Meet the Dietitian: Community Service Series

By Danisa le Roux

My community service story looks a little different to most newly graduated community service dietitians. As my graduation drew near, the fear around the reality of my future started to become overwhelming. I started to have countless doubts about the path that I decided to take. Not because I didn’t love what I studied, but because reality hit me that this is what I will be doing for the rest of my working life, and uncertainty started to creep in. The fear of being placed away from my family and friends also gripped me. I graduated in the year 2019 and ended up being placed at a clinic that ended up being, as I feared, far away from my family and friends. Far away from everything I knew. 

Out of fear, I decided to decline the position and take a year to regroup and find out if this is really what I wanted to do with my life. Sometimes it’s important to be 100% sure. Long story short, I ended up being excited to apply for my community service year (round 2) for 2021, and no matter where I was to be placed, I knew this time I was certain, even if the distance was scary. I ended up being placed at Red Cross War Memorial Children’s Hospital, which is a dream come true, seeing that my passion is paediatrics.

I decided to become a dietitian because I knew that this is where my passion lies. I have a heart for maternal and child nutrition and working with children has always been a dream of mine (second to having my own children one day). I also have a passion for food and health, as well as for people in general. Dietetics covers all these passions and was therefore the ideal career path for me.

I studied at Stellenbosch University, and am so grateful for the incredible friends, and now colleagues, that I made during my 4 years of studying.

At Red Cross Hospital my main focus is optimizing nutrition within the first 1000 days of life. I work in the short stay ward, gastro ward as well as trauma ward. I, therefore, see many patients who present with malnutrition in all its forms (Failure to thrive, underweight babies, SAM/MAM, micronutrient deficiencies, etc.) I have also (nearly) mastered the effective management of acute and chronic gastroenteritis through the guidance of my incredible colleagues. On occasion, I will also cover the longer stay wards where I will see various patients who need feeding prescriptions and nutritional support either orally or via tube feeding. I also run our obesity, general, infectious disease and Cerebral Palsy clinics. And my favourite part of it all is providing breastfeeding support and education to mothers who need it. 

My main challenge when stepping into my community service year was the extra hours I needed to put in to refresh my theory after being out of practice and studies for just over a year. The knowledge came back quickly, however, and with practice and guidance from my colleagues, my confidence in patient care and management improved tremendously. 

If I could encourage any future community service dietitians/fellow community dietitians with anything it would be the following:

  • Follow your passion no matter how scary it might be.
  • Put in the extra study/research time. Continued learning is good and helps a lot.
  • Don’t be afraid to ask questions. Everyone was once where you are.
  • If you make mistakes, it’s not the end of the world. You will grow and learn from them. I had to, and still constantly have to remind myself of this.

Meet the Dietitian: Community Service Series

By Elske Rich

When it came to choosing a career path I knew one thing: I want to help people. This combined with my passion for Biology at school led me to find dietetics. At the University of the Free State, I met the most amazing group of ladies and lecturers who made me fall in love with all aspects of Dietetics. Now I adore this profession and its neverending possibilities.

I completed my Community Service year at the fairly new and very small Albert Nzula District Hospital in Trompsburg, about 120km from Bloemfontein. Situated next to the N1 right in the heart of the Free State this hospital was sometimes the only option for a higher level of medical care for up to seventeen small surrounding towns. This means that I spent half of my time driving to surrounding clinics and the other half in the hospital treating in- and out-patients or managing the food service unit along with the other Dietitians.

This hospital was my first choice as I worked in Trombsburg as a student. I knew the area and the type of patient that was to be expected but I never expected to gain so much happiness. Albert Nzula only opened its doors for the first time about four years ago. This meant that the Dietetics department had so much room for growth which excited me a lot. I spent my spare time developing educational material and organising wellness events as far as COVID-19 allowed in order to promote the profession.

Challenges included limited staff during the pandemic but this allowed me to feed patients and help them with sip feeds when there were not enough hands available. There was also no parenteral nutrition or a theatre but luckily Bloemfontein was not too far away. It became a part of the job to get creative with feeds in the hospital setting and spend long hours on the road driving to clinics that were far away. During the pandemic, it also became our job to supervise the food service aspect of the quarantine and isolation sites in the district. So not one day was the same.

If you know me, you know I love public speaking. As a result, all the health talks at the clinics were memorable to me. Especially when I got the patients to interact and start holding each other accountable as a community for their individual health goals. In addition, what I adored most was just really talking to people and seeing the impact of very small but significant changes in their life. I also really enjoyed visiting the clinics and having an excuse to hold and weigh all the babies!

I encourage you to make the best of every situation by looking at what service you offer from a patient’s point of view. If your approach is one filled with compassion and determination you can help every single person around you. I always say: “Everyone eats so there must be something I can help with.”


Meet the Dietitian: Community service series

By Leandré Piek


“Flexibility is key”

I remember doing a “personality test” during my dietetics studies that pointed out that I’m as flexible as a rock, not having the ability to eagerly adapt to new and unexpected environments and changes. This was true of me since I absolutely love structure, or so I thought.


As I entered my last year in high school, I still had no idea what I wanted to do with my life – but I knew it would be something in medicine and health sciences. It was thus appropriate to go to the open day at the Tygerberg Campus of Stellenbosch University, hoping that I would find some clarity!

Thank you to the 4th years at the dietetics stall who convinced me to choose dietetics as my future profession. With no plan B, I applied for the 4-year course, and by grace, I got accepted. With lots of grace, I got through the 4 years to where I am now!


Where am I now? Not in the Western Cape where I was hoping to be placed (I think a few can relate to this). No, I was placed at Kakamas Hospital in the Northern Cape, and can I just say how grateful I am for being Afrikaans!

During my comserve year I am getting the best of both worlds – a mixture of all there is to dietetics. I work in the hospital, at clinics, see out-patients, work in the food service unit, do training and health talks and manage a Severe Acute Malnutrition Project in the district. I absolutely love the variety, although it took me some time to get used to everything. It is not all textbook work, and it is normal to swim a bit before finding solid ground.

One thing that I can encourage is, to ASK QUESTIONS! Don’t be afraid to learn from others or to show vulnerability. After 4 years of studying, you know a lot, but you don’t know everything. After the anxiety and uncertainty of my comserve placement, I am extremely grateful for the journey so far.

In a rural setting, you must work with what you have, and this has improved my ability to be flexible and think out of the box! But it is absolutely what you make of it – how you see every opportunity, how you build relationships, how you treat other people, and how you keep on trying to do better.


Don’t be afraid to be flexible – it opens new doors that you didn’t know you needed.


Meet the Dietitian: Community service series

By Chené Vorster


“Stay positive by staying negative.” – The main joke of 2020

I stumbled upon dietetics by accident and I have never looked back. A friend of mine stated that she wanted to become a dietitian and she was going to shadow them in the upcoming holidays. Curious about this unknown career and unsure about what I wanted to study, I decided to do the same. The moment I entered the ICU, I fell in love with dietetics. As the university years progressed along, I realised how big this field was and I was amazed by all the areas we work in. I studied at the University of Pretoria, the “Jakarandastad” gave me fond memories and the opportunity to work from Stanza Bopape CHC to Chris Hani Baragwanath Academic Hospital.

During the year 2020, I was busy completing my community service year at Thelle Mogoerane Regional Hospital – a 760-bed hospital in Vosloorus, Gauteng. The first three months of the year went well, I was fortunate enough to have another comserve walk this daunting road with me. I ran the medical and surgical wards and occasionally a paediatric ward – everything was going well. I will never forget when a colleague sent me the post with the caption “It’s here”. We had been following this covid-19 but was told it’s too hot in SA. On the 23rd of March, everything started to change. We tried not to panic but the lack of knowledge on this virus and protocols on its treatment, the implication of the lockdown and all the new rules were overwhelming. We can no longer eat together, we had to rotate offices to prevent overcrowding, insufficient PPE and the emotions were running high. We had to close down the OPD and ‘sneak’ out some packages to patients that were being turned away. The importance of a dietitian became very clear during the pandemic and our services were needed all around.

My wards shifted and I was now in charge of the covid PUI ward, medical wards and occasionally the covid wards. I was terrified to go in there, terrified to walk out – “What if I contracted it?”. The kangaroo pumps ran out and I was feeding patients myself from time to time. The pandemic wasn’t all bad though, I built fond relationships, learned how to dance to Jerusalema, gained so much knowledge and love what I do. I am forever grateful that I could fight on the frontlines.

My advice to those who are still fighting on the frontlines:
MDTs are very important. Befriend everyone – they are an excellent support structure!
Don’t be intimidated – you have a lot more knowledge than you think. If the opportunity arises, write a protocol or volunteer to assist in a difficult case. Your hard work will not go unnoticed.
Be kind, but don’t allow anyone to walk over you – if there’s a problem, sort it out immediately.
Stay positive by staying negative – wear your PPE, wash your hands and sanitize everything. Practice social distancing and be a role model in your community.


Meet the Dietitian: Community Service Series

By Santi Turner

Hello, my name is Santi Turner and I’m currently 1 year post-comserve 

I’ve always had a big passion and interest in health, food and people. Dietetics is a combination of all 3 of these elements and that’s why I chose it!

My aunt is a dietitian in Namibia and she definitely sparked my interest in this field. I’m so glad that I chose to study dietetics and I can’t see myself in any other job.

I studied at the University of Stellenbosch on Tygerberg campus and graduated at the end of 2019 after 4 hard-working years. I was blessed with the most incredible friends that helped me get through the course! I might be biased, but I believe that we had the best lectures and got the best practical experience on Tygerberg Campus!

I completed my community service year at Rob Ferreira Hospital in Nelspruit, Mpumalanga. It’s a tertiary hospital and we rotated wards every 2 months. I had the best year and made a lot of new friends! My biggest advice to final years would be to choose a tertiary hospital if you want the most clinical/practical experience. Some of my friends in rural clinics never worked with parenteral or enteral feeds, but they still had great health promotion opportunities. 

I currently work for a private practice in Nelspruit and I see out-patients at our practice as well as in-patients at two private hospitals in the area. Private is a lot different than government in terms of the environment that you work in, but you still get very good practical experience! The private sector was a big adjustment for me as I wasn’t the only dietitian in a hospital ward anymore. All of a sudden I was being surrounded by several other dietitians.

What I love most about my job is seeing the progress that my patients make. It could be someone progressing from a tube feed to oral feeding or a pt coming in for a weight-loss consultation and gradually shedding off the weight to reach her end goal!

My biggest advice to future dietitians would be to work hard and be like a sponge. Embrace all the new learning curves that come your way! Absorb new information and learn from the mistakes that other health professionals make. Be the best version of yourself!


Meet the Dietitian: Community Service Series

My Unexpected Journey

Written by JéJéan du Plessis

As a little girl walking around the grocery store, it was the norm for me to turn around the pretty pictures of products and focus on the more ‘boring’ nutritional information.

   This was to ensure that I stay clear from any allergens that could lead to an eventful trip to the hospital. Being surrounded by all of the knowledge of food as a child (and now adult) with severe allergies, it was quite inevitable for me to find a passion for nutrition, thus leading me to study dietetics at the NWU Potchefstroom Campus.

   Like most of us, while studying for my degree at Potchefstroom, I quickly developed a love for therapeutic nutrition. Any form of Hospital assignments or practicals were written in my diary with the most beautiful washi tapes and highlighters, and during my last year, I was completely fascinated by all hepatic- and liver-related diseases.

   This led me to be deeply disappointed, as I was not placed at either of my five options for my Community Service Year. I was placed in the District Office in Ekurhuleni, which is Clinic-based work. Yet, and to my surprise, I am enjoying it tremendously! I mostly see outpatients throughout my day; do in-service training with the clinic staff members; are responsible for health campaigns; visit surrounding ECD centres; Old Age Homes; and Mental Health Institutions.

   In the past few months, my love for Community Nutrition grew overwhelmingly, and I was never aware of just how rewarding this spectrum of dietetics can be! You walk a close path with each of your patients, struggle with them to find a suitable diet, and try different approaches to see which will fit their lifestyle best. Through this process, you really get to know the person sitting on the other side of the table, which truly spoke to me, as you can really feel the difference you make in most lives.

   A new field of interest for me is definitely Diabetes and the nutritional management thereof, since I quickly realised that these people’s way of living is changing drastically within a few weeks from diagnoses, and giving them the best possible support will make the worlds difference to them, but that can also be said about any patient seen in the clinic setting.

The moral of my story is the following:

  • The biggest curveballs in life can be full of opportunities and self-exploration experiences that will ensure huge growth within you as an individual, and newly graduated dietitian.
  • Always remember that you are making a difference, no matter if you are calculating a TPN feed in an ICU setting, or if you are working at the local clinic with patients who really need your expert advice to live the best possible quality of life.

Meet the Dietitian: Community Service Series

By Ilse Gravett

At the end of every stage in our lives, we find ourselves in a tricky position where we need to decide what our next step is. For a 17/18-year-old, it is quite daunting, well it was for me. I had so many different ideas of where I wanted to be and what I wanted to become. Eventually, I applied to study medicine at the University of Pretoria, and dietetics at the North West University. I got accepted for both medicine and dietetics, but I chose dietetics. Deep inside me, I knew that I wanted to do more and be more. Please don’t get me wrong; all doctors are real superheroes and I have a huge amount of respect for each one of them! There were times that I even wanted to be one of them. But it was not until my final year that I realised the honour and privilege of being a dietitian. Being a dietitian, you get to really make a difference in a person’s every-day life. Essentially, everyone needs to eat, and you get to be the expert. You get to work with the sick and the healthy, the individual and the community. So here I am, already in the last week of my community service year.

I got placed in a hospital I have never heard of in a town I didn’t even know existed. St Patrick’s Hospital, Bizana, Eastern Cape. What a blessing! Looking back, I know that I have learned so much – some might even help you on your journey:

  1. Share your knowledge. We forget that information that seems like common sense to us, might prevent severe acute malnutrition in a toddler or help the sweet old lady gain control of her blood pressure.  
  2. Be extra… Okay, not annoyingly extra, but be extra kind and go the extra mile. You have no idea what battle your patient or even colleagues are fighting, so never underestimate the power of that.
  3. Don’t settle for the “lack of resources” excuse. Rural hospitals are challenging on a whole different level. In most cases, you don’t have all the fancy feeds or even a feeding pump. This means you really need to think outside the box and get creative. You are the expert; you can do it!
  4. Focus less on yourself. With this I don’t mean let yourself burn out – please take your break when necessary. But you are doing this year to serve the community. So, don’t always think about how much you can get out of a situation but how much you can give. Once you do that, you will feel how you automatically grow.
  5. Look on the bright side. One of the biggest challenges I had to face this year, was to accept the fact that I will only see “basic” cases. And wow, how my perception of “basic” cases changed. Every case has so much detail to it and a lot that you can master.
  6. Give it time. This is probably the most cliché of them all, but really – give it time. It doesn’t all happen overnight, and that’s okay. Be open to growth and to learn from those who have been there longer. They have a different kind of knowledge that books don’t have.
  7. Enjoy! Make friends with anyone, have inside jokes with the cleaners, get to know all the different cultures, and make every day an adventure.

In the end, it’s all up to you and the choices you make each day. I hope you choose to make it the best 365 days of your life!


MEET THE DIETITIAN: COMMUNITY SERVICE SERIES

By Nicoli Haasbroek

“Trust the process!”

No one would ever really know what a dietitian does until they are on the receiving end of our services. I remember another health professional saying to me that she never really knew what a dietitian does until her mother was hospitalised and treated by a. That is when she realised the impact that our profession has on all our patients.

Becoming a dietitian never crossed my mind, until I went to the open day at Kovsies – because even I was not sure about what dietetics encompasses. Afterwards, I went home and immediately applied for this four-year BSc degree not knowing what I was getting myself into. When I received the message from the University of the Free State notifying me of my acceptance I was ecstatic! Before I knew it, this city girl loaded her car to start her dietetics journey in Bloemfontein. After the first week, I knew that dietetics chose me.

At the end of the year, I found out that I was placed at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), formerly known as Joburg Gen, which was my first choice (#blessed). Cut to, I have just started my last month of the community service year at CMJAH and what a year it has been! I remember in my first few days asking “is it normal to feel like I don’t know ANYTHING?!”. That feeling only lasted until the end of that week as I remembered that I possess a lot of knowledge.  Another thing that scared me, in the beginning, was that out of my whole fourth-year class which consisted of a total of seven girls, yes, seven, I was the only one placed in Gauteng. I felt lost, alone, nervous and only slightly excited. Now I wouldn’t trade the people who walked through this year with me.

Currently, I am doing my final block in the orthopaedic and vascular wards, but previously I was in infectious diseases, GIT surgery, neurology, radiation oncology, paediatrics, neonatal and obstetrics & gynaecology. I was also responsible for various outpatient clinics (slimming, general clinic, new-born clinic, lipid clinic and supplementation). Through these wards and with all the patients I have treated, it was once again made clear to me that paediatrics is my passion. What a beautiful thing when passion and purpose collide!

To future Comm Serves:

  • Take it all in! This year goes by very fast and before you know it it’s time to start looking for a new job.
  • If you feel clueless during the first few weeks – it’s okay because you are not alone!
  • Don’t be scared to ask questions and learn from your colleagues including the multidisciplinary team, seniors and peers.
  • Don’t forget that you are treating a person and not just a disease condition.
  • Make a difference where and when you can.
  • Take care of yourself.
  • Spend your hard-earned money wisely 😉

Most important; the experience you have this year, what you learn & what you make of this year ALL DEPENDS ON YOU!


MEET THE DIETITIAN: COMMUNITY SERVICE SERIES

By Dur-e-nayab Burki

As the name Solanum Lycopersicum is not commonly said, neither is mine.

Hello everyone, my name is Dur-e-nayab Burki and like the word mentioned before, not everyone calls me by it, instead, they call me Nayab or Nabi for short as it is easy, the same way we call Solanum Lycopersicum a tomato. Simple really!

I am currently a community service dietitian, working at Witbank Provincial Hospital, which is located in Mpumalanga. It’s an hour from home, but still a little distant. To be honest, I never saw myself becoming a dietitian, All I knew after graduating from matric was I wanted to study in Varsity and the fact that my Dad is a doctor, I leaned more towards health sciences.

I applied for BSc Dietetics at Sefako Makgatho Health Sciences University (SMU), previously known as MEDUNSA. In my 4th year of studying, I did my internship for Therapeutic nutrition in Dr George Mukhari Hospital, as well as my Foodservice training, where I learned more theoretically. Later, I was transferred to Jubilee Hospital, where I learned more practically. I did my Community block in Phedisong, a clinic in Ga-Rankuwa.

Yes, it was overwhelming, but asking for help when needing it was the step needed to overcome the fear of the unknown and extremely emotional rollercoaster ride. But in the end, when I look back – with all the support from my classmates, supervisors, lecturers, friends and family, I said ‘that was worth it!’ and ‘I made it!’- the most satisfying feeling ever.

My Community service year has thought me that you are in control of what you decide to do with this year. Yes, new experiences are part of It, but working alongside other medical professions, such as OT’s, SLT’s, PT’s, Nurses and other medical staff actually showed me how important my role as a dietitian is. What’s even more important is educating them about my role as a dietitian for a patient. To give a patient the correct NF feed is Crucial in their treatment, however to others, any feed is fine!

I’ve also learned from a nurse, when working in neo-natal ICU, about how to do continuous feeds of EBM, when resources are limited, to use an IV bag – interesting right?

One major thing I’m excited to report is the amount of emphasis I have put on referring patients with any nutritionally affected conditions, to the doctors I know, my dad and sister. And I have seen changes to their mindset when working with patients because they always ask ‘ hey Nabi do we refer patients with renal dysfunction & HPT with low appetite to Dietitians?’ and I reply ‘ Yes. Please!’. Changing one doctor’s perspective at a time is a small step to making a big change.

Also use the opportunity to ask your colleagues as well – learn from their experiences, because by the time you start enjoying this year with all you learn, it has already gone by. (To Esme and Loren – thank you for this year).


MEET THE DIETITIAN: COMMUNITY SERVICE SERIES

By Mariska Barnard

I started my studies enrolled in the BPharm course, but realised it wasn’t what I wanted to do.  I wanted to journey with my patients and help them achieve health through nutrition.  I have a passion for prevention of disease as I don’t want anyone to go through long, tiresome treatments for any disease/illness.  Thus I decided to study dietetics, a way of treating patients with no side effects!

I studied dietetics at the wonderful North West University on the Potchefstroom campus and then completed my Master’s degree at Nelson Mandela University.  And finally it was time for my community service year.  I work in Bloemhof, a small town in North West, as a sub-district dietitian.  We are responsible for all the clinics in the sub-district.  We consult chronic patients, audit Road-to-Health booklets, do health talks, organise Vitamin A and deworming campaigns and much more.  Working in a sub-district setting you learn a lot about other programmes as well.

When I first arrived, I was nervous, I didn’t know if I was going to be able to do the work and I was in a little town with my family 800 km away and I knew no one – probably the feeling of everyone on their first day.  The first challenge I experienced was thus a mental one, I was not prepared to do community work, I expected to be placed in a hospital as I just applied to hospitals, and wasn’t placed at one of my options.  I was negative about my placement and I felt lost.  But I was welcomed with open arms, everyone in our team is friendly and I have an amazing supervisor that is passionate about community dietetics.  I instantly admired her passion and my eyes opened up to all the possibilities of community work.  My mindset changed quickly!

This year I have learnt about the set-up of community dietetics, about the way in which our community lives and how to adapt in unsuspected circumstances.

Tips for others walking the same path:

Help where you can:  This year we helped other programmes with their campaigns and then COVID-19 happened.  Now we screen the community and do contact tracing.  This not only teaches you a lot, but it also builds your character.

Always be ready to learn:  I once asked my supervisor to sit in while I counselled a newly diagnosed diabetic, and it was the best thing I could have done!  When I was done counselling I asked her if I missed something, and she started talking to the patient, using some Tswana words that I did not know yet, and describing some practices in different ways, using easier words.  I learnt so much in just five minutes!

Never stop fighting for your profession:  Sometimes you won’t understand why staff members don’t listen when you ask them to do the right thing.  Accepting that behaviour can’t be changed instantly will save you a lot of frustration.  Rather go back and ask again or do training.  Showing them that you won’t back down makes the difference!

I want to encourage you to be open to the journey ahead and to accept the challenges. We are all stronger than we think and capable of extraordinary things!


MEET THE DIETITIAN: COMMUNITY SERVICE SERIES

By Jemima Meyer

As a dietitian especially enthusiastic about community health development and digitalising healthcare, I can’t wait to harness the potential of digital technologies to improve our food and nutrition systems. But first I’ll have to complete my community service year.

After graduating from the University of the Free State, I was placed at the South African Military Health Service in Bloemfontein. At the military clinic, I spend most of my time treating patients with lifestyle diseases (obesity, diabetes, high blood pressure, and high cholesterol levels) and other conditions (e.g. HIV, TB, allergies and IBS). I am responsible for promoting health by launching community projects. I also pay monthly surprise visits to military messes to evaluate hygiene and the nutritional adequacy of their menus.

Though I have considered studying a wide range of disciplines (data science, genetics, physiotherapy, music, sound engineering, journalism, you name it), I don’t regret choosing Dietetics. The impact that simple dietary changes can have on a person’s emotions and quality of life is astounding. I also love the controversy in nutrition science. As dietitians, we have to analyse research findings and methodology and compare it to other available studies. In that way, we constantly challenge and update our views. Nutrition science is a tricky research field because researchers cannot simply perform RCTs (randomised clinical trials) to establish the effect of food on health. Usually, we have to make do with looking at the relationship between food intake (actually, what people report eating) and health outcomes. We also have to account for the effect that other variables may have on health. For example, if a population group that drinks a glass of red wine every day has a lower risk for developing cardiovascular diseases, can we assume that wine has some sort of preventative effect? Or is this positive outcome rather because of something else (e.g. financial or lifestyle factors)?

The most frustrating aspect of this occupation is that few people understand why dietitians work in hospitals or clinics. It is common for people, upon meeting a dietitian, to ask about weight loss, banting, veganism, intermittent fasting … Hopefully, in time, it will become general knowledge that dietitians are also responsible for tube feeding and intravenous feeding; and that nutrition plays a pivotal role in preventing and treating gastrointestinal disorders, cancer, HIV, TB, kidney disease, liver disease, burns, etc.

When I’m not busy being a dietitian, I like to meet new people, play the piano, and compose songs. I also enjoy writing and am currently busy with my debut poetry anthology.


MEET THE DIETITIAN: COMMUNITY SERVICE SERIES

ONCE A FUSSY EATER, NOW A REGISTERED DIETITIAN

By Jessica Botes

 

I was unsure of what I wanted to study but one thing I did know was that I wanted to help people on a daily basis – yes, I know its cliché.

So when the time came to apply for university I chose anything and everything – audiology, physiotherapy, emergency care practitioner, etc.

On a whim I applied to study Dietetics at the North-West University in Potchefstroom after chatting with a friend of the family who is a dietitian and has spent her career in the therapeutic and research fields. I was fascinated. We spoke about ongoing studies involving genetics and nutrition, the integral part nutrition plays in healing a sick body, the role dietitians play in a hospital setting and much more. This awakened a new interest in me and so my journey began.

We got the email that I was accepted- as if it were fate.

Ironically to everyone’s surprise I was now going to be a Dietitian even though throughout my life I have been the fussiest eater ever! I lived off Pronutro/Cornflakes and my scope of vegetables were carrots (only raw) and mealies. I can now proudly say I am in love with all foods and the way they benefit our bodies.

 

Fast forward to 2020, I am doing my community service at Tembisa Provincial Tertiary Hospital. Every day I get to encounter so many new and interesting patients in the wards as well as educate outpatients in our clinic, who are faced with extreme socioeconomic circumstances.

 

Although I’ve been taught to use the ideal products specific for our patients, in government settings you will be challenged by limited resources. Another difficulty is communication, whether it be with patients or staff. This includes language barriers and ensuring my prescriptions/recommendations are followed. Yet these challenges all mounts up to experience and can only enrich me for the better!

 

I love interacting with patients, getting to know them, being that person who shows a little extra care that they may need and always trying to put a smile on their face. This has been especially important during lockdown as all my patients do not have their loved ones visiting – I can’t even imagine being unwell and isolated.

Their progress and healing is so rewarding to witness. Whilst working in the burns and surgery unit, the amazing transformations I experienced there will forever remain with me. My patients have taught me how a positive attitude in dark times can always get you through.

 

Walking into community service, remember:

  • Each day that you get up for work, go in with a positive mind set. You may be tired, you might be struggling to adjust but being negative will hinder your learning experience.
  • Never be afraid to ask. You are still learning and are not expected to know everything.
  • Ask to do extra work, ask to help fellow colleagues, every opportunity that presents to learn – grab it.
  • Don’t be afraid of fellow healthcare professionals. You are an expert in your field. Be confident in your knowledge.
  • Go on ward rounds and interact with your allied health professionals.
  • What you see in the hospital can be emotionally exhausting- lean on your fellow colleagues for comfort, they see what you do every day too.
  • AND ENJOY!

 


Meet the Dietitian: Community service series

By Danielle Smith

 

I studied dietetics at Stellenbosch University and Mia was at University of Cape Town, after her undergrad and an honours degree at SU. Both of us ended up graduating as dietitians at the same time last year. 

To our surprise, we both ended up being placed together at Themba Hospital for our community service! 

I decided to study dietetics because I have always been fascinated by the impact that a well-balanced diet can have on your well-being. I have a special interest in eating disorders and how to achieve holistic health. I thoroughly enjoy working in clinical and community settings. Mia is very passionate about paediatrics and loves both the community and clinical aspects of it. She hopes to study further regarding the first one thousand days and has a special interest in breastfeeding.

What surprised us was how much the Western Cape province differs from Mpumalanga! It was challenging to suddenly have such a big responsibility. Both Mia and I had to become used to the freedom that we suddenly had, without constant supervision or guidance. 

One of my favourite things from this year was having the opportunity to get to know my patients. It was also a lot of fun to be able to work alongside other allied health professionals with patients who required a multisectoral approach. Mia and I have been able to grow as dietitians, and have become confident with our role in a patient’s road to recovery. 

Mia and I have summarised a few points for any dietitian doing their community service in the near future:  

  • Thoroughly enjoy your time where you are placed! A year goes by so quickly, therefore be able to enjoy your time while your there. 
  • Remember to challenge yourself out of your comfort zone!
  • It’s so important to motivate yourself to constantly educate and update yourself with the latest research for our profession. You won’t be exposed to everything in your community service year, therefore it’s essential to participate in as many educational courses in the year as possible. 
  • Lastly, always promote our profession! Sometimes doctors and other health professionals do not understand or acknowledge the need for a dietitian. It is so important to advocate for the profession and to constantly show them what our role as dietitians are in the medical field. To this end, we started our own Instagram page: @ournutritionmission. We share case studies and really try to explain in easy terms what a dietitian’s role is in all settings.

Enjoy your time as a community service dietitian; soak in every moment, learn and grow as much as you can as both a dietitian and an individual. And most importantly, enjoy the journey! 

-Danielle & Mia


Meet the Dietitian: Community Service series

By: Emma Slabbert

 

A year like none other!  A few of the highlights (and low-lights) of my year as a community service dietitian

And just like that – Community service 2019 is drawing to an end.  It’s unbelievable really. I don’t know where the time has gone! It has been the most wonderful year of growth, development and learning and as I come to the end of this journey I think about all the amazing memories I have made, experiences I have had, people I have met and most importantly how much I have learnt – not only about my profession, but about myself too! And, (something I did not think I would be saying when I started this year), I feel extremely sad that this year is already finishing and I am so grateful for this opportunity.

I started my 2019 community service in a new province, 100s of kilometres away from home and my comfort zone. I was a scared, newly graduated dietitian not knowing what to expect and who felt like I didn’t know enough to be going into the working world, never mind be managing patients on my own! Yet I am proud to say, I leave 2019 feeling so fulfilled, confident in myself, my work and am ready to take on any new challenges that I may face.

I’m a coastal girl, born and bred in Port Elizabeth, very much a home body and loved summers spent on the beach. Then here came comm serve 2019 and I saw myself relocating to Welkom, a town in the Free State between Bloemfontein and Johannesburg, pretty far from where and what I’m used too, with unbearably hot summers, freezing cold winters and thousands of kilometres away from any beach. I was not looking forward to it at all.

But wow am I grateful for this placement! The work environment was better than I ever could have imagined (so much better than being a student), my new work colleagues were more than welcoming, helpful and friendly, taking me under their wings and giving me the confidence, responsibilities, opportunities and experiences I needed to make me into the knowledgeable and confident dietitian who I feel I am today, and for this I am forever grateful.

Waking up excited and happy to go to work every morning was something I always hoped for since I was much younger and that is exactly how I felt this year. I have had the most amazing clinical exposure, experiences and opportunity to work within a multidisciplinary team.  

One thing is for sure – the practical aspect is very different to that of the theory and being able to finally put into practice all those years of theory work studied is just amazing. From working in the paediatric wards, burns unit, ICU, surgical wards, medical wards, ante- and post-natal wards, as well as seeing out patients weekly; I really feel so blessed and privileged to have had this opportunity to be exposed to the many different aspects of where a dietitian is needed, is important and to be able to experience, first-hand, the positive impact that we can have on a patient’s well-being and recovery.

From calculating Enteral and Parental feeding regimes for critically ill patients, to simply educating and supplementing malnourished patients, to assisting mothers and promoting breastfeeding, it has been so fulfilling to know that I was able to make a positive impact in these patients’ lives.  When out-patients are happy to see you each month and mothers cry happy tears at the growth of their children, it gives you a feeling of purpose that cannot be explained.

The year was certainly not easy and many challenges were faced. From being involved in a car accident in February and writing off my car as result, to being admitted into hospital with the Influenza virus mid-year and to pushing through the homesickness, I can say that all these challenges contributed to my personal growth and made me a stronger person.  These challenges wouldn’t have been overcome if it wasn’t for the amazing support system that I made in Welkom – my colleagues, friends, and the incredible group of comm serves – as you can imagine being far from your family and loved ones can be hard. I have met some amazing people this year and have made friendships which I know will last a lifetime and for that I am so grateful for.

Another highlight that is worth a mention was being given the opportunity to go into theatre and observe a surgery – a reversal of a colostomy – which made 100 times more sense after seeing it in real life than trying to fully understand it from a textbook.  Also, being able to see inside a theatre was really cool and not something that everyone gets an opportunity to experience.

 

If I can offer advice to future community service dietitians, as well as comm serves from other healthcare professions, it will simply be:

  • Go into your comm serve year with a positive and open mind.
  • Be excited for the experiences you are about to endure.
  • Make good relationships with the people you work with and be humble.
  • Ask for help when needed and don’t be afraid to say you don’t know something.
  • Grab every opportunity with both hands and learn from it.
  • Be social and attend events with the other comm serves so that you can make friends and build a support system of people who are all experiencing similar challenges / stages of life.
  • Network!
  • Be confident in your knowledge and always be willing to learn more.
  • Attend ward rounds and make yourself known to the rest of the multidisciplinary team.
  • Have fun and take it all in – it goes by way too quickly!
  • You will never be a comm serve again so make the most of it!

 

To all the future comm serves – good luck and enjoy – I am a little bit jealous that mine has come to an end and just know that this is your time to shine and really make all those years of studying so worth it!  When I started out my studies to become a dietitian I had no idea of the in depth hospital work that it entailed and after completing my studies and especially this comm serve year, I can’t picture myself doing anything else other than being a hospital dietitian!

 

Emma Slabbert

2019 Community Service Dietitian


Meet the Dietitian: Community service series

If you have accomplished everything you have ever dreamed about… What is the next step?

By Rian Coutts

 

Story behind why I became a Dietitian.

Life is always full of twists and turns, full of unexpected journeys and becoming a dietitian was probably the most unexpected one for me. The real feeling of why, started when I was first introduced to the hospital and clinic environment when still at University. I studied at the University of Potchefstroom (NWU) and from the start I knew I wanted to make a difference. I always believed that it is the small thing in life that matters and nutrition, in every way is definitely one of the biggest smallest things that matters the most. If you can teach anyone to understand the importance of that, everything will just fall into place. That in extent will always be the main reason why I became a Dietitian, to emphasize the importance of nutrition in all aspects of life, more specifically in children. 

The second part of the journey lead me to a small town in the North West called Wolmaransstad where I’m currently working at the small primary Hospital of Nic Bodenstein.  A big part of my daily duties is the management of Malnutrition, more specifically Severely Acute Malnutrition (SAM) cases. You can almost say that this year made me a specialist in the management of SAM cases. It became a big part of me and I am very passionate about it. That being said it is also the biggest challenge. Not all the cases are the same, meaning every paediatric patient seen with SAM is a different case and when the opportunity presents itself you have to use more than your knowledge. But I have been given a lot of opportunities to promote health in all aspects, which is a big part of me as well.

In every situation you have to trust yourself, don’t be afraid. Use everything you have inside and be prepared to take risks when it comes to yourself. First impressions are difficult because, everyone sees situations differently. In the end you have to have a little faith, no one said it was going to be easy, but it is most definitely worth it. What I’ve learned is that every day has a different challenge, a different test will present itself when it is most unexpected. 

 

A small message of encouragement is…

Don’t worry about where you might end up, it doesn’t matter. You are there to make a difference and that is more important. Take every day as a new day, a new adventure and never forget that a dream is just the starting point of something, not the end.

 

unnamed (1)

 

 

 

 

 


Meet the Dietitian: Community service series

By Kinza Hussain

 

I always say the profession of dietetics chose me. After completing a 3-year B.Sc degree in Biochemistry, I attended the Honors evening at the University of Cape Town to figure out what my next step would be. I was always intrigued by the medical field but when I heard what an honours degree in nutrition and dietetics could offer me, it was love at first sound!

I loved the idea of working in a hospital setting and more so, I was fascinated by the role nutrition plays in health and disease in both critical and stable phases. For this reason, I completed a rather stressful (to say the least) two-year honours degree and graduated as a dietitian in 2017.

 

It took a year before I got a post to do my community service and during this year, I explored the other branches of dietetics, namely fitness, research and healthy cooking. Instead of losing hope of one day practising as a clinical dietitian, I grew even fonder of the field and was convinced more than ever that this path was for me.

February 2019, I finally got placed at Kopanong Hospital in Vereeniging, Gauteng. I am responsible for part of the pediatric ward where I overlook a spread of diagnoses. From Severely Acute Malnourished babies to obese children to lactation consulting. I am also responsible for the female medical ward and the surgical ward. Here I see to the management of non-communicable diseases as well as the numerous indications that lead to nasogastric feeding in adults.

Although it is not my responsibility, I sometimes get given the opportunity to manage infectious diseases such as HIV/TB to remind me of how broad this field really is.

Being placed in an Afrikaans speaking community, the initial stages of my job was quite challenging due to the fact that I do not speak or understand the language at all (originally being from Zimbabwe). My other challenge was mastering the art of doing all that I can with all that I have. Once I overcame these two main challenges, I really found myself truly enjoying my work. The grand pediatric ward round which includes the entire multidisciplinary team kicks off my week every Monday morning.

Not only does nutrition play an ample role in the patient’s management, but how it ties in with other spheres of treatment such as the rehab input from occupational therapists and physiotherapists really fascinates me. I also love the fact that I am still learning. From my fellow dietitians in my field and from the doctors as I nutritionally manage a patient.

More than halfway into my community service year, do I have any words of encouragement? Definitely!

  • Getting into this year, know that your experience is going to be similar but different. You may face the same challenges as everyone else but how you handle them is what will make your journey unique. I would say don’t let these challenges dim your sparkle.
  • Continue and complete this year with the same enthusiasm as you started it. There may be days you’ll feel otherwise but you will be making a difference in lives as you hoped to.
  • Don’t underestimate the small but valuable extra effort you make for your patient. It goes a long way for them and their recovery.
  • Always respond to your gut feeling. If something bothers you while managing a patient, speak up. And speak again. And again.
  • Ninety-nine percent of the time, you will pick up on missed ques which can literally save a life!
  • Develop and maintain a good working relationship with the nursing staff of your hospital. They run the hospital and if you want to successfully manage a patient, their support will help you achieve that.
  • Lastly, while you enjoy what will most probably be one of the best years of your life in terms of personal and professional growth, be sure to let it all out. When your first patient passes on, you may think you’re alright but it has a way of surfacing way later. Be sure to allow yourself to heal so that you can continue improving lives…with your nutritional and dietetic powers!

All my best wishes ☺


Meet the Dietitian: Community service edition

By Marlize Erasmus

Every 4th-year Dietetics student experience feelings of stress, anxiety and excitement when making the decision of where to do their community service year. I googled every hospital on the list, trying to figure out where to go. I got my first choice (believe it or not) – a rural hospital (Connie Vorster Memorial District Hospital) in a small town called Hartswater in the Northern-Cape. This is where driving past cows and chickens on your way to the clinic is a daily norm.

The first time I heard about dietetics was from my grade 9 teacher when I had to do an assignment on what career to follow. I decided to shadow a clinical Dietitian in grade 11 and got intrigued by the profession. It wasn’t until my first year while studying dietetics at the Potchefstroom Campus of the North-West University that I knew I made the right choice. I realised that dietetics is my passion.

I did not really know what to expect when I started. I quickly realised that this was nothing like that perfect picture of dietetics that you have while studying. Especially when you are working in a place with severely limited funding and resources with communities in extreme poverty. This makes both spectrums of under-and-over nutrition (Obesity and Non-Communicable Diseases as well as a high prevalence of Severe Acute Malnutrition) major problems in the communities in the area.

I originally felt estranged to dietetics because working in rural is nothing like the bigger hospitals I was used to when I did my internship. Something important to know is that working in a rural hospital means there is no such thing as parenteral nutrition, fancy surgeries or certain wards like ICU or Renal. You are working with the basics.

I was not enthusiastic about community nutrition at varsity so I felt a bit discouraged when I found out that half of my time this year would entail working in the clinics. I developed a new kind of appreciation and love for working in the community. Community nutrition started to change me. It is especially in rural communities where dietitians are extremely needed. Working in the community can be challenging but the reward is sweet when you can see you’ve made a difference. I came to love going out into the community to fetch a SAM kiddie, to do outreaches and health talks and to work at a hospital alongside people who make the hard days better. I believe it was God’s plan that I got placed in Hartswater. This has shaped me into a better Dietitian and a better version of myself.

No matter at what hospital you are or what type of dietetics work you do, it is always important to realise that at the end of the day your happiness as a human being is a necessity. This is not only a year for practical experience in the dietetic profession but a year of personal growth and new adventures. Be open-minded as you step into the unknown.

 


Meet the Dietitian: Community service series

Dietetics might have been my plan B, but it turned out to be the (B)est plan yet!

 

By Carmyn Gast

 

Nutrition has been known to play a key part in good health since the time of ancient Greeks, with Hippocrates famously writing “Let thy food be thy medicine, thy medicine be thy food” in the 5th century BC. However, the profession of dietetics itself is relatively young, having only been put in the forefront of patient care by Florence Nightingale and Alexis Soyer during the Crimean War in the 19th century. And it was only in 1974 in South Africa that the Health Professions Act officialised Dietetics as a profession.

So being a dietitian means that you’re also a pioneer in this profession – an exciting but sometimes frightening experience. Which is exactly what I felt like when I walked into the very rural district hospital in KwaZulu Natal on the first day of my community service year. As the only dietitian in the hospital, I was immediately given all of the responsibilities of running an entire Dietetics Department. From consulting with and managing all the in-patients and out-patients, to budgeting and controlling all the nutritional feed stock, to auditing the hospital kitchen and the surrounding clinics, to supervising and assisting the Nutrition Advisors (something unique to KwaZulu Natal), to doing seemingly never-ending administration tasks and statistics, to training fellow health care professionals on nutrition, to advocating for patients’ nutritional health at meetings, to learning the local isiZulu language to be able to communicate with patients – there was (and still is) always something more to do and something more to learn.

The most important thing I have learned thus far is to always remember your heart. The nature of our job is to deal with people, and people are extremely complex and they often only encounter us when they’re not feeling well. Unfortunately the public healthcare system is under immense pressure in our country so most health care professionals only spend a handful of minutes with each patient before moving on to the next patient. So I consider it a privilege that, as a dietitian, I get to spend more time with patients. It gives me great joy to be able to sit down, talk with and really get to know my patients. After all, food and nutrition is such a personal thing – it gives you a real understanding of a person and their life. And this enables you to meaningfully and effectively help a patient to reach and maintain their optimal nutritional status. And a healthy happy patient makes for a very happy heart.

Sometimes the importance of dietitians is undermined and poorly understood, but as pioneers, it is up to us to continually show and prove our worth as a profession. And hopefully sometime in the near future the rest of the world will catch up and wake up to the most important fact that we already know – that food is life. In the meantime, let’s show them how it’s done!

 


 

Carmyn had the wonderful initiative to take a photo and add a caption each day of her Community Service Year to document the real and ‘unfiltered’ journey. See more on Intstagram @BecomingAnRD.

 

day10

First day out to the clinics #Day10 #BecomingAnRD #scenicroute #roadtrip #longroad #landscape #blueskies #mountains #Drakensberg

day 78

Some days I forget how lucky I am to be working in such a beautiful setting… Yes, it’s rural and in the middle of nowhere. Yes, the resources are limited and the circumstances are trying. Yes, there is sadness and heartbreak when patients pass away/ you can’t help them in more ways. Yes, I can barely understand/ speak the local Zulu language. BUT the people are friendly and welcoming, and the natural environment is breath-taking. Each and every day has beauty in it, you just have to find it. This aloe is flowering just outside my office and is proof that something beautiful can still emerge from harsh circumstances. #Day78 #BecomingAnRD #dietitian #dietitiansofig #nutritionexpert #rurallife #nature #aloe #naturalbeauty #outdoors #flowers #hope #indigenousflowers #hardyflowers

 


Meet the Dietitian: Community service series

Take the journey!

By Colette Dreyer

 

Are you ready for your journey in Dietetics? My journey started from a young age having a passion for delicious food and a healthy, active lifestyle. Cycling competitively made me realise that proper nutrition was essential to sustain performance.  I realised how big the impact of food is on our health, energy levels, performance, overall well-being and daily lives when a close family member was diagnosed with Idiopathic Pulmonary Fibrosis and had to lose weight in order to be added to the lung transplantation list. This encouraged me even more to become involved in changing lifestyles of individuals.

I started off by completing a BSc. Human Movement Sciences degree followed by BSc. Honours in Nutrition. This was a great combination, but my aim was to provide individualized meal plans for individual goals and specific disease related conditions. The best decision I finally made was to study BSc. Dietetics at the North West University, Potchefstroom.

And so, my journey as a community service dietitian, and the only dietitian placed at this specific community health centre in Johannesburg began. This came with uncertainties at first as I am responsible for all dietetic services at the facility. Although I was placed out of my comfort zone, as this was not one of my five placement options, and I’m only the third dietitian placed at this facility, I realised the lack of education in this community and the opportunity to contribute to the dietetic department. I gain a lot of experience in various aspects such as malnutrition, cerebral palsy, tuberculosis, brain injury, percutaneous endoscopic gastrostomy, pregnancies, hypertensive and diabetic patients as well as patients living with HIV.

Everyone has a unique nutritional composition and individual goals to attain. When patients progress towards, or reach their goal, their gratefulness is very rewarding. I developed skills to explain complex ideas simply, and to use different techniques when a communication barrier occurs. Creative methods were developed to improve patient’s lifestyle and nutritional status with their available food and resources. Attending monthly district meetings held at different facilities provide the opportunity to meet other dietitians and to become familiar with surrounding facilities. This is truly a great year to improve your practical skills and to gain more knowledge.

Tips:

Say yes to the journey – Life do not always go according to your plan. Sometimes an unexpected opportunity arises. Be open minded, say yes to the opportunity and climb out of your comfort zone. That is the only way to grow and learn.

Be friendly & have respect – It can be difficult to obtain cooperation from colleagues and patients but being friendly and treating them with respect will assist you in doing your job more efficiently.

Promote our profession – Amongst staff and patients.

Do not leave the facility unchanged – You have a big opportunity to make a difference wherever you are placed. Identify a gap and fill it or bring something new to the facility.

Lastly, remember that the community service year is what you make of it. Make sure your journey count!

 


Meet the Dietitian: Community service series

“DIETITIANS ARE ADAPTABLE!”

 

By Yuri Bhaga

 

I am a community service dietitian currently working at a hospital in Witbank, which places me very far from where I got my dietetics training at UCT . But a lot closer to home in Pretoria where I completed my BSc degree 3 years ago.

When I got accepted to study dietetics I had no idea what I was getting myself into. Much like everyone else who hasn’t gotten the formal training, I had a very narrow understanding of what the title “Dietitian” stood for. Now 3 years later it has become a great passion of mine and I make sure to promote the profession and spread awareness of the role that nutrition has in all areas of our health.

Being familiar with the Western Cape health system, Mpumalanga was new to me.  The province had its own set of unique challenges and demands that I had to learn to adapt to. The system is under immense pressure with far less than adequate resources and it would be a lie to say it doesn’t get frustrating at times. Some days will go smoothly and you will be able to implement a plan within the hour, thanks to a great multidisciplinary effort. Other days you will receive the wrong referrals and it will take up to 2-3 days just to start a feeding plan. It’s not always easy but it does provide hands on experience and a great opportunity for learning – and the feeling when you see an improvement in a patient’s condition or receive sincere thanks from a patient post counselling can really put things into perspective. Sometimes it’s not even about the clinical work or education you give but simply chatting to the patients and seeing how they feel that can make a world of difference to their stay.

I have been very fortunate to have arrived to an established and supportive department with members of staff who have years of experience and are always open to lending input and giving help should I need it. The hospital offers the majority of the services of a tertiary hospital which means I will have been exposed to a diverse patient population by year-end which is both a wonderful thing and a little daunting. That said, not everyone will have the same experience of community service, but if you are willing to work with what you have and find opportunity to improve and make good of what’s at your disposal you will come out having grown as both a person and as a professional.

Community service year is a great opportunity to gain independence and to be a fresh pair of eyes to fill gaps that are missing. Personally, it has put meaning to a phrase that I heard from an educator in my internship year: “Dietitians are adaptable!”. This year is all about what you are willing to put into it and the attitude you have going into the year will determine what you get out– as cliché as it sounds.

That’s not to say you MUST be busy day in and day out with no chance to breathe. Rest is equally important. I have found it has been of great benefit to find a support group. I am lucky to have been warmly adopted into the Speech and Audiology department where I go to spend most of my lunch breaks, or to vent about something that’s on my mind and have made new friends with their comm-serves. Working in a hospital is different for everyone and can be very taxing so it’s always good to have something other than work to help destress. If time allows it, find a new hobby or continue engaging in activities you enjoy –  I have decided to try my hand at sign language classes.

To conclude :

  • You won’t know everything (and that’s fine, you have plenty of time to learn and read-up)
  • Ask as many questions as you need (granted you have tried to come up with the answers yourself first)
  • Speak up and be firm – but polite.
  • Get to know your surroundings and the people you work with.
  • Have confidence, you likely know much more than you think! 😊
  • And lastly , enjoy it and take it all in!!

 


Meet the Dietitian: Community service series

Read more about her love-at-first-sight story with Dietetics.

By Rhodene Oberholzer

A little over seven months ago I moved into a tiny apartment in Johannesburg, nervous about starting my community service year at Charlotte Maxeke Johannesburg Academic Hospital. Suddenly, I felt as if I forgot everything I learned in my four years studying at the North-West University of Potchefstroom. I could feel my heart making 20 000 jumping jacks per minute as I walked through the hallway on my way to the dietetics department, my very first day as a dietitian. I honestly did not think I would be able to do this, but fast-forward seven months later and I cannot believe how much I have learned and grown as a person so far.
The reason why I decided to become a dietitian is quite simple, it is like a love-at-first-sight kind of story. I always knew I wanted to work with people, but being a dietitian never really crossed my mind as something I wanted to pursue. It was only in my matric year that I decided to shadow a clinical dietitian. The profession fascinated me, and I soon realised that my idea of what I thought a dietitian did was only a drop in the ocean. So, I instantly knew I found my calling.
Now this year has probably been the most challenging, but rewarding time of my life. I feel so blessed to be able to work in a place where I get to see and learn so much.

Working in a clinical environment, we as dietitians are responsible for all the dietary needs of patients, whether it is total parenteral nutrition (TPN), enteral nutrition, dietary education, supplementing a patient’s diet or prescribing a special diet meeting the requirements for their specific disease condition. At first, this was very intimidating for me, but after a while, you can see how your interventions pay off, and it gets so much easier. Nothing is more rewarding than seeing the premature baby gain weight, the severe acute malnourished child gaining his appetite again, to hear the patient with muscle wasting say that she feels much stronger after drinking the supplements you provided, or even just getting a smile from a patient because you ordered him some extra jelly and custard.

I also have the opportunity to work in various clinics this year (such as Paediatric Diabetics; Orthopaedic Slimming; Neonatal; as well as a General clinic) where we assess and counsel out-patients with a specific nutrition related health problems.
For any future community service dietitian that feels nervous about starting this next chapter: I understand how you feel. I don’t think starting your first job is supposed to be a walk in the park, so be kind to yourself if you feel anxious and unsure. I did not believe it at first, but I promise you it will get better. Take your December holiday to rest, and have peace about where you are placed as it is only for 12 months and time goes by so fast. I think the biggest mistake you can make as a community service dietitian is to finish your 12 months, feeling like you did not learn much and made no difference where you were placed. Enjoy being a dietitian, fall in love with your work, as it really is such a fun and exciting profession to be in!

 


Meet the Dietitian: Community Service series

 

Meet Community Service Dietitian, Iman Gierdien! She is passionate about forming relationships with patients, remembering faces and seeing the impact she is making on, not only the patients, but on their families too.

Written by Iman Gierdien

The thought of becoming a dietitian never crossed my mind. I didn’t know much about the profession until I came across it when applying for university. After researching, the then unfamiliar occupation showed to be a perfect combination of my interests and hobbies: the human body and food. The more I researched, the more I became excited even though the ‘’mighty’’ google couldn’t fully describe what, and how much, you do as a dietitian.  

So, I started my roller-coaster journey at Stellenbosch University. Four years blinked away, and I was halfway through final year applying for community service. Being married and never having been away from home I naturally chose options close home or big cities. To me family and being close to those who love and support me was more important than the type of facility, the type of work I would do or the state of the working environment.  

My greatest fears then came true; I was only placed after swops and appeals were closed. When I read the name I thought, wow, where is that? I had never heard of it, never even seen it on the list and it was definitely not one of my ‘’many’’ (5) options. Again, I relied on google and google maps to help me along.  

Making the decision to accept the post was difficult. I would be 14hours away from home and family, 7 hours away from my husband and in rural Eastern Cape, deep deep rural. After much deliberation and many tears, I accepted. However, it is nothing close to what I was expecting both socially and emotionally. I have made friends that feel like family and I’m in an environment that is so uplifting and positive even though I came with such a pessimistic attitude.

 I am one of two dietitians at the hospital and together we conquer the challenges thrown at us. We are working with a community riddled with non-communicable disease, TB, HIV, teenage pregnancies and severe malnutrition in its children.  We are working with a community that is set in their ways and beliefs and that is crippled by their economic status.

 However, the best part of work is the people. Being a primary, small, hospital you’re able to form relationships with patients, remember faces and you’re able to see the impact you’re making on, not only the patients, but on their families too with such limited resources and little contact sessions.

 Community service shouldn’t be a year for you to think about how much academic experience you gain. It’s an opportunity to go outside your comfort zone and develop soft skills. It should be about gaining understanding and empathy for the determinants of health and actions so that it allows you to grow into a holistic healthcare practitioner and human.

 So, the greatest advice I could give is to use your community service as a year for you to cultivate the skills that cannot be taught.


Meet the Dietitian: Community service series

An unforgettable community service experience in the ‘forgotten province’…

By Inarie Jacobs

Health should not be taken for granted – a lesson I learned as a child whilst being very ill due to my poor lifestyle and dietary habits. After this experience, I decided to study dietetics at the North-West University of Potchefstroom to share this lesson as far and wide as possible.

I started my community service journey in December 2018 at a small rural hospital in the beautiful Transkei area of the Eastern Cape – a.k.a. “the forgotten province”. The challenges seemed a bit overwhelming at first as I had to trade my luxurious lifestyle habits for much simpler ones. Not only was the hospital an hour away from where I lived but it also never had a dietitian or a dietetic department before. No equipment and no supplements together with a huge language barrier made counseling with patients nearly impossible. To be honest, the tunnel did not seem to have light at the end.

However, after a few weeks of feeling really sorry for myself, I noticed how heavily the burden of wasting, obesity and poverty weighed on this community. The effects of the nutrition transition were clearly visible in this rural area which made me realized how badly nutrition intervention was needed. This led me to change my perspective and strategy towards this year and soon my challenges transformed into endless opportunities.

I get to build and establish a whole new dietetic department to promote our profession – an opportunity few community service dietitians have. I’m forced to improvise and to be more creative with cost-effective tools and methods to educate and treat patients – a skill I would have never developed if things were easy. I’m forced to reach out to the surrounding dietitians for help – a network of professional colleagues I would have otherwise not built.  I’m also trying to learn the beautiful isiXhosa language to interact with patients – a privilege I would have otherwise not had.

In short, comfort does not enhance growth! I’m grateful to be pushed beyond my comfortable limits as it is teaching me more than any book ever will!

I encourage all future and current community service dietitians to rise to the opportunity to lead, to influence and to inspire others with your attitude, deeds, and knowledge. To Quote Anne Frank: “You don’t always know how great you are, how much you can accomplish and what your potential is”. Dare more boldly, walk that extra mile and give it all you have!

A few rural survival tools:

  • Breathe…
  • Rural is never a textbook case.
  • Be culture sensitive and respect different views/religions.
  • Get to know local indigenous foods, what traditional foods are and how they are prepared.
  • Ask for help as much as possible. You don’t have to know everything, just be willing to learn.
  • Know that change doesn’t happen overnight and that some may be very resistant towards it.
  • Be kind and treat people with respect, no matter their background, title or position.
  • Be gentle and patient with yourself, your progress and setbacks.

 

ABOUT ADSA
ADSA, the Association for Dietetics in South Africa, is one of the country’s professional
organizations for registered dietitians. It is a registered non-profit organization served by qualified volunteers. The Association represents and plays a vital role in developing the dietetic profession so as to contribute towards the goal of achieving optimal nutrition for all South Africans. Through its network of ten branches, ADSA provides dietitians with the opportunity to meet and network with other professionals in their provinces. Through its comprehensive Continuing Professional Development (CPD) system, ADSA supports dietitians in meeting their mandatory on-going learning, which is essential to maintain their registration status with the Health Professions Council of South Africa (HPCSA). Visit: http://www.adsa.org.za


Meet the Dietitian: Community service series

“The best decision I’ve made in my life…”

By Bonnie Evert

“TPN? Food in arteries?” These were my thoughts, as a very inexperienced 17- year- old girl, when the Registered Dietitian (RD), who was assisting a very close family member of mine in the ICU, explained what all the little bags hanging above the bed were in aid of.

My perception that RDs only help fat people lose weight was destroyed and the profession fascinated me. I canceled my application for the air force and immediately applied to study B.Sc. Dietetics at the NWU Potchefstroom Campus – which has been the best decision I’ve made in my life, thus far.

Five years later, I am working at a psychiatric hospital to complete my community service year. It is not quite the same as the acute setting we became familiar with in our 4th-year internship. This psychiatric hospital specializes in patient-care for the intellectually disabled patient, rehab for mood disorders, substance abuse or both, and a rehab unit that accommodates patients with spinal cord as well as brain injuries.

When starting anything new, there are a few challenges and opportunities. Here are a few of mine as a new Comm-serve.

  1. Opportunity

Working in a psychiatric hospital is very interesting and different to an acute hospital. Not a day goes by where an opportunity doesn’t arise to learn something new, read up on a rare condition or have a heart-warming encounter with a patient.

  1. Multi-professional team

I have realized the importance of working together in a multi-professional team, including the occupational-, speech- and physiotherapists, and how important each unique role is regarding nutritional management and overall patient care. I have come to understand that one cannot be a one-dimensional dietitian: yes, we are the nutrition experts, but it won’t hurt to learn more about all the complex medical aspects of different patients. In fact, it will improve your nutritional decision-making.

  1. To err is human – it’s okay to make mistakes

This is only relevant IF we use our unintended mistakes as learning curves and IF they do not harm anyone, of course. I have often felt as though my opinion is not worthy or helpful until I realized that if I don’t speak up immediately and take a stand for my patients (who often cannot speak for themselves), a greater risk is imposed on their healing and well-being. However, it is our responsibility to be updated with the latest evidence-based guidelines and medical nutritional therapy to support our opinions.

  1. Separate your work from your private life

In our line of work, it is our job to be empathetic towards patients and to remain professional. I learned that to keep my emotions from getting the better of me at work, I will have to find a way to debrief – and believe me – it is important to talk about your feelings. Thankfully, I have the best support system at work and an absolute role model as my supervisor who taught me this: It is important to be empathetic towards patients, but so is protecting yourself and ensuring the quality of your work.

Some of the highlights I have enjoyed about this year include the opportunity and privilege to help others and actually make a difference. The possibility of improving my knowledge as well as my work ethic – which includes earning a salary – has been outstanding.

My heartfelt message to anyone reading this article is NEVER to underestimate yourself, treat others the way you would like to be treated, stay up to date with the latest research, be positive and most of all enjoy the journey, it passes all too quickly!

ABOUT ADSA
ADSA, the Association for Dietetics in South Africa, is one of the country’s professional
organizations for registered dietitians. It is a registered non-profit organization served by qualified volunteers. The Association represents and plays a vital role in developing the dietetic profession so as to contribute towards the goal of achieving optimal nutrition for all South Africans. Through its network of ten branches, ADSA provides dietitians with the opportunity to meet and network with other professionals in their provinces. Through its comprehensive Continuing Professional Development (CPD) system, ADSA supports dietitians in meeting their mandatory on-going learning, which is essential to maintain their registration status with the Health Professions Council of South Africa (HPCSA). Visit: http://www.adsa.org.za


Meet the Dietitian: Community Service Series

Challenge… Accepted!

By Liezel Engelbrecht

I am probably not your typical community service dietitian: I am 37 years old. At 32, after nearly a decade in the media industry, I gave up my career as a content editor in order to pursue a new goal: to make a contribution in the field of preventative healthcare.

I was probably a little less apprehensive than first-time careerists going into my community service year (I am currently placed at a provincial hospital in Cape Town). It thus came as somewhat of a surprise when I found it challenging to adjust to the new routine, my new role and establishing new goals.

Let me start with the routine. Initially, I was thrilled to be able to start at 6:30 if I preferred. Getting up early in exchange for a more leisurely afternoon sounded like a good deal. I didn’t, however, take into account how emotionally taxing being a hospital dietitian would be. Even though I now technically had a large chunk of the afternoon to myself, I was so tired from the adrenalin of the day that I didn’t feel like my usual gym class or an afternoon run. Almost four months in, I have now adjusted my working times slightly, but I’m still working on striking the right balance to optimize my energy levels while building in some much needed “me”-time.

Secondly, the new role was an adjustment. A month before I started at the hospital, the chief dietitian contacted me to share that she’s had a major health setback, and would only be coming in intermittently for the first three months. Needless to say, I was a bit anxious, as this meant I wouldn’t have a supervisor or mentor. Luckily, this angst soon dissipated. She had arranged for the previous (very competent) community service dietitian to help out in her absence, who was extremely patient in showing me the ropes and guiding me through the hospital systems. Now that my supervisor is back, I am using the opportunity to soak up as much of her 25 years of experience as possible.

Which brings me to the next challenge I experienced: setting new goals for myself. It’s not called “community service” for nothing. In my final (internship year) studying at Stellenbosch University, we got a taste of working in various practical settings, such as hospitals, clinics and in rural areas. The hospital environment did thus not feel uncomfortable. However, in the community service year, your focus shifts from being a good student to being 100% focused on serving patients eight hours a day, every day. And serving takes up a lot of mental and physical energy! My goals thus changed from expecting results and feedback following projects, assignments, and exams, to attempt giving quality service to each patient, every day. Though this goal sounds obvious, it really is challenging to be fully present and equally enthusiastic and thorough with every patient you see, especially since you might do counseling for the same type of conditions and work out requirements for similar types of patients repeatedly. The end result will however only be rewarding if you manage your own expectations.

In conclusion, I encourage all prospective community service dietitians to see this year for what it is: an opportunity to get a better understanding of how the public health system works; an opportunity to become really good at something (you can become an expert at diabetes education, breastfeeding counseling, or any other area where you have an interest in), and, most importantly, the opportunity to serve.

Whether you love or hate this year, one thing is certain: you will grow.

More tools that work for me:

  • Respect the system, but don’t lose your enthusiasm. Fresh eyes are great for spotting areas of possible improvement. And if you have an open-minded chief dietitian (like I have), your ideas or suggestions might just get used and have a long-lasting positive effect.
  • Smile (even if you’re in a terrible mood). This makes you appear friendly. And if someone smiles back, you’ll instantly feel better.
  • Ask for help. It’s okay not to know how everything works initially, or what all the diagnoses and abbreviations mean. You’ll get better.
  • Accept (and face) your mistakes. I had many (I lost a scale, measuring tape and calipers in the wards, all in my second month!). You can only learn from them.
  • It’s okay to be affected if you lose a patient. Make sure you can talk to someone. It also helped me to talk to more experienced health professionals about their coping mechanisms.
  • Don’t neglect yourself. If you’re not in a good space mentally, chances are this negative energy will follow you around.

If you are a community service dietitian and would like to share your story, pop Abby Courtenay an email at adsapublicrelations@gmail.com with the subject line ‘Meet the Dietitian- Community Service Series’.

ABOUT ADSA
ADSA, the Association for Dietetics in South Africa, is one of the country’s professional
organizations for registered dietitians. It is a registered non-profit organization served by qualified volunteers. The Association represents and plays a vital role in developing the dietetic profession so as to contribute towards the goal of achieving optimal nutrition for all South Africans. Through its network of ten branches, ADSA provides dietitians with the opportunity to meet and network with other professionals in their provinces. Through its comprehensive Continuing Professional Development (CPD) system, ADSA supports dietitians in meeting their mandatory on-going learning, which is essential to maintain their registration status with the Health Professions Council of South Africa (HPCSA). Visit: http://www.adsa.org.za