It’s my pleasure Welcome to another edition of Heartbeat. I’ve been delighted to receive your texts from across South Africa saying that you want to see more of the magazine. We love hearing from you. Please keep the messages coming, and let us know what you want us to cover.
Daphney Noziwe Conco is Heartbeat’s Editor-in-Chief and Research Manager at DENOSA Professional Institute
In this edition we focus on the growing government and worldwide emphasis on youth-friendly health services. We are committed to
supporting you to deliver these services, and to exploring what this focus on the youth means for us as nurses and as parents. We’ve got features on what the new law about children and sex means for nurses working with teenagers; on how the Government’s new schools health campaign will work, and much more. Enjoy!
y e n h p Da
with your thoughts on 081 555 4397 or email her at email@example.com
This edition I’m particularly enjoying ...
Saving for the future: we could all use some tips
Sister Abegail Nteka: you will be inspired by this amazing woman’s story
Sophie Ndaba: her battle with high blood pressure
What do we want for our girls?
11 Sex and adolescents: what the new law means for you
– Sophie Ndaba, page 7
– SIster Abegail Ntleko, page 43
I love my job!
– School Nurses, page 16
Contents 1 editor’s note
Welcome from Daphney Noziwe Conco.
4 Vox pops
What’s the beat of your day?
6 Have you heard?
46 Try it, you might like it: female condoms
8 SIngle moms
Making it work
11 Protecting the
children The law and you
12 Female condoms Sisters doing it for themselves!
16 School nurses
Our children’s health
19 Sister speak
Ask Sister Lebo
Tips on saving for old age 26 Social media How to get connected
It’s time for a break!
34 Patient sensitivities Those difficult situations
37 Healthy feet
When you’re on the move all day
38 Nurses under attack
40 Diary of a country hospital
43 Real lives
Sister Abegail Ntleko
46 What’s cooking?
48 And one more thing Dr Sue Goldstein
Your life, your story
Social media: how to get started, page 26
The beat of your day What’s your favourite song of the moment? Here’s what nurses in and around Johannesburg told Heartbeat.
Colours of Love The Layabouts featuring Portia Monique I love it because it’s a slow jam with a house beat and I can’t help but move to it. I also like the lyrics because they make sense to me – love is an emotion but it’s visible because it has so many colours.
Charlotte Mahlangu Nursing Student, S G Lourens Nursing College in Pretoria
Lebo Motlaﬁ Registered Nurse, Anova Health Institute. Mentors nurses at clinics in Soweto
Who Am I? Casting Crowns It reminds me that my salvation isn’t dependant on my works but is by His grace.
During the festive season I went home to North West and my two-year-old nephew wouldn’t stop singing that song!
Nozipho Guma, Registered Nurse, Anova Health Institute. Mentors nurses in Johannesburg CBD and Helen Joseph Hospital
yoUR VoiCe Martina Manaka, Professional Nurse, Anova Health Institute. Mentors nurses in Alexandra
All of me John Legend It shows the reality about love , you know. Just surrendering yourself to your loved one.
Jika Mi Casa I like this song because my nephew who’s one year old likes it. It’s the only song he recognises and when it comes on TV he’s the first one to turn around and notice.
sile Madiba, Registered Nurse, Emergency Department, Netcare Rosebank Hospital
Roar Katy Perry I especially like the video because it makes me remember that no matter what you do to put me down as a woman I can still survive.
Thulani Mafuna Registered Nurse, Medical Ward, Netcare Rosebank Hospital
Thobekile Mtshali Enrolled Nurse, Emergency Department, Netcare Rosebank Hospital
Dancing On The Ceiling Lionel Richie This song reminds me of me and my husband before we got married – when we were young and beautiful and so in love.
Rose Makgoloane Clinical Nurse Specialist, Surgical Ward, Netcare Rosebank Hospital
Wake Me Up Avicii It’s upbeat – it keeps me awake! It helps me get motivated.
Have you heard…?
The World Health Organisation (WHO) has issued new guidelines for the amount of sugar that is safe to eat. The WHO now says that reducing sugar to below 5% of total energy intake per day would have health benefits. That’s about 25g – roughly six teaspoons - of sugar for an adult of normal weight every day. (One can of fizzy cooldrink contains about nine teaspoons of sugar).
A new study suggests that warmer temperatures are causing malaria to spread to areas that were malaria free. Scientists say the disease is now entering higher-up areas in Africa and South America. They say people in those regions are now at greater risk of getting malaria, especially as they have not been exposed to the disease before.
Scientists in Denmark have found that a large weight gain does not trigger type 2 diabetes. They found instead that most people diagnosed with type 2 diabetes did not get the disease until they had been overweight or obese for some years.
Researchers in the United States say a baby carrying the HIV virus may have been cured through early treatment. Anteretroviral drugs were given to the baby four hours after birth. Nine months later, the child is thought to be HIV-negative, though it is still receiving anti-AIDS drugs. It is the second such case reported in the USA.
Also in America, researchers have demonstrated than an injection of ARV drugs can protect monkeys against the HIV virus for weeks. This may mean that, in the future, human beings could protect themselves from HIV with an injection every few months. Some people take pills daily to cut their risk of getting HIV. The injection would be an alternative to those daily pills.
The Government says that the mortality rate for children in Gauteng has dropped from over 10% in 2006 to over 3% in 2013. Officials say one reason for this improvement is the introduction of ‘Kangaroo Mother Care’ to hospitals in Gauteng. ‘Kangaroo Care’ involves continued skin-to-skin contact between the mother and her newborn.
Healthy eating is key Hypertension sufferer Sophie Ndaba We know her as the funny, forever single ‘Queen Moroka’ in Generations. Sophie Ndaba chats to Heartbeat about her health issues. “I only discovered it a few years ago during a time when I was suffering high stress. I started getting severe headaches. That’s when I was diagnosed and told to slow down,” says Sophie. Hypertension, or high blood pressure, is known as the “silent killer”, because the symptoms are hardly ever noticeable. It affects about about one in four South Africans. One of those people is actress Sophie Ndaba, who plays “Queen Moroka” in the soapie Generations. You would never think this beautiful actress had health issues, but that’s hypertension for you. Very few people even know they have it until it’s in the danger zone. Then it can lead to a heart attack, stroke, kidney failure and even premature death. Sophie, like many people, is genetically predisposed to hypertension. “Both my parents suffered hypertension, and diabetes. So I’m very aware that I’m at risk,” she says. Sophie says she manages her condition by eating healthily. “I researched everything I could about a healthy lifestyle, and now I’m aware of what to avoid eating, like fatty or starchy foods. I also try and get enough rest and exercise, and I take my prescribed medications without fail.” Sophie, born in Soweto, grew up in foster care in Zimbabwe. There she learned about all about the practices of traditional healers. “I found it very interesting. I learnt about the herbs they use from the bush or garden. I believe natural organic
herbs should be taken seriously, so that we can cut out chemical drugs as much as possible,” says Sophie. Sophie has partnered with Vital Health, a health foods product range, and was a patron of 5-a-Day for Better Health Trust, the campaign that promotes eating five fruit or vegetable portions a day. “ I’ve learned a lot about supplements. I take calcium and Vitamin C, and other vitamins and minerals relevant to my health,” she says. Sophie has a busy schedule driving to and from the SABC to film the episodes for Generations, and she also has her own wedding planning company, so it’s difficult to find regular times to exercise. “But I exercise when I can, and I’m sleeping more. Getting enough sleep is important to keep me going,” she says. One of the most important ingredients of good health is a “positive outlook on life”, says Sophie. “I love being happy. Smiling from the inside out definitely adds a few more great years. There’s nothing to lose being positive, and everything to gain!”
Prevent or reduce high blood pressure • Have your blood pressure checked regularly
• Maintain a healthy body weight
• Get as much exercise as possible
• Watch your alcohol intake
• Reduce your intake of salt • Eat more fruit and vegetables
• Don’t smoke.
• If you have been prescribed blood pressure medication, take it as directed
Making it work Danel Botha*, a nurse at a Garden Route hospital, was just six weeks pregnant when she separated from her son Gerrit’s* father. Her ex-partner provides financial support but he rarely sees Gerrit. Danel has to deal with the demands of her 7am-7pm shift in a busy hospital as well as all the needs of her four-year-old son.
Danel says she would not manage without her family close by. “My parents, my two sisters and their families all live within a 1km radius of my house, which makes such a difference,” she says. Her family help by taking Gerrit to and from school, feeding him his dinner and giving him his bath. “So when I pick him up just after 7pm, he’s ready for bed. This gives us some time together when we get home. We normally have a mug of Milo together, watch a bit of a DVD and then read a story. I make sure he’s in bed by 8:15pm,” Danel explains. Cherenity Vosloo, a second year bridging student at Mediclinic Panorama, has been a single mom for a year. She has a two-year-old son Eljan, whose father sees him at agreed times. In between, Cherenity also relies on her family, particularly her mother, for help.
Her saving grace, she says, is a strict routine. “I work the day shift, so we get up at 5am and I drop Eljan at crèche. I pick him up again just after 7pm. He has had supper by that time, so when we get home it’s bath and bed. I usually just grab a sandwich for supper. This routine is very important to help keep us on track,” Cherenity says. Cherenity manages during the week by herself. But her family steps in to look after Eljan when she needs some time to recharge.
*Not their real names 8
Single parents in the medical profession can face extra challenges. Two single-mom nurses tell us how they stay close to their children.
Meeting the demands
But even with the help of their families, ultimately these women face their roles as mothers and nurses on their own. “It can be very overwhelming. I look after sick people the whole day, and then I am a full-time mother and look after my son. I sometimes don’t have any energy left after such a long day,” says Danel.
Both roles come with a lot of responsibility, and I have to give each 100% or nothing. Both women look for opportunities to unwind. Cherenity reads a good book, or watches her favourite soapies and TV series. Danel enjoys reading at night if she’s not too tired. On weekends she loves cooking and making preserves. She tries to make ‘special time’ to spend with Gerrit. “For example, when I have to work the whole weekend – Friday to Sunday, 12 hours each day – I keep him out of crèche on the Monday. We go to the beach, a movie or a kiddie-friendly venue for some fun. When I’ve had a long day, he gives me a ‘foot massage’. It’s more like a tickle, but it’s the idea that counts!” Danel says, adding that the two of them are very close and share an incredible bond. Similarly, Cherenity and Eljan are also very close, and she gives him regular outings and together time. “Just as I work a 12-hour shift, so he has a 12-hour shift at the crèche, so I like to take him out to entertainment centres. At home, we love watching movies together and singing nursery rhymes,” she says.
Quality not quantity
Willem Oudshoorn, a counselling psychologist working in the public healthcare system, says:
“Making this time for your children is the best thing single mothers can do.” “It’s so important to prioritise family time each day with your child, even if it’s just sitting together and talking”, says Willem.
A big part of that is leaving your work behind at the end of the day and really focusing on your children. “When I am at work, I give everything to my job”, says Danel. “When I leave the hospital, I am my son’s mother, and I leave the patients behind. That is very important.”
“Even though I work long hours, my free time is Eljan’s time,” says Cherenity. “I hardly ever go out with my friends because that’s the only time I have to spend with my son.”
Tell them if you’re battling
Willem says this can be a challenge for healthcare workers who might feel they have nothing left to give at the end of the day.
“If you’re battling, tell your kids in an age-appropriate way. This doesn’t mean offloading your problems on to them, or letting them feel overhwelmed by what you are facing. But children as young as six can understand if you’re having a hard time with something. It may be a relief to them to learn that they are not the source of your anxiety and stress. Be sure to tell them things will get better, and to remain positive, as your mood and attitude will affect your child,” he explains.
Many single parents constantly feel guilty. Guilt that they have to work when they should be with their children, guilt that they aren’t giving their children a ‘normal’ upbringing with two parents present and guilt that the time they do have with them is split between other things, like chores. Often, this is a bigger problem for shift workers whose time is more limited.
Ditch the guilt trip
“Single mothers working long hours often feel guilty, but they don’t need to. It’s not only the amount of time you spend with your children that is important; the quality of that time together also makes a difference,” Willem says. “Structure is vitally important; maintain a routine so that your children know what to expect every day, and so that free time can be spent well together. Try to include your child in deciding how you will spend your ‘quality time’ slots.”
In their own words Everybody has their own way of being a single parent. Here is some from-the-heart advice from other single mom nurses:
“Exercise is very important; it releases feel-good endorphins. And always remember to be honest with your child.” Danel Botha “Take it one day at a time. Make time for your children as it will have a major effect on their future. But don’t forget to have ‘me’ time as well, even if it’s just going for coffee alone or reading a book that you love.” Cherenity Vosloo
Doctors and nurses have welcomed a new ruling from the Constitutional Court about sex between teenagers. Heartbeat looks at what this ruling means for those working with children. “The Sexual Offences Act criminalised sexual activity between children aged 12 to 15. Even hugging and kissing would constitute a criminal offence under the Act,” says Shahida Omar from the Teddy Bear Clinic for Abused Children. The Teddy Bear Clinic was one of the children’s organisations that asked the Constitutional Court to look at the Sexual Offences Act. The Court ruled that the Act violates the rights of children. This new ruling changes the obligations of doctors and nurses working with sexually active teenagers.
Shahida Omar said the Act led to children being treated as criminals. They would have to be interrogated by police officers, appear before a prosecutor and face the associated social stigma.
“The humiliation and shaming was counter-productive. It was more harmful to children than helpful,” she said. Hard for nurses
Matshidiso Dipudi now works for DENOSA, the Democratic Nursing Organisation of South Africa. Until 2011, she worked at Stredford Community Health Centre in Orange Farm in Gauteng.
She says the Sexual Offences Act put her in a difficult position when caring for teenagers who had sex. “There was a rule that if we booked appointments for antenatal patients and we found a child that was underage [legal age for consensual sex is 16], we should immediately call the police so that they could investigate how this person fell pregnant, whether she was raped or not and who the perpetrator was,” says Matshidiso. “This made it worse for those who had been raped and fallen pregnant because they had to deal with the added fear of being prosecuted by the law.” Matshidiso says this law only added to the number of teenagers who avoided going for health care. “A lot of young people don’t know their rights [and so are scared],” she says.
Call the police
Dr Andani Maphaha* agrees. She works with victims of sexual violence at the Thuthuzela Care Centres in Johannesburg. Andani says the Sexual Offences Act made things harder for children, as the police were brought into situations that could have been solved between families or with a social worker. Dr Maphaha says the Act also made it harder for health professionals. “Once you [health professional] were aware of sexual activity between children you had to notify the police. It always made it difficult, especially when you think about the other counterpart; if they are of the same age then who’s the perpetrator, who’s the victim? ”
The doctor said she was not “putting a stamp of approval” on teenage sex. But she said: “This should not be a criminal offence; we should rather look at other avenues in which sexual activity at such a young age can be dealt with. For many of the kids I come into contact with it was a mistake but do they really need a criminal record? We should rather rehabilitate them and make them aware of the consequences of sexual activity at that age.”
What does the Constitutional Court ruling mean for parents? Prinslean Mahery, Wits Law Lecturer says: “One of the reasons why this issue was important for the Court to consider was because the law basically made it difficult for a parent to speak to their adolescent child about sex. It would be as if you were encouraging them to do something illegal. So by taking that away the Court is opening the path for parents to play a part in assisting adolescents and other children with sexual education.”
The law basically made it difficult for a parent to speak to their child about sex. Dr Andani Maphaha says:
“Parents have a huge role to play. They should be coming to us for more information on how to educate their children or to look for avenues to take their children to get professional help. I think the de-criminalisation will put the power back in the hands of the parents.”
Shahida Omar, head of the Teddy Bear Clinic says: “We are hoping that Parliament will fix this piece of legislation during the 18 months they have been given.”
“The criminal justice system was given the responsibility where we need to give parents greater responsibility. We need parents to engage with the Department of Education and schools to have a look at their life skills programmes. In theory these programmes are there but the practical implementation leaves much to be desired. The Education Department needs to be more active in enabling children to make the right choices.”
* Not her real name
The law and you: What does the new Constitutional Court ruling mean for you if you work with children? Prinslean Mahery, a Law Lecturer at Wits University, explained that sections of the Sexual Offences Act relating to children having sex have been suspended. “The Constitutional Court [has given] Parliament 18 months to fix the law and has ruled that there should be no more reporting of such incidents, or investigations into them. This means that there is currently no obligation to report adolescents having sex.” Mahery said that the court ruling is only applicable to sexual activity among children between the ages of 12 and 15 years. “So for example if you know of a 17-year-old having sex with a 13-year-old, the 17-yearold is committing an offence and that must be reported to the police[as statutory rape],” she said.
To sum up: [‘Consensual sex’: this means sex where both parties have agreed to have sex together]
You don’t have to report:
• Consensual sex between children aged 12 – 15 years
You do have to report:
• Anyone having sex with a child under 12, even another child of the same age • Consensual sex between anyone 16 or older and a younger person • Non-consensual sex (rape) forced on any young person.
doing it for themselves!
“Baby, my penis doesn’t fit into those small condoms.” “I can’t feel anything when we have sex with a condom on.” “I have a latex allergy – I can’t wear those.” These are some of the common excuses men give for why they can’t, or don’t want to use condoms, according to Sister Nora Masinga*, from Sedibeng district health services in Gauteng. “There are men who don’t want to use condoms because they claim their penises are too big,” she laughs. But there is one solution to all of these excuses: the female condom. It even comes with the added bonus of more pleasure.
Female condoms have had a reputation for being noisy, intimidating and expensive. But there are new, improved versions with more to come in the near future.
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: 5 years
*not her real name
The FC2 is the female condom currently available in the public sector. Like most female condoms it is made from synthetic latex which is safe for those with a latex allergy.
The FC2 has two rings. According to Sister Nora, that means twice the amount of pleasure. ‘The outer ring is for her pleasure and the inner ring is for him,’ she says. The outer ring of the female condom can rub against the clitoris during sex creating more sensation. The penis bumping into the inner ring is said to give more pleasure to the man.
The Cupid, a newer female condom available on a small scale in South Africa, has an inner sponge instead of a ring. The sponge is said to limit the chances of semen spilling out when the condom is removed because of its absorptive nature. It comes in two colours – normal and pink. And it’s also the only female condom on the market which is vanilla scented.
The latest female condom to be developed is called the Women’s Condom but it will only be available in South Africa next year. Vivienne Naidoo is from the international organisation that developed the Women’s Condom, The Programme for Appropriate Technology in Health. She says this condom is easier to insert. The condom is enclosed in a small, tampon-shaped capsule. This capsule dissolves once it is inserted into the vagina, releasing the condom sheath. There are four small patches of foam on the sides of the sheath that cling to the vaginal wall. The foam patches are there instead of a ring or sponge device, to hold the condom in place during sex.
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Sister Nora trains other nurses to teach patients how to use condoms. “The thing about the female condom is that it gives you, as a woman, more control,” she says.“You can also insert it before sex starts so you don’t have to stop and ruin the mood.” Another advantage, she says, is that unlike the male condom you don’t have to withdraw immediately and remove the condom. “You can lie and cuddle with your partner after sex.”
Challenges for nurses
Sister Nora says that although there are many benefits there are also a lot of challenges to using the female condom for nurses as well as patients. “The biggest problem is we don’t have models for demonstrations. We end up having to make a fist with our hands and show how to insert the condom that way,” she says. Patients, especially women, often find it difficult to negotiate condom use with their partners.
Condom 15) ’s n e m o W in 20 uth Africa
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Experimenting Vivienne Naidoo has used both the FC2 and Women’s Condom with her husband. “The FC2 is a bit messy [it comes with pre-added lubricant] and is not as easy to insert as the Women’s Condom,” she said.
“The material of the newer condom is very thin, it isn’t noisy and both my husband and I found it pleasurable.” She said the lubricant for the Women’s Condom comes in a separate sachet, which gives users more freedom to decide how much or little to use. The FC2 is also made of a thinner material than the male condom – which allows for better heat transfer – so sex can feel more natural.
Sister Nora’s advice, “Try it. You might like it.” “Sometimes you will find a woman is even afraid to just introduce the topic,” she says. “I believe it’s important to go beyond the nurse-patient relationship and really try empower women,” she adds. “I tell them to experiment – you can make things exciting by treating condoms like sex toys – not just a necessary tool to protect you from HIV and unwanted pregnancies.” She says there are different styles of putting condoms on (like with your mouth) and that women shouldn’t be afraid to explore “so that we can make men more interested in using condoms”. “If a man says he can’t use a male condom because his penis is too big – acknowledge that. Tell him some men are just gifted and he is one of the lucky ones! They would like that – but offer the female condom as a solution – you might be able to trick them this way!” she laughs.
at work Beating stress
When work is going well it’s easy to feel calm and motivated. But what about the times we we feel ground down by long shifts, physical strain and dealing daily with human suffering? Clinical psychologist, life coach and motivational speaker Omphile Sebitloane shares some tips for ﬁnding inner peace in the hard times at work. Talk it out: If you face conflict at work you can use the grievance forums in place. But do also share your thoughts and issues with a friend or loved one. Communicating is a great healer, and you’ll also find you are not alone in facing difficult issues. Give yourself credit for your good work: Think about how you helped a patient to recover, and how you contributed to them regaining their health. Look at the social benefits of what you are doing, and your contribution to the country’s healthcare system. An appreciation of your own good work will help you to remember the meaning of your job beyond your salary. And it will help you stay motivated and compassionate in your work.
Reﬂect: Conflicts can be heated, so when things simmer down think about how you can contribute to resolving the issue. You may need to apologise if you’ve been in the wrong. But you can do so knowing that you have taken the higher ground and allowed everyone, most of all yourself, to move on. Nurture your spirituality: In an environment where there is sickness and death, perhaps you wonder why there is so much suffering. Your spirituality means it’s okay to not have all the answers, and to believe in workings of a higher power, your God. Your spirituality keeps hope alive, and gives you strength for the journey ahead. Be kind to yourself: Everybody has moments of self doubt and feelings of unworthiness from time to time. It is normal. The trick to regaining your self-confidence is to remember that you are unique and have the gift of your own experiences and blessings. The Serenity Prayer is useful to remember: ‘God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.’ Treasure family time: It’s easy to get caught up in the pressure of all that has to be done at home. Find the time to catch up with what’s been happening in the worlds of your loved ones. Try to plan some fun weekend outings together, like going to see a movie or taking a picnic to the park.
What does the Government’s new school health programme mean for us as parents and as nurses? The first phase of an ambitious new programme to improve the health of our schoolchildren is underway. The Integrated School Health Programme aims to address the immediate health problems of learners. But it also wants to promote the health and wellbeing of these learners throughout their childhood and into adulthood. Health Minister Aaron Motsoaledi explained the thinking behind the Integrated School Health Programme (ISHP): “There are 12 million pupils. We can’t wait for them, in our wrong curative model, to get sick and only then take them to hospital. We want them to get the help in school.”
How it works
The ISHP has begun by targetting South Africa’s neediest schools in ten pilot districts. But it will eventually reach all school children. Nursing teams visit learners in four key Grades: One, Four, Eight and Ten. The nurses are backed up by mobile units. Lekwetji Komane from the Gauteng Department of Health explained how it all works: “Each team consists of one professional nurse and one nursing assistant. A nurse examines each child from head to toe, including a vision test, hearing test and mouth inspection. If there are simple illnesses present such as a cough or a rash, medicines are dispensed immediately. Each nursing team carries a cooler box equipped with basic medicines.”
“There are 12 million pupils. We can’t wait for them to get sick and only then take them to hospital,” Dr Aaron Motsoaledi, Minister of Health Mobile units
“If the problem is more complicated then the child is referred to a primary health mobile. Each mobile unit consists of three vehicles: an optometry vehicle, a dental vehicle and a primary health care vehicle. These visit the school after the nursing team has been, to treat problems identified. All treatment, including spectacles, is free to pupils. Each school should have one initial visit and a follow-up visit each year.”
The Integrated School Health Programme, ISHP, is creating job opportunities for nurses. “Provinces are employing more school nurses. Limpopo recently appointed 41 new school nurses,” says Dr Lesley Bamford, a child health specialist at the Department of Health. Lekwetji Komane from the Gauteng Department of Health agrees. “Once this programme is rolled out countrywide, there will be many additional nursing positions available. Ideally there should be one nurse to 2000 pupils. Currently, in the area of Tshwane [in Gauteng], there is one nurse to 2 800 pupils. So even within the existing systems, there is a need for more nurses.”
New HPV vaccine for girls The government has also launched an HPV vaccination campaign as part of its Integrated School Health Programme. HPV is associated with cervical cancer which kills more South African women than any other cancer. School nurses will provide free HPV vaccines to Grade 4 girls in the poorest 80% of schools.
The Department of Health has urged parents and guardians of Grade Four schoolgirls to support the HPV drive The Department of Health has urged parents and guardians of Grade Four schoolgirls to support this HPV drive by giving their consent, and by discussing the significance of this vaccination with their daughters.
diRoNTSo TLadi A school nurse’s story
“I love my work” “I sleep peacefully at night because I know that every day, I have helped at least one child,” says school health nurse Dirontso Maria Tladi. She is one of the 20 Pretoria nurses who are piloting the Integrated School Health Programme (ISHP) in Gauteng. Dirontso Tladi is based at the Stanza Bopape community clinic in Mamelodi, Pretoria. “We visit schools every day and sadly, because of the type of school we visit,we see high levels of poverty. But the work is very interesting and rewarding.” Dirontso says that the most in need are those from childheaded households. They mostly survive on grants and government feeding schemes. “At school, children get breakfast and lunch and the poorest families get a little food to take home after school. Some schools have vegetable gardens and they allow scholars to harvest food to take home.”
“The biggest problems we see are high levels of HIV and child abuse,” she explains. “Stepfathers often abuse stepchildren. We are able to refer families to social workers in our district for counselling. This is important because abused children are so vulnerable.”
Some children are already taking antiretrovirals and others need to be taken to a clinic for testing. “Parents are often in denial but we must involve them and obtain their consent. We follow up with the child at school some time later to check that the problem is receiving attention.” “We commonly see laryngitis, oral health problems, hearing problems and vision problems. Each province has a mobile unit that can treat these conditions. We frequently diagnose skin conditions such as ringworm and we can supply medicine to treat these. If the child is in Grade One or Four, we usually leave medicines as well as instructions with the teacher. Parents collect the medication from the teacher and are taught how to administer it.” If there is an emergency condition the school nurses get the principal’s permission to refer the child to the clinic where a doctor can prescribe stronger medicine.
“I love my job,” says Dirontso. “Children in Grades One and Four are so helpless. I feel I am doing good.” Dirontso certainly sees nursing as a vocation. “When I was at nursing school the senior nurse said to me I must make every bed as though my own mother were to sleep in it. I must talk to each patient the way I would talk to Jesus. Children are helpless and parents are not well educated and have feelings of inferiority. They need to be helped to dig themselves out of the hole of poverty.”
Sister speak My story
Lebo Ramafoko is the head of Soul City and an ‘agony aunt’ to the nation
My 22 year old daughter recently got married. I was filled with lots of emotions. I had my daughter when I was 20 years and 11 months. My pregnancy was taboo because I was unmarried. I had brought shame to my family because instead of studying (I was a second-year university student) I became pregnant. Luckily my parents were able to look after my child till she was 6, and I could finish my studies. My experience of becoming a young mother, coupled with my work at Soul City, made me sensitive to issues about young people and sex. Firstly, I became aware that many adults have a problem recognising that their children are sexual beings. Secondly, parents want to either ignore the fact that their children are having sex or want to control it.
Adults have a problem recognising that their children are sexual beings I have tried as hard as possible to bring up my daughter differently. This forced me to confront my own deeply ingrained beliefs about sex. These are some of the beliefs I had to unlearn to bring up my daughter with a healthy sense of her sexuality.
Sex is a sin
I am sure that most religions have good intentions. But this message communicates that sex is wrong. To a 15-year old with raging hormones, it makes something very natural seem very shameful. As a result, young people turn to their friends rather than their families to learn about sex. In this day of cell-phones, they can access porn sites to satisfy their curiosity. Parents lose the opportunity to pass on values about sex.
Sex is dirty
Many women are taught that their bodies are not good enough. They believe that their vaginas are dirty. Some even put disinfectant there. How can you control your body if you are afraid or ashamed of your body parts?
Men must enjoy sex, women are sluts if they do
We also bring up girls to believe that their bodies are there in order to please men. Then we are surprised if they cannot say ‘no’ to whatever men want them to do. I have had to challenge these beliefs for myself. I had to accept that, despite what I was taught, I am a sexual being with sexual needs and that I have a right to enjoy sex. But it was so much harder to give my daughter the same message! The more I practised it, the more I was brave enough to tell my daughter that she has the right to enjoyable and safe sex because she wants it, not to please a man. It was not easy when she told me that she had started having sex. But I was proud to know that it was her decision; that she would be responsible and, above all else, have pleasurable sex. Many parents fear that talking to their children about sex will lead to promiscuity. For me, the opposite is true. My daughter has understood that her body is hers and that she must decide for herself when she is ready to have sex. She knew that she could talk to me instead of her friends. She understood our family values Would you like to ask and, at 22, she married the Sis’ Lebo about a problem? man she wanted to have Text her on 081 555 4397, or lots of good sex with email her on because he is the man firstname.lastname@example.org. who respected her and If Sis Lebo publishes your problem made her happy. in the magazine then you will
win R500. You can remain completely anonymous: your name will not be used. Heartbeat
, e f i L Your ory... t S r u o Y Writing is a great form of self-therapy. It can help to make your life more meaningful and productive. Find inner wisdom: Dr Garisch says that when you get into writing it’s like having a conversation with your inner voice of wisdom.
‘Journal therapy’ can help you to change your life for the better. Keeping a journal simply involves writing, either regularly or just every now and then, about yourself and your life in a notebook. You may choose to keep your journal private or to share it with others.
Why keep a journal?
Dr Dawn Garish is a medical doctor who found that writing helped her to improve her emotional wellbing. She now teaches a course on writing to medical students at the University of Cape Town. Dr Garish says keeping a journal can help us to: Build emotional resilience: In particular, it can help you cope with stress. Journalling can help you to offload at the end of a difficult day. Heal trauma: Writing helps trauma victims come to terms with difficult experiences. Improve self-knowledge: Writing encourages us to explore who we are.
Journalling is a gift you give yourself How to start?
Can you apply this to your own life? Of course! If you just write for only ten minutes a day you can improve your relationship with yourself and those around you. Keep in mind that it’s a process. It’s not about keeping a log-book of who-said-what on the ward. It’s not about writing an account of your life. It’s about you becoming a gentle witness to your own special, unfolding story. You may see that you can change patterns of behaviour. You may find you enjoy the time spent alone with yourself. If you’re worried you’ll have nothing worth saying or showing the world, don’t fear. As you pour your thoughts on to the page, you’ll find it easier to reflect your own experiences. Journalling is a gift you give yourself. It’s not meant for another’s entertainment.
“Journalling helped me to deal with being raped” Nosipho Kota, 39, a poet and Assistant Director for Media Liaison at the Department of Health in Port Elizabeth. “I started journalling seriously 20 years ago, when my father passed away. We had a lot of unfinished business and since he wasn’t there to hear my pain, I decided to write down my feelings. Now, whether I’m confused, sad or happy, I write it down. Journalling helps me clarify what my joys and struggles are. Looking back at my pile of my journals, I can’t believe some of the things I went through. In my late twenties, journalling – and therapy - helped me deal with the fact that I was raped at 11. For years I’d blocked it out. Sometimes I struggle to write consistently because of the pressures of a career, motherhood and life in general. I try to write daily but I get tired because I have three young kids. I usually write in the early morning, while they’re sleeping. If I pick up my pen and my journal during the day then they want to write in it as well, so I have to have crayons and paper there for them!
ritic “When y ou com e to write, you hav one of th e to do is to de e first th you tha al with th ings t says th e voice ings like ‘who do in s id ‘y e ou can’t you thin write’ or k you are She beli ?” says eves this Dr Garis inner vo of voice h. ice is oft s from o en a mix ur past. it lies at ture Dawn s the hea ays igno rt of wh about: im ring at writin proving g therap your se back ow y is all lf-estee nership m and ta of your king life. Practice helps to defeat th Let go o at critic f the ne al voice ed to be write, e . perfect ven if yo and jus u think spelling t it’s bad and gra . Forget mmar ru to keep about les. Jus writing, t do you as hone r best stly as y ou can.
Through practice, journalling has become second nature. It does wonders for your soul.”
Tools, Tips & Prompts To start, you don’t need much. You can use a computer or pen and paper. Set aside a specific time for writing when you won’t be disturbed. If this is not possible then try to find other ways to make writing a ritual. For example, use a nice pen or pencil, or make yourself a special drink or snack, or light a candle. Jump right in by free-writing for a set time – say, 10 minutes. Set an alarm and just let your pen keep moving for 10 minutes. You don’t even need to go back to see what you’ve written. This “writing sprint” is good for clearing emotions. To ﬁnd your voice, look back at your life and stop at an episode that was very hard. Explore this memory by writing it down. This can help us when we are feeling psychologically unwell. Gather a series of sentence starters as writing prompts: phrases like “I wish”, “Today I feel… “ or “I remember…”.
You ma st write! can chany see that you ge patte behaviou rns of r
After journalling, give yourself a small reward – a hot shower, a refreshing cup of tea. This helps you associate writing with something enjoyable and nurturing.
Will you be
What can you expect?
If you’re a nurse or medic working for a state hospital, you will be paying monthly pension contributions to the Government Employees Pension Fund (GEPF). The amount that you’ll get when you retire depends on how much you earned each month and how many years you worked for. Members of the Government’s pension fund, the GEPF, with less than 10 years’ service receive only a once-off, cash, lump sum (called a gratuity). Members with 10 or more years’ service receive a lump sum and a monthly pension (an annuity). It’s a good idea to find out how much you’ll get, as some GEPF members would need to boost their savings to have enough when they retire. 22
One of the best ways of saving is by taking advantage of the many senior citizen/pensioner discounts available in most product sectors, from insurance policies to groceries. A good place to start is to join, for free, the SA Association of Retired Persons (www. saarp.co.za), an excellent source of information and good deals on everything from internet providers to cheap flights and car hire specials. Another good site to find specials is
www.seniorservice.co.za Some discounts are available to you as early as age 55, but most are for 60’s and over. It’s up to you to always ask, wherever you go, ‘do you have a pensioner’s discount?’. And know that, as a person who has worked and served the people and economy of this country, you deserve every cent of it.
As you get older, saving money and paying off debt become top priorities. Do you worry about your retirement? You aren’t alone. Only five in 100 South Africans will have enough money to be financially independent in old age. Many pensioners – nearly a quarter of retired people - still have children to support, according to Sanlam. Statistics show that more than a third of pensioners use up their entire pension payout within two years of retiring. Saving for old age
Be careful of funeral policies More policies, less money
“People think that the more funeral policies they have, the more money they’ll get. But this isn’t necessarily the case. Most insurance companies will pay out less if you have other funeral policies. In some cases, they will only agree to pay out one policy,” warns Lyndwill Clarke from the Financial Services Board.
CHECK that your family will get what you expect they’ll get Being cheated
You also need to be careful of unscrupulous or dishonest insurers, as there are many of them around. “Funeral
cover is a big driver of non-bank and informal financial products. This means that there is a lot of scope for unscrupulous insurance brokers, and the most at risk are the lower income groups,” warns the debt management company DebtBusters.
CHECK that your policy is underwritten by a licensed financial services provider (FSP) Funerals are important events. But many South Africans over-invest in funeral policies, to the extent that other priorities in life are compromised.
CHECK that you can afford your funeral cover
A pension comparison R35 000/month salary working for 30 years R846 000 gratuity R19 120 pension p/m
A hospital manager earning R35 000 per month who retires at 60 after 30 years service will probably be in a secure position, for example, as she’ll get a gratuity (one‑off payment) of R846 000 (before tax) as well as R19 120 pension (before tax) each month.
R18 000 /month salary working for 9 years R582 000 gratuity No monthly pension
A nurse earning R18 000 a month
for nine years before retirement will only get a R582 000 gratuity (before tax) from the GEPF, and no annuity (no monthly pension). This means she will have to live off the gratuity amount until she dies, so investing that money in a retirement plan that pays her out a set amount every month would make good sense for this nurse.
Saving for old age: beware of ‘Ponzi’ schemes and high interest Lyndwill Clarke from the Financial Services Board says that many employees who get a big lump sum payment when they retire fall into the trap of investing in “Ponzi” schemes. These are fraudulent investment operations promising big returns that never come. “People lose a lot of money to these schemes, so stay away, even if it sounds tempting,” he says.
Even more people, including those approaching retirement, fall victim to lenders who will take you for all they can Low income workers are particularly at risk. In Lebo’s case, the interest rate she’s paying on her loans is 32%. This means that if she borrows R3000 she has to pay back an extra R960! As Finance Minister Pravin Gordhan pointed out earlier this year, ‘some of these lenders charge interest rates running up to 800%”, and many don’t even offer you a paper contract. But when you fail to pay, they start intimidating you or your employer’. Borrowing or lending can badly compromise your retirement funds, Clarke says. “And although it might be tempting, try not to borrow from your retirement fund. If you do, try and pay it back before you retire. You will need every cent of it in your old age,” he says.
tips to boost yoUR RetiReMeNt fUNds
Save up any extra cash for your retirement. We can’t predict how how long we’ll live, so we need to be prepared for a ripe old age.
Pay off your bond repayments as soon as possible. If your house is paid off it will save you a lot of money that you can put into retirement savings instead.
Don’t spend your pension funds when leaving a job and moving to another job. Let your pension grow for longer in another pension fund.
Don’t spend tomorrow’s money today. South Africans are poor at “impulse control” when it comes to retirement savings. Don’t splash money on furniture, appliances or cars if you can help it.
Know what you earn and what you spend it on. Speak to a financial planner to help you. You can control your money, rather than waiting until you get a horrible wake-up call about your debt.
Shop around, stay up-to-date for the best retirement policies Elias Shamatla at the National Debt Mediation Association says that when he counsels those in debt he looks at all their policies to see which ones are working well, and which ones can be dropped or consolidated with others. “Some people I see are paying up to R4000 a month on life cover policies. That is too much by most people’s standards. And when I dig into these policies, I see that many of them old ones that don’t even offer good cover. There are lots of better policies available these days,” he says. Shamatla says that the best plan is to see a financial planner to look at your policies, and advise you of the other policies available on the market. Sanlam, Liberty, Old Mutual, Discovery, Momentum and Allan Gray are among the financial institutions offering competitive retirement products. Your financial planner will look at which one suits you best. Lyndwill Clarke says that when talking to a financial planner, make sure he or she is registered with the Financial Planning Institute of South Africa. “Most importantly, be sure you understand exactly what you are buying and what you can expect out of it when you retire. Be sure that it addresses your needs and that you can afford the pension plan you are buying,” he says.
From March 2014, every person is allowed to invest up to 27% of their income (salary without deductions) in a pension fund, retirement annuity or provident fund, and it will be tax free. In other words, you won’t be taxed for the money you invest for your retirement.
Don’t retire with debt Even if you do get a comfortable pension, it doesn’t help to retire with a lot of debt on your shoulders, or too many policies draining your monthly income. Hundreds of nurses and even senior medical staff end up in debt counseling, says Elias Shamatla at the National Debt Mediation Association, and many of them will go into retirement with debts that will quickly eat up their pension payouts.
Elisas is counseling a senior nurse, Lebo*, a deputy manager at an Eastern Cape state hospital approaching retirement. Lebo earns R41 000 a month before tax. Lebo owes R260 000 in debt. This includes eight cash loans worth R13 000, used for various building renovations and new furniture and appliances. Lebo pays out money for 16 policies (including life cover, accidental death cover and a number of funeral policies), and is still paying off her vehicle at R4300 a month. Lebo takes home only R16 000 each month. Elisa says: Lebo ended up in debt counselling because after all her deductions and policy premiums, she only takes home R16 000. With this she has to pay the vehicle, school fees, transport, groceries and Stokvel, so she doesn’t have enough left over to service her debts. She’s going deeper and deeper into debt, and if she doesn’t do something now, she will retire with all a lot more debt on her shoulders, because debt accumulates very high interest,” says Elias.
The best way to get rid of debt is to pay off all your short-term debt first, like credit cards, unsecured loans (a loan without a house or car as security) and clothing accounts. “If you can pay more into your bond account, do it. The sooner you can get rid of all debt from your life, the better,” advises Shamatla. *Name changed.
Want to be able to send an email but don’t know where to start? Tired of wondering what Facebook is or how to join it? Heartbeat takes you through social media and explains how to get started. So everyone around you is emailing, on Facebook and sharing photographs and you’re feeling a bit left out? Welcome to the World Wide Web and a new way of communicating through what’s called ‘social media’.
Everyone can join, no matter how little they know about computers. What’s social media?
Social media has been around since human beings began communicating! The terms simply means the way one person communicates with lots of other people. But now, in the age of the internet, people are finding new ways to talk to each other, and to meet people with similar interests or ideas. Instead of meeting up in a church hall, playground or shop, people are getting together online. This means they get connected to the web [see opposite for how to do this], and, once connected, they put in the address of a community they would like to join. These comunities are often called ‘platforms’ (See below for examples of some of the bestknown platforms, like Facebook).
What can social media do for me?
You can use social media to find school mates from long ago or you can connect with family and friends. It’s not only fun and games though. You can join a cause you believe in, or watch a lecture from a knowledgeable person who interests you. Social media can open you up to new ideas, a different way of doing things or provide you with information on practically every subject under the sun. You can ask a questions and anyone in your online community can answer you. Or you can start a debate and get other people’s views on a matter that interests you. In order to join an online community or ‘platform’, you need to be connected to the web.
Google is the world’s largest search engine. This means its one of the best places to start looking for anything you want to know about. If it’s on the internet, Google will find it. Go to www.google.com.
How do I get connected?
There are different way of connecting to the web but all of them require either a computer or a smartphone. If you don’t have either of these then you can use a computer at an internet café. But if you are looking to set up a regular internet connection at home then you have a few options.
If you have a landline at home:
ADSL is technology that provides connection to the internet through an existing landline in your home or business. You can get a service provider to set up an account for you: compare deals at some of the better known service providers like Telkom, Afrihost or Mweb.
If you don’t want to connect through a landline:
3G or USB Dongle is a portable device that you plug in to your laptop or computer to allow you to access the internet. It works through a cellphone network. So you can sit anywhere in the country where there is a cellphone network signal and connect using the dongle.
If you choose a dongle, then you will need to buy data bundles:
for the phone but for your internet. Different service providers such as Vodacom or MTN have different pricing options for data bundles.
To go online we use internet data which is measured in bytes. With data bundles it doesn’t matter how many minutes you stay connected but rather how many bytes you use. What are your payment options?
Some of the plans give you a limited number of days to use the data bundels you’ve bought. For example the data bundles expire after 30 days and then you have to buy more data. On the following page is a breakdown of some of the popular service providers and some of the data plans on offer. There are specific terms used to measure the memory capacity or the size of the data plan you choose. Megabyte or Meg or MB is a smaller unit which gives you a limited amount of usage of the internet Gigabyte or Gig or GB is larger and provides you with more units that you can use online: 1000MB’s = 1 GB.
You buy data bundles in the same way, and in the same places, that you buy airtime. But you use these bundles not
Getting an email address
Once you’ve chosen the best method for you to connect to the internet you can get yourself an email address. You’ll need this to sign up to the different social media platforms we spoke about earlier.
TIP: Choose a name for your account that will be easy for you to remember. It’s not always possible to use your real name because sometimes someone else, possibly with the same name as you, has already used it. So choose another name that you will remember. There are quite a few free options for you to chose from. These are four of the most popular in South Africa.
Gmail: Go to www.google.com. Click on Gmail to sign up by following the easy steps. Yahoo: Visit www.yahoo.co.za and click on the sign up button. Follow the steps to create your account. Webmail: Go to www.webmail.co.za and click on Register free to create your email account. Hotmail: Visit www.hotmail.com which will take you to a Microsoft account page. Click on sign up to create your email account
wHAt CAN tHe iNteRNet do foR yoU?
Here are two nurses’s experiences: Sister Phyllis Nkonjera is a retired nurse who now works part time at the Golden Harvest Retirement Village in Randburg, Gauteng. Before retirement, Sister Nkonjera worked as a nurse in the UK for 10 years. She returned to South Africa to teach at a nursing college in the Eastern Cape. Sister Phyllis is very connected to the world wide web and is up to date with the latest trends. With her Vodacom contract of just over R800 each month, Sister Phyllis uses her mobile smartphone for email, Facebook, chatting for free on Whatsapp and BBM and catching up on the latest news online. She also does her daily bible study, all from her mobile phone.
Sister Phyllis is also on Twitter. She mainly tweets news from her church or the latest antics of her grandchildren. What Sister Phyllis loves about her smart phone and being connected is that communication is so much quicker than it was a few years ago. “I can get hold of someone in an instant and keep in touch with the friends I have made overseas,” she said. “Everything is within reach.”
enrolled Nurse Mandla Mkhize* has recently joined the nursing profession and works fulltime at a large public hospital in Johannesburg. Mandla became a nurse after completing his training in 2009. Mandla use two different service providers, MTN and 8ta for different purposes. With 8ta he has a R405.00 monthly contract which offers a combined package of a smart phone as well as a laptop. He also has a prepaid MTN/ Blackberry account which costs him just over R200.00 every month. This account gives him access to the Blackberry BIS service which allows him unlimited internet access. Besides checking his Facebook a few times a day, Mandla uses the internet connectivity to make payments mainly to his siblings. He finds it easier to send money instantly using his phone and
laughs about the days he had to leave work to stand in a bank queue to send a small amount of money. He also enjoys the fact that he has easy access to Google, which allows him to check medical terms in an instant. “Sometimes instead of looking for a medical book I quickly google certain terms to fully understand a patient’s diagnosis if I haven’t experienced it before, “ he says, “It really is a great help when I have to respond to a patient’s needs quickly.” *not his real name
TIME FOR A BREAK!
You work hard all year, so a good break would be great.
GAUTENG Rhino and Lion Park, Krugersdorp. A nice day out for the family: this is a big private game reserve, home to buffalo, lion, white rhino, wild dog, cheetah, hippo, crocodile and more than 20 buck species. Overnight visitors can book into the reserve’s log cabins that all have jet baths, or into self‑catering chalets. For the children, there’s a jungle gym and playground, and a swimming pool. Day fees: Adults: R120, children R80, pensioners R90. Tel 011 957 0349. Maropeng/Sterkfontein Caves, in the Cradle of Humankind World Heritage site. The Sterkfontein Caves, about an hour’s drive from Johannesburg and Pretoria, are world famous for their ancient fossil ﬁnds.Tours of the caves start every hour. There are also two restaurants at Maropeng visitor centre. Day fees: Adults R135, children (4‑14) R75. Tel: 014 577 9000. 30
South African Tourism runs a campaign called ‘Sho’t Left’, which ﬁnds local holiday deals for holidaymakers on a budget. Browse on the website, www.shotleft.co.za
FREE STATE Vaal River. How about a couple of nights at the Emerald Resort, on the banks of the Vaal River? This resort offers selfâ€‘catering units, and thereâ€™s plenty of entertainment for the kids including an indoor pool with water slides, and a bowling alley. A two bedroom chalet (sleeps 4), with fully equipped kitchen, lounge, TV with selected DStv channels and a braai area, costs about R1115 per night on a midweek special. Tel: 016 982 8000.
Table Mountain: Take the Cableway to the top of Table Mountain for a wonderful view of the city. Return ticket per adult is R205, children R100. Accommodation in Cape Town is expensive The Protea Hotel Sea Point has a swimming pool and great views of the ocean. You are also right next to the popular Waterfront shopping mall. A family room for 4 is about R3000 per night, but also ask about specials. Tel: 0861 11 9000
LIMPOPO Metcourt Khoroni hotel, Thohoyandou, near the Kruger National Park’s Punda Maria gate: A more affordable hotel styled in contemporary Afro‑chic, with lots of dining facilities and entertainment options for the kids, including a crèche so that mom and dad can take a break. Rates are from R500 per person sharing. Tel: 011 928 1928
NORTH WEST Pilanesberg Game Reserve near Sun City: try Manyane resort. It offers chalets cheaper safari tents, which have a fridge plus real beds. They also have facilities and services that you don’t usually associate with accommodation on a safari, such as a swimming pool, restaurant, playground and superette. And they are close to Sun City. Rates are from around R1680 for two nights in a 2‑sleeper safari tent to R2520 for two nights in a 2‑sleeper chalet. Tel: 014 555 1000.
KWAZULU NATAL Durban beachfront: A favourite hotel on Durban’s Golden Mile beachfront is the Blue Waters hotel, a 3‑star hotel with fabulous views of the ocean. Its out‑of‑season rates are around R948 per night for a family room (sleeps 4), including breakfast. You’re also in walking distance of Durban’s restaurants, shops and night spots. Tel: 031 327 7000.
MPUMALANGA Kruger National Park: the largest game reserve in South Africa, this is the home of the awesome Big 5 wildlife experience. Kruger safari camps are dotted all over the park, and many of them are only a half‑hour drive from Nelspruit. The most affordable of the Kruger camps are Skukuza, Olifants, Letaba and Orpen restcamps, starting at about R840 for a two‑bedroom bungalow per night. Tel: 021 4241037. Graceland hotel, Secunda: A popular hotel for the whole family, because there is lots to do, whatever your age. This hotel has a video arcade for the youngsters, as well as a movie theatre and a live entertainment venue. It has four restaurants to choose from, and a beauty salon. Rates start at around R700 per person sharing, but ask about off‑season deals. Tel: 017 620 1000
www.krugerpark.co.za | www.graceland.co.za
Those difficult situations
How are you feeling today Mr Masemola?
Do you know I am a man? I have been to the mountain. Look you are so young. A girl. And now you I’m glad. My are coming to touch me name is Sister Carol. Baba it’s bath where you should not.
time now – would you like me to help get you clean and ...
It can be hard to know how to handle a patient that feels awkward or angry at being washed. Nurses share some simple strategies that have helped them. 34
YOUR MONEY AT work Sister Carol Ngwenya has worked in both Charlotte Maxeke and Far East Rand Hospitals in Gauteng. She says she often found it hard to be a young woman caring for older patients who did not want their bodies or private parts exposed to her.
“In many Southern African cultures there is a line drawn between male and female, young and old,” says cultural analyst Professor Pitika Ntuli. Respect
Professor Ntuli tells the story of when he was sick in Swaziland. ‘’There was an old man in the hospital with me who was very traditional. The nurse came in and said to him, ‘I am going to bath you now’. He said absolutely not! The following day another nurse came and said ‘Baba how are you today? You are fine? I am happy. You know one of the things which make us sick is when we don’t wash and the germs spread so it becomes necessary to avoid that. I am here to help you get clean with the respect I would give to my own father’. After a while I saw he was being washed and I asked him what changed his mind. He said ‘That child respected me. I knew with that kind of respect that she is going to see me as a human being and not see my private self’.”
“That child respected me. I knew with that kind of respect that she is going to see me as a human being and not see my private self”.
Sister Carol faced many similar situations. “If it is a man who is refusing the first thing I would do is try get a male nurse but that is often impossible. When I worked at Far East there were only five male nurses and often none would be on duty at the time,” she says.
It’s a question of respect, of humility, of trust “The second thing I would do is to try get a family member to help me wash. Even though it’s not allowed to have family there during procedures I would bring them in because then there is someone the patient knows and trusts with him.” But she says this is also not always possible. She says sometimes it’s just you and the patient. No male nurse. No family member. And that’s when you have to get creative.
Trust and humility
Professor Ntuli says that in this situation, “It’s a question of respect. It’s a question of humility. It’s a question of trust. Those are the three pillars of communication in this particular situation.” Sister Carol agrees that it’s important to show respect and humility as well as to gain a patient’s trust. She says that the best way to do this is to make the patient feel in control, especially if he is a man.
“You should give him choices so he feels like he is making the decisions. In his culture he demands respect so you should do your best to make him feel respected,” she says.
“Ask if he would mind if you closed the curtains. Ask if he would like to do the bed-bath himself or if he would like to go to the shower - even though you know he is too sick to move.” “Give him control and he might eventually say – ‘Sister I am not feeling well, could you help me? ’,” says Sister Carol. Professor Ntuli agrees with this strategy. She says giving the patient choices shows humility and that you trust them enough to make the right decision.
procedures It is also important to explain a procedure to a patient before you start, as well as why it is important. Sister Carol says that if a patient is embarrassed to display their whole body you can explain that you can cover them with a sheet during the the whole procedure if they would prefer it.
“Maybe an elderly lady has wet the bed but refuses to be washed. You can give her the basin and soap and some privacy. But she will probably not be able to reach everywhere. So after you have let her try herself you come back with a strategy: ‘Gogo, you know you are not feeling well. You did not wash your back nicely – can I maybe help you wash your back?’ Maybe she has not washed her private parts well so you explain why you need to help: ‘Gogo we do not want you to get an infection. We have to clean so that the outside germs cannot go inside because the inside is clean’.”
“You could say ‘it’s so nice that you seem so good humoured Mama! You know I nursed my mother when she was your age. But yoh! What a cantankerous woman! How do you maintain your dignity?’” laughs Professor Ntuli.
Humour can also help to relax patients and make them feel more comfortable.
Sister Carol smiles as she remembers: “Once you develop a relationship with a patient they will trust you and maybe no‑one else. Then you really know you have made him or her feel comfortable – just like my Mr. Masemola.”
“You have already indicated you had a mother who you loved and respected – and you have washed your mother who agreed to it. You are indicating you would like to give the same respect to this patient as you gave your own mother,” he says.
Conversation is a very important tool to gain a patient’s trust. Creating a conversation helps to make patients feel involved in what you are doing. Sister Onika Maphisa, who works at Zola Clinic in Soweto, says that talking about family is a good way to start a conversation. “You can tell her about your own kids and then ask about hers. Most people have family so it is a common talking point. It will make them feel like you are just another person they can relate to, and you are not there to judge,” she says. Sister Carol says that sometimes older, more traditional men feel better if you are a married woman. “But even if you are not married you have to devise a way.” Sister Carol says that before she was married she would sometimes tell her patients she had a husband and children just to make them feel more comfortable.
Sister Mary Naiker*, who used to work at Greys Hospital in KwaZulu-Natal, says, “If you have a passion for nursing it will shine through. Don’t just try to get through the procedure. Try to get to know the patient and to make them feel important. If you are genuine about caring for the patient he or she will sense it and begin to trust you.”
She is not working today, she will be back tomorrow. Are you ready for your bath?
Good morning Mr. Masemola, I am Sister Palesa. I will be looking after you today. Where is Sister Carol?
It’s fine. I will wait till tomorrow. *Not her real name
Home remedies and exercises for feet. Footsore after a 12-hour shift?
There are steps nurses can take to ease their aching feet, says Gina Badenhorst, Secretary of the Podiatry Association of South Africa. Podiatrists are professionals trained in the care of the foot and ankle.
Slim: Carrying excess weight results in increased strain on ligaments, muscles, and joints. Soak: Soak your feet in a basin of warm water with Epsom salts (one tablespoon per litre). The salts draw out excess fluid and lactic acid. The magnesium eases pains. For swelling, elevate feet for a half hour after the soak. For smelly feet, add baking soda. Stretch: Ease contracted muscles by lengthening them after bathing, or at tea and lunch breaks. See Gina’s exercises. Stroke: Apply oil to the soles and massage feet. Focus on the plantar fascia, which runs from the ball of the foot to the heel. Tightness here can cause heel soreness. Use a wooden foot roller if you
have one, or roll a tennis or smaller ball around under your foot. Support: Make sure your shoes have decent arch supports to absorb shock. Worn out soles are harmful. If you are doing a lot of walking or standing, you should try to change your shoes every six months. Have at least two pairs of work shoes and rotate them. Get fitted properly at least once a year. Some nurses find compression stockings helpful. They squeeze surface blood vessels and muscles, so more blood returns to the heart and less pools in the feet.
Podiatrists are professionals trained in the care of feet and ankles.
Podiatry Association of South Africa Share Call: 086 110 0249 (Honeydew, Johannesburg) www.podiatrist.co.za
A • •
Slowly move foot, spelling the alphabet. Do not let hip or knee move.
Perform 3 sets of 20 repetitions, once a day.
• • •
Sit on chair, feet flat on floor. Raise involved foot up on heel of foot. Lower and repeat.
Perform 3 sets of 20 repetitions, once a day.
• • •
Sit in chair, feet flat on floor. Raise involved foot up on ball of foot. Lower and repeat.
Perform 3 sets of 20 repetitions, once a day.
Stand facing wall, hands on wall, step forward with one foot Keep rear leg straight with heel on floor.
Perform 1 set of 3 repetitions, twice a day.
attack Nurses under
Nurses often face danger at work
handi*, a senior nurse at Johannesburg’s Charlotte Maxeke hospital, has seen a woman being stabbed in a corridor. She has also had to counsel a young nurse who witnessed a patient being shot in the surgical ward. Thandi has also had some close shaves: “One Saturday night, we admitted five men who’d been shot, four of whom died from their wounds. Later, another guy in a leather jacket came in looking for the surviving patient and you could just see this was trouble. Nothing happened, but you felt that it could’ve turned nasty at any moment,” she says.
Patients vulnerable too
A month earlier, in June, a mentally ill man stabbed several people, including an intern doctor, at the Chris Hani Baragwanath hospital. Days later at the same hospital, a nurse was stabbed 10 times by “We have been her boyfriend, apparently undetected by security staff. spending a lot
of money on security,” Dr Motsoaledi, Health Minister
Patients are also vulnerable. In July 2012, a psychiatric patient strangled a pensioner to death in the early hours of the morning at the WF Knobel Hospital in Moletji outside Polokwane. This death prompted an internal investigation into security, and into why a mentally ill patient was in the same ward as ordinary patients. 38
‘The lack of security facilities is becoming one of the main reasons for nurses to leave the public sector’
At Port Elizabeth’s New Brighton Clinic earlier this year, the number of aggressive patients became so overwhelming that nurses refused to come to work. “A person will threaten you just because you want to go to tea. They will even hold you hostage,” said one nurse.
All these incidents show that nursing can be dangerous, particularly for women at state-run hospitals. “Physical violence is not the only issue,” says Simpiwe*, a senior nurse who works at Chris-Hani Baragwanath. “Male nurses or patients shout and whistle and make rude comments,” she says. * Names have been changed
Thandi says Charlotte Maxeke hospital is full of long, dark corridors and staircases that nurses have to walk at night when the lifts are out of order. “You feel really vulnerable,” she says.
Outsourced security The National Education, Health and Allied Workers Union (NEHAWU) says the problem is that security for state hospitals is largely outsourced to private security companies.
“These companies don’t provide enough staff, and also, guards are generally on three month contracts and are undertrained for the job. So the turnover of guards is high, and because it’s not a permanent job, they are open to corruption,” says Sizwe Pamla, national spokesperson for NEHAWU. Government hospitals, Sizwe says, need to take responsibility for their own security and employ permanent, decently paid security staff who get ongoing training.
Neonatal wards are vulnerable to baby theft and most private hospitals have high security in these wards. But at Charlotte Maxeke hospital, where babies have gone missing in the past, Thandi has “never seen a security guard” in the neonatal ward.
The Department of Health says security for both hospital staff and patients is an urgent priority, but at the same time, it doesn’t want to “militarise” hospitals. “At the end of the day these are public places where people who are sick or injured are coming to heal. Often these patients and their family are in emotional turmoil as well. You don’t want to insist on people being searched. It’s a sensitive issue,” says Fidel Hadebe, Director of Media Relations for the national Department of Health.
“The lack of well-established security facilities is becoming one of the main reasons for practising nurses to leave the public sector for safer health facilities in the private sector or in other government departments,” said Democratic Nursing Organisation of SA (DENOSA) president Dorothy Matebeni recently. DENOSA has called on the Department of Health to develop a “clear programme” for safety and security in public hospitals.
Health Minister Dr Aaron Motsoaledi says the government is addressing the security issues in hospitals. “We have been spending a lot of money on security,” he says. Motsoaledi agrees that outsourcing security to private firms is part of the problem, and is looking at making provision for hospitals to directly manage their own security.
Tips to stay
• Watch for signals associated with violence, like drunkenness, anger or the presence of a weapon, and stay well away. • If you can’t avoid aggressive situations, try to defuse anger. You can often do this by just listening. Don’t attempt to reason with a person who is in a rage. • Report any criminal incidents immediately to your superior.
• Don’t return the threats to a colleague or patient when they become threatening. Keep a calm, caring attitude. • Don’t be alone with a potentially violent patient or visitor. Make sure you have access to a door or exit path. • Try and walk in pairs, especially over weekends, at night or in risky parts of the building. • Ask a security guard to escort you to your car if getting to the car-park makes you anxious. • Be proactive about your safety. Wherever possible, take steps to protect yourself before you are under attack.
Diary of a
One small rural hospital practices the best of old-fashioned nursing “I love every minute of my work,” says Anneri Rautenbach, Manager of Wilhelm Stahl Hospital, as we head through the clean, sturdy corridors of this country hospital in the Karoo town of Middelburg.
The hospital was established in the 1930s. Today it serves this community of approximately 44 000 people and is extremely busy. The hospital see roughly 800 cases in Casualty every month. Below: Wilhelm Stahl Hospital in the Karoo town of Middelburg. The hospital opened in the 1930s.
Paediatrics We reach the Paediatric Ward and enter a cosy room where premature babies are looked after in two functional but old incubators. A mother with a newborn baby is sitting in a chair here, resting her infant against her chest, a blanket covering the little one that weighed in under 2kgs. Anneri asks if she might see the baby, and the mother lifts the blanket to reveal her tiny head. “You are breastfeeding your beautiful baby, aren’t you?” Anneri gently enquires, explaining that they strongly encourage breastfeeding. “Running a country hospital requires a lot of energy because you are on the go all the time– one minute a baby is being born, the next you are helping to save a patient’s life, and the next you are trying to resolve an employment issue for a staff member. For me it is extremely important to have a happy, motivated staff,” Anneri explains.
Matron and midwife Between Anneri and the hospital Matron of 19 years, Cornelia Nieuwoudt, Middelburg’s hospital is in sound hands. We meet Cornelia en route to Casualty. She is the kind of person who immediately inspires confidence. “The beauty of working in a country hospital is that we all know each other and we know our community,” Cornelia explains. “Our nursing staff is able to get good, old-fashioned bedside nursing experience in all the wards. We have a strong paediatric and maternity ward, and we deliver 30 babies a month. We also do Caesarean sections and a variety of the more minor operations.” Cornelia is an advanced midwife. Sometimes she is called out in the middle of the night. “Fortunately I live five minutes away, which is another benefit of living in a small town,” she smiles.
I love every minute of my work
The Casualty section is extremely busy. Patients are admitted and attended to without delay – far faster than at a city hospital.
“We currently have 32 nurses; one full-time doctor, one community service doctor; and one part-time sessional doctor,” Anneri explains. “We would like two full-time doctors. But it is not easy to attract doctors to rural areas even though doctors and professional nurses get an extra 22% of their salary to encourage them to work in the rural areas.” “We are still short of senior nursing staff,” Anneri explains. “To give you an idea, all the suturing is handled by the nursing staff, so we really need the skills.”
“We deal with everything from stab wounds to motor vehicle accidents to primary health care,” Cornelia explains.
The biggest challenge is the moratorium on non-clinical posts, which has left the hospital with 15 vacant posts for administrative staff, cleaners, food servers, aids and porters … all of whom they badly need.
Complex cases or cases in need of specialist attention are referred to the hospitals in Port Elizabeth. The hospital has two ambulances for emergencies.
Doctors and professional nurses get an extra 22% of their salary to encourage them to work in the rural areas
atron of 19 hl Hospital M
Budgets are extremely tight. Hospital maintenance, including painting, gutter repair and upgrading of buildings, is not what Anneri would like it to be, and neither is the hospital equipment: “Our main problem is old equipment, such as incubators, life-support devices and the ECG machines. We can buy one incubator this year. Luckily, the Board of Commerce in Middelburg has also promised to donate an ECG machine.” “We also need to enlarge the hospital but we haven’t had enough budget to do any building for the past 20 years,” Anneri explains as we head for her office.
A cosy room in the Paedia tric Ward whe are looked af re premature ter in two func babies tional but date d incubators.
“The hospital has an ARV Wellness Clinic where anyone can come for testing or counseling. We have over 300 patients on ARVs,” she explains. “We work closely with the community-based clinics around HIV/AIDS, but also for other issues such as TB, child malnutrition, alcoholism, teenage pregnancies and dental care.”
The hospital regularly has to extract teeth under anaesthetic in children from two years upwards. Parents either don’t teach them to look after their teeth or they don’t have the money for toothbrushes and toothpaste. Children with a mouth full of rotting teeth are admitted to the hospital for dentectomies all too often.
e on duty in the
Hash Sister Nombulelo 42
Social issues Drug abuse and alcoholism are major social problems in the community, and Casualty deals with countless numbers of alcohol and drug-related injuries. Foetal Alcohol Syndrome (as a result of mothers drinking during pregnancy) is another problem. Willhelm Stahl Hospital tackles all these issues to offer an invaluable service to the community.
It is extremely important to have a happy, motivated staff
The Heart of South Africa:
Sister Abegail Ntleko Sister Abegail’s story inspires awe and hope. She started school at 14, overcoming poverty and racism to fulfill her dream of nursing her community. She has helped so many with so little. “I gave up on marriage because I only finished my studies at the age of 35 in 1968 and all the single men were far too young for me,” Sister Abegail laughs. “I wouldn’t commit chicken murder by getting married to a boy of 24,” she says with a twinkle of humour. “I used to say to them: you still smell of your mother’s breast milk!” At the age of 79 Sister Abegail Ntleko, or Sister Abe as she is known by her community, has no regrets about sacrificing a chance at romance to care for her patients and to be a mother to the more than 30 orphans or unwanted children she has adopted over the course of her life.
Sister Abe was born in 1934 to an extremely poor family in what was then the remote and rural town of Harding in KwaZulu-Natal. She was the youngest of 12 children and her mother died just after she turned three. This meant she was soon left alone with her ailing father as the other children had either left home or died by the time of her sixth birthday. Abegail desperately wanted to go to school so she could care properly for her father. But he believed that education would encourage a girl to run away and never return, and he would not allow her to go to school. Heartbeat
By the time Abegail turned 14 she was desperate. She believed that if she did not take action she would remain in her crumbling rondavel for the rest of her life. She bravely approached the induna of her village in an attempt to change her life story. And, to her father’s great displeasure, it worked.
But that did not stop her. She worked hard to complete her primary schooling. She then ran away for a year to work as a domestic worker in order to get money for high school fees. Sister Abe graduated at the ripe age of 28 and then went on to fulfill her dream of qualifying as a nurse.
She moved to Underberg KwaZulu-Natal in 1980 because no other nurse was willing to work in the underserviced area. She soon learnt that tuberculosis, leprosy and tetanus were the illnesses troubling the community. Many of her patients had never received any form of health care before. But they flocked to her. “The first month I had 400 patients, the next I had 800 and by third month I was caring for 3000 sickly people,” she says. There were so many ill patients she no longer had any time for herself.
White resistance – and dogs
“On top of the desperate health situation in the area there was a lot of resistance to me from the white community,” she says. In an attempt to gain the white farmers’ trust she set up meetings with their wives to discuss how she could help them. One day she had an appointment with a farmer’s wife: “I arrived a bit early and she wasn’t there so I waited,” she says. The farmer’s wife arrived 20 minutes later with a pickup truck full of dogs. “They ran straight for me barking and biting me all over,” she says. They ripped her clothes until she was left in just her panties. She said if she had run away “they probably would have killed me”. The farmer’s wife took her time to come to Sister Abe’s aid and screamed that it was Abe’s own fault. Sister Abe spent two weeks recovering from her injuries. She says in her book: “At first I was angry with [her], and then I was angry with myself, and then I noticed how both kinds of anger fed off of each other.” So Sister Abe decided not to take any action against the woman: “I forgave her, and she never gave me a hard time again. In fact, she was friendly after that. It was a horrible experience but one that taught me that at the end of the day, it’s much easier to understand, to forgive, and to let go.” 44
“A remarkable tale of what it means to be fully human.” —Reverend Archbishop Desmond Tutu
Sister Abegail Ntleko, 2012
Empty Hands is the inspiring story of a young Zulu woman, Abegail Ntleko, who overcame tremendous challenges in order to attain her dream—to live a life of service. Born into abject poverty in rural KwaZulu-Natal, South Africa, she was barred from education and stunted by gender bias and racial prejudice. Determined and steadfast, she prevailed against the odds, first fulfilling her aspiration to become a nurse, and then going on to become one of South Africa’s preeminent community leaders. In her fight against the AIDS pandemic, Abe came face to face with its most tragic consequence: an ever-rising number of orphans. In response, she began adopting dozens of children, providing these most vulnerable victims with a nurturing home. With great warmth and lucidity, Sister Abe tells a story that offers hope and gives testimony to the power of love and compassion.
“It was a horrible experience but one that taught me that at the end of the day, it’s much easier to understand, to forgive, and to let go.”
Storyzon LLC, San Francisco, CA www.storyzon.com
Empty Hands: The Life of Sister Abegail Ntleko This book moves the heart and inspires the soul.
In Empty Hands Abegail Ntleko tells her own story. She humbly describes her many hardships with a suprisingly off-beat sense of humour. We read of how she overcame poverty, prejudice against girls and racism to achieve her dream of becoming a nurse. Archbishop Desmond Tutu says in the introduction. “Sister Abegail’s is a remarkable tale of what it means to fully human”.
Sister Abe Matriculated at the ripe age of 28 and then went on to fulfill her dream of qualifying as a nurse.
Th e Li fe of Sister Ab egai l Ntleko
However her first day of school was discouraging. The teacher asked the pupils what they wanted to be when they grew up. When Sister Abe immediately said, “I want to be a nurse,” the teacher, and her six and seven year old classmates, all burst into laughter.
Because of Sister Abe’s bravery, humility and hard work to heal the community (she largely won the battle against TB, leprosy and tetanus), the white farmers came to support her. But disaster struck just as she started reaping the rewards of her sacrifices.
Th e Li fe of Sister Ab egai l Ntleko
“She was so thin, she was bringing up, she had diarrhoea, she was coughing and had no strength at all,” says Sister Abe. “I said it can’t be cholera because in Harding it’s very cold so it must be something else.” She pauses before saying: “I told her it might be TB but it’s funny how it doesn’t look exactly like TB. When I got her results from the hospital they told me about this brand new disease – AIDS.”
It was a time when HIV‑infected people were shunned and stigma around AIDS was strong.
Sister Abe receives the Unsung Hero of Compassion Award from the Dalai Lama in 2009.
Empty Hands Th e Li fe of Sister Ab egai l Ntleko Introduction by Reverend Archbishop Desmond Tutu
Sister Abe saw her first patient with HIV in 1987. She was appalled, as she sat night after night with the sick and dying, that her hard work in healing the area had been destroyed almost overnight. In the evenings she borrowed a car from the Department ofwithHealth for an awareness campaign she Photo Dalai Lama by Michael Yamashita. Photos on front and back organised. She needed official permission from covers by Stefano Massei, 2012. the Department so that she wouldn’t get into trouble with the police. She says she spoke to “anybody who would listen” to stop the spread and the stigma of HIV. It was a time when HIV-infected people were shunned and stigma around AIDS was strong. Even Sister Abe’s colleagues were affected by it.
“The other nurses were so scared of these patients that in my clinic I ended up being the only one taking blood,” she says. “They were scared they would get this brand new disease. They said ‘what will happen if the patient jumps up and I’m poked by the needle?’ And then I said why would you allow that – because you have to speak calmly to the patient to prepare them for when you take the blood. I also used to say to them: it’s not only AIDS you can get through blood. Aren’t you scared of hepatitis B which kills you before even three days have passed?”
At first the government did nothing about HIV. So Sister Abe took matters into her own hands. In 1989, together with some local churches, she started an organisation to try to fight some of the devastation caused by the illness. Through the Underberg/Himeville AIDS Initiative (UHAI) she conducted outreach education, opened a counselling and testing centre and distributed food to needy children – mostly orphans. She nursed patients by day and co‑ordinated the UHAI by night: “I virtually didn’t sleep anymore.”
By 2000 she retired from her day job to focus on UHAI and the many AIDS orphans in her community. She used her retirement annuity to start an orphanage called Clouds of Hope. More recently Sister Abe started Kulungile, another orphanage which she runs today. Sister Abe never had a chance to play like other children because she was constantly looking after her sickly father and trying to find food for them both. But she has given so many other children a chance to play, to be educated and to be truly loved.
“It is people like Sister Abegail who usher in a better future for South Africa.” Archbishop Desmond Tutu further praises her never-ending quest to help those in need: “Her’s is a remarkable tale of what it means to fully human. It is people like Sister Abegail who usher in a better future for South Africa.”
Previous page: Sister Abe with her children in Underberg. Far left: Abegail Ntleko receiving the Unsung Hero of Compassion Award from the Dalai Lama in 2009. Left from top: The foot of Mvoleni Mountain, Sister Abe’s Book and some of her children in the rural area.
Cooking for your family is an act of love
cooking? Paul Potsane (25) is a professional nurse at Hillbrow Community Health Centre in Johannesburg. He cooks a hearty meal once a week for his family, usually on a Sunday. “My wife Inshaaf is Malay”, Paul says “so I’ve learned to combine the best Malay flavours with the nicest tastes from my own Sotho culture.” “I cook healthy, colourful food, but I have to be careful not to use too much chilli, because we have a one-and-a-half year old son, Mohammad Loot,” smiles Paul, who believes a good husband cooks at least once a week for his family. “Cooking for your family is an act of love,” he says. Paul chose to cook five delicious dishes, all served together like a tapas (mix and match). His dishes are simple, inexpensive, quick to cook and filled with nutritious ingredients. And they serve four to six people.
Fish curry and rice Ingredients
Two packets of hake medallions (defrosted) One onion, one tomato and one pepper Frozen peas (handful) One clove of garlic and a sprig of fresh ginger Curry powder (with two leaves) Methi seeds (palmful) Lentils (half cupful) Rice (one cupful) Spices (a small palmful of cloves, aniseed, Allspice, elachi pods) Salt and Sugar
Chop the onion and green pepper. Braise the onion in a big saucepan over heat for two minutes. Add the methi seeds. Grate the tomato into the saucepan. Grate the garlic and ginger, and stir into to the mix. Add frozen peas. Mix in curry powder and spices. Stir for two minutes. Add the fish medallions, then a teaspoon of salt and a teaspoon of sugar. Allow the mix to simmer for about 30 minutes, occasionally stirring. Boil the rice and lentils separately until soft. Drain off, then mix the lentils into the rice in a bowl. Empty the fish curry into another bowl to be served alongside the rice.
Nutritionist Ria Catsicas says: “Hake is a most ideal protein source from a health point of view. It is low in total fats and saturated fats (significantly less than lean beef), yet provides the same amount of high proteins as chicken and meat. Lentils and rice are high in dietary fibre, which helps prevents constipation and other intestinal disturbances.”
Beetroot and mayonnaise salad
Green pepper and baked bean relish
One stick cinnamon
One tin of baked beans
Three tablespoons of mayonnaise
5 whole beetroot
Peel and boil the beetroot for two hours. with a stick of cinnamon for flavour. After they are cooled, grate the beetroot and put into a bowl. Mix in three tablespoons of tangy mayonnaise. “You can also put onions and vinegar into the mix. This is called ‘Sunday food’ in Soweto,” says Paul.
Nutritionist Ria Catsicas says: “Beetroot contains powerful antioxidants (because it contains betanin) and it also has a phytonutrient (a natural plant chemical) that has proved to contribute to lowering blood pressure.”
Mixed vegetable gravy Ingredients
Half packet of mixed vegetables (carrots, mielie, green beans, onion, garlic). Packet Knorr Rich Beef and Tomato soup
Put the mixed vegetables in a saucepan with a little water and leave to heat. Pour Knorr soup powder into a cup and mix with some water. Pour the soup mix into the saucepan. Stir until you have a gravy consistency, then take it off the heat.
One pepper, one onion and one chilli
Chop up the green pepper, onion and chilli and put the mix into a bowl. Drain off excess water from the tin of baked beans and add to the mix. Garnish the dish with coriander. “Your food must be a little bit stylish,” says Paul.
Nutritionist Ria Catsicas says: “Baked beans are part of the legume family and are a source of soluble fibre. Eating beans contributes to improved blood glucose control and so provides optimal energy levels throughout the day.”
Pumpkin mash Ingredients
One packet of chopped pumpkin, sugar
Boil the chopped pumpkin for 15 minutes, until soft. Drain it off and allow to cool. Use a masher to mash the pumpkin. Add a half teaspoon of sugar to taste.
Nutritionist Ria Catsicas says: “Pumpkins are packed with beta-carotene, which counteracts oxidation processes and by doing this, keeps all our body cells in tiptop condition. They also contain Vitamin A, which promotes healthy vision.” Heartbeat
... and one more thing
What do we want for our
What can we, as health workers, do about the violence against girls and women in our country? Dr Sue Goldstein has a simple suggestion. Starting a new year makes me think back to the last year. It was a bad one for women in South Africa: so much rape and violence. It makes me think about where our country is going wrong and what we as health workers can do better.
We need to appreciate our girls more How can we support women in a way that makes us, and our whole society, healthier? I think firstly we need to appreciate our girls more. Young girls and women are often brought up to feel second-best, less loved and less cared for than boys. There are more sports available for boys and fewer jobs expected of them in the home. Young boys get more free time. Why do we continue to do this if we believe in gender equality? Equality starts at home!
An important way to support women is to judge less Secondly, I think we tend to be judgemental about other women: why does she have sex with this person? Why doesn’t she do this? What clothes is she wearing? Why does she dress like that? Why does she want to terminate her pregnancy? Unless we walk a mile in a person’s shoes how can we criticise that person? But more than that, we have forgotten the importance of supporting each other in an environment where men often get the best of things.
So what do we want for our girl children?
We want them to finish school, to find love, to find work, to be able to support themselves, to find happiness.
What don’t we want?
To have them abused, raped or worse. We don’t want them to be dependent on someone else, to have someone else make decisions for them about their bodies and their lives. But then we as health workers need to think about whether we too are trying to make decisions for others about their bodies and their lives. As health workers a really important way to support women is to listen more and to judge less. It is really quite simple, isn’t it?
Dr. Sue Goldstein is Programme Director at the Soul City Institute for Health & Development Communication. She is also the mother of three girls.