Meet the Dietitian: Community service series

Chat Leave a comment May 30, 2019 nutritionadsa

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

Women and Diabetes in the Spotlight this November

Chat Leave a comment November 14, 2017 nutritionadsa

Over the past decades, the rise of diabetes around the world has been so prevalent and extreme, it is sometimes referred to as the epidemic of our modern times. In 2017, the diabetes focus theme is Women and Diabetes. Globally, diabetes is the ninth leading cause of death in women, resulting in 2.1 million deaths each year. It is estimated that there are currently more than 199 million women living with diabetes, and by 2040, this total is expected to reach over 310 million.

Registered dietitian and ADSA (the Association for Dietetics in South Africa) spokesperson, Ria Catsicas says, “According to the latest mortality report for South Africa released earlier this year, diabetes is ranked as the leading cause of death in women, and the most important risk factor for developing Type 2 diabetes is obesity. At this time, more than 60% of South African women are either overweight or obese, putting them at higher risk than men of developing diabetes in the future.”

Gender also means that women experience additional health risks due to obesity. As Ria notes: “Almost 17% of pregnant South African women experience gestational diabetes which is directly related to obesity. This condition puts them at risk of experiencing high blood pressure during their pregnancy, miscarriages and still birth. In addition, the babies of mothers-to-be with gestational diabetes tend to be large which can contribute to complications during birth and are themselves at a higher risk of developing type-2 diabetes later in life. Obesity also plays a role in increasing the risks of female infertility.”

Optimal nutrition is key for the person with diabetes; it is also crucial for those who may not have diabetes yet, but are insulin-resistant and those with a family history of diabetes, as genetics are also a risk. Optimal nutrition is also essential for all women – up to 70% of cases of Type 2 diabetes can be prevented by following a healthy lifestyle.

Type 1 diabetes is managed by medication (injectable insulin and or tablets),a controlled diet and exercise; but when it comes to Type 2 diabetes, good nutrition along with other healthy lifestyle changes are usually the first line of treatment to manage diabetes, and if medication is required, a healthy diet can complement and often influence the medicine, to help avoid experiencing the life-threatening complications of diabetes. Tabitha Hume, also a registered dietitian and ADSA spokesperson, points out that common-sense healthy lifestyle changes can be a vital safeguard. “Balanced meals that are made up of a combination of high fibre, low-GI carbohydrates, lean protein and healthy plant fats with generous helpings of vegetables and salads and some fruit (in controlled portions) can be a general guide. However, plasma glucose control is very individual, depending on the severity of the diabetes, and the type and dosage of medication being used. Diabetics will need the help of a registered clinical dietitian who can support them in translating these guidelines into the practical meal plans that best suit their food culture, their taste preferences, daily routines and lifestyles.’’

ADSA spokesperson, Nasreen Jaffer agrees, “There is no ‘one size fits all’. In order to make a sustainable change to a healthier eating plan, all aspects of a person’s life must be taken into account. A working mom with kids at school does not have the same amount of time for food planning and preparation compared to a stay-at-home mom. It is the role of the dietitian to help tailor an eating plan that is healthy – as well as practical, affordable and do-able for the individual.”

All three experts agree that this year’s World Diabetes Day focus on women is relevant to the adoption of healthy lifestyles across South Africa’s population.   While many men play a prominent nurturing role in the home, and many are becoming increasingly interested in the impact of nutrition on health and physical performance, it is still common for women to take the dominant role in the nourishing of the family, and ensuring health and disease prevention.

Tabitha points out: “Since women are most often the home chef, the grocery shopper, and the planner of meals and snacks for children and the family, if nutrition education is targeted at women, there is a higher chance that healthy nutrition guidelines filter through the whole family and have the biggest impact. Family traditions, practices and cultures most often derive from the mother in a family which is why children often adopt the religion and language of the mother. This is where the ‘Mother Tongue’ phrase originates. South African women are encouraged to develop a ‘Mother Meal’ concept moving forward, helping to instil healthy eating habits in children from a young age.”

World Diabetes Day on 14 November aims to shine a light on the risks for developing diabetes; as well as the needs for regular screening, access to information, self-management education, treatments and support, which includes optimal nutrition.