Healthy Times December 2021

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WHY THE STEREOTYPING AND STIGMA AROUND MENTAL HEALTH MUST STOP

SINGER SONGWRITER

SIMPHIWE DANA

Staying mentally healthy while living with depression and anxiety is an “ongoing” process

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healthy times l 5

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4 COVER STORY Singer songwriter Simphiwe Dana says staying mentally healthy while living with

depression and anxiety is an “ongoing” process 5

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MENTAL health The need to normalise self-care and address mental health issues is increasingly important in an often chaotic world

7 SUMMER ALLERGIES Expert advice on how to minimise the uncomfortable effects of seasonal allergies 8 HEALTHY EATING Swapping out junk food for healthy options can combat the obesity and chronic disease causation battle Disclaimer: While every effort has been made to ensure that the information in this publication is sound, it is expressly not designed to diagnose or treat a medical condition or health problem. The information does not constitute medical advice. It is also subject to personal interpretation and may become dated or obsolete.

The publisher, editor, authors and their employees or agents, therefore, cannot accept responsibility for the information in this publication or for any errors, omissions or inaccuracies contained therein, whether arising from negligence or otherwise.

They are therefore not liable for any direct or indirect effects of the information. Please consult a qualified healthcare practitioner regarding any medical or health issues.

Copyright: Picasso Headline. No portion of this magazine may be reproduced in any form without written consent of the publisher. The publisher is not responsible for unsolicited material. Healthy Times is published by Picasso Headline. The opinions expressed are not necessarily those of Picasso Headline. All advertisements/advertorials have been paid for and therefore do not carry any endorsement by the publisher.

11 HEART HEALTH Shedding weight through crash dieting is bad for your heart. We offer some

alternative approaches 12 EYE CARE Why early eye examinations are important for diagnosing visual impairment and identifying the appropriate corrective treatments 15 SKINCARE Some tips from the experts on what you should keep top of mind this summer 16 BLOOD DONATION

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healthy times l 3

COVER STORY

Simphiwe Dana

The struggles and strengthening of

SIMPHIWE DANA Singer songwriter Simphiwe Dana says staying mentally healthy while living with depression and anxiety is an “ongoing” process. Here’s how she does it, writes Nia Magoulianiti-McGregor

s

imphiwe Dana says staying on top of her depression and anxiety has been a lifelong struggle. Sometimes she’s battled to get out of bed beset with dark thoughts. Other times she’s talked herself into thinking it was “under control”. And sometimes, she would invite friends over, cook and play music. But her children, Zazi, now 18, and Phalo, 16, kept her going.

A self-confessed introvert, Dana says she was surprised at the effects of hard lockdown.

“I think of myself as a hibernating person so I imagined I would revel in restrictions. But I discovered very quickly the fact they weren’t on my terms unsettled me.”

Dana says the time came when she couldn’t “escape” using her usual defences. “It led me to a dark place. I opened festering wounds. I was forced to confront certain existential issues.

“I needed a supportive environment to heal and understand that part of that healing means breaking into little pieces and building myself up again.”

“I had been living with depression without guidance, and during lockdown, my usual escape outlets were shut. I couldn’t go walking whenever I chose. And, although I’m a loner, occasionally I want to socialise with my friends. Besides external restrictions, my inner jail had become bigger than I could control.”

Dana says she “thrives” on control and felt like it was slipping away. “It triggered childhood memories of feeling helpless. I had to ask myself, ‘why do I feel the need to control so many aspects of my life?’ These were times of deep reflection. I realised developing coping mechanisms had become a badge of honour.”

None of it was working anymore. Dana had questioned the need for therapy before but finally got to a point where she didn’t want to “manage and control” her demons. “I didn’t want to be responsible for them anymore. I wanted it all to go away.”

She doesn’t know the crux of her condition exactly. “Maybe it’s a chemical imbalance mixed with social anxiety or psychological factors. I’m still getting to the bottom of it. But I always knew my thought patterns were intense. I always wondered what triggered certain feelings, but to articulate it as something that needed my attention took some time.

“Worrying about how it reflected on me professionally incapacitated me, so I created a safe space in my personal life. I had to educate people around me while dealing with depressive episodes. I needed them to know the ‘pull your socks up’ idea only exacerbates the situation for sufferers. I had to empower myself, and help my friends, my partner and my children understand.”

Dana is living her truth increasingly. She came out on Twitter last year saying she was set to marry Berlin-based opera singer, Pumeza Matshikiza. “I know coming out means Africa will block me. But after a lot of thinking I’m ok with it. I’m marrying a woman and I have never been happier. I’m gay,” she tweeted.

Dana says she’s in a much healthier place now and that dark night of the soul led to a helpful discovery. “I realised my coping mechanisms were more escapist than useful.”

She takes anti-anxiety medication, but not anti-depressives fearing they may block her creativity, and exercise helps.

“A healthy and supportive home environment is paramount to feeling healthy mentally,” Dana says. “Family needs to understand you’re not ungrateful for your life; it isn’t about being indulgent. That’s why so many of us suffer in silence. We don’t want to place another burden on our family or the community.”

She says she feels like she’s handling her traumas now. “I needed a supportive environment to heal and understand that part of that healing means breaking into little pieces and building myself up again.” For that, she says, a good therapist gives the space to be completely honest and “face the fear of what that honesty means”.

It takes courage, but “the more you speak openly about it, the more it helps. It’s about thinking: ‘My life looks like this. But instead of wishing this away, I will find a way through it’.

“The more you allow yourself that reflective space, the more your life starts making sense.”

Image: supplied

“I had to educate people around me while dealing with depressive episodes. I needed them to know the ‘pull your socks up’ idea only exacerbates the situation for sufferers.”

4 l HEALTHY TIMES

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2021/11/24 12:35 PM

MENTAL HEALTH AWARENESS

Normalising mental healthcare must

START TODAY Elaine Brass, CEO of Health and Welfare Sector Education and Training Authority, shares why normalising mental health is more urgent today than ever before

o

ctober, which was Mental Health Awareness Month, put the spotlight on what is being described as a “mental health emergency” by professionals across the globe. In our own country, the statistics are shocking. The South African Depression and Anxiety Group (SADAG) reports that its suicide helpline has, in the last nine months, received over 2 000 calls daily from people with suicidal thoughts.

This paints a bleak picture of a persistent issue – many South Africans simply don’t have access to mental healthcare, which can provide them with immediate interventions both from a psychological and a pharmaceutical point of view.

Image: iStock.com, Portrait images: supplied

STUMBLING BLOCKS

People are waiting too long to reach out for help. During the Health and Welfare Sector Education and Training Authority’s (HWSETA) recent Mental Wellness Livestream series, our guest clinical psychologist Anele Siswana highlighted that South Africans don’t always know how to speak about their mental health challenges such as depression and anxiety.

“The very social construct of our society does not lend itself to Anele Siswana an understanding of mental health; how to talk about it and where to find professional help,” he said. He also pointed out that in some communities behavioural changes due to mental health challenges are seen as demonic possession, which means that often people don’t seek help for fear of being ridiculed and shunned.

Another major stumbling block in mental healthcare is stigmatisation. The question here is: are we doing enough to fight mental health stigmatisation? Sadly, in my view, the answer is “no”. Proactive awareness and education are needed to normalise mental health awareness and challenges.

“We need to get to a point where talking about mental health becomes almost boring. It should be normalised to a point that it forms part of everyday discussions.” – Dr Bello Alvarez

Dr Bello Alvarez, the host of the livestreams, said: “We’re dealing with both internalised and externalised stigmatisation. We need to get to a point where talking about mental health becomes almost boring. It should be normalised to a point that it forms part of everyday discussions.”

As the health and welfare SETA, we believe that conversations around topics like mental health can only help to break down these barriers. It is evident that proactive education awareness is needed: we need to talk about common disorders and how they can be treated.

INCREASED AWARENESS

Fortunately, there is good news in the form of increased worldwide awareness of mental health, mainly due to the toll of the COVID-19 pandemic. The pandemic has mitigated some of the stigmatisation. Alvarez remarked on how those in the health sector are increasingly seeing highly functional individuals coming forward with their mental health struggles, speaking openly about the daily challenges they face.

The pandemic has, if anything, provided a firm platform to have open and honest conversations with our loved ones, friends, and colleagues.

Dr Bonolo Mashishi, a virologist and guest on our livestreams, offered this advice: “Define your needs for yourself and share these with those around you. We need ongoing conversations.

Tell your family how you are feeling and have an authentic discussion. We’ve found that some people struggle to talk to their family members; a good starting point is to be open and honest Dr Bonolo Mashishi about how you are feeling, this sets the stage for constructive conversations going forward.”

Siswana emphasised the importance of family support. “It is vital that families, armed with mental health knowledge, intervene when a loved one starts showing signs of mental health issues. Low energy, weight loss or gain and self-isolation are all red flags that need addressing.”

Normalising self-care should become commonplace in our society and the foundation for engaging in conversations and seeking help. We live in unprecedented times, and our new normal will carry on for the foreseeable future. So, we must normalise a culture where people use psychological services and maximise their capacity for coping with stress, anxiety and depression.

We must familiarise ourselves with the signs and symptoms of mental health challenges, talk openly about them and find help to strengthen our respective life journeys.

HEALTHY TIMES l 5

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2021/11/24 12:53 PM

ALLERGIES

Keeping seasonal allergies

AT BAY Caryn Gootkin gets advice from the experts about how to minimise the uncomfortable effects of allergic rhinitis

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any of us suffer from allergic rhinitis, commonly known as hay fever, as soon as spring arrives and our bodies react to the seasonal allergens we inhale. “Seasonal allergies are becoming more common,” says Dr Sarah Karabus, a paediatric allergologist and board member of The Allergy Foundation of South Africa. “One of the contributing factors might be global warming, leading to the prolonged flowering and pollen seasons that we see in South Africa,” she says. “Common pollens that cause allergic rhinitis in South Africa are grass and tree pollens, with weed and flower pollens being less common.”

If you suffer from a runny nose, itchy eyes, congestion, sneezing or sinus pressure between August and March each year, you should see an allergist to determine the cause. “Allergy tests are safe and Dr Sarah Karabus accurate, even in small children,” Karabus says.

Image: iStock.com, Portrait images: supplied

PREVENTATIVE MEASURES AND REMEDIES

Once you know which allergen your body is reacting to, try to avoid it as far as possible.

“You could do this by staying indoors on hot, windy days,” says Karabus. “Pollen particles stick to clothes and hair, so take a shower and change clothes after being outside. Wearing sunglasses can also help, as can staying indoors when grass is being mowed.”

There are many different remedies for hay fever. “To pre-empt your symptoms, begin your treatment a few weeks before the pollen season starts so that you are well under control by the time the season arrives,” Karabus advises.

Make sure you use the correct medication for your condition. “Saline nasal sprays, which can be used frequently, rinse out allergens from noses and eyes, while oral antihistamines (preferably the nonsedating type) are safe to use on a regular long-term basis,” says Karabus. “Corticosteroid nasal sprays should be used daily, rather than as needed, as they take a few days to work optimally. They reduce the underlying inflammation in the nose and are a very important part of allergic rhinitis treatment.”

“To pre-empt your symptoms, begin your treatment a few weeks before the pollen season starts so that you are well under control by the time the season arrives.”

– Dr Sarah Karabus

As a longer-term solution, you could also consider desensitisation medications, also called immunotherapy. “These can be taken either as daily drops under the tongue or as ‘allergy shots’ once a month,” says Karabus. “They work by exposing the body to small amounts of the particular allergen over time, eventually teaching the body how to tolerate the allergen instead of reacting to it.“ And don’t forget that indoor allergens like mould, house dust mites, cockroaches and pets, all of which are present all year round, can contribute to your symptoms. “Reducing damp; ventilating your home well; reducing dust, cleaning carpets and fluffy toys; washing your linen weekly at 60 degrees; and getting suitable dust-proof covers for pillows and mattresses can all help reduce uncomfortable symptoms,” Karabus says.

TESTING FOR SEASONAL ALLERGIES Testing can reveal what your body is reacting to, enabling you to reduce your exposure to those allergens.

“Studies show that allergies may affect up to 30 per cent of adults and 40 per cent of children, and that most seasonal allergies are related to pollen,” says Dr Tamara Kerbelker, registered allergy subspecialist, University of Cape Town and Red Cross War Memorial Children’s Hospital.

“It is important that you first visit a trained medical professional to take a detailed history of your symptoms. The diagnosis of an inhalant allergy requires both compatible symptoms and a test demonstrating sensitisation to an allergen.”

There are two ways of testing for inhaled allergens: a skin prick test or a blood test.

“A skin prick test is highly sensitive and specific for particular inhalants, but will require one prick per allergen that you are testing for,” explains Kerbelker. “Results are available within twenty minutes of taking the skin prick test, and the tests are relatively cheap. The blood test for inhalants has variable sensitivity and specificity, however, it has the advantage over skin testing of being performed on a single sample. The blood test can be performed while the patient is on antihistamines. It also allows for testing of a wide Dr Tamara Kerbelker variety of inhaled allergens.”

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2021/11/24 12:27 PM

HEALTHY EATING

Junk food

SWAPS How swapping out food with little to no vitamins, minerals, or fibre can combat the obesity and chronic disease causation battle. By Anna Trapido

Dark chocolate has less fat and sugar than milk or white chocolate and is packed with antioxidants. Plus, its uber-intense tastes tend to reduce the urge to overeat.

• Leafy Greens Café. Gauteng. Veggielicious, super-food chic.

Breakfast on bold spicy ginger shots and gluten-free pancakes.

Savour the cauliflower kale with organic wine to wash it down. www.leafygreens.co.za • 3638 Shalati Junction. Even the most dedicated animal observer Chef Mmabatho Molefe must occasionally stop for food. So, put down the binoculars and pick up a fork at Kruger Park’s Shalati 3638 culinary complex.

Chef Andrew Atkinson’s stylish bistro menu includes pies made from low fat, locally sourced, sustainable venison. For those who don’t want to eat the wildlife they watch, there are superb ancient grain, low GI salads. www.krugershalati.com • Emazulwini Restaurant, Cape Town. Chef Mmabatho Molefe’s tiny, harbour-facing, modern Zulu restaurant offers all the health-promoting properties one would expect from one of Southern Africa’s great ancient food genres. Fermented mabele (sorghum) rich in beneficial bacteria and enzymes is topped with braised ulimi noshatini tongue.

Heritage maize, marula nut and legume melanges for vegetarians. Great Isijingi (pumpkin porridge) for pudding. www.instagram.com/emazulwini_restaurant/

IMMUNE-BOOSTING SOUTH AFRICAN EATS

While the following proudly South African eats don’t constitute diagnosis or prescription, they can help to support immune function.

• Thepe. What’s not to love about free, healthy food? Amaranth (aka thepe is not indigenous to South Africa, but has long since run wild and made itself at home in Mzansi. Widely cooked as morogo, it grows out of almost every crack in the pavement and on the edge of every farmer’s field. Packed with vitamins C and E, it is also rich in minerals including calcium, iron, magnesium, potassium, and zinc.

• Mopane worms (aka masonja). Gram for gram, mopane “worms” (they are actually caterpillars) contain more protein than beef.

They are also a superb source of immune-boosting iron and zinc.

• Turmeric (aka borrie). South Africa’s favourite yellow rice spice contains curcumin, which has antioxidant and anti-inflammatory effects.

• Snoek (and other oily fish). These are great sources of immune-empowering omega-3.

Images: iStock.com, Portrait image: Cole Ndelu

d

efinitions differ, but almost everyone understands the term “junk food” to mean industrially processed, high-calorie, low-nutrient edibles containing trans fats, refined sugar, salt and an assortment of unpleasant additives. Almost everyone hankers after this sort of unhealthy sweet, salty, fatty food at least some of the time, but there are relatively simple swaps that can cool at least some of the cravings.

Speaking of cool, what is summer without ice cream? Those looking for a lower fat and sugar-laden alternative will adore Dr Tracy Nelwamondo’s Modern Traditions marula nut “milk” and baobab vegan ice “cream”.

Nelwamondo’s fabulous frozen dessert is wonderfully “creamy” in taste and texture.

Want chocolate chips on that ice cream?

Don’t deny yourself, do as Darth Vader does and come over to the dark side. Dark chocolate has less fat and sugar than milk Dr Nelwamondo’s vegan ice cream. or white chocolate and is packed with antioxidants. Plus, its uber-intense tastes tend to reduce the urge to overeat. Chocolate studies suggest that dark chocolate with 50–70 per cent cacao enhances blood flow, improves gut health and eases stress.

Despite its potential benefits, dark chocolate can be high in calories and saturated fat, so eat it in moderation. Fortunately, dieticians say that the intense taste of deeply dark chocolate (such as Afrikoa’s 80%) means it only takes a few squares to satiate most stomachs.

Very few of us can control our consumption when it comes to potato crisps, which is a problem because these are often fried and super-salty. Too much sodium can cause increased blood pressure and heart disease. Try swapping chips for chickpeas, it’s not the same, but tossed in a little olive oil, chilli powder and cumin, they provide a similar moreish nibble and crunch sensation.

THREE HEALTHY RESTAURANTS

8 l HEALTHY TIMES

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2021/11/24 12:49 PM

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DON’T LET HEART DISEASE RUIN YOUR

When your heart’s health needs medical help, gap cover can save your pocket, writes Tony Singleton, CEO at Turnberry

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eart disease is one of the leading causes of death in our country, according to the Heart and Stroke Foundation. There are many different types of heart disease, which require different treatment and have different risks and outcomes. Lifestyle plays a significant role and while some Tony Singleton risk factors are out of our control, including age, sex, genetics and family history of heart disease, the vast majority of heart diseases and strokes (up to 80 per cent) can be prevented by controlling risk factors, states the foundation.

While increasingly common, heart disease can be a costly experience. Gap cover can help to save your pocket when medical help is necessary to save your life.

THE HEART OF THE PROBLEM

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In a life-threatening emergency where a member cannot select a DSP, the claim will be funded in full until the member is stabilised. The patient will then need to be moved to a DSP if they want their medical scheme to continue to fully fund the treatment.

While heart diseases are typically PMBs, there are certain elements of treatment that may be subject to sublimits. For example, the stents used to open blocked coronary arteries are considered to be prostheses, as are pacemakers, meaning medical schemes may only fund a portion of the cost. There may also be costly shortfalls with regard to doctors and surgeons.

For example, in 2020 we received a claim from Andrew Appelgryn for open heart surgery expenses, resulting from a heart attack. Appelgryn was at work one day when he became short of breath and experienced chest pains. He thought it was heartburn, but the antacid he took didn’t help. He ended up having a quintuple bypass and spent almost two weeks in ICU and had a long and difficult recovery. The last thing on his mind was paying bills.

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BEYOND THE EMERGENCY

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2021/11/24 1:52 PM

HEART HEALTHY

Crash dieting can damage

YOUR HEART

Losing weight rapidly might make you look good, but it can play havoc with your heart.

Rodney Weidemann investigates the dangers

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Image: iStock.com

ith summer on its way, many people are looking to perfect their “beach bod”, but getting your body in shape rapidly inevitably involves some form of crash diet to foster rapid weight loss. However, while such an approach may make you look good quickly, it can create problems for both your immune system and your heart.

Hayley Cimring, nutrition team leader at the Heart Foundation, says that crash diets are a popular way to reduce food intake to bring about weight loss. These diets usually require radical changes to eating patterns that are not healthy, practical or affordable in the long-term, which means they become unsustainable.

“Research suggests that rapid weight loss can slow your metabolism, leading to future weight gain, while depriving your body of essential nutrients. What’s more, crash diets can weaken your immune system and increase your risk of dehydration, heart palpitations and cardiac stress,” she explains.

Some fad diets can harm the heart due to the high intake of a single food group such as fat. Even though fat is a food group vital for bodily functions, it is advised to be consumed sparingly even when of good quality. Bad fats – such as saturated and trans fats – can increase blood cholesterol, one of the major risk factors for heart disease.”

Cimring adds that if you are concerned about heart disease, look out for these symptoms: • pressure, fullness or a squeezing pain in the centre of your chest that lasts for more than a few minutes • pain that spreads to your shoulder, one or both of your arms, your back, or even your teeth and jaw • increasing episodes of chest pain • shortness of breath, which may be a sign of heart problems.

“Crash diets can weaken your immune system and increase your risk of dehydration, heart palpitations and cardiac stress.”

– Hayley Cimring

EAT WELL, MANAGE STRESS, GET MOVING

“To achieve a successful and healthy weight loss, you need to apply a comprehensive approach that includes changing eating habits, increasing activity levels, and making changes to behavioural habits that will impact long-term heart health.

“It’s also worth noting that there is no one specific diet to help achieve healthy weight loss. Instead, it is far more important to find a new eating pattern that suits the individual and can be sustained long-term,” advises Cimring.

Gradual, sustained and healthy weight loss is best achieved by combining a healthy eating pattern with regular physical activity, she says. This is also good for the heart as it lowers blood pressure, cholesterol and blood sugar, all of which can increase the risk of heart disease if uncontrolled.

“Managing stress is another way to help alleviate a symptom that seldom causes heart disease on its own, but is nonetheless a well-known risk factor. Some of the best ways to achieve this are to cut bad habits. Rather than turning to alcohol, smoking or caffeine to relieve your stress, exercise regularly and eat a healthy balanced diet – this will help you to feel energised and keep your heart healthy.”

An estimated 70–80 per cent of heart disease and strokes can be prevented by your life choices and habits, Cimring suggests. In fact, she continues, making good nutritional choices is one of the best weapons you have in the fight against heart disease – even small improvements can make a big difference.

“Being active is one of the most valuable things you can do to help maintain a healthy weight and lower your risk of cardiovascular disease. Getting active should become a regular habit and a way of life. Any activity that gets you slightly out of breath and the heart pumping faster, counts. I would recommend trying a brisk walk, cycling, gym classes, soccer, swimming, dancing, gardening or even playing an active game with the kids,” she concludes.

HEALTHY FOODS, HEALTHY HEART

Eat more healthy foods such as: • Fruits and vegetables • Beans and lentils • Low fat or fat-free dairy • High fibre wholegrain starchy foods • Lean and fresh protein • Healthy fats Look for the Heart Mark on foods to help you choose healthier options.

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EYE CARE

Eye health

AND SAFETY

Visual impairment in children can cause severe sight loss and even blindness if left untreated.

Caryn Gootkin talks to eye experts about the importance of early eye examinations

COMMON EYE PROBLEMS

“Refractive errors among children – including myopia (nearsightedness), hyperopia (farsightedness), and astigmatism – are common and need to be assessed in health evaluations of children to allow for early intervention,” says Gray. “Eye testing is an essential component of the assessment of normal development that all children should undergo.”

“Other common eye problems in children that cause visual impairment are strabismus or crossed eyes, and lazy eye or amblyopia,” says Cullen.

There is a critical period in childhood development during which vision errors need to be corrected to allow the eye and vision to develop and reach full potential. “An eye that remains untreated and unfocused can become lazy (amblyopia) and, if not dealt with timeously, may lead to a condition that is incapable of remedy, even with spectacles, at a later stage,” says Gray. “The American Optometric Association recommends that children have a comprehensive baseline eye examination at either 6 or 12 months, and then have an additional comprehensive eye test at least once between the ages of three and five.”

Many different types of corrective treatments are available for children with visual impairment. “Some of the treatment options include glasses, contact lenses, patching, and even surgery, depending on the cause,” says Dr Cullen.

“The sooner a problem is detected, the better the outcome in most cases. Early detection enables early intervention, which optimises development of the brain’s visual centres, including vision and depth perception.”– Dr Claire Cullen

CHOOSING THE RIGHT PRESCRIPTION SUNGLASSES Summer is the perfect time to upgrade your sunglasses, which are so much more than just a fashion statement. “Sunglasses ensure that you are always protected from ultraviolet exposure, especially the harmful UVA and UVB rays, which can damage the eyelid, cornea, lens and retina of the eye,” says Tariq Khan, optometrist at Neovision Claremont.

Tariq Khan

UV PROTECTION

Choose sunglasses with 100 per cent protection against UVA and UVB rays that also block UV wavelengths up to 400 nanometres. “Replace sunglasses that are scratched as the damage to the protective coating can let in harmful UV rays,” says Khan. “Polarised lenses reduce glare bouncing off surfaces like water or roads, providing a better visual experience especially when driving and doing outdoor activities.

Combined with 100 per cent UV protection, polarised lenses also provide the benefit of blocking horizontal UV rays.”

BIG IS BETTER

When it comes to choosing the size of sunglasses, bigger is always better!

“Oversized or wraparound sunglasses limit more UV rays from passing through the sides of your sunglasses and can also protect against cataracts and skin cancer around the fragile tissue of the eye,” says Khan.

LENS COLOUR

Darker lenses are not necessarily better, but can be more suitable for certain conditions. “Depending on your needs, grey lenses reduce brightness without colour distortion, while amber lenses improve contrast and depth in lower lighting,” says Khan.

PRICE

Pricing matters for the quality of the frame – but not the lens. “As long as your sunglasses offer 100 per cent UV protection, they are good enough,” says Khan.

Image: iStock.com, Portrait images: supplied

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study by The World Health Organization in 2017 estimated that 19 million children under the age of 15 have a visual impairment. “Around 63 per cent of these 19 million children are believed to have easily correctable errors that impact Wendy Gray learning,” says optometrist Wendy Gray of Hilliar and Gray Optometrists. “Many children in South Africa have undiagnosed, untreated, but correctable visual problems that could be identified with early examination.”

According to research conducted in 2019 by the World Bank and the EYElliance, children with visual impairment lag behind their peers with learning outcomes. “It is estimated that 80 per cent of our sensory input from the world around us comes from vision,” says ophthalmic surgeon Dr Claire Cullen of KiDS EYES. “The first 1 000 days of a child’s life are extremely critical in their overall development, so early detection of a visual problem is of vital importance. The sooner a problem is detected, the better the outcome in most cases. Early detection enables early intervention, which optimises development of the brain’s visual centres, including vision and depth perception,” explains Cullen.

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SUMMER SKINCARE

SKINCARE

advice from dermatologists

While you should be looking after your skin all year round, here are some tips from the experts on what you should keep top of mind this season. By Thando Pato ALWAYS USE SUNBLOCK

Everyone needs to wear sunscreen throughout the year, no matter what the season, says dermatologist Dr Nomphelo Gantsho from the Cape Skin Doctor practice. Sun protection factor (SPF), she says, refers to sunscreen’s ability to shield your skin from the sun’s ultraviolet rays.

“SPF is the measure of time it will take for a person to start burning if they apply the sunscreen as directed. Everyone needs to apply a broad-spectrum sunscreen, containing UVA and UVB photoprotection, with an SPF of at least 30 for dark skin and 50 for fair skin.”

Dermatologist Dr Dilshaad Asmal recommends applying a shot glass size amount of sunscreen to your face and body, and reapplying it every two hours if you swim, sweat, or spend long periods outdoors. Sunblock helps to minimise sunburn, but doesn’t completely prevent it,” she says.

TREATING SUNBURN

Asmal says symptoms of sunburn include a dramatic change in skin tone with hints of red, pain or tenderness at the affected area, swelling and, in extreme cases, blisters. “You can also suffer systemic symptoms such as headache, nausea, fatigue, gritty eyes and dehydration.”

For mild sunburn, both doctors recommend taking cool baths or showers. If you opt for a bath, add 60g baking soda, suggests Asmal. Gantsho says: “As soon as you get out of the bathtub or shower, gently pat yourself dry, but leave a little water on your skin. Then apply a moisturiser to help trap the water in your skin; this can help ease the dryness. Use a moisturiser that contains aloe vera or soy to help soothe the sunburn.” Asmal advises taking anti-inflammatory tablets to help reduce any swelling or discomfort, and drinking lots of water to prevent dehydration.

In the case of severe sunburn, where there is redness on your skin, pain and blistering, Gantsho advises seeking medical assistance immediately. “Take extra care to protect sunburned skin while it heals. Wear clothing – tightly woven fabric works best – that covers your skin when outdoors.”

LOAD UP ON VITAMINS

Vitamin C is a natural antioxidant and encourages collagen production in the skin, helping to protect it from sun damage, which is why it is found in most anti-ageing products. “Vitamin C is necessary for growth and development and is essential for repairing body tissues. It can enhance the effectiveness of sunscreen and help to repair dry skin,” says Asmal.

Other vitamins that are good for your skin include vitamin D and E, says Gantsho.

“Vitamin D is one of the best vitamins for your skin; it helps reduce the amount of inflammation and irritation to your skin. Vitamin E is an antioxidant, its main function in skincare is to protect against sun damage and treat inflammation. Vitamin E also assists sebum production to help improve dry skin.”

GET RID OF DEAD SKIN

Exfoliating your skin, body and face is important to remove layers of dry, dead skin and unclog pores.

Gantsho recommends exfoliating a maximum of once or twice a week, using a gentle scrub. “Start slow,” says Asmal, “don’t start doing three exfoliations a week, rather start exfoliating every ten days then increase the frequency. If you overexfoliate your skin, it will become irritated, dry and damaged.”

She recommends using exfoliating bath mittens for the body. “Be gentle, if you are rough, you can cause tiny tears in the skin. Use small circular motions. Don’t exfoliate if skin is traumatised or sunburnt,” she concludes.

Images: istock.com

USE LIGHTER SKIN CARE PRODUCTS

Your skin products should be seasonal to protect your skin and work effectively against the climate. Asmal says that in summer, you should use a gentle foaming cleanser and a lightweight SPF 30 moisturiser. “Moisturisers or sunscreen that are too thick can lead to blocked pores, inflammation and acne,” she explains. Asmal recommends using serums containing vitamin C, which will assist with pigmentation, fine lines, and collagen production. Too-hot showers, she says, may sensitise the skin and cause inflammation. Women should also consider lighter make-up foundations in the summer to avoid clogged pores.

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BLOOD DONATION

LIFE-SAVING BLOOD - why you need to donate

Thando Pato finds out from the South African National Blood Service about the impact of COVID-19 on blood supplies and why they rely on voluntary blood donors

“At any given time, we require five days’ stock to safely meet the country’s demand for blood.” – Khensani Mahlangu

WHO NEEDS BLOOD AND WHY

Mahlangu says that every two seconds someone needs blood. And, since blood cannot be manufactured and has a limited shelf life, stocks must constantly be replenished by blood donors.

Each pint of donated blood can save up to three lives. Some of the procedures requiring donated blood and the amount needed include: • • • • • • •

28 per cent to treat cancer and aplastic anaemia 27 per cent during childbirth 21 per cent for scheduled surgery 10 per cent for paediatric care 6 per cent goes to laboratories 6 per cent for orthopaedic care 4 per cent for accident or trauma victims.

HOW TO HELP

To donate blood, you can visit any donor centre countrywide. To find a donor centre in your area, visit www.sanbs.org.za, or call 0800 11 90 31. Mahlangu says that COVID-19 protocols and precautionary measures are in place at all their sites. “In addition to thoroughly assessing donors and staff at all entry points to our facilities, we defer donors with flu-like symptoms as a precautionary measure.”

Mahlangu says anyone found to be at risk of being infected with COVID-19 will be deferred from donation as follows: • Individuals who have travelled overseas will be deferred for 28 days from the date of return.

• Anyone with a confirmed diagnosis will be deferred for 28 days from the date of complete clearance of symptoms.

• Individuals who have had close contact with anyone with a confirmed or probable infection will be deferred for 28 days from the last date of contact.

• Anyone exhibiting flu-like symptoms on the day of donation will be deferred for seven days.

Potential donors can donate blood every 56 days and don’t need to be vaccinated.

“Anyone, vaccinated or not, can donate blood. Like many international blood collection services, we allow people who have been vaccinated against COVID-19 to donate blood. We do not require blood donors to disclose that they have been vaccinated nor do we document which THE SOUTH vaccine they have received.”

AFRICAN NATIONAL Mahlangu urges everyone to donate regularly. “While BLOOD SERVICE these may be uncertain times where everyone is concerned for their safety, the need for blood will not cease. Millions of people get to live lives full of possibility and hope and happiness because of the selfless act of blood donors. Let us continue to work together to ensure that life-giving blood is available to those who need it.”

Images: Images:supplied iStock.com, Portrait image: supplied

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ess than one per cent of South Africans are active blood donors, according to the South African National Blood Service (SANBS).

This means the country is prone to regular blood shortages. And, lockdown restrictions brought about by the COVID-19 pandemic have had an adverse impact on regular blood collection Khensani Mahlangu initiatives, says Khensani Mahlangu, communications manager at SANBS. “Our blood collections have been significantly hindered by COVID-19 restrictions, which left us unable to access schools, universities and businesses. Despite more people reintegrating into their workplaces, we are still experiencing declines in blood stocks. There is apprehension from our corporate partners and schools to host us on-site, which means that we are struggling to meet our collection goals,” she explains.

Before the pandemic, Mahlangu says, blood stocks fluctuated throughout the year. “Declines are commonly experienced during school holidays and the festive season, when, commonly, people go on vacation, and schools, universities and companies are closed. Blood drives at university campuses and schools yield about 40 per cent of our collections.”

Mahlangu says that current shortages are so severe that there may be insufficient supply for the country. The SANBS needs to collect 3 500 units of blood a day to ensure a steady supply of blood products. “At any given time, we require five days’ stock to safely meet the country’s demand for blood,” she says.

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BONE MARROW DONATION

A simple act of

HEROISM Fatalities from bone marrow diseases could be reduced if more people signed up for the donation process, writes Rodney Weidemann

Image: iStock.com, Portrait images: Supplied

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n South Africa, around 350 bone marrow transplants are done annually, notes Jane Ward, deputy director of the South African Bone Marrow Registry (SABMR), adding that the sad reality is that a bone marrow transplant is often the last resort for a patient. Without it, the likelihood of them not surviving is very high.

Jane Ward “One of the biggest challenges faced is that the registry is not representative of the demographic makeup of SA. While we have around 75 000 donors on the registry, there is a lack of donors of colour,” she says.

“Other challenges include cultural and religious beliefs – largely due to a misunderstanding of religious views and ignorance of the donation process – a lack of awareness that transplants can save lives, the myth that donation is a painful and costly process, and medical mistrust.”

Potential donors between the ages of 16 and 45 can sign up with the SABMR, and donors aged 18–55 can sign up with DKMS Africa.

Perry Loebenberg, clinical haematologist at Constantiaberg Haematology, says that the most common bone marrow diseases requiring transplants are leukaemia, lymphoma and multiple myeloma.

“Treating these requires a more complex match than a simple blood grouping. Because a genetic match is required, the best chance of finding a donor is via a family member, which offers a 25 per cent chance for a full match. If there is no match with family, patients register with the SABMR, giving them at best a 1 in 100 000 chance to find a donor,” he says.

“In South Africa, our fantastic ethnic diversity plays against us with its vast genetic diversity, coupled with the fact that the majority of donors come from a single Perry Loebenberg ethnic group.”

All donors need to do when they are matched is undergo a medical to ensure they are healthy enough to donate stem cells and then have a short series of injections to boost the production of extra bone marrow stem cells.

A SIMPLE PROCESS, A LIFE-SAVING GIFT

Alana James, executive director at DKMS Africa, agrees, explaining that there are far more Caucasian donors both on the local registry and globally. “We are trying to create education and awareness in areas and communities that have not been accessed previously,” she says.

“We have been incredibly fortunate both in respect of South Alana James African citizens who donate, and corporate donations that help to fund tissue testing and surgeries for those patients who can’t afford it.”

All donors need to do when they are matched, explains Ward, is undergo a medical to ensure they are healthy enough to donate stem cells and then have a short series of injections to boost the production of extra bone marrow stem cells.

“The same stem cells found in your bone marrow are found in your circulating blood, so a nonsurgical, outpatient procedure is used. Blood is removed through a needle in one arm, passed through a machine that collects stem cells, and returned through a needle in the other arm.”

DKMS encourages readers to do what they can to promote becoming a donor. “Talk to your friends and family about it, or like and share on Facebook. Your action could inspire someone who may be a critical match, but had never thought of donating,” James says.

Loebenberg notes that while there are only 75 000 donors on the South African registry we could, given our population numbers, boost these numbers significantly.

“If you are willing to donate blood, bone marrow only involves a bit more time, but is an incredibly heroic act that can save someone’s life. It is a beautiful and selfless deed that directly impacts patients’ lives and offers them the gift of a future,” he concludes.

IT’S EASY TO BECOME A DONOR

Contact the relevant agency to apply and you will be sent a registration kit. After filling in the standard registration forms and acknowledgements, you swab the inside of your cheeks with three separate swabs, place them in the supplied envelope and put this in the provided courier envelope, which is collected and taken to a lab for testing.

Within 6–8 weeks you will receive an SMS confirming you are an active donor. You remain on the registry until you are 60, or have donated stem cells to a patient.

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TELEMEDICINE and Diabetes

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he COVID-19 outbreak has disrupted every sphere of our lives. The hard lockdowns brought the country to a halt, while businesses, schools and even hospitals had to adhere to social distancing as a preventative measure to stop the spread of the virus. These measures facilitated the migration of health services online as the treatment of noncommunicable diseases such as diabetes needed to continue.

The recent Enabling Telemedicine for People Living with Diabetes: Focus on South Africa report by The Economist Intelligence Unit (EIU), supported by Abbott, has revealed that diabetes was the second leading cause of death in South Africa after tuberculosis (TB). The condition needs regular check-ins with healthcare professionals and close monitoring, which precipitated a shift to remote patient consultations and telemedicine in the country.

Telemedicine is widely defined by the World Health Organization as the electronic delivery of healthcare services at a distance “for the diagnosis, treatment and prevention of disease and injuries” to better the health of individuals and communities. The EIU report states that not only was there an increase in the use of telemedicine in the wake of the pandemic, but also a rise in digital literacy, high technology adoption rates and more patients being monitored via virtual calls, WhatsApp and mobile phone apps.

TELEMEDICINE IS CRUCIAL FOR THE TREATMENT OF DIABETES

An analysis of COVID-19 patients by the Department of Health in the Western Cape found that almost half of those who died had diabetes as a comorbidity. In addition, people living with uncontrolled diabetes, including those using insulin, are more likely to develop more severe COVID-19 symptoms if they become infected.

So, as a precautionary measure, telemedicine can be instrumental in ensuring adequate management and better clinical outcomes for people living with diabetes.

The use of telemedicine has enabled innovations that help with diabetes care, and will further complement soon-to-be-introduced telemedicine services such as smart glucose monitors that share patient data with healthcare professionals in real-time.

“Diabetes is one of the most prevalent noncommunicable conditions in South Africa,” says Bernard Brisolier, business unit director for Abbott’s diabetes care business in Africa. “However, technology like Abbott’s FreeStyle Libre is enabling people Bernard Brisolier

“Telemedicine offers solutions to delivering healthcare services at scale, at the right time and at any location.” – Professor David Segal living with diabetes to better monitor their glucose levels without the need for finger-sticking. By simply scanning their compatible smartphone over a coin-sized sensor worn on the back of their upper arm, users can measure their glucose levels and voluntarily share valuable information with their treating doctors through secure cloud-based digital tools, like LibreView. The FreeStyle Libre system improves HbA1c (average Professor David Segal glucose levels over three months), time-in-range and clinical outcomes while reducing the need for in-person hospital appointments.”

The importance of telemedicine in the management and treatment of diabetes in the new normal is not lost on medical professionals.

“A large pool of people have diabetes and other noncommunicable diseases (more than 30 per cent of the global population) and they are especially vulnerable to COVID-19,” says Professor David Segal, a paediatric endocrinologist.

“Telemedicine offers solutions to delivering healthcare services at scale, at the right time and at any location, especially during the pandemic, when we need to use technology to create ‘healthcare with no address’. We cannot build enough hospitals or spend enough money to treat everyone with legacy hospital-based systems of care. Telemedicine can take healthcare to the people rather than the other way around. It has the potential to improve outcomes, reduce costs and increase convenience and customer satisfaction.”

The EIU report projects that as lockdown restrictions ease, new hybrid models of care will emerge, and a balance will be struck by alternating patients between in-person and virtual appointments. This has been made simpler with the introduction of new, easier-to-use self-monitoring tools.

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Image: iStock.com, Portrait images: supplied

Telemedicine is instrumental in the adequate management of diabetes in the new normal.

Bernard Brisolier, business unit director for Abbott’s diabetes care business in Africa, and Professor David Segal, a paediatric endocrinologist, explain why

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