Barry Streek
The University of Transkei (Unitra), which has overdraft facilities of up to R78-million, is using its government subsidy to pay off its debt and will continue doing so in the next financial year, Minister of Education Kader Asmal has disclosed.
”The University of the Transkei has been in a critical financial position for the past few years. Continued operations have been possible only through access to increasing overdraft facilities,” Asmal said in reply to a question, tabled in the National Assembly by Lucas Mbadi (United Democratic Movement).
Asmal disclosed that he had approved overdraft facilities of R65-million for the University of Fort Hare, R50-million for the University of the Western Cape, R30-million for the Medical University of South Africa (Medunsa), R25-million for technikons in KwaZulu-Natal and R16-million for technikons in the Eastern Cape.
Higher education institutions had to obtain his approval for any loans in excess of 5% of their average annual income for the past two years.
However, in the case of Unitra, Asmal conceded that ”it is possible that the available funding will not be sufficient for the university, even after restructuring, to meet its financial obligations through to the end of this year”.
Asmal said the immediate financial implications for his department were to ensure that Unitra was allocated a subsidy for the 2002/2003 financial year to enable it to pay off its overdraft.
He said officials in his department were constantly monitoring the finances of all universities and technikons, but ”there is, unfortunately, substantial disparity in the quality of the financial management between various institutions”.
@Why aren’t we having fun yet?
Industries have been created around men’s sexual problems, but the 43 per cent of women who don’t enjoy sex have been ignored. Jessica Berens meets the Berman sisters, doctors who are dedicated to ensuring girls come out on top
Peace in heaven and glory in the highest; navel gazing has descended 12 inches. What are we looking at? We are looking at labial arteries, bulbospongiosus muscle and pudendal nerves. We are looking at muscles and nerve-endings that are, or should be, responsible for those pleasurable contractions that lie at the centre of culture (or advertising, as it is now known) but whose exact physiological anatomy remains a mystery. We are looking at the vulva, a place that has been explored, navigated and photographed but for which there is still no map.
It was only three years ago that the Australian urologist Helen O’Connell discovered that the clitoris extended three-and-a-half inches into a woman’s body, making it a far larger and more complex organ than it had been perceived. The clitoris an organ designed purely for pleasure has 8 000 nerve endings. But are we having fun yet? No we are not.
In 1999 the Journal of the American Medical Association reported a survey that showed one in 10 men were experiencing sexual problems, but the numbers were four in 10 in women. Forty-three per cent.
Sex-sated culture still deifies the female body as a lifeless mammarian goddess, but the woman inside that body is reporting record levels of sexual disinterest. Libidos are low, orgasms are not forthcoming and the consequence is physical pain, emotional distress and insoluble relationship problems. These ”disorders” are now medically termed as FSD female sexual dysfunction.
No, we are not having fun yet.
Welcome to the University of Los Angeles Medical Centre. I wait for the Berman sisters in the Elmer Belt Conference Room at the Centre for Urology in Westwood. There are black-and-white photographs of various ”fathers of urology”.
This is a manly atmosphere, but urology, until now, has been a manly concern. Indeed, one of the reasons the American Food and Drug Administration is loath to sanction the sale of Viagra to women is because there has been so little scientific research into the physiology of female genitalia.
The siblings arrive. They are attractive, blonde and smiley. They are enjoying something of a success in the US, partly, perhaps, because they are blonde and smiley, nice Jewish girls from the Upper East Side, partly because they are well-qualified, and partly because they are in the right place at the right time.
Laura (32) is a sex therapist. Jennifer (36) is a surgeon who decided to specialise in urology because she enjoyed the procedures, because it offered a lifestyle that allowed her to be a mother and because, as a field of research, it offered the potential for discovery.
While working in residency in Maryland, she found that the path to reconstructive surgery of the female pelvic floor was hampered by a lack of knowledge about nerve endings that is, the relationship between the spinal cord, the uterus, the vagina and the clitoris was still unknown.
Jennifer is fascinated by the mechanics of female sexual response; she provides the clinical perspective. Her sister investigates the emotional roots of the problem. And, since they believe that most disorders are the result of both, they are uniquely positioned to provide a realistic picture and to advise on suitable treatment.
As a teenager Jennifer began to read Judy Blume, a US author specialising in novels for adolescents about the progress from childhood to sexuality, which described both masturbation and orgasm. Her father found Forever and ripped the book in half.
Sex, in the Berman household, was discussed openly, but the overriding message was that they should avoid it if possible. Laura: ”From early on there was the message that we should not be sexual until we were in the context of a healthy, loving relationship.”
Laura: ”There are two components one is about feeling at ease with your sexuality and the other is acting on it by putting yourself at risk of pregnancy and sexually transmitted diseases. These were very separate issues in our house, and I still think that in order to be sexually responsible you need to first feel good about yourself and your sexuality, and I think they are responsible for that.”
It quickly became apparent that Jennifer was going to become the doctor. Laura could not stand the sight of blood, Jennifer took to medicating her horse. Jennifer’s research into subjects such as nitric oxide takes her to places that make her sister shudder working on cadavers, for instance, to study the female genitalia.
Laura trained to be a sex therapist at the New York University Medical Centre. ”I was exposed to everything under the sun,” she says. ”I talked to peep-show workers and prostitutes. I went to gay bars and S&M meetings. I had to confront every value I had, question it, analyse it and understand it..”
She moved to Spain with her husband and worked there until her marriage broke down, leaving her with no immediate prospects.
Jennifer, meanwhile, had taken a job in Boston and invited her to work with her. They founded a clinic for women’s sexual health in 1998, then moved to California last year. Now they run two clinics a week and see about 40 new patients a month. The average age is 45, but there have been 18- and 80-year-olds and, though mostly heterosexual, they represent a diverse ethnic spectrum.
The sisters have outlined the categories that define female sexual dysfunction in their book For Women Only. It falls into four parts. One of these is hypoactive sexual-desire disorder, the symptom of which is a lack of interest. The causes can be various anti-depressants, for instance, are known to lower the libido. They may also be emotional or the physical result of menopause.
Sexual-arousal disorder is characterised by the physical inability to maintain lubrication, because of decreased sensation and, sometimes, because of diminished blood flow to the vagina or clitoris. Orgasmic disorder is the inability to reach climax despite stimulation. This can be caused by a number of things, including trauma (such as sexual abuse or a physical accident), hormonal deficiency or damage incurred during pelvic surgery.
Finally, sexual-pain disorder is intense discomfort experienced during penetrative sex. It may have its origins in emotional causes, in surgical procedures or in the onset of menopause.
Treatments vary and many of them are still experimental. The Bermans have participated in clinical trials for Viagra and remain enthusiastic about its prospects, despite disappointing statistics.
They also believe that testosterone is important in governing libido and sexual response.
Some women arrive with their partners; some do not. Who are they? They are Janet (35) mother of two from Boston who, having been sexually abused by her brother, could only reach orgasm by self-stimulation.
When it came to her husband she shut down. Her husband was talking about divorce. ”Shutting down,” say the Bermans, is a ”survival” response. Viagra did not work for Janet. Therapy and anti-depressants did.
Debra (31) and her husband Scott, from New York, had four children and were experiencing a common problem: unequal libidos. Debra was exhausted; Scott wanted sex.
Debra had put on weight and felt ashamed of her body. The Bermans encouraged Scott to stimulate his wife with a vibrator.
They observed healthy pelvic blood flow, engorgement and lubrication. They tested her blood for lowered testosterone levels, a common cause of lowered libido.
Debra was found to have normal levels. The Bermans suggested the couple take time away from the children to focus on each other, and referred them to a therapist. They also prescribed a low-dose testosterone cream and Viagra. The couple began to make progress.
The solutions are not always so simple. Ann and Charles were in their seventies. They had grown apart in their marriage, but Charles wanted to restore the intimacy they had lost. Ann, post-menopausal, had lost interest in sex. She was angry with her husband, who had engaged in extra-marital affairs. She did not want to undergo a physical examination nor did she want to take hormones. Nor did she wish to live alone. The Bermans told them that couple therapy would help them work through the anger that fulminated at the centre of the relationship; but the couple remained in limbo, unable to make a decision. Change is frightening and, at 70, difficult.
The patient who presents herself to the Centre for Pelvic Medicine is a brave woman. She must be ready to discuss the most intimate details of her sex life with Laura, whose questions will be about everything from masturbation to the possibility of sexual abuse in childhood.
Jennifer’s equipment is designed to assess PH levels, vaginal elasticity, clitoral sensation and pelvic blood flow, but it looks as if it has been stolen from the set of Dead Ringers. Jennifer admits they do make women nervous, but then the women are also keen to find the root of their problems.
The EROS CTD (clitoral therapy device) is a vacuum designed to increase the blood flow to the clitoris.
The TSA 11 NeuroSensory Analyser was developed to research the effect of neurological disorders such as multiple sclerosis on the female genital organs. It is a black probe attached to wires and clamps.
The 3D video glasses are more fun. They are fitted with an erotic video, the patient self-stimulates with a vibrator, and the effects are assessed by a vaginal probe and ultrasound.
In the US the Berman sisters are seen as representing the next stage of the feminist movement, a movement that has been somewhat stagnant of late, impeded as it is by dull old ideas that are unable to counteract the commercial power of regressive imagery.
Detractors may observe that to emphasise female sexuality is to conform to male thinking a woman must have sex to be happy and there is something wrong with her if she does not. And it could easily be argued that our expectations are far too high. There are other things to do.
Nevertheless, the ability to have an orgasm is fundamental. Laura Berman believes that sex can reduce stress, enhance mood and increase self-esteem.
”Sexuality is a central part of who we are,” she says. The physical reality is that the more sexually active a woman is, the better the blood flow to her genitals, which means less risk of vaginal atrophy. Then there is the sociological point that says in a time of high divorce rate there is good reason to encourage happy sexual relations. Sex is cited again and again as a root cause of marital and relationship breakdowns; improve on these problems and you contribute to a healthier picture of society.
Jessica Berens 2001. This article first appeared in the Observer Life, May 2001