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Doctors pull back the curtain on COVID trauma

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Watching a quarter of their patients die from COVID-19. Being yelled at by a family unable to come to terms with their father’s demise. Spending hours talking to families and rabbis when a patient refused ventilation. Seeing the first critically ill young patient typing a goodbye message to his wife, afraid to close his eyes in case he stopped breathing. Witnessing a 17-year-old flinging herself on her father’s body, begging him to keep fighting (when family were allowed into wards).

These are just some of the traumatic experiences that Drs Carron Zinman and Anton Meyberg describe as they try to capture why being on the frontlines of the COVID-19 war has been so devastating to the mental health of doctors and other frontline workers.

They are both pulmonologists at the Linksfield Clinic in Johannesburg, working together during the pandemic. “The most poignant time was when I watched Anton say the vidui prayer for our patients who we knew weren’t going to survive,” says Zinman.

Going back to the beginning, she recalls how they “understood coronaviruses, but SARS-CoV-2 changed the rules. While we were grappling with the complexities of this new disease, we had to contend with a deluge of patients”, many of whom were seriously ill.

“I remember the terror when the first AIDS patient was admitted. I looked after the nursing sister who picked up Ebola, dressing in a spacesuit to assess her. In those times, I felt calm and in control. But COVID-19 was overwhelming and exhausting, and caused a high level of anxiety and stress,” she says.

She remembers getting used to PPE (personal protective equipment), which is uncomfortable, restrictive, and depersonalising.

“We felt like we were fighting a war whose rules of engagement we didn’t understand. I remember the shock at the sheer number of death certificates we had to sign. I recall when Anton admitted a friend – it’s impossible to stay dispassionate in that situation.”

She was deeply affected by the rollercoaster of emotions when patients were well enough to be discharged, yet died suddenly, or the guilt of children who had inadvertently given their parent/s COVID-19.

“More often than not, only one of a couple would go home. The ward rounds felt interminable, often being interrupted by calls for resuscitation and admission. It’s an unpredictable disease and as such, we couldn’t always prepare the families for what was to come. We felt like we were being pulled in multiple directions while being physically tired, sleep deprived, and emotionally drained,” says Zinman.

“Then the second wave hit. We had become complacent, believing we understood this disease, but COVID-19 decided otherwise. The new variant affected younger patients, led to a fuller intensive-care unit and a higher percentage of patients on ventilators. This time, patients tried to get us to promise that they would survive to see their children grow up, and we witnessed last phone calls to wives in which they professed their love and asked them to look after their babies. A lot of time is spent agonising over our decisions, trying to find something more we could do. The emotional trauma inflicted by COVID-19 is unique.”

A local general practitioner (GP), who spoke on condition of anonymity, says, “Since the beginning of the pandemic, I have experienced anxiety, although over time, what specifically triggers it has changed.

“In the beginning, I felt overwhelmed by not knowing enough. We saw the hospitals in Italy, and it was frightening. The thought of possibly having to work in a hospital setting after a number of years as an office-based practitioner was overwhelming. The ‘silver lining’ was the realisation that I wasn’t alone in feeling majorly under-prepared.

“The fear of becoming ill, of bringing the illness home to my family, coupled with the enormous pressure of trying to be available to see patients while having kids at home remote-learning was exhausting,” she continues. “By the time the second wave came, I felt more knowledgeable, but when it came, it was much harder.

“The number of patients who contracted the virus was high. The practice couldn’t keep up with the appointments, tests, and patients who needed to be managed at home. The constant feeling of not being on top of things and also of ‘neglecting’ non-COVID-19 patients took a toll.

“There was the stress of trying to find hospital beds for patients. Everyone was under immense pressure, which was palpable. Trying to support families, keep them updated on their relatives, as well as dispel myths and give reliable advice all felt like a lot to manage.

“And then there were the deaths. So many deaths. It really took a toll on me. I had physical symptoms of anxiety such as a tight chest, abdominal cramps, insomnia, and headaches. I absorb a lot. Usually I try to make time to decompress, but during the peak, it was really impossible. The thought of a third wave gives me massive anxiety. I’m choosing not to think about it.”

Clinical psychologist Dr Hanan Bushkin says that among the medical professionals he has treated, “the rate of burnout, post-traumatic-stress disorder (PTSD), depression, and anxiety is through the roof. With the pandemic showing no end in sight, it has become way more difficult. The brain likes to predict the end point and if it can’t, despondency and depression set in.

“Doctors used to have time to be with family, rest, see friends, exercise, and so on but now they don’t,” he says. “This pandemic has piled on their stressors and eradicated their resources. It’s like being a soldier who has only trained for war but is now experiencing real war, and it’s a whole different ball game. They are seeing traumas that the public don’t see, and this can lead to huge frustration at the ignorance, arrogance, and lack of prevention they see on the street.”

Bushkin says GPs often treat generations of families and get to know them well. Now, he says, “they have a front-row seat to families being broken and the incredible losses of many people that they had a personal relationship with”. In addition, before the pandemic, people who died were usually elderly, or slowly declined after a cancer diagnosis. Now, patients of all ages are getting sick and dying within weeks. “It’s incredibly traumatic,” he says.

“PTSD doesn’t get you when you’re in it,” says Bushkin. “It’s afterwards when the trauma hits, when someone tells themself, ‘I cannot believe that’s the world I’ve just come from’.” He hopes that when the pandemic is over there will be some kind of platform or forum that allows healthcare workers to “de-brief” what they’ve witnessed.

Clinical psychologist Dr Dorianne Weil, who has consulted healthcare workers since the beginning of the pandemic, says, “Doctors are looked to for answers. But if they don’t have all the answers, it creates a dissonance that’s incredibly stressful. They may feel like an ‘imposter’, like they are ‘living a lie’. Everyone sees them as heroes, but they don’t feel that way.”

“There is also the pervasive fear of contracting the virus and passing it onto their families. They become ‘torn’ as they know it’s their calling. Sometimes they don’t want to rely on their families as a support system as there is a feeling that ‘unless you’re in my shoes, you don’t know what it’s like’,” she says.

Doctors have also had to take on the role of being their patients’ families, when family members haven’t been allowed to comfort dying loved ones. “They are stepping into a role that they aren’t usually called to do. It’s unprecedented, and it’s really getting to them.”

So what can we do to support our frontline workers? “There needs to be a group effort to do what these professionals are recommending,” says Bushkin. “I cannot think of a greater insult than for them to come out of a ward and witness people disobeying the rules. It’s incredibly disheartening, and doctors are devastated. It’s the least we can do.”

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UCT lecturer’s Hitler comment causes outrage

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The fact that a high-level University of Cape Town (UCT) lecturer told his students that “Hitler committed no crime” seems too unbelievable to be true, but it happened on 7 April 2021, on the eve of Yom Hashoah.

The phrase was uttered in a pre-recorded “introduction to political science” lecture by Dr Lwazi Lushaba, a lecturer in the political studies department at UCT, for first-year students. His only response to questions by the SA Jewish Report about his comment was, “please watch and be educated”, attaching the lecture and signing off as “Commandante Lushaba”.

During the talk, he claimed that politics hadn’t been informed by the lived experiences of black people, and that it took “what Hitler did to white people” to have massacres recognised in political science. “All Hitler did was to do to white people what white people had reserved for us – black people,” Lushaba said. “And so his crime, if he had a crime, was to do unto white people what white people have thought was right to do only to black people.” He went on to say that the Holocaust mustn’t be prioritised over other massacres.

The comments have sown deep division, and have been hijacked by some wanting to criticise Israel and the Jewish community. However, leading educator Professor Jonathan Jansen tweeted, “From the Wits student, Dlamini, to the UCT lecturer, Lushaba, the positive referencing of Hitler is more than attention-seeking behaviour by the intellectually vacuous. They reveal the utter depravity of the public discourse on university campuses today.”

The Democratic Alliance (DA) is to lodge a complaint against Lushaba with the South African Human Rights Commission. “The Holocaust was unequivocally a crime against humanity orchestrated by Hitler. The DA therefore strongly condemns the comments made by Lushaba,” said DA MP Natasha Mazzone.

“His comments weren’t only racist, offensive, and vile, but also completely insensitive to the victims and survivors of the Holocaust and the Jewish community as a whole. In remembering the victims of the Holocaust, we must place a renewed sense of responsibility on those in positions of power and influence to defend the truth and defend our democracy against any racist or antisemitic sentiments.”

“Lushaba has a long history of offensive and controversial actions,” Mazzone said. “In 2019, he allegedly took exception to one of the contenders in UCT’s election of its dean of humanities being Tanzanian and not South African. In an interview with Power FM, Lushaba stated that “reason and rationality are white”. Lushaba was also suspended by Wits [the University of the Witwatersrand] in 2015 for “participating in activities which weren’t conducive to free and fair elections, and were intolerant to a democratic society”.

The DA urged the institution’s vice-chancellor, Mamokgethi Phakeng, to place Lushaba on suspension pending the investigation. But UCT’s students’ representative council (SRC) has defended the lecturer. SRC chairperson Declan Dyer said it noted the public reaction, but the comments had been taken out of context, and were part of a larger critique of political science.

Student responses have varied. Jewish student Sam McNally, who is studying for a Bachelor of Arts in English and politics, told the SA Jewish Report, “As someone who has watched the lecture in its entirety, I believe Dr Lushaba’s point about the hypocrisy of ‘Western’ or ‘white’ political science holds up, but only in a very general sense. But his argument neglects to mention that Jews at the time weren’t exactly considered white and certainly weren’t considered such by eugenics, the prevailing racial ‘science’ of the time that formed a large part of Hitler’s justification for his actions.

“My main issue regarding the statement that ‘Hitler committed no crime’ is that it bears little to no relation to the point [Lushaba was trying to make],” continues McNally. “White people being hypocritical about genocide has nothing to do with Hitler’s criminality. As to whether Dr Lushaba meant something different by his comment – which is a theory I have heard postulated, particularly in the form, ‘He didn’t mean to say that Hitler committed no crime, but that he committed no more of a crime than colonial architects of genocide’, my view is that if he meant that, then he should have said it.”

Another Jewish student, speaking on condition of anonymity, says, “I believe Dr Lushaba is very critical of white people. I believe he was very negligent in his use of words. However, I don’t believe his statements were hate speech or antisemitic. I believe he was trying to illustrate the point that the world took notice of atrocities only when they were done to white people.”

Professor Adam Mendelsohn, the director of the Kaplan Centre for Jewish Studies at UCT, says, “On the face of it, Dr Lushaba’s comments appear to justify the Holocaust and absolve Hitler of responsibility for mass murder. Hearing his comments in the context of the broader lecture, Dr Lushaba seems to be claiming that Hitler acted within the legal and institutional system of the German state, and was therefore – according to the prevailing terms of German law – guilty of no explicit crime. This interpretation may make sense given Dr Lushaba’s larger argument about the shift of thinking within political studies as well as his repeated recognition that Nazism was responsible for genocide.

“All that being said, the historical claims that Dr Lushaba makes – about Hitler’s rise to power, the role of law within the Nazi state, the nature of Nazi antisemitism, and the ‘whiteness’ of Jews, the timing of the Final Solution – betray significant historical blind spots and errors,” Mendelsohn says. “At many points in his lecture, dubious historical claims are yoked to polemical claims. He could do with reading much more about Nazism and the Holocaust.”

Mathilde Myburgh, communications officer at the Cape South African Jewish Board of Deputies, says the board has given videos of Lushaba’s lecture and supporting information to its antisemitism and legal subcommittee, which is investigating the matter.

“Academic freedom and freedom of expression mustn’t undermine the central aim of our Constitution, which is to build a united and democratic South Africa based on mutual respect, understanding, and human dignity. Universities help shape the minds of the future leaders of our country. The personal views shared by this UCT lecturer were received as hateful and deeply offensive, and should have no part in the academic syllabus of a public university,” she says.

“To our knowledge, Dr Lushaba hasn’t yet apologised for or retracted his remarks. We await his further engagement on the matter, and would be willing to meet him. We have reached out to Vice-Chancellor Phakeng, and the university has launched an investigation. We believe the matter is for UCT to investigate and respond before any further measures are considered.”

Tali Nates and Mary Kluk of the South African Holocaust & Genocide Foundation say, “The Holocaust is one of the most horrific periods in the history of mankind. It’s deeply disturbing to hear reference to this painful history in a manner so laden with irony and cynicism without consideration of the damage and hurt that this flippant reference can cause.”

Says UCT spokesperson Elijah Moholola, “The University of Cape Town has been alerted to and notes with grave concern comments allegedly made by a staff member during an online class. We are verifying all the facts. In the meantime, UCT is clear that all brutalities of genocide constitute both formal crimes against humanity and ongoing sources of pain. We distance ourselves strongly from any other view. The matter is receiving attention through all appropriate channels.”

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Graeme Bloch: icon of education and activism

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In a tragic irony, a man who lived life to the full was condemned to endure an illness that meant he could no longer move or speak. But when Graeme Bloch died on Friday, 9 April 2021, at the age of 65, there was little doubt about the impact he had made on the struggle for a democratic South Africa and in the field of education, his true calling.

Watching their brother deteriorate from someone who hiked, ran marathons, loved to debate, and was an excellent speaker has been difficult for Lance and Shaun Bloch, two of his brothers who spoke to the SA Jewish Report in the wake of his death. Graeme was diagnosed with Progressive Supranuclear Palsy seven years ago.

The seven Bloch siblings have faced much trauma and tragedy in recent years, when their elderly mother, Rosalie Bloch, and her partner, Aubrey Jackson, were murdered in their home in 2018.

“I was actually in Cape Town to wrap up their estate last week when Graeme got pneumonia and was hospitalised,” says Shaun. “Graeme tested COVID-19-negative. Ironically, my brother, Guy, was admitted to the exact same ward at the same time for a minor health issue. It was a blessing in disguise because Guy could check on Graeme in the night.” He says Graeme was “up and down”, but “eventually deteriorated quite quickly and passed away”.

His life was fascinating and full from the start. As one of seven siblings (six boys and a girl), “it was an exciting, vibrant, intellectual household”, says Lance. “My father was a plastic surgeon, my mother a lawyer, so it was a really stimulating environment.” Shaun feels that debate, discussion, education, and recognising that all people are equal were all Jewish values instilled by their parents, and had a profound impact on Graeme, informing his choices from a young age.

“At the same time it was a very active family – we spent almost every weekend on the mountain,” says Lance. “He was a high achiever academically. I was often known as ‘Graeme’s brother’, as he really blazed a trail at school and university.”

Bloch’s passion for education and equal access to it started young. “In Standard 6 [Grade 8] he joined the organisation National Youth Action [NYA], which was the first non-racial schools’ organisation that agitated for fair and equal education for all,” says Lance.

Cape Town academic David Scher also remembers Bloch from their school days at Westerford High School. “There were so many Blochs that they were called ‘Blochlets’,” he joked. “Joining the NYA was really brave, as school principals disapproved of it, and it was unheard of for schoolchildren to be politically involved.”

As a University of Cape Town student, Graeme got involved with the National Union of South African Students and End Conscription Campaign. He was detained and arrested by apartheid security forces in 1976, and was “banned” from 1976 to 1981.

Scher recalls, “At the age of 20, he [Graeme] was beaten up in detention by the infamous [Warrant Officer Hernus JP] Spyker van Wyk, who brought his children along to watch the interrogation.”

Says Lance, “Being detained and on the run scarred him a bit. It made him more nervous, but also more determined. He was extremely brave.

“When he was banned for five years, he wasn’t supposed to be in touch with more than one person at a time, but he used to break that law,” Lance says. “He would come to family meals, and the Security Branch would be sitting outside the house. Sometimes, my mother would go out and give them coffee!”

Scher reconnected with Graeme when they both worked in the history department at the University of the Western Cape (UWC) around 1986. “He was part of the temporary staff. He couldn’t get a permanent position because he was so often on the run. I remember once I was staying with my in-laws. One evening, there was a knock on the door and there stood a stranger. I didn’t recognise that it was Graeme in disguise! He had come to collect exam scripts to mark.

“As a lecturer, he couldn’t be seen on campus in case he was arrested,” says Scher. “He would say that it was a ‘soulless experience’ not to be able to have a permanent academic job – he felt it keenly. Such was his sacrifice. And the students at UWC really adored him. He came to the university straight after he was released from detention, and they gave him a massive reception as he addressed them.”

“Education was really his passion,” says Lance. “He inspired a whole generation of youth.”

Former Finance Minister Trevor Manuel elaborates on this. “In the mid-1980s, Graeme ran education programmes for children who have since gone on to do amazing things in life. He gave them vision, determination, and hope. Many of them attribute where they are today to Graeme ‘unlocking’ their potential. That was Graeme – education wasn’t just academic, it was a deeply felt and passionate thing.”

Doron Isaacs, a founder of Equal Education (EE), remembers how “Graeme was an EE board member from 2010 for two and half years through the organisation’s most intense period of campaigning. What I most admired in Graeme was how seriously he took the school-going activists within EE, how he listened to them and engaged them, almost treating them as his leaders. He retained an instinctive radicalism acquired in his youth, but what he most admired in young activists was conscientiousness, discipline, hunger for knowledge, and patient organising. In spite of his close ties to the ANC [African National Congress], he never wavered in backing EE to confront the government and its leaders.”

Manuel continues, “Graeme was willing to do even the most menial tasks. When we launched the UDF [United Democratic Front] in August 1983, he landed up making soup. I don’t think his soup would have made MasterChef, but he did it because someone needed to do it.”

It was in the UDF that Graeme met his soulmate and future wife, Cheryl Carolus, who would later become the ANC’s deputy secretary general. Many describe how they complemented each other – Graeme was more subdued while Cheryl is more extroverted. Together, they were a force of nature.

“Another thing I remember is that all the mothers of other activists adored him,” says Manuel. “All of them, without exception, had the most unbelievable affection for Graeme. And being invited by so many families for supper made him the envy of his friends. Many of his networks were built like that.

“Whenever I visited his house, the most common feature in all their photos was laughter. He was a radiant, happy individual. The illness took away his ability to speak, but even as recently as a month ago, he would laugh at jokes. Notwithstanding the fact that he couldn’t talk, his joie de vivre wasn’t dimmed.”

Former Constitutional Court Judge Albie Sachs remembers how Bloch played a key role in welcoming him back to Cape Town after 24 years in exile in May 1990. “My first wish was to climb Table Mountain. I got the message out that after I landed at the airport, I wanted to go to my mom and have tea with her, then put on my takkies and climb my beloved mountain.

“But I needed someone to escort me. My arm had been blown off, and I wasn’t sure I could make it. I was told that comrade Graeme Bloch was the ANC’s ‘exercise person’, and had put together a team of comrades to join us,” Sachs says. “He took me up Constantia Nek, we walked past the reservoirs … I still remember the exact route after two decades … down Kasteel’s Poort, along the pipe track, and finally arriving at Kloof Nek corner. I felt triumphant. I wasn’t sure I could even do it, but he made it happen. You couldn’t have found a more gracious, warm, and generous person. He loved the mountain, and he loved freedom.”

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Lost Barmitzvah boy finally finds his way home

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When Stephen “Sugar” Segerman started searching for the Barmitzvah boy whose photograph was on his mantlepiece, he didn’t imagine he would find out from someone half way around the globe that the boy had once lived a few houses away from him.

Last week, the SA Jewish Report described how Segerman – who once searched for and found the musician Sixto Rodriguez

– was now trying to identify the boy in a photograph he found at the Milnerton Market in Cape Town a few years ago.

Within a few days of publication and the story spreading around the world, the identity of the barmi boy as the late Arnold Kleinberger was revealed. Segerman had an emotional meeting with Kleinberger’s daughter, Aura Zartz, who lives in Cape Town, on Tuesday (13 April) this week.

“In the days following the story appearing in the SA Jewish Report, it was shared all over the world, judging from the enthusiastic responses I immediately received,” Segerman said.

“I started receiving a lot of emails from people who thought they recognised the barmi boy. One said, ‘My name is Cedric Reingold. I grew up in Highlands Estate and matriculated from Herzlia in 1978. I recently read the article, and recognised the person in the picture. His name is Arnold Kleinberger. He was in our third-grade year and if I’m not mistaken, left [Herzlia] sometime thereafter.’”

Speaking to the SA Jewish Report from Chicago, Reingold said that he was scrolling through the online version of the paper, when he saw the photograph and immediately recognised Arnold. He then confirmed it with others in his matric year Facebook group. “But actually, I was 100% sure, even though he wasn’t at Herzlia for long [he then went to Cape Town High]. I can’t explain it – I just knew.”

Said Segerman, “I was elated. I then started an online search, and found that Arnold Kleinberger was born in 1960, which meant his Barmitzvah would have been in 1973, fitting with the timeline. Sadly, he passed away at the young age of 37 in 1997. I found a photo of his tombstone from the Cape Town Chevrah Kadisha website, and studied it to find any clues.

“It said that he was mourned by his family, but only his mother Sadie was named. I found out she had passed away in 2015. Her tombstone said that she was mourned by her daughters Marlene and Anita, son-in-law Maurice, and granddaughters Nadine and Aura.”

He searched the name Kleinberger on Facebook, and found a Doré Kleinberger, whose mother had been Eva Wolovitz. That led Segerman to Wolovitz’s tombstone, where again, he saw the name Aura. Further googling lead to the birth announcement of Aura and Adam Zartz’s son on the Herzlia Alumni Association site.

At this point, Segerman turned to his daughter, Natalia, and son-in-law, Ryan Rabinowitz, who were visiting from London, and asked if they knew them.

“Ryan looked at me with great surprise and told me that not only did he know Adam very well, but they had sat next to each other at shul that very morning,” said Segerman. “He immediately contacted Adam, and we spoke to his wife, Aura, who confirmed that the barmi boy was her late father, Arnold.

“She said that Doré was her mother, and her aunts were the late Anita Shenker and Marlene Kleinberger. Marlene had lived in Milnerton and passed away a few years before. Anita had cleaned out Marlene’s house and sent numerous items to the Milnerton Market.

“Aura was nine when her father passed away. She confirmed that his Barmitzvah was on 13 January 1973, and she had recently been given his Barmitzvah book by Anita’s husband, Maurice Shenker, which contained the same photo I had. She then told me that her father had grown up in Oranjezicht.”

Segerman and his wife have lived in Oranjezicht for the past 24 years, and it turns out they live just four houses away from where the Barmitzvah boy grew up.

In addition, Arnold’s parents’ domestic worker, the late Lettie Gal, would sometimes work for the Segermans. This is just one of many other coincidences linking all the people connected to the story.

Zartz, whose first-born child, Allegra, is named after Arnold, said that her father was always “elusive” to her. Her parents divorced when she was three, and she didn’t see her father much in the years before his death, which were marked with difficulties.

She said that when Segerman phoned, she felt like she was on some kind of ‘Candid Camera’ show – it didn’t feel real. In some ways, she felt heartbroken that her father’s photo had landed up in a stranger’s home, “but then I felt a huge amount of comfort that he was so close to where he grew up”.

She spent much of her childhood in her late grandmother’s home, and feels closely connected to it. Segerman emphasised that he has always felt very protective of the photograph, which meant a lot to Zartz.

Her mother, Doré, is the last remaining Kleinberger. She said Arnold’s father, Ernest, came to South Africa from Germany in 1936 when he was 13. “He had his Barmitzvah on the boat!” His mother, Sadie, was born in South Africa. She understands that Arnold was quite a “troubled child”, but also had many happy moments in his parents’ home and general goods stores, where he would help himself to chocolate.

“Their home was always warm and welcoming – a central meeting place that people gravitated towards,” Kleinberger said. “Arnold had a tough exterior, but was the kindest person. I think he had a difficult time in the army. But he loved Formula One racing and motorbikes, and would time keep at Killarney. He also loved to braai and surf. For our honeymoon, we went up the coast with his surfboard.”

Segerman was deeply moved by these revelations and in the days after finding all of this out, he went on his regular walking route, which passed the house that Kleinberger grew up in.

“Today my walk was different – more special and emotional than ever before. I stopped at both gates and thought about Arnold and all that has happened these past few days.” He has decided that he will say Kaddish for Arnold on his yahrzeit.

Zartz said that when Segerman first called, “I thought, ‘What is my father trying to tell me?’ And when I heard Stephen say he lived in Forest Road, I realised that he was just trying to make his way home. I don’t want to keep the photograph. I give it to Stephen with a happy heart. This story means that my dad is exactly where he needs to be.”

Correction: In the 9 April edition of the SA Jewish Report, we wrote that Stephen Segerman’s Mabu Vinyl store had closed. This is an error – it has not closed but has moved to new premises at 285 Long Street, Cape Town. We regret the error.

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