Much like the planet’s air temperature, diabetes rates are rising around the world.

Extreme heat, heavy floods, air pollution and infectious diseases will make dealing with diabetes harder and make the condition more common, research shows.

A serious chronic disease, diabetes is the leading cause of death for South African women. 

It is caused by the body’s inability to produce (enough) insulin or use it properly. Insulin is the naturally occurring hormone that allows the body’s cells to take up sugar — also called glucose — from the blood so that its energy can be released to keep the body working. But when enough insulin isn’t made or the body can’t use it well, too much sugar is left in the bloodstream, which can lead to heart disease, vision loss, kidney problems, nerve damage and even amputation.

The world already does a poor job of looking after people with diabetes, especially when public health systems are under pressure. Adding climate change to the mix will make things even more difficult. So what’s the fix?

Types of diabetes

An estimated 15% of South African adults have type 2 diabetes, a form of the disease that develops over time, rather than someone being born with it. In 2011, it was estimated to be around 7%. Family history can contribute to the likelihood of getting the disease but almost 90% of cases are linked to being overweight.

Type 2 diabetes makes up about 96% of diabetes cases worldwide. It is sometimes referred to as a “lifestyle disease” because a healthy diet and exercise can prevent and, in some cases, reverse it. But many people with type 2 diabetes need to take a lab-made form of insulin to keep their blood sugar levels stable.

Doctors aren’t sure how to prevent type 1 diabetes, which is an autoimmune disease. This means that the body attacks itself by mistake. Type 1 diabetes is usually diagnosed in children or young adults and people then need daily insulin injections to control their blood sugar levels and stay healthy.

Hormonal changes during pregnancy can also change how insulin works, sometimes resulting in gestational diabetes. It could up the chance of a child developing obesity or type 2 diabetes. While it usually goes away after the baby is born, it increases the chances of the mother developing type 2 diabetes later in life. 

Diabetes meets climate change

Extreme heat due to climate change affects our health, and research shows that in the US alone, 100 000 new diabetes cases could develop each year with a temperature increase of just 1°C, and heighten the chance of someone who already has diabetes ending up in hospital or the emergency room.

People with diabetes often have trouble keeping their body temperature in check through natural processes like sweating when it’s hot. Overheating can upset the way the body controls blood sugar levels, leading to dehydration or heat stroke which, without treatment, can quickly damage the brain, heart and kidneys.

These complications also influence how full hospitals are as well as the workload of health workers. In Brazil, researchers found that a 5°C increase in daily temperature led to 6% more diabetes-related hospitalisations.

Air pollution is a problem, too. Burning fossil fuels like coal, which is a big part of the reason for climate change, also makes the air dirty. Breathing in tiny bits of solid materials in the air increases the chances of developing diabetes, while the pollution from climate change-induced wildfires can heighten the chance of someone with diabetes needing hospital care.

Infectious diseases such as malaria and cholera will also become more common, with changing weather patterns shifting how far and fast germs spread. Because diabetes can weaken a person’s immune system, they can’t fight off germs as well as healthy people. That means they are more likely to get serious infections, including tuberculosis (TB), one of the main causes of death in South Africa.

Our reporting on the aftermath of the 2021 Durban floods showed more of the knock-on effects of climate-related floods. The closure of clinics, the loss of personal property like ID documents and being forced to move because of the disaster caused people to miss HIV treatment. Other studies have shown that in the face of climate disasters, TB spreads easier too. In the same way, if people with diabetes can’t get their daily insulin, it can quickly turn deadly.

Early warnings and sugar taxes

There are ways we can prepare for the impacts of climate change on diabetes and the healthcare systems that support patients. Early warnings, such as the soon-to-launch pilot programme through MomConnect that will alert pregnant women to coming heat waves, could be expanded.

But getting a handle on diabetes rates is the best place to start.

Clinics and hospitals in South Africa are required to provide treatment for people with diabetes. However, research shows that, in many cases, people aren’t put on the right treatment. A five-year plan released by the health department in 2022 to deal with noncommunicable diseases such as high blood pressure, obesity and diabetes could combat some of that.

Combating obesity, which affects one in four South Africans, will help.

Susan Goldstein, a public health researcher at Priceless SA told Mia Malan in a recent Health Beat episode that barring companies from marketing ultra-processed foods to children and requiring labels on food with too much salt, sugar or fat have been shown to curb sales. The health department’s 2023 draft legislation on the labelling and advertising of foodstuffs is promising.

Research shows that our sugar tax has worked. South Africans bought 28% fewer sugary beverages and manufacturers started cutting back on sugar in their products after it was enacted in 2018. 

This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the newsletter.

He was a journalist, too. 

But Tiisetso Makube was a rare breed of journalist, the sort who write from the soul. He was on a quest for truth. He bled out his words, and he paid dearly for each one. 

He was my friend, and I was his editor. 

I loved him through the words he would deliver in a voice so distinctly his own; I fell for him the first time I read him. Often Tiisetso would ask questions in his pieces. He asked himself. He asked the reader. He asked the universe. He wanted an answer but so often he had none, not one, at least, that would be the least bit satisfactory. So he would ask. What time is it? he wrote, more than once, quoting a poet whose name he never told me. 

So beautifully he would put the mundane, so passionately he would tell the story of his country through his subjects. Tiisetso wasn’t always an easy edit. And I wasn’t always an easy editor. We would go back and forth in our dance. He put up with me and my nit-pickity ways. I pried and pushed because I knew there was more I could take from his fingers on that keyboard. In the end, he would always give it up, give it everything. And when it was done, when it was all on the page, I would only ask for another. 

One day, a couple of years ago, he sent me an email out of the blue. It was this: an excerpt Anton Chekhov’s Terror. “I am afraid of everything. I am not by nature a profound thinker, and I take little interest in such questions as the life beyond the grave, the destiny of humanity, and, in fact, I am rarely carried away to the heights. 

“What chiefly frightens me is the common routine of life from which none of us can escape. I am incapable of distinguishing what is true and what is false in my actions, and they worry me. I recognise that education and the conditions of life have imprisoned me in a narrow circle of falsity, that my whole life is nothing else than a daily effort to deceive myself and other people, and to avoid noticing it; and I am frightened at the thought that to the day of my death I shall not escape from this falsity. 

“I don’t understand men, my dear fellow, and I am afraid of them. It frightens me to look at the peasants, and I don’t know for what higher objects they are suffering and what they are living for. 

“If life is an enjoyment, then they are unnecessary, superfluous people; if the object and meaning of life is to be found in poverty and unending, hopeless ignorance, I can’t understand for whom and what this torture is necessary. I understand no one and nothing.” 

I heard today that Tiisetso was gone, found dead on Wednesday in his home in Tsakane on the East Rand. I understand he likely died of a seizure. Tiisetso lived alone. He was just 35. I lost a friend. His daughter, Natalie, named after Nat Nakasa, lost her father. Many, many, many people lost a friend. And South Africa this week lost one of their own. 

This week we lost a true writer.   

Here are some of my favourite pieces by Tiisetso, which appeared in the Mail & Guardian:

Snapshots of a life that was 

Nat Nakasa: Writing to the beat of a different drum 

Fish tales and faded hope on the famished road to Mangaung 

Buckets, pits and poverty: how the other half defecates 

1. It seems inadequate to call Adam Shatz’s review of Congo: The Epic History of a People by David Van Reybrouck a review, even if that’s what Ça va un peu, in the London Review of Books, is. But what you get out of it is a rollicking ride through the tumultuous history of what is now the Democratic Republic of the Congo in 5 032 words. It’s an outstanding long read that’s well worth the time, whether you are a Congo-watcher or not.

2. The science of human decay by Joseph Stromberg ran on Vox. It takes a look at Freeman Ranch, one of the world’s few (apparently there are five in, you guessed it, the United States) body farms. Located at the Forensic Anthropology Centre at Texas State University, the centre’s mission is to find out what happens to bodies in various states of decomposition. If you ever needed a reason to decide on cremation when you die, watch the video.

3. @benedictkelly recommends this from Wired for all the geeks out there: Wrinkles in spacetime by Adam Rogers. It’s about a famous astrophysicist, simulated black holes, wormholes and the movie Interstellar. Also on Wired, I found a fascinating piece for your, err, entrepreneurial (read: criminal) friends on online drug dealers who are using darkcoin, “bitcoin’s stealthier cousin”.

4. @zoddies loved Zadie Smith’s 10 rules of writing from @brainpicker which ends with equally inspiring links to Kurt Vonnegut’s 8 rules for a great story, David Ogilvy’s 10 no-bullshit tips, Henry Miller’s 11 commandments, Jack Kerouac’s 30 beliefs and techniques, John Steinbeck’s 6 pointers, and Susan Sontag’s synthesised learnings.

5. @nikistarfish liked Of gamers, gates, and disco demolition by Arthur Chu on The Daily Beast, taking on #gamergate, haters in history and the bad old days of disco.

6. On Foreign Policy, @shaundewaal picked up Why is Bahrain outsourcing extremism by Ala’a Shehabi who takes a look into the country’s Isis problem. Also on FP, he found The gangs of Iraq, where Tirana Hassan writes about how pro-government militias are using ISIS as a “pretext to destroy Sunni Arab communities”.

@tanyapampalone is the executive editor of the Mail & Guardian.

But it wasn’t the story that shocked me as much as the photo. It could have been anywhere in South Africa: a modest table lined with goods, the vendor waiting for her next customer.

The image stood in stark contrast to a video I saw via a friend’s Facebook post. In it, a young man boasts about fancy cars and pool parties and how Johannesburg is where it’s at. What was unnerving was that, while sitting on a street corner in the northern suburbs, what he was really talking about was the kind of hope that fuels the American Dream, the promise that things can only get better. And he was sure that time had arrived in South Africa.

The video took me back to a visit I made to Los Angeles earlier this year. As I drove the broad streets and eight-lane highways that ran through my childhood neighbourhoods, a worrying low-level hum, the faint sense of fingernails running down a chalkboard, ran through my body. Things were falling apart. The centre could not hold.

It was then I learned about a homeless man living in his car on the street where my parents’ dental office has been situated since 1967, the year before I was born, and was told how this is quite common these days. Increasing numbers of formerly middle-class people, now homeless, are living in their cars on LA’s suburban streets, moving around to keep from being harassed by police.

It was the paint peeling on a friend’s once picture-perfect upmarket suburban home, the grass wilting in the searing San Fernando Valley heat; I was there when he, nearly 50, got the call to tell him he had been laid off.

Another high school friend, who owns part of a small winery further north, was unsure how he would support himself if his business, which was new and struggling, had to shut down.

It was my mother, 75 and still working a couple of days a week in the dental office she sold a few years ago, because she can’t sit still but also because she worries, since my father’s death 15 years ago, about how to pay for things like the exploded geyser or the fridge that just went kaput.

My mother is healthy in body and mind and, at this rate, will live well into her nineties. To retire now, when she can still turn over a decent pay cheque, seems irrational to her. And it probably is.

Buying into the dream
Americans have cellphones, televisions, running water and electricity in their homes, and many of them have cars. The employed go on the one- or two-week holiday that is the company standard. Though, maternity leave is not mandatory. A United Nations report recently found that of the 185 countries and territories surveyed, all but three provided cash benefits to women during maternity leave: the United States was right there with Oman and Papua New Guinea as non-providers for their nations’ mothers.

In the Eighties, globalisation was positioned as democracy just as communism began to fall: a way for the corporates to get their way with the developing world. The West sold it as “the dream”, and many bought into what was beaming from their TV screens.

In South Africa, so much has changed in the past 20 years: the black middle class is rising, urban landscapes have shifted dramatically, new cars pack the highways, shopping malls are ubiquitous.

At a glance, you could mistake parts of the country for suburban America: immaculate, expansive homes with swimming pools, lush green lawns, industrial-size kitchens and three hulking cars in three-car garages – like the ones on reality shows that are nothing like reality.

Many aspiring middle-class South Africans dream – like Americans dream – of places like Agrestic in Weeds, which was partially shot in Calabasas, a neighbourhood not far from where I grew up.

But those aren’t America’s middle classes. That’s upper middle-class America you’re seeing on your TV screens. Calabasas is home to people like Justin Bieber and Will and Jada Smith, part of the ever-increasing wealth of the One Percent, or at least those hanging high in the top five. But the glory days of the American Dream are over.

Upsetting the American apple-pie cart
When I was growing up, my parents were both dentists with their own practice. I had three siblings. For most of our education we went to public school, and we took summer vacations on my mother’s parents’ farm, where she grew up poor, in the Midwest. We did not go to Italy or Algeria or Tunisia, where my father grew up. Taking four children on holiday anywhere that required plane fares wasn’t an option, even if you were in the upper middle class.

We did not get the latest toys and my parents drove used cars, but we all went to university and three of us went on to get postgraduate degrees.

If you take a glimpse at the modest incomes of me and my siblings, we sit firmly in the middle class, with the exception of my eldest sister, who married better than the rest of us. Educated as a dentist, she was mostly a stay-at-home mom, owing to her position in the top five percent; she has a house in one of the most expensive neighbourhoods in California and, with a group of friends, owns a cabin in a top ski resort as well as a prime beachfront home. They have a healthy retirement account, plenty of investments and money saved for their children’s college educations.

But of my parents’ four children, my eldest sister is the only one, at 50-something, who is living the American Dream. Barring World War III, the Great, Great Depression of 2021 or the “Big One” – the earthquake that has been threatening to shake California into the sea – she will retire very comfortably.

The rest of us, lily-white with all the opportunities that were afforded us, with our American passports, our university educations, we’re getting by and holding thumbs for the best as we stare down the increasing inequality gap that promises to upset the American apple-pie cart.

One thing seems certain: we are part of the first generation of Americans to do worse than our parents. We have been outclassed. And it’s going to get much, much worse than most Americans could ever imagine before it gets better – if it ever does.

Paying less
Consider this. An August 2014 study, paid for by the US Conference of Mayors, showed that while the country had recovered all the jobs lost during the “recession”, the replacement jobs pay an average of 23% less than those lost.

“The long-term problem isn’t unemployment; it’s poverty,” Stephen Levy, director of the Centre for Continuing Study of the California Economy in Palo Alto, told the LA Times recently. “It’s not jobs; it’s wages.”

Earnings for low- and mid-wage Americans continue to erode. The Times reported on a study out of the University of California, Berkeley which revealed that real hourly wages are 6.7% lower than they were 35 years ago for the bottom half of the workforce; since 2003, median wages went down by 7.2%. It was only the top 20% of earners who saw real wage gains; economist Edward Wolff found in 2010 that it was this group of Americans that held 88.9% of the country’s wealth.

A Pew Research Centre report found that student debt rates have soared in young households from 16% in 1989 to a record 37%, severely stunting their capacity to get ahead. But they are faring far better than their non-college educated peers.

My parents supported me through undergraduate school – it was the no fancy car or vacation policy that allowed them to do that. But unfortunately for me, I decided to get my MA in writing in my mid-thirties. I will be paying off my student loan until well into my sixties, thanks, in part, to the ever-declining rand. By which time, if we can afford it, my child will be out of university and we will likely be helping her to pay off her student loan.

Don’t get me wrong. Some of my best friends are rich. And I love America. But I yearn for what America was.

“Give me your tired, your poor. Your huddled masses yearning to breathe free,” the inscription on the Statue of Liberty reads.

It was that which led my father and his entire family from Tunisia, selling everything they had, to New York. When they arrived in the Fifties, public college education was virtually free. America worked for my father – despite his Italian heritage, which placed him among the dirty WOPs (without papers) – and for his siblings, who, it gives me an enormous peace of mind to say, have all retired well. Times have changed.

Lou Reed eloquently translated Lady Liberty’s inscription for modern times in Dirty Boulevard: “Give me your hungry, your tired, your poor, I’ll piss on ’em. That’s what the Statue of Bigotry says. Your poor huddled masses, let’s club ’em to death.”

Middle class problems
I’ve seen enough dire poverty to know that despite our #middleclassproblems, my siblings and I will end up far better than most. My eldest sister will continue her life in Agrestic. My other sister, after an atrocious divorce from an ex-Google executive, is managing to get by, renting out the front of her well-placed home just outside San Francisco while living in a small space in the back and working as a physician assistant in a public hospital.

My brother’s former corporate computer security job had him save well for his retirement. With a second child on the way, he’s moved his family in with his in-laws to get help with the new baby but also to save some money as they rent out their townhouse while his business gets off the ground.

As for us? My husband is a serial restaurant and bar owner, which has been a rocky road. I’m a journalist. Not the highest paying of careers. We rent our two-bedroomed flat in the same neighbourhood where my husband grew up and our daughter goes to public school. I don’t imagine I will be able to retire, though I do worry a lot about what a 65-year-old editor might be doing for work in 20-odd years’ time.

But right now, in South Africa, we live a better middle-class existence than we would in the US. In South Africa, I have a domestic worker twice a week, I drive a nice car and in the beautiful neighbourhood where I live, the public schools are great – better than many of California’s public schools, which are ranked among the worst in the nation.

By virtue of swapping countries eight years ago, we have moved toward the top end of the economic scale as opposed to existing in the bottom half, though I say all that knowing quite well – and with an aching, persistent guilt – how completely unsustainable South Africa’s inequality is, with its massive, unacceptable levels of poverty that support our comfortable middle-class lives.

The truth is, I fear for my future and that of my child. Will she, like me, do worse than her parents and continue the spiral downward? The American Dream is on its last gasp and without intervention, the country will devolve. Already the Organisation for Economic Co-operation and Development says that, next to Chile, the US is the most unequal society in the developed world.

The failure of capitalism just 20 years after the failure of communism does not bode well for the rest of us. After all, what happens in the US tends to spread like a virus around the world.

In his “memo to my fellow zillionaires”, which ran in Politico in July, wealthy entrepreneur Nick Hanauer, who puts himself at the top .01%, captured the essence of the dangerous One Percenter game.

“If we don’t do something to fix the glaring inequities in this economy, the pitchforks are going to come for us. No society can sustain this kind of rising inequality. In fact, there is no example in human history where wealth accumulated like this and the pitchforks didn’t eventually come out. You show me a highly unequal society and I will show you a police state. Or an uprising. There are no counter-examples. None. It’s not if; it’s when.”

Call them pitchforks or burning tyres, the end point of massive inequality is the same for all of us.

There’s also a section called “rehab reviews” where you can take a look at independent write-ups of various facilities much like you would before going on holiday.

At the top of the current list is the Cliffside Malibu, where celebrity gossip website TMZ swears Lindsay Lohan checked in for her sixth attempt at recovery.

Like many treatment centres in Malibu, it comes with a chef, walks on the beach, workouts with personal trainers, acupuncture, massages and “manis and pedis” – all for just $58 000 a month for a “semi-private” room or $73 000 for a private one. Oh, and outside of therapy groups and one-on-one counselling, clients are welcome to use their phones, watch TV or surf the web.

The beachfront neighbourhood is saturated with rehabs like this one that employ the “Malibu Model” of treatment. It’s a play on the industry standard, the “Minnesota Model”, a disease-based model of addiction, fostered by the respected treatment centre Hazelden in Minnesota, and is based on the 12-step programme of Alcoholics Anonymous.

The Malibu Model comes with highly individualised treatment plans and extras such as acupuncture, equine therapy, yoga and meditation, a sumptuous departure from the clinical, bare bones, tough love approach that’s offered at many rehabs.

Growth industries
“What are Malibu’s growth industries?” asked a recent New York Times article. “Answer: Winemaking and sobriety.” It’s a question that could be as relevant to Cape Town as it is to Malibu.

I thought I might begin my journey at Montrose Place where, in the early days of 2010, there was rampant speculation by both local and international media that Tiger Woods had checked in for sex addiction after his string of marital infidelities became public.

It was never proved that Woods even set foot in the country, much less the luxury treatment centre, which opened in 2007. But, out of it, a star rehab was born.

With a price tag in pounds – 10 000 of them a month – it unabashedly catered to a British clientele of “actresses, burned-out City types, sports stars and over-privileged teenagers”, according to a lengthy 2010 article about the facility, and its founder Johnny Graaff, in the Daily Mail.

Along with a formidable team of psychologists, occupational therapists and addictions counsellors, the mansion in Bishopscourt came with its own gym, home cinema, swimming pool, chef, dietician and koi pond.

“Why should people go into a grotty dive because they’re ill?” Graaff told the London Evening Standard later that year. “There can be a punitive environment in other clinics,” he told the Mail. “They’ll tell you you’re a terrible person and you need to pull yourself together, which is traumatic for someone who’s ill.”

He should know.

Graaff, the grandson of Sir De Villiers Graaff, told the Mail he was a four-gram-a-day cocaine addict who seemed to have hit bottom after his involvement in a car accident that led to the death of 35-year-old Guida Correia in 2003.

Local papers reported that Graaff’s Corsa bakkie allegedly hit Correia’s Jetta at 160km/h near the family’s De Grendel wine estate in the Tygerberg Hills. She died later in hospital. Graaff was eventually acquitted of culpable homicide.

Destined for success
After that, he ended up in various rehabs, relapsing, and going back for more. It was after he finally had some time sober that he went to his father with a business plan that seemed destined for success, considering what was happening overseas.

But when I tried to contact the facility in May, I found it had been replaced by something called Montrose Manor, which specialises in eating disorders. “We are not an addiction treatment facility anymore,” the message came back.

And so, as quickly as it appeared to have shot to international success, the most exclusive drug treatment centre South Africa had ever seen seemed to have all but evaporated.

Allan Sweidan is a psychologist with salt-and-pepper hair and a specialisation in addiction care. He’s also the managing director of Akeso, a group of six psychiatric hospitals and two treatment centres, including the recently acquired Stepping Stones and its secondary treatment facility, the Beach House. Both are based in the sleepy seaside resort town of Kommetjie.

Unlike most treatment centres, the well-regarded Stepping Stones is a registered psychiatric facility that specialises in dual diagnosis for patients suffering from a mental illness as well as addiction, as so many addicts are.

It has 30 beds, which are filled by a generous helping of foreign clientele, mainly Dutch, an attractive hold-over from the previous owners, one of whom was Carrie Becker, the original founder of the facility who ran it until it was sold to Akeso last year.

Donald Grove, the hospital manager, says it’s like “running a hotel for people with special needs”.

There are counsellors, nurses, administrators, catering and maintenance staff – 38 in total, making the staff-to-client ratio better than one to one. And that type of treatment doesn’t come cheap.

The facility charges R56 000 for locals and €6 700 for foreign clients.

Making good sense
A lot in rands, but translate that into the high-quality treatment with the beachfront view and travel to the tip of Africa, far away from your drug-abusing environment, and it all makes good sense. Still, although you’ll find it listed on the website luxuryrehab.in, Stepping Stones is no Cliffside.

“There is a great therapeutic environment at Stepping Stones,” said Sweidan. “But it’s the old Kommetjie Hotel. It’s hardly Sun City.”

I had been told the inside of its walls have seen the likes of rock stars and best-selling authors, politicians and TV personalities. But, from the outside, Stepping Stones looks like an aging block of white-washed beach flats.

Enter through the glass doors and into the lounge area and you’ll find a whiff of the hotel lodge, what with the old-school African décor, oversized fireplace and comfortable couches in a dated colour scheme of maroon, yellow and beige.

If patients weren’t in detox (there are facilities on the premises, staffed with 24-hour nurses who monitor the intense process of relieving bodies of their drug of choice), their day would have begun with coffee and a walk on the beach.

At 7.30am they would have shown up for their “serenity meeting” and breakfast, and 9am their programme would have begun: presentations on their drug histories, some Nia dancing, drum or equine therapy, some group work around the 12 steps or a one-on-one with their counsellor.

The day might have been complemented with a massage, a trip to the gym or an outing to the local mall to get their hair cut. They would end their day with a beach walk, dinner and an AA meeting. Lights out at 11pm.

Not a holiday camp
“They work really hard when they are with us,” says Sweidan, who lost a brother to a drug-related illness. “They are in groups all day, five and a half days a week. They aren’t sweeping the floors but they aren’t doing whatever they want when they want. It’s damn painful. The process of recovery is not a holiday camp.”

That comes into sharp focus in the room where art therapy classes are held. On the walls the minds of patients are sketched out on oversize brown paper.

Life-sized outlines of their bodies are filled with paint: chakras are presented in muted, muddy colours; a bottle of wine protrudes from the side of a head like an extraneous limb; a genital area explodes in great blobs of golden glitter.

So while art therapy might sound namby-pamby, it appears to bring out some seriously deep-seated issues.

Still, I was reminded of something New York Times columnist David Carr wrote in his gripping memoir, Night of the Gun. In it, Carr recounts the strict, rough-and-tumble treatment centre where he got sober where even the notion of art therapy would have been laughed out of the grubby building.

His Rx for Garbage Heads: “Enter the booby hatch. Preferably a place you never, ever want to go back to. Avoid treatment centres with duck ponds, good food, or a record of admitting Britney Spears or Lindsay Lohan.”

Next stop: facility with duck pond.

I arrived on a stormy day in Hout Bay and nearly parked in the best available space until I read the sign. “Goats may climb on vehicle if you park under tree.”

A coalition of animals
Confused, I decided to squeeze in a bit further down. As I walked toward Harmony’s office, I realised they weren’t being funny: two goats sat comfortably on the tennis court near the swimming pool. They were joined by a coalition of animals: chickens, two donkeys, an ostrich and, yes, ducks that had their very own pond.

I was ushered in by one of the counsellors to the day’s lecture. At the top of a set of stairs, in a cold room with turquoise curtains and long desks, a blonde woman with a ponytail pulled up a Powerpoint presentation.

“Why do some people use?” asked the presentation, which was created by Dr Rodger Meyer, who many refer to as the father of addiction medicine in South Africa.

“Intoxication, experimentation, celebration, deviation, medication, obfuscation, annihilation,” it answered. The patients slowly nodded their heads in agreement as we moved on to the more pressing part of the discussion. Why do some people become addicts and others don’t?

The counsellor presented the Vietnam Study, often quoted research in halls such as these, which found that 46% of soldiers in Vietnam had used heroin at least once during their tour. But when they returned home, only 12% continued to use, the analogy being that some people use drugs environmentally and can stop taking them. Others can’t.

Harmony’s founder, Steve Thomson, is part of that 12%.

A towering, charming man in his 50s with a shaved head, a stern brow and deep-set blue eyes, he still maintains his thick Scottish accent, despite a childhood growing up in Benoni with two alcoholic parents.

He left Cape Town for Glasgow at age 20, returning 15 years later with an addiction to “anything that was going”. Eventually, he checked himself into Kenilworth Clinic, then relapsed. He entered Tharagay House, another treatment centre, this time for four months. It was there that something took.

“Sometimes you enter a treatment centre and form a bond. That’s what happened to me. That same bond, if I’d been in Malibu or in some shithole, it was that bond that got me clean and sober. The first time in my life, someone got me. And she would have got me anywhere.”

Hippie suimmer camp
Thomson hopes that some of the bodies that pass through Harmony – one of the most well known being cricketer Herschelle Gibbs – will get got. What Thomson has managed to create in this rustic beach cottage compound is more hippie summer camp than luxury beachside resort. But the rules are strict: like it or not, you are going for that 7am beachwalk, rain or shine.

Men and women are segregated in both sleeping areas and in most activities. There will be no sugar, no junk food, no processed food and the carbs served by the kitchen will be few and far between. (The facility recently teamed up with Professor Tim Noakes for an inpatient programme for sugar and carbohydrate addiction.)

They offer massage, meditation and yoga, as well as holotropic breathwork. The cost for 30 days: R35 000; foreigners pay double. Add on a bit more for one of the two private suites, one of which is named after Desmond Tutu, who gave the facility his blessing.

Thomson opened Harmony in 2008, but it all started with Serendipity, the tertiary care facility in Woodstock in 2001. Since then, he’s opened Akron Addictions Clinic in Kommetjie, the secondary care facility Harmony House, as well as three sober living houses around Cape Town.

Rehab is big business that feeds on itself and, as Thomson knows as well as anyone else, tends to come with plenty of repeat customers.

“The nature of the disease is such that people will be back. And they will go back to those who helped them originally. You have this carousel of broken people that you fix, but not completely. It’s a cash cow.”

That’s Herman Lategan, a freelance writer who lives in Cape Town. A friend insisted I meet him, saying he would give me the inside scoop on all things rehab precisely because, well, he was on the inside. A lot. I emailed Lategan when I arrived in the city and got an enthusiastic, though interesting, response for someone in recovery.

“Let’s meet for drinks,” he wrote.

Dreadful food
Over a glass of beer at the Devil’s Peak Brewing Company, Lategan told me of his battle with benzodiazepines, the class of sedative-type prescription drugs fondly known as “benzos” to addicts, and more than his fair share of cocaine.

He’s been to five rehabs in total – twice at Kenilworth Clinic, stopping off at Stepping Stones, and over for a stint at Harmony, after meeting Thomson in “The Rooms”, the accepted code word for 12-step meetings. Each time, he relapsed. Finally, in 2009, at the government hospital, Stikland, where “everything was tidy and the food was dreadful”, something clicked.

“I walked out of there and I was whole,” he said. “I have never gone back to sleeping tablets, or Xanor, or cocaine or anything else.”

Eventually he went to work at Montrose Place. It was 2011 and, as Lategan tells it, Graaff’s behaviour was erratic; not long after that the facility closed down and Graaff disappeared from the scene. And that, he said, was while the family had already made plans to open another facility in the winelands near Somerset West.

That night I ended up at the Pot Luck Club, overlooking the city lights from the top of an old Woodstock warehouse. Over exquisite small plates of Korean fried chicken with pineapple and miso slaw, I met a woman who was eight months sober. I’ll call her Patricia.

Patricia wore diamond earrings the size of plump peas and a diamond ring that acted as a small hand weight on her slender, pale finger. Patricia sipped on Coke Lite and told us of her addiction to benzos. It was her second tour through treatment; 10 years before she had found herself in another one, overseas.

She openly talked about her recovery, about The Rooms where she now spends much of her time and about her current volunteer work at her treatment alma mater, Harmony.

As we spoke, our waitress – a perky, attentive blonde – rang in with her own story.

“Everyone is taking drugs. Except him,” she said, giggling, and pointing across the room to another waiter. And then, almost as an aside: “My father just got out of Kenilworth. Alcohol, you know?”

The next day I found myself in the genteel suburb of Kenilworth meeting Dr Roger Meyer at the psychiatric group practice which specialises in addiction medicine. Housed in a refined office with hardwood floors and dark leather couches, it exudes the particular, fragile quietness found only in rooms such as these.

The practice sits across from the Akeso-owned Kenilworth Clinic, the psychiatric hospital where Meyer began his foray into addiction medicine.

Severely damaged hands
Meyer, who wore comfortable jeans and a grey K-Way sweatshirt, his readers perched on top of his head, told me he worked as a GP through a harrowing intravenous drug addiction that left his hands severely damaged; they are thick, like baked bread, and if you look closely you will see the tiny pockmarks, which are scars from abscesses left from repeatedly injecting himself.

“My little works of art,” he says.

Meyer got clean in the United Kingdom more than 25 years ago. But upon his return to South Africa, he couldn’t find a Narcotics Anonymous meeting to support him in his recovery. So he started his own. (There are now more than 70 meetings you can attend on any given week in the Cape Town area.) He continued in private practice until he began to amass a patient roster that included an increasing number of addicts.

In 1992 he and Carrie Becker, who would handle the therapeutic part of the project, started up an addiction unit at Kenilworth Clinic, the first in the country. (They split, with some differences, in 1996 when Becker was offered the hotel in Kommetjie. Eventually Meyer acquired a share in the clinic, selling it later to his partner, who then sold it on to Akeso in 2012.) Since then, the number of private treatment centres has mushroomed. There are now more than 30 operating in the Cape Town area, 19 of those being in-patient clinics.

In his silver Mercedes, we took a tour of the addiction medicine saturated neighbourhood – Tharagay House, Meyer’s own treatment centre, the secondary facility Kenilworth House, as well as the Living House, a sober living home, are just a few – while he told me of his journey through addiction medicine.

“Nobody has spawned their own competition more successfully than I have,” Meyer told me. “They have either worked for me or been patients of mine, and I won’t say which. And I’m proud of that. If you look around the world, there are little focuses of addiction treatment expertise – southwestern England, the States, Australia. We’ve got a whole network of respected facilities.”

One of those is Seascape House, which Meyer opened in 2008.

Situated in Dolphin Beach, Bloubergstrand, from the outside it looks like a boutique hotel. I found the chef, who trained at Zevenwacht Wine Estate in Stellenbosch, in the kitchen, preparing rocket, avocado and feta salads for lunch.

The 12-person facility, which, when I was there had almost all foreign patients, charges R35 000 for locals with an extra 20% premium for foreigners. It has a unique setup.

Clients who come here have already detoxed and most stay for two months. After the first week, they have access to their cellphones and their computers; they can even go down to the corner café for a coffee, and hopefully not something more stimulating.

But, as Meyer says: “If you are going to relapse, the best place to do it is in treatment.”

Sadly, relapse is often part of the recovery process. But try telling that to an addict’s family member who has just shelled out tens of thousands of rands, only to find their loved one smoking or snorting or shooting up days, months, or even years later.

“It’s not like having your appendix out, where you go in a hospital with a sore tummy, your appendix is removed and you leave three days later and you are more or less cured. Addiction is a chronic problem. It needs to be understood that rehabs are part of the process.”

It was just outside Somerset West, along Winery Road, that winemaking and sobriety finally did meet. Rustenburg Addiction Care is South Africa’s upmarket rehab pièce de résistance.

As we drove down the brick road into the facility, which was shrouded by a canopy of trees, a small herd of springbok dined on a manicured lawn. Here, on this Dutch colonial estate, there is a French chef, two swimming pools, a rose garden and – never mind a duck pond – a small lake with weeping willows that look on to the vineyards beyond.

This would have been Johnny Graaff’s next treatment centre. But he moved to London, abandoning it along with Montrose Place, which, according to an attorney for the family, was repurposed for “business reasons”. What he left behind allowed “a little piece of rehab paradise” to fall into Meyer’s lap.

It’s clear Meyer is proud of what he’s built, revelling in his latest treatment acquisition. But throughout all his successes Meyer is most proud of his own recovery from an addictive disorder.

“At the end, if I had died, it would have been a relief. To carry on the addiction had become such hard work and I didn’t know how to get out of it. Sometimes you wish death would embrace you. But I went to a treatment centre where the disease-model theory began to make sense and I realised this was something I could recover from.”

And that, says Meyer, is what is really what treatment centres –whether they come with high thread counts or threadbare sheeting – are offering.

“The fundamental commodity of what we sell, what the client is buying from us,” he says quite simply, “is hope.”

Tanya Pampalone is the executive editor of the Mail & Guardian. She oversees print and digital narrative features and special editions, such as this one. Follow her on

@tanyapampalone

The New York Times bestseller by David Sheff, the journalist father of a crystal methamphetamine addict, unravels his son’s addiction, its effect on him and his family. Son Nic later wrote Tweak: Growing up on Methamphetamines, while Sheff’s latest book, Clean, takes a well-reported look into the latest addiction research and treatment models in the United States.

CATASTROPHE: OY VEY, MY CHILD IS GAY (AND AN ADDICT) by Anne Lapedus Brest (Jacana)

The title might be cringe-worthy but it gets the point across. This is the tale of a nice Jewish mother who discovers her beautiful King David-educated daughter Angela is not just a lesbian, but also addicted to CAT (methcathinone, a synthetic amphetamine). Brest details her own struggle to come to terms with her guilt while trying to bring her daughter back from the abyss.

DYSTOPIA by James Siddall (Jacana)

The subtitle sums it up: ”From glittering media career to sordid shebeen gutter – and back again.” Siddall was the twentysomething deputy editor of South African Playboy whose addiction to alcohol and benzodiazepines ultimately left him homeless, resulting in a court-ordered two-year rehab incarceration and a fight for his own recovery.

I WANT MY LIFE BACK by Steve Hamilton (Penguin)

Hamilton’s spiral into alcohol and drugs began as a teenager, landing him with a criminal record at 15. It took 11 institutional stays and being pronounced dead three times for his recovery from a heroin and alcohol addiction to come about. A founding member of Narcotics Anonymous in South Africa, he is now on the speaker circuit about addiction.

LIT by Mary Karr (HarperCollins)

Raw honesty paired with disturbing detail and glorious prose sucks you into Mary Karr’s rough-and-tumble world, which is well soaked in vats of alcohol. The daughter of alcoholic parents from Texas, it’s a miracle that Karr made it out alive, much less as a Guggenheim Fellow in poetry and a professor of literature at Syracuse University.

MEMOIRS OF AN ADDICTED BRAIN by Marc Lewis (PublicAffairs)

What makes this addiction memoir even more addictive is that Lewis is a neuroscientist who meticulously takes you through his drug use – from cough medicine and LSD to heroin – and then tells you exactly how the drugs he has been experimenting with since he was a teenager affect the brain.

PERMANENT MIDNIGHT by Jerry Stahl (Process)

Stahl was the coolest writer on the block who happened to be shooting heroin while contributing to Esquire and being gainfully employed on some of the hottest TV series of the time, Thirtysomething and Twin Peaks. Penned before addiction memoirs had their own genre, the book resulted in a movie starring Owen Wilson and Ben Stiller.

THE NIGHT OF THE GUN by David Carr (Simon and Schuster)

The New York Times columnist reports his way through his own addiction beginning with the night his friend held a gun on him. Or maybe Carr was the one holding the gun? What keeps you hanging on through his alcohol-fuelled cocaine binges and intravenous drug use is that, despite it all, he’s going to end up on the front page.

SCAR TISSUE by Anthony Kiedis (Hyperion)

This rollicking ride comes with oodles of ego, mounds of drugs and lots of sex. Fans of the Red Hot Chili Peppers should not miss singer Anthony Kiedis’s memoir, from his down-and-dirty Hollywood childhood with a dope-dealing father through to the scandalous heights of rock stardom, all tinged by alternating states of massive addiction and recovery.

SMACKED by Melinda Ferguson (Penguin)

This suburban girl goes really, really bad: losing her home, husband and two children, and ending up in Hillbrow’s drug and prostitution underworld. It is probably South Africa’s most well-known addiction memoir. Ferguson followed up the book with Hooked, an account of her struggle with her ongoing recovery.

Catastrophe: Oy Vey My Child is Gay (and an Addict) by Anne Lapedus Brest (Jacana)
The title might be cringeworthy but it gets the story across. This is the tale of a nice Jewish mother who discovers her beautiful, King David-educated daughter Angela is not just a lesbian, but also addicted to cat (synthetic amphetamine). Brest details her struggle to come to terms with her guilt while attempting to bring her daughter her back from the abyss.

Dystopia by James Siddall (Jacana)
The subtitle sums it up: “from glittering media career to sordid shebeen gutter – and back again”. Siddall was the twentysomething deputy editor of South African Playboy whose addiction to alcohol and benzodiazepines ultimately left him homeless – resulting in a court-ordered, two-year rehab incarceration and a fight to recover.

I Want My Life Back by Steve Hamilton (Penguin)
Hamilton’s spiral into alcohol and drugs began as a teenager, landing him a criminal record at the age of 15. It took 11 stints in an institution and being pronounced dead three times for Hamilton’s recovery from heroin and alcohol addiction to take place. A founding member of Narcotics Anonymous in South Africa, he is now on the speaker circuit talking about addiction.

Lit by Mary Karr (HarperCollins) Raw honesty paired with disturbing detail and glorious prose sucks you into Karr’s rough-and-tumble world, which is well soaked in vats of alcohol. The daughter of alcoholic parents from Texas, it’s a miracle that Karr made it out alive much less as a Guggenheim Fellow in poetry and a professor of literature at Syracuse University.

Memoirs of an Addicted Brain by Marc Lewis (PublicAffairs)
What makes this addiction memoir even more addictive is that Marc Lewis is a neuroscientist who meticulously takes you through his drug use – from cough medicine and LSD to heroin – and then tells you exactly how the drugs he has been experimenting with since he was a teenager affect the brain.

Permanent Midnight by Jerry Stahl (Process)
Stahl was the coolest writer on the block, who happened to be shooting heroin while contributing to Esquire and being gainfully employed on some of the hottest TV series of the time, Thirtysomething and Twin Peaks. Penned before addiction memoirs had their own genre, the book resulted in a movie starring Owen Wilson and Ben Stiller.

Scar Tissue by Anthony Kiedis (Hyperion)
This rollicking ride comes with oodles of ego, mounds of drugs and lots of sex. Fans of the Red Hot Chili Peppers should not miss lead singer Anthony Kiedis’s memoir, from his down-and-dirty Hollywood childhood with a dope-dealing father through the scandalous heights of rock stardom, all tinged in alternating states of massive addiction and recovery.

Smacked by Melinda Ferguson (Penguin)
This suburban girl goes really, really bad – losing her home, husband and two children and ending up in Hillbrow’s drug and prostitution underworld – is probably South Africa’s most well-known addiction memoir. Ferguson followed the book up with Hooked, an account of her struggle with ongoing recovery.

The Night of the Gun by David Carr (Simon and Schuster)
The New York Times columnist reports his way through his addiction, beginning with a night in which his friend pulled a gun on him. Or maybe Carr was the one holding the gun? What keeps you hanging on through his alcohol-fuelled cocaine binges and IV drug use is that despite it all, he’s going to end up on the front page.

My husband and I looked at one another quizzically and turned back. There she was, eyes shut, head folded down, hands pressed together. Our daughter was praying?

The next day, after dropping Tatiana in her preschool classroom, I headed to the school office.

The headmistress was a stern, no-nonsense woman, prone to sending curt newsletters lecturing us new parents on our lax approaches to discipline.

I was led into her office to run through what had occurred in the back seat of our car the day before.

Simple question
"I'm not sure who she's praying to," I said, trying to make light of the situation. "Buddha or Allah or Jesus?"

The headmistress pursed her lips.

"Here," she said, unimpressed with my heathen ways, "we pray each morning."

"I just didn't know this was a religious school," I managed, before I was sent on my way.

It was clear: this was a Christian place.

Marked parents
From then on, we were marked. We averted the thin smiles that shot past us when we dropped off our child. Tatiana continued to pray in the back seat, off and on, for that year. We came to accept it like we did the Barney song; slightly odd, but if it made her happy, well, pray on.

When Tatiana started public school, I found prayer more concerning. Each morning as the children lined up before class, their legs crossed on the cold concrete outside the main hall, they would recite their Christian-based school prayer.

The children were instructed that they didn't have to participate if they didn't want to – a good thing since more than a quarter of them were Muslim.

Why it happened at all bewildered me; what an alienating ritual for those not in the right club. How did this all jive with our Constitution? Why wasn't anyone saying anything? But, really, I knew. I had already learned why one would keep their mouth shut on matters of God.

Yet we had to say something after Tatiana's first-grade teacher told her she was Christian. It was our own fault. We didn't discuss religion much, other than to say that we believed in the universe and that there were a lot of gods and so it was difficult to commit to just one. Which, it appeared, was a not clear enough concept for a six-year-old.

Pick one
One afternoon the teacher went around the class asking each child their religion. When she came to my daughter, Tatiana said she didn't know. So the teacher asked which holiday she celebrated. Christmas, came the answer. Tatiana informed us that evening of her conversion.

The next day I scoured the shelves at the local bookstore and picked up What Do You Believe?, which presented the world religions in a simple, colourful format. My daughter, in turn, picked up my husband's old children's Bible and read it every night for a month.

After that, Tatiana told a few friends at school that she was not Christian, that she was not anything in fact. They teased her for a few weeks, insisting she was lying.

Tatiana is now in senior school. She tells me the headmistress at this public school sometimes recites a prayer, and the children are asked to lower their heads.

I'm still uneasy about prayer in school. But my daughter, seemingly comfortable in her secularism, doesn't mind. She dutifully lowers hers and says an "Amen" in closure, accepting it all with grace.

Tanya Pampalone is the executive editor of the Mail & Guardian. She oversees print and digital narrative features and special editions, including the annual religion edition. Follow her on @tanyapampalone.

An interesting sort of irony. Jock of the Bushveld, which was written by Clyde’s great-grandfather, Sir Percy ­FitzPatrick, is a South African classic that was first published in 1907 at the urging of FitzPatrick’s friend Rudyard Kipling, and it hasn’t been read widely for years.

I met Clyde, who owns a lodge in the Addo Elephant National Park in the Eastern Cape, and his sister, Sally Ann, who works for a publishing company and lives in Parkhurst, after I returned from a trip to Jock Safari Lodge in the southern part of the Kruger National Park.

I was trying to figure out how it was that FitzPatrick’s descendants had come to build the first private concession in the park. The siblings are the children of Patricia and Desmond Niven, who was one of three children born to Cecily FitzPatrick — her father Percy’s only surviving child — who married Jack Niven in 1923.

The family, Clyde explained, first built the lodge in 1983, after the National Parks Board asked them to take part in a new venture, a creative sort of funding strategy that would allow the park to build upmarket lodging without impinging on their own severely constrained budget.

The ask: build a lodge in the middle of the Kruger National Park and let us hire it out and we’ll give the family exclusive rights to it for 40 nights a year.

The family chose a spot situated on the confluence of two rivers — the Biyamiti and the Mitomeni — near Old Jock Road, which once formed part of the transport route between Delagoa Bay (Maputo) and Lydenburg, the route FitzPatrick travelled as a transport rider and prospector’s hand, the adventures of which he wrote about in Jock.

After 1994, Clyde explained, the parks board felt uncomfortable with the notion of those “exclusive” camps, demarcated the concessions and leased them out on open tender. These days the owners of Jock Safari Lodge — with its 12 chalets in the main lodge area and a smaller encampment called ­FitzPatrick’s, with three suites — are the Shamwari Group and the former owners of the V&A Waterfront, the Dubai World Group.

The FitzPatrick Family Trust (which also oversees the Percy FitzPatrick Institute of African Ornithology at the University of Cape Town, and has entrusted historical documents to the National English Literary Museum in Grahamstown) maintains a marginal ownership —as well as their designated nights throughout the year.

The rooms, which stand alongside the mostly dry riverbeds, come with their own treehouse viewing area with a big day bed that you can plunk the whole family onto, a private plunge pool and an outdoor shower.

The rooms themselves aren’t large, but they do the job, a good-sized bath, a king-size bed, a full bar (not inclusive, and, sadly, not always restocked, even with the basics, when we were there) and a copy of Jock of the Bushveld — the modern, edited version, racist rhetoric removed. There’s a spa and a small gym situated near a statue of Jock himself.

The dining room is grand in the evening, beautifully lit with candles and zipped down to keep the cool night at bay. But food was uneven when we were there — one night a great lamb curry, the other a braai with 1980s hotel-school-style creamed spinach. The meals and two game drives were included in the price, which makes it slightly easier to swallow the generous price tag.

The drives — early morning and early evening — were expertly ­handled by experienced guides who really knew their bush and, with their radios, were able to deliver the best of it. But it is their latest offering, a first of its kind adventure in the Kruger National Park, that takes the more adventurous on a two-day walking safari, where upmarket camps are set up in different locations in the park, with tents, canvas washbasins and lanterns. At R2 000 per person per night, camping with experienced guides in the middle of the park, is really a once-in-a-lifetime experience.

It’s something that would have made FitzPatrick and his daughter, Cecily, proud. Clyde tells the story of his adventurous grandmother who went on a hunt for Jock’s grave in 1948. She and Eric Chapman (and a man referred to as Mr Costa) found it, with the help of some long-time residents, including the famed game ranger Harry Wolhuter, who pointed them in the right direction — a fig tree, just as FitzPatrick had written in Jock.

When they reached the spot, Cecily changed her mind. Family legend has it that their grandmother said she decided “it would have been a pity to disturb the dear old dog’s bones — let him lie”.

Her grandchildren say they are planning an adventure of their own — one that will take them to where she left off. Sally Ann and Clyde say they want to follow FitzPatrick’s trail, which was once demarcated by a series of brass plaques in the Kruger National Park, which have, over the years, been stolen. Clyde and Mike Wolhuter, Harry’s great-grandson, plan to replace the plaques.

It’s a worthy exercise for a fascinating historical character — the son of an Irish-born judge of the Supreme Court of the Cape Colony, FitzPatrick worked as a prospector’s hand, became the editor of the Gold Field News in Barberton, was tried and imprisoned for high treason for his involvement in the Jameson Raid, wrote four books (Jock, The Transvaal from Within, The Outspan and South African Memories, which was published posthumously) and went on to become an MP of the Union of South Africa.

Like his great-grandfather, Clyde is a bit of an adventurer — he once travelled by ox wagon with Andrew Hall — the grandson of Hugh Hall, another central character in Jock — along the same trail through the Selati area that FitzPatrick took.

Both he and Sally Ann thought the Shamwari Group’s latest venture of taking people out into the bush was a splendid idea.

The writer was hosted by Jock's Safari Lodge.

● Great for: A long bush weekend for a family, or a romantic getaway.

● Cost: Standard rates start at R3 100 per person per night, including game drives but you can find occasional specials starting at about R2 500 per person per night, including meals and game drives. The Explorer Camp costs R2 000 per person per night, all inclusive.

● Accessibility: Located in the southern part of the Kruger National Park, it is a five-hour drive from Johannesburg.

● Information: Visit www.jocksafarilodge.co.za or check bushbreaks.co.za for late-booking specials.

The Grugq also advised would-be hackers (at whom his discussion, subtitled "lessons in counterintelligence from history's underworld", seemed to be aimed) not to talk to the media.

The online brochure of the eighth annual ITWeb Security Summit, held at the Sandton Convention Centre this week, didn't include his photo or even give him a title.

But the Grugq broke his own code last year when he spoke to Forbes, who revealed that he's originally South African, is based in Bangkok, and arranges six-figure (US dollar) deals between government agencies and hackers for, the magazine wrote, "hacking techniques that take advantage of secret vulnerabilities in software", taking a 15% cut.

The Grugq was one of the speakers.

The others seemed to be more interested in telling you how to protect yourself from computer security threats like The Grugq.

Commercial espionage
It is a $100-billion industry. That's if you believe the estimates of the event's keynote speaker, Misha Glenny, the investigative journalist whose book DarkMarket: How Hackers became the New Mafia recently came out. Glenny, whose PowerPoint was much more impressive than The Grugq's, churned out the main computer security threats – crime, commercial espionage and spying and warfare – to dramatic James Bond-style music with flaming words like "cyber malfeasance" burning on the screen.

Glenny, who is a former BBC journalist and wrote McMafia, on organised crime, in 2009, said the first thing he learned from the ­hackers he interviewed was to read Sun Tzu's The Art of War, the thrust of which was to understand that you must "know your opponent and learn from him".

What we can learn from the mostly white, mostly male, largely pale and collared-shirt-without-ties-wearing gathering, is that they like coffee. A lot. The queue snaked around the Mimecast booth – where conference goers waited patiently for their free cappuccinos, lattes and espressos, or for a chance to stand inside their "air vac" machine and gather a bunch of red tickets which flew around them and put them in line to win docking stations, something called virtual recording glasses, or a Nespresso machine.

Just across from the booth, was Jacques van Heerden, chief executive officer of Global Technology Security Provider. His drone, which looked like a tiny alien aircraft, proved popular with conference goers. Van Heerden – who is also a master instructor who teaches ethical hacking – said he brought the drone, along with other security-compromising gadgets to show potential clients just how vulnerable they are.

It seems that little, easy-to-obtain devices with nice names like Pineapple, Raspberry Pi and Rubber Ducky can help a hacker take over your entire computer system.

"I say I have god powers," said Van Heerden without blinking. "If I hack into your network I control your network. I've got the keys to your kingdom."

This means penetration and, if it happens, things will surely go tits up.