br />
Speakers: Mrs Kerrie Austin (Physiotherapist), Mrs Antoinette Human (Psychologist - Education)<br />
The workshop will be conducted, free of charge, on Saturday, 1 September <strong>2018</strong> (venue will be confirmed).<br />
To make a booking, please contact <strong>MDF</strong> Gauteng before Friday, 17 August by phone on 011 472-9824<br />
or by e-mail at mdfgauteng@mdsa.org.za.<br />
Muscle Riders <strong>2018</strong><br />
(Ride For A Purpose – ride for those who can’t)<br />
This is the seventh year that we will be participating in the Telkom 947<br />
Cycle Challenge. The cycle challenge will take place on Sunday,<br />
18 November <strong>2018</strong> at Riversands Commercial Park. Our Muscle<br />
Riders are a group of cyclists who care for people affected with muscular<br />
dystrophy and want to make a difference in the lives of those less fortunate than<br />
they are.<br />
Please ask family and friends who cycle to ride for us. We would like to get more riders who can help generate<br />
awareness and much-needed funds. We rely on the support of individuals and companies to support us so that<br />
we can give our members the assistance they need. We wish to thank everyone who rode for us last year and<br />
is supporting us again this year.<br />
Website: www.muscleriders.co.za<br />
Facebook page: www.facebook.com/mdfgautengcycle<br />
Should you be interested in riding for us or helping us to make this event a success, please let us know so that<br />
we can provide you with further information.<br />
37
KZN Branch<br />
Updating of information<br />
for Muscular Dystrophy<br />
Foundation KZN Branch<br />
Dear Members<br />
In order to ensure that the Muscular Dystrophy<br />
Foundation database contains updated and<br />
accurate information, we request that you<br />
notify the KZN Branch immediately of any<br />
changes to information provided, by contacting<br />
the KZN Branch directly, either by phone (031<br />
332 0211) or by email (accountskzn@mdsa.<br />
org.za), so that your information can be<br />
updated accordingly.<br />
Thank you in advance for your assistance and<br />
support.<br />
9 DISABILITY<br />
RIGHTS VIOLATIONS<br />
1. EXCLUSION FROM EMPLOYMENT<br />
Widespread discrimination means that 7.5% of South<br />
Africans who have a disability do not participate in<br />
the economy.<br />
2. INEQUALITIES IN EDUCATION<br />
Unequal education opportunities condemn 1000s of<br />
persons with disabilities to poverty and deprivation.<br />
3. DENIAL OF REASONABLE ACCOMMODATION<br />
Equitable measures to support the participation of<br />
persons with disabilities in society on an equal basis<br />
with non-disable people are ignored.<br />
4. INACCESSIBILITY<br />
Accommodation, buildings, services, information<br />
programmes, communication remain inaccessible.<br />
5. NON-PROVISION OF ASSISTIVE DEVICES<br />
Assistive devices are essential for living ans accessing<br />
fundamental rights and freedoms including the right to<br />
communication, mobility, education.<br />
6. MARGINILISATION BY SOCIETY<br />
Attitudinal barriers in society disable persons<br />
with impairments.<br />
The Muscular Dystrophy Foundation<br />
of SA would like to thank the National<br />
Lotteries Commission for their support.<br />
7. STIGMA IN CULTURAL BELIEFS<br />
Disability is seen as a curse in some cultures and the<br />
related stigma forces families to hide their relative with<br />
a disability.<br />
8. PREVALENCE OF DISABLISM<br />
Prejudices towards, and stereotype about, disability<br />
and persons with disabilities are prevalent in society<br />
which results in disability discrimination.<br />
9. INACCESSIBILITY TO JUSTICE SYSTEMS<br />
Persons with disabilities are more vulnerable to<br />
neglect, abuse, and exploitation and are unable to<br />
access justice due to disablism.<br />
NCPD Disability Rights Violations DL Flyers March <strong>2018</strong>.indd 2 <strong>2018</strong>/03/14 8:37:<br />
38
Stockists of all the leading import power brands
SOMEONE I LOVE<br />
Needs a Cure<br />
Please Support<br />
MUSCULAR DYSTROPHY<br />
AWARENESS & RESEARCH<br />
WE NEVER GIVE UP HOPE<br />
Contact us for further information:<br />
The term muscular dystrophy (MD) describes a disorder<br />
that affects the muscles, resulting in progressive<br />
wasting and weakness of the muscle. Symptoms may<br />
appear at birth, in early childhood, or later in life.<br />
Neuromuscular disorders affect not only the muscles<br />
but also the nervous system.<br />
Individuals of either sex and all ages<br />
and ethnic backgrounds can be<br />
affected by MD.<br />
NATIONAL OFFICE<br />
Tel: 011 472-9703<br />
E-mail: national@mdsa.org.za<br />
Website: www.mdsa.org.za<br />
CAPE BRANCH<br />
(Western Cape, Northern Cape & part of Eastern Cape)<br />
Tel: 021 592-7306<br />
E-mail: cape@mdsa.org.za<br />
GAUTENG BRANCH<br />
(Gauteng, Free State, Mpumalanga, Limpopo & North<br />
West)<br />
Tel: 011 472-9824<br />
E-mail: gauteng@mdsa.org.za<br />
KZN BRANCH<br />
(KZN & part of Eastern Cape)<br />
Tel: 031 332-0211<br />
E-mail: kzn@mdsa.org.za