Bonitas - Parenting Hub

Partnership with GOTG brings water to teaching hospital

When a hospital has interrupted water supplies, the consequences are dire. Water that is essential not only for handwashing, hygiene and drinking but for cleaning and sterilising instruments, laundry, cooling medical gas and suction compressors for patients on ventilators. The list is endless. It is clear that both the patients’ health and the medical staff’s ability to provide quality healthcare will be severely compromised. This is what happened at Kalafong Hospital – an 1 118-bed teaching hospital in Atteridgeville, Pretoria. The hospital was built in the 1973 and services a large population of residents in Pretoria and beyond. The University of Pretoria uses Kalafong Hospital as a training institute for the Faculty of Health Sciences. They reached out to Gift of the Givers (GOTG) with respect to water challenges at the hospital and GOTG agreed to step up to another issue that required humanitarian aid. ‘We rely on stable water supply to service patients adequately and provide a safe training environment for our students,” said Professor Priya Soma-Pillay, the Chairperson of the School of Medicine at UP. ‘As the Chairperson of the School of Medicine at UP responsible for training at our health facilities, I’m grateful to Gift of the Givers Foundation and Bonitas for hearing our plight. With consistent and reliable water supply we can ensure the health and safety of patients, staff, students and the proper functioning of medical equipment.’ GOTG began exploring the possibility of a borehole to supply uninterrupted water and partnered with Bonitas Medical Fund for funding. Drilling began on 20 January this year and by the 26 January they found water at 148 metres. The borehole currently yields 8 000 litres per hour and is literally a fountain of life for this healthcare facility. In addition, 8 x 10 000 litre water storage tanks have been installed. The partnership between Gift of the Givers and Bonitas began in 2018, the key objective: To provide relief to the most vulnerable and marginalised communities, specifically in the field of healthcare interventions. Bonitas donated R1.2 million to the Kalafong Hospital borehole project. Lee Callakoppen, Principal Officer of Bonitas says, ‘This and the other projects carried out together with GOTG, align with the Scheme’s commitment to being the medical aid for South Africa. It is the perfect partnership, as we have the same passion and drive to assist where it is needed most. ‘ The borehole will provide water to the hospital’s reservoir and supplement the municipal water supply by 150 000 litres a day. This is over half of the hospital’s daily consumption of between 200 000 and 250 000 litres. It will also help lower running costs by reducing the water bill, these savings can be channelled into other operational costs. Importantly though, when there are intermittent water cuts in the area, the hospital can rely solely on the borehole to continue to function efficiently. The water was tested using The South African National Standard (SANS) 241 test – a drinking water specification that outlines the minimum requirements for potable water to be considered safe for human consumption, after an ultraviolet system was installed Other projects involving the partnership between GOTG and Bonitas include: Sponsoring final year medical students who were struggling financially, water interventions at Tower Psychiatric Hospital, Senekal Orphanage, Cwebeni Village in the Eastern Cape, disaster relief after the KZN floods and the sponsoring an audiology programme testing the hearing of 16 000 learners in KZN. Dr Imtiaz Sooliman says, ‘We know what a difference this consistent water supply has made to Kalafong Hospital. After all, clean water is life and clean water is health. We look forward to our continued partnership with Bonitas, always with the health and wellness of South African being the priority.’

June 24, 2024

Pregnancy, your body and your baby – week 22 of your pregnancy

Your second trimester has you feeling more yourself, and feeling your growing baby moving inside your tummy is bound to bring a smile to your face. Your body may be feeling some strain as your baby grows in weight and size, and you’ll need to remember to eat healthy in order to ensure that you little one receives all the needed nutrients from you. Changes to your body at week 22 Your body may be feeling slightly uncomfortable all round thanks to the changes that pregnancy has had on your body. You may notice your back, pelvis and hips aching, leg and foot cramps, as well as swollen feet. This can be alongside heartburn, constipation (and possible haemorrhoids) as well as stretch marks. Your baby’s growth at week 22 Your baby is now approximately the size of a coconut and is sleeping in cycles – the time that you don’t feel them moving around will be when they are asleep. At this time your little ones taste buds are developing, and what they find tasty later in life may be influenced by what you’re eating. So try to keep it healthy and to stick to fruit and wholesome veggies. Their eyes are almost fully developed but lack colour in the iris. Your little one is also becoming more sensitive to outside stimuli, so you may notice that they react to loud noises. Things to remember at week 22 During your pregnancy, eating healthily is something that is important to keep in mind. Afterall, what you eat is nourishment for your baby. During your second trimester try and eat foods that are rich in protein, calcium and iron. These will help your baby’s growth – protein helps in tissue development, calcium helps in the formation of bones and teeth, and iron helps carry oxygen to your developing baby.

June 18, 2024

Coronary CT – detecting disease before it becomes life threatening

Radiology imaging techniques play a crucial role in the early diagnosis, management and monitoring of lifestyle diseases. Advancements in high-quality imaging, using reduced radiation doses, have positioned radiology ideally for this role. This contributes significantly to the understanding and treatment of these conditions. One such condition is cardiovascular disease, which accounts for approximately 30% of deaths worldwide, coronary artery disease is the commonest form. Dr Vishesh Sood, a diagnostic radiologist practising at SCP Radiology, says ‘radiology’s role in diagnosing and managing coronary artery disease is pivotal.’ What is coronary artery disease? Coronary artery disease is the gradual narrowing of the coronary arteries, which supply blood to your heart. What causes this narrowing? It is caused by plaque building up in the inner lining – a process known as atherosclerosis. Plaque is made up of deposits of varying degrees of fatty substances, cholesterol, cellular waste products, calcium and fibrin. As it builds up in the arteries, the artery walls become progressively thickened and stiff. What happens when this build up occurs? These signs and symptoms of coronary artery disease occur when the heart doesn’t get enough oxygen-rich blood. Reduced blood flow to the heart can cause a wide range of symptoms, most commonly chest pain (angina) and shortness of breath. A complete blockage of blood flow can cause a heart attack, which means that blood flow to a part of the heart is reduced for a long enough time and the heart muscle is permanently damaged or dies. What are the risk factors you CAN control? High blood pressure Elevated cholesterol levels Smoking Diabetes Overweight or obesity Lack of physical activity Unhealthy diet and stress What you can’t control However, it’s important to note that genetics also play a crucial role in determining an individual’s risk level. Managing coronary artery disease involves adopting lifestyle changes such as a healthy diet, regular exercise, and quitting smoking, along with medications like statins to lower cholesterol. A coronary CT empowers doctors to recommend these changes and treatments, with the aim of preventing serious cardiovascular events How long does this condition take to develop? Coronary artery disease generally progresses gradually over decades. The disease may go entirely unnoticed, until a significant blockage causes problems or a heart attack occurs. ‘Which is why,’ says Dr Vishesh Sood, ‘we advocate the use of a CT Coronary Angiography, the most sensitive imaging method to confirm the disease.’ He says, ‘This is particularly important in patients with non-specific symptoms, for example chest pain, which could be caused by a range of problems like musculoskeletal issues, gastrointestinal conditions or even anxiety. In these instances, coronary CT angiography is an excellent non-invasive test to confirm whether high levels of plaque are present in the coronary arteries.’ What is a CT Coronary Angiography (CTCA)? It produces detailed images of the heart for precise evaluation of the coronary arteries. A contrast dye is injected into a vein (usually in the arm) before imaging, to increase the visibility of any obstructions in the coronary arteries. The advantages It provides high resolution images of the coronary arteries, during a short, non-invasive procedure. The disadvantages Even though CTCA provides detailed images of the coronary arteries, it does not allow for interventions, such as inserting a stent during the same procedure. It is used primarily for diagnosis. Dr Sood says, ‘This is not the only method for detecting coronary artery disease. The diagnostic ‘gold standard’ has always been coronary/catheter angiography.’ What is a Coronary (Catheter) Angiography During this procedure, a catheter is threaded through blood vessels to the coronary arteries and a contrast dye is injected to make the arteries visible on X-ray images. The advantages It allows for detailed analysis of the blood flow within the coronary arteries. If a balloon needs to be inserted to stretch open a narrowed or blocked artery, it can be done at the same time. ‘Although’, says Dr Sood, ‘the more popular choice is to insert a permanent stent to allow blood to flow more freely, which can also be performed during a Coronary Angiography.’ The disadvantages It is an invasive procedure. Threading a catheter through blood vessels, usually from the groin or wrist, up to the coronary arteries can be uncomfortable for patients. It may take an hour or longer to complete and may result in bleeding, infection and some potential damage to blood vessels. Who makes the decision to do either procedure? The specialist will do a thorough assessment and then makes the decision. ‘The choice between cardiac CT and angiogram depends on the specific situation, the information needed and individual patient factors,’ explains Dr Sood. ‘Cardiac CT is often used for initial screening non-invasive assessment, while conventional coronary angiography is usually for cases where more detailed information about the blood flow is required or when the plan is to insert a balloon or stent into the artery to expand it.’ CTCA is quickly becoming a cornerstone in modern cardiology to detect coronary disease can be detected and managed before it becomes life threatening.

June 14, 2024

Pregnancy, your body and your baby – week 21 of your pregnancy

At week 21 of your pregnancy you’re now just over half to meeting your baby for the first time. You’re still in your third trimester, so take advantage of feeling better with a smaller baby bump while you can. Your body at week 21 Typical pregnancy symptoms during this are an achy back, swollen feet, heartburn, hot flashes, forgetfulness (nicknamed ‘baby brain’) and leg cramps. You may have also noticed stretch marks on tummy, breasts, thighs and butt, and this is thanks to your quickly growing tummy and baby. Headaches during pregnancy are fairly normal, especially if you’re slightly tired or dehydrated. However, if you experience bad headaches for hours on end, or ones that won’t go away, consult your doctor as you may have high blood pressure. This is also known as pre-eclampsia, which is a pregnancy complication characterised by high-blood pressure and protein in your urine. Your baby at week 21 Your baby is now the length of a banana or a carrot. Around this time your baby will also start sleeping and waking at different times (not necessarily the same as yours though). Your baby is also drinking amniotic fluid, although the placenta is how they receive the majority of their nourishment. Things to keep in mind at week 21 Braxton Hicks contractions are also known ‘false labour’ and they are your body’s way of preparing you for labour. These contractions are your womb contracting and relaxing and while they can be uncomfortable, they aren’t painful. Braxton Hicks contractions vary in length, and aren’t rhythmic, which is what differentiates them from normal contractions. There isn’t a treatment for these contractions, but changing your position (if you’re lying down) or taking a relaxing bath or nap can help ease them. If you’re unsure of whether or not you’re having Braxton Hicks contractions or labour contractions, contact your doctor immediately, as you may be going into preterm labour.

June 11, 2024

Championing the fight to prevent pneumonia

Every year a day is set aside to raise awareness of pneumonia, promote prevention, treatment and provide an annual forum for the world in the fight against pneumonia. The theme for World Pneumonia Day in 2024* is, ‘Championing the fight to prevent pneumonia’. According to the World Health Organization (WHO), pneumonia is one of the most common causes of morbidity in SA children, despite improvements in immunisation and HIV management programmes. WHO also states that globally a child dies from pneumonia every 30 seconds. This is higher than malaria, HIV/AIDS and tuberculosis combined. In South Africa, flu and pneumonia ranked second (after intestinal infectious disease) as the leading cause of death in children under 5 years. This just doesn’t make sense when vaccines are available in both the private and public healthcare sector for children and adults. As part of the Expanded Programme on Immunisation, babies have a series of 4 vaccinations: At 2 months of age, 4 months, 6 months and 12–15 months. What is Pneumonia? Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund says, ‘pneumonia is a respiratory infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus, causing symptoms such as cough with phlegm or pus, fever, chills and difficulty breathing’. Types of Pneumonia Bacterial pneumonia Viral pneumonia Fungal pneumonia Aspiration pneumonia: This type is more common among certain people, including older people and those with nerve disorders or swallowing issues The flu shot as the first line of protection Dr Hadebe recommends having a flu vaccine and says it is the first line of defence when it comes to protecting yourself. Studies show it reduces the risk of contracting flu by about 50 to 60% and also helps prevent the development of Pneumonia. According to the New England Journal of Medicine (NEJM – 2015), ‘In addition to reducing the risk of hospitalisation for an influenza (flu) infection itself, flu vaccination appears to reduce the likelihood of hospitalisation for influenza-associated complications such as pneumonia.’ Perhaps the more telling piece of data shows that only 29% of the overall population have been vaccinated against flu, emphasising the need for more effective delivery of preventative services to prevent Pneumonia deaths. Pneumococcal vaccine There is also a vaccine that protects you against Streptococcus pneumoniae bacteria which causes 80% of Community Acquired Pneumonias (CAPs). These streptococcal bacteria can spread from the nose, throat and ears to cause pneumonia – a severe infection of the lungs. It also protects you against other pneumococcal diseases including those of the bloodstream (Bacteraemia) and the lining of the brain and spinal cord (Meningitis). Who should have the Pneumococcal vaccine? People over 65, particularly in a retirement village Anyone with heart and lung problems, including asthma or with chronic illnesses like anaemia, diabetes or kidney failure. Immune-suppressed people, including those who are HIV-positive Caregivers and close contacts of any of the above Smokers, as they are more prone to respiratory illnesses Cancer sufferers The WHO reports that some preliminary studies suggest that obesity and especially extreme obesity, may also be a risk for more severe disease. Signs and symptoms of Pneumonia may include: Chest pain when you breathe or cough Confusion or changes in mental awareness (in adults aged 65 and older) A cough, which may produce phlegm Fatigue Fever, sweating and shaking chills Lower than normal body temperature (in adults older than age 65 and people with weak immune systems) Nausea, vomiting or diarrhoea Shortness of breath When to see a doctor? With virtual consultations readily available, it’s recommended you first consult your doctor via a telephone or video call to discuss your symptoms, especially if you are having difficulty breathing, chest pain, persistent fever of (39°C) or higher or a persistent cough, especially if you’re coughing up phlegm. Your physician will then decide whether you need a face-to-face consult and examination. Dr Hadebe says that, despite the evidence of the efficacy of these vaccinations, there is not enough uptake. ‘It is up to each one of us to take charge of our health, this includes having regular wellness checks and ensuring that you have a flu vaccine and, if you are vulnerable to develop pneumonia, have the pneumonia vaccine at the same time.’ Remember that your GP is your first port of call for all your healthcare needs.

June 10, 2024

Tackling women’s health holistically

‘A woman’s health is her Capital’ As far back as 2014 at the World Health Organization’s (WHO) ‘Partnership for Maternal, Newborn and Child Health Forum’, South Africa stated their alliance with WHO’s statement and said, ‘the health of mothers and their children is key to achieving development equity.’ Which is why Bonitas Medical Fund, the Medical Aid for South Africa, has teamed up with CareWorks, to bolster its mother and childcare benefits and introduce a new Female Health Care Programme. With this renewed commitment to the health and wellbeing of women and toddlers, the Scheme will shine a light on the importance of preventative care and empower women to prioritise their health. ‘In South Africa, women face a range of health challenges influenced by socioeconomic, cultural and environmental dynamics at play,’ says Dr Themba Hadebe, Clinical Executive at Bonitas. ‘Many of these healthcare factors are unique to women. Early disease detection and appropriate care programmes are proven key factors in improving treatment outcomes and prognosis. Dr Hadebe says, ‘It is common knowledge that women often put their own health needs aside to care for their families. This programme will pro-actively assist women and provide them with support, to ensure that they access prevention services when they need to, as well as treatment plans.’ Top health issues in South African women are: Non-Communicable Diseases (NCDs) Diabetes in South Africa’s is the second deadliest disease and is also the leading cause of death among women in the country. 68% of women are obese, which is a strong risk factor for Type 2 diabetes. In addition, it is estimated that 10% of pregnant women in South Africa have gestational diabetes, which may go undiagnosed. This evidences the urgent need for screening and diagnosis. Breast and Cervical Cancer The statistics are stark: 1 in 6 women worldwide is estimated to develop cancer during their lifetime. By 2040, there will be a projected rise to 30 million new cancer cases amongst women globally. Screening services are encouraged for early HPV (Human Papilloma Virus) detection and breast cancer diagnosis. Mental Health Approximately 25.7% of South Africans are affected by probable depression, with similarly elevated levels of anxiety, particularly among women. These rates are influenced by socio-economic status, adverse childhood experiences and educational levels. HIV/Aids South Africa has one of the highest HIV prevalence rates in the world – with women, especially young women, being disproportionately affected. Of the 7.3 million adults living with HIV, 64% are women. According to Dr Mizpah Moru, the Clinical Service Manager of CareWorks, ‘The programme is focussed on educating and empowering women to take control of their health and to address any barriers that may stop them accessing health services. ‘We have a highly skilled female team of clinicians who understand the specific healthcare needs of women.’ Online Assessment and Preventative Screening There are various modules in the Self Health Evaluation (SHE) – each are educational and designed to alert potential red flags related to the likes of cardiovascular disease, hypertension and diabetes. Other modules deal with prevalent cancers, mental health, pregnancy and communicable diseases like HIV, as well as screening questions for TB and STIs. SHE and risk identification will enable targeted messaging to members. Screening results will trigger a support process to assist members in accessing appropriate, targeted care programmes. ‘We’ve taken proactive steps to address their unique healthcare needs. Our aim is to provide inclusive, tailored healthcare solutions at every stage of life,’ says Dr Hadebe. Female members will be encouraged to access their Bonitas benefits to: Promote preventative care strategies for both females and toddlers Detect non-communicable diseases such as hypertension, diabetes, mental disorders, cancers, etc. Help females plan appropriately during their reproductive ages Help expecting mothers to detect and manage any risks and complications as early as possible in their pregnancy Improve access for females and toddlers to essential care Improve parent education and awareness about toddler care Expansion of the Maternity Programme The comprehensive Maternity Programme includes support for new parents with milestone reminders for children under three, immunisation reminders and online screenings for infant and toddler health. Enhanced support for expecting mothers, includes: Early identification of high-risk pregnancies Weekly engagement for high-risk pregnancies Post-childbirth follow-up calls Online assessments for pregnancy and mental health Midwives and nursing sisters will provide nurturing and caring support to women who have suffered a miscarriage and assist them in working through both the physical and mental issues associated with the loss of their baby. Support will be offered to parents of neonatal babies The programme also includes a library of female specific health topics – with a monthly focus – screening reminders and support, all communicated through SMS, WhatsApp, emails, calls and other existing digital platforms. ‘The aim of the new Female Health Care Programme is to raise awareness and promote education around health and wellness,’ says Dr Hadebe. ‘It’s about influencing behaviour positively and encouraging early screening and preventative services. Importantly, it is also about providing inclusive, tailored healthcare solutions at all stages of life, to help members live their healthiest life.’

June 7, 2024

Pregnancy, your body and your baby – week 20 of your pregnancy

Congratulations to you and your baby, you’re officially halfway through your 40 week pregnancy. It’s crazy to think that 20 weeks ago you had your last period, and now a new life is blossoming inside of you – you may even know their gender and are thinking about possible names. Your baby at week 20 You little one is now roughly the size of a grapefruit or banana, and if you haven’t been able to feel your baby move around, at week 20 things may change. Although your baby still has a fair amount of room inside of you, and you should feel her moving around inside your tummy.Their heart is pumping between 120-160 beats per minute and their senses and reflexes are becoming more developed. How you’ll feel at week 20 You may have noticed the appearance of a dark vertical line on your belly, this is normal in pregnancy and is known as a linea nigra. This line isn’t a problem and is caused by hormones during pregnancy. If you’re wanting to travel or are planning to organise a baby nursery in your house, use the time during your second trimester to your advantage, as your pregnancy symptoms won’t be as intense as they were in your first trimester, and your belly won’t be inconveniently big just yet. But that being said keep your needs in mind and don’t push yourself to do something if you aren’t feeling comfortable. Things to remember at this time During your pregnancy you may experience lower back pain thanks to your growing baby putting increasing strain on your body. If your pain is unbearable it’s best to seek the advice of your doctor or physio, but if you are managing there are a few things you can do to make your life more comfortable. Practicing prenatal yoga, deep breathing, being aware of your posture and a pregnancy belt are all things which can help ease your tired back.

June 4, 2024

Time to quit. World No-Tobacco Day

‘A billion deaths can be prevented this century, if governments act now to reduce tobacco use’. [World Health Organization] Ahead of World No-Tobacco Day, commemorated annually on 31 May, the World Health Organization (WHO) is calling on governments to adopt policies that shield children from exposure to harmful tobacco products. This year’s theme: ‘Protecting children from tobacco industry interference’, gives young people across the world, the platform to urge the tobacco industry to stop targeting them with products that are harmful to their health. Statistics indicate that smoking among young people remains high. More than 38 million youngsters, aged between 13 and 15, are using some form of tobacco. Tobacco use affects all communities. It has direct harmful effects on health, but also impacts a country’s economy and environment and hinders their achievement of Sustainable Development Goals*. ‘Lifestyle-related diseases stemming from tobacco, alcohol and obesity, have overtaken infectious diseases and become one of the biggest killers,’ says Dr Themba Hadebe, Clinical Executive of Bonitas Medical Fund. ‘We often think tobacco use is no longer an issue. And, while the number of people smoking in South Africa has fallen by over 20% over the past two decades, the reality is that we still have a long way to go.’ One of the reasons for the decline in cigarette smokers is that South Africa is part of The WHO Framework Convention on Tobacco Control (FCTC). The FCTC is an international treaty which requires governments to, amongst other things, raise tobacco taxes, ban tobacco advertising and make public places smoke-free. It also urges governments to protect their policies from tobacco industry interference and to ensure children grow up free from commercial pressure to start smoking. South Africa was one of the first country signatories to the FCTC on 16 June 2003, the treaty was enforced on 18 July 2005. The facts are clear: Tobacco is harmful to your health. It was responsible for a million deaths during the 20th century and tobacco use could kill 1 billion during the 21st century. ‘We encourage you to take action now,’ says Dr Hadebe. ‘If you are a smoker, quit and if you’re a non-smoker, help a friend or family member to quit.’ He says there are a number of support groups available. ‘At Bonitas we offer our members a fully supported stop smoking programme through GoSmokeFree. The programme, available through participating pharmacies, begins with a pre-quit assessment and then one-on-one sessions with a nursing sister and trained advisors to develop an individual plan to stop smoking. ‘When you quit smoking, good things start to happen,’ says Dr Hadebe, ‘you can feel and see almost immediate improvements to your health.’ The health benefits Not only can you save up to R1 000 a month when you quit your 20-a-day habit, but you will enjoy the following health benefits: After 20 mins: Your blood pressure and pulse rate slows After 8 hours: Your nicotine levels reduce by half and oxygen levels return to normal 24 hours: Carbon monoxide leaves your body and lungs start to clear mucus and smoking debris 2-3 days: Your sense of smell and taste is enhanced 72 hours: Breathing is much easier and energy levels will increase 3+ months: Your skin starts to look younger and your teeth whiter 5 years: Heart attack risk falls to half that of a smoker 10 years: Your risk of lung cancer falls to half that of a smoker and heart disease risk to the same as someone who has never smoked It’s never too late to quit and it’s easier to stop smoking with the right support. Try the following: List the reasons you want to quit Set a date to give up smoking Tell people you are quitting Use stop smoking aids Join a free support group (even on Facebook) for support and advice Have a plan for when you are tempted to smoke (a distraction) List your smoking triggers and how to avoid them Keep cravings at bay by keeping busy Exercise away the urge to smoke Throw away all your cigarettes before your start Remember: Never give up giving up!

May 31, 2024

Pregnancy, your body and your baby – week 19 of your pregnancy

At week 19 you’re just one week off being halfway through your pregnancy! Your baby is now the size of a mango, and the exciting news is that you’ll soon find out (if you want to) whether your baby is a boy or a girl. Your body at week 19 You may have started to notice some pelvic pain and abdominal pain due to your baby’s growth. Your muscles and ligaments are working hard to support your expanding bump and this can cause discomfort. Regular gentle exercise (and if you were fit before your pregnancy, that’s a bonus) can help strengthen the muscles around your back and pelvis which can alleviate discomfort. Leg cramps are another pregnancy symptom that many expecting moms experience. These frustrating pains can often be experienced near the end of the day. Calf stretches and drinking plenty of water are two ways in which you can help reduce cramps. Your baby at week 19 Your baby is now the size of a mango, and at this time their skin becomes covered in a greasy, waxy substance called vernix caseosa. This protects the skin from the amniotic fluid in the uterus. Your baby’s first set of teeth are developing (although these won’t be visible for a while after they are born) and hair is starting to appear on their head. Things to remember at week 19 Around week 19-20 you’ll have a morphology scan which is an ultrasound which examines your baby’s body, the placenta and umbilical cord. The scan is used to check for any structural abnormalities in your baby, but it will also be the first chance you get to see your baby. This scan is also when you’re able to find out your baby’s gender.

May 20, 2024

Pregnancy, your body and your baby – week 18 of your pregnancy

Your pregnancy is starting to become more obvious, and if you’re trying to conceal your bump, you may start finding this more difficult. Inside your body, you may feel your little one moving inside of you – you may even notice that the movements are in response to noises as your baby can start to register sounds. Your body at week 18 You may have started to notice dizziness when you stand up. To lessen this, get up gently when you stand from sitting or lying down. Your back may be feeling increasingly achey, so avoid doing activities that aggravates it. You may also notice swelling in your hands and feet, as well as increasingly difficulty to get to sleep. Your baby at week 18 Your baby is now the size of an artichoke or a red bell pepper, and it’s around this time you’ll start to notice your baby moving around inside you. You may have noticed this previously, especially if you’ve had a baby before – but this is the time that little one’s movements become more distinct. However, they’ll feel more like a flutter than a strong kick, so don’t be concerned if you’re unsure of what you’re feeling at first. Things to remember at week 18 Although pregnancy is a happy and exciting time for many moms-to-be, it can also be very stressful. Antenatal anxiety is both fairly common during pregnancy, especially if your pregnancy is unplanned, you have external stresses such as financial strain, or you experienced depression and anxiety prior to pregnancy. A bit of worry during this time is normal, as you are going through many new experiences. However, if you feel like your worry is crippling and you can’t enjoy day-to-day life, then you may be experiencing antenatal anxiety. This is nothing to be ashamed of, and seeking medical guidance can help make your pregnancy easier and happier.

May 13, 2024

Getting to grips with flu

Few common illnesses are more unpleasant than the flu. The aches, pains, chills, fever and cough are bad enough. Add the other potential symptoms including runny nose, vomiting, diarrhoea, fatigue or sore throat and you’ll want the illness to be over as soon as possible. Or try to prevent it. Annually, flu kills around 11 500 people in South Africa and 20 000 are hospitalised. ‘The seasons are changing and with it comes the ‘flu virus,’ says Dr Themba Hadebe, Bonitas Medical Fund’s Clinical Executive. ‘Now is the time to take precautions against catching flu, including having a flu vaccine, which is recommended by the World Health Organization (WHO).’ Why a Flu vaccine? Although the flu vaccine will not eliminate your risk of developing flu, it helps reduce your chances of severe infection. What are Flu pandemics? These occur when a new flu virus emerges that is significantly different from circulating seasonal strains, causing widespread illness worldwide. Best known examples are the: 1918 Spanish flu, 1957 Asian flu, 1968 Hong Kong flu and the 2009 H1N1 pandemic. The 1918 Spanish flu pandemic was the most severe, it is estimated to have been responsible for the deaths of 50-100 million people. What is Flu? Flu is a contagious respiratory illness caused by the influenza viruses. It can cause mild to severe illness and can lead to hospitalisation and even death, especially in high-risk groups such as young children, the elderly, pregnant women and people with underlying health conditions. What is the current Flu strain in South Africa? There are four types of flu viruses: A, B, C and D. Most seasonal outbreaks of flu in humans are as a result of the A and B viruses. The most commonly reported influenza viruses for 2024 are type A(H1N1) and type B. What are the most common Flu symptoms in 2024? These may include the following: Fever of 38˚C or higher Aching muscles, especially in your back, arms and legs Chills and sweats Why do I need a Flu shot every year? ‘All viruses mutate – meaning the genetic material of the cell changes – but not at the same rate. Some mutate very quickly, including the flu virus. Which is why we get a new flu vaccine every year,’ says Dr Hadebe. Other preventive measures include frequent handwashing, covering your mouth and nose when you cough and sneeze, avoiding close contact with sick individuals and staying home when ill. Will the flu shot give me Flu? A flu shot cannot cause flu. Flu vaccines are currently made either with flu vaccine viruses that have been ‘inactivated’ and are not infectious or with no flu vaccine viruses at all. Some side effects may occur like redness, tenderness and swelling where the shot was given but this is mild and will only last a few days. These are infinitely preferable to a bad case of flu. Who should get a Flu vaccine? Annual flu vaccines are recommended for everyone six months and older, especially for those at higher risk of complications. The vaccine helps your immune system fight off the virus by producing antibodies which is why it’s best to vaccinate in April or May, before the start of flu season. Flu vaccinations are available at most pharmacies and the costs are generally covered by medical schemes. Anyone in the high-risk groups including: Healthcare workers Individuals over 65 years Individuals with chronic diseases – or comorbidities – for example: Cardiac disease, diabetes, asthma, kidney diseases (due to poorer baseline immunity) Pregnant women People with a BMI over 40 People who are immune compromised Who should NOT have the Flu vaccine? Those allergic to eggs or egg proteins as the vaccine manufacturing process involves the use of chicken eggs Infants under 6 months of age Individuals who may have had a severe reaction to a flu vaccine in the past Individuals who may be suffering from flu symptoms already How is flu transmitted? It spreads mainly through respiratory droplets when an infected person coughs, sneezes or talks. It can also spread by touching surfaces contaminated with the virus and then touching your mouth, nose, or eyes. What are the complications of Flu? Flu can lead to various complications, such as pneumonia, bronchitis, sinus infections, ear infections and worsening of chronic medical conditions like asthma or heart disease. Complications are more common in high-risk groups. ‘Flu viruses spread very quickly from person to person’, says Dr Hadebe. ‘Even if the flu vaccine is not 100% effective, it will reduce your risk of getting flu, and, if you do get it, it will be a great deal milder’.

May 9, 2024

Pregnancy, your body and your baby – week 17 of your pregnancy

Week 17 your baby is getting bigger, and this week they’ll start developing more fatty tissue. You may have started to notice an achy back and pelvis, and getting a good night’s sleep may have become increasingly more difficult. Your body at week 17 At week 17 you may see an increase in your appetite, a far cry from the nausea you experienced in your first trimester. Your breasts are also increasing in size as they prepare for milk production – for some women this growth is more than others. Your growing baby’s weight can also put added strain onto your spine and pelvis, meaning you could start to experience backache. Prenatal yoga and supportive chairs and shoes, are all ways in which you can help your body feel more comfy. Your baby at week 17 Your baby is now the size of an onion or orange, and at this time her fatty tissue is starting to form – this will help keep her warm after she’s born. Although the head is still the biggest part of the body, the body proportions are starting to become more even as your pregnancy progresses. Your baby is now learning to suck, so that when they’re born they can easily feed, although this reflex won’t mature until later in your pregnancy. Around this time, your baby’s finger prints will also form. Things to remember at week 17 Your pregnancy changes your whole life, including the way you sleep. Even though the position you sleep in is something fairly simple, which you probably hadn’t put much thought into before. As your pregnancy progresses, a good night’s sleep is something that may become increasingly difficult. It’s recommended that you avoid sleeping on your back in your second and third trimester, as your uterus and baby can put pressure on your spine and vena cava. Sleeping on your left side is ideal as this supports optimal circulation. Once your belly gets bigger, you can even look into getting a pregnancy pillow, which offers support for your entire body.

May 6, 2024

Pregnancy, your body and your baby – week 16 of your pregnancy

You are now 4 months pregnant, and have 24 weeks left to go before you birth day, although this may seem far away your baby has done so much growing in these past 16 weeks and still has lots left to do before they are born. Your body at 16 weeks Your pregnancy hormones can make your veins stretch, giving you varicose veins. While these distinctive purple lumps are the prettiest sight, generally they are painless and harmless. Pregnancy brain is another sign of a baby that you may have noticed, many moms-to-be notice they may become more forgetful or inattentive. The exact reason for this isn’t clear, however, stress and having many items on your to-do list could be contributing factors towards this. You may also notice some pregnancy weight gain (which is normal and nothing to worry about!) and your boobs will have probably gone up a few cup sizes as your body preps for breastfeeding. Be sure to invest in comfortable bras, such as maternity or sports bras, as this can help ease any discomfort. Your baby at 16 weeks Your baby is now the size of an avocado. This week may be the one that you first start to notice small kicks from your little on moving around. Another exciting marker of this time is the fact that your baby can start hearing your voice, so make sure you chat to them throughout your day. This’ll also be roughly the time that their eyes become more sensitive to light, their bones and muscles are hardening and strengthening and their eyebrows, hair and lashes are forming. Things to take note of around this time. During pregnancy you may struggle with constipation. This is a fairly common pregnancy complaint thanks to pregnancy hormones and the extra iron you’re taking in your prenatal vitamins. Eating more fibre, drinking lots of water, and exercise can help keep you regular. If you’re still struggling, chat to your doctor and they may prescribe stool softeners to help.

May 2, 2024

Measles – it’s a serious illness

The World Health Organization (WHO) has warned of an ‘alarming’ increase in measles cases – almost 45-fold in Europe last year – but outbreaks of new cases and even deaths are being reported globally. WHO believe this is a result of fewer children being vaccinated against the disease, especially during the Covid pandemic. However, measles is preventable, thanks to a vaccine that was introduced in 1963. Since 2000, the measles vaccination programme has averted an estimated 57 million deaths worldwide. However, the Covid-19 pandemic disrupted global vaccination activities which, in 2021, resulted in the lowest measles-containing-vaccine first-dose (MCV1) coverage levels since 2008. Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund takes a look at this ‘childhood’ disease to remind us about what causes it, the symptoms and why we should vaccinate. What is measles? Measles is caused by a virus and can affect anyone but is most common in children. It infects the respiratory tract and then spreads throughout the body. Some of the more common measles symptoms include: High fever Cough Runny nose Red, watery eyes (conjunctivitis) A rash all over the body (3-5 days after symptoms begin). Complications of measles can lead to: Ear infections Diarrhoea Pneumonia (infection of the lungs) Other respiratory infections Encephalitis (inflammation of the brain) which occurs in about one in every 1 000 people with Measles. Blindness Measles can be serious Measles is so much more than just a fever and rash that clears up in a few days. It can cause serious health complications, especially in children under the age of 5 and adults over the age of 30. If a woman catches Measles during pregnancy, it can be dangerous for the mother and can result in her baby being born prematurely with a low birth weight. Even with the best care, people can still die after contracting measles (1 to 3 out of 1 000 people). Being vaccinated is the best way to prevent getting sick with measles or spreading it to other people. Measles is contagious Measles is easily spread through the air when an infected person coughs or sneezes. It is very contagious: One person can infect up to 9 out of 10 people around them if they are not adequately protected. In fact, an infected person can spread measles to others even before they know they have the disease – from up to four days before developing the measles rash to around four days afterwards. The measles vaccine The best protection against measles is the Measles-Mumps-Rubella (German Measles) (MMR) vaccine. The MMR vaccine provides long-lasting protection against all strains of measles. Your child will need two doses of MMR vaccine for best protection: The first dose at between 12 and 15 months of age The second dose at between 4 through 6 years The Measles-Mumps-Rubella-Varicella (MMRV) vaccine, which protects against four diseases, is also available to children from 12 months through 12 years of age. Treating measles As measles is caused by a virus, there’s no specific medical treatment, it has to run its course. However, if your child has measles they need to drink plenty of liquids, get lots of rest and stay at home to prevent spreading the infection. Measles outbreaks The people most at risk during a measles outbreak are non-immune person (not vaccinated or vaccinated but did not develop immunity). Unvaccinated young children and pregnant persons are at highest risk of severe measles complications. The fact is that measles is still common and with a break in the vaccination regime we are seeing more outbreaks. The best way to fight it and prevent it spreading is to vaccinate. Did you know? South Africa follows International Guidelines in providing vaccines to children. This programme is known as the Expanded Programme of Immunisation (EPI). Parents need to take responsibility to ensure their child is vaccinated on time: Not only to help protect the child against certain illnesses but also to contribute to the overall health of children in the general population. ‘Childhood vaccines are a critical part of a child’s health, they work by stimulating and teaching the immune system how to fight certain infections,’ explains Dr Hadebe. ‘Bonitas recognises this and we cover immunisation, on most plans, according to EPI up to the age of 12.’

April 25, 2024

Pregnancy, your body and your baby – week 15 of your pregnancy

Congratulations, you and your baby are now at week 15, while your baby still has lots of growing to do, you should make sure that you make the most out of feeling more energetic during trimester two. Join prenatal classes, enjoy walks outside and start planning how you’ll rearrange your house for the arrival of your new bundle of joy. Your baby at week 15 Your little one is now roughly the size of an apple or pear, and at this point your baby’s ears and eyes are starting to become more developed, and are moving into the correct place on their head. Soon they may even be able to hear the sound of your voice. During this time their bones and muscles are also getting stronger, not only this but her limbs are getting longer and are able to move. You won’t be able to feel any movement just yet, but it won’t be long! Your body at week 15 At week 15, your increased energy levels may also mean that you may experience increased libido. Although you may have higher energy levels, you’ll probably also notice that your expanding belly is itchy, thanks to stretching skin. If you are feeling increasingly hungry, thanks to a reduction in morning sickness, be aware of what you’re putting into your body. Certain foods, such as ripened cheese, can be damaging to your baby. However, the inclusion of healthy snacks can be beneficial to both of you, and by doing research or chatting to a dietician, you can make sure that you include food groups that’ll be nutritious to you and your baby. Things to keep in mind at week 15 Another pregnancy symptom is sensitive gums and teeth. The reason for this is hormonal changes which increase the blood flow to your gums, making them swell. Not only this but you may be more susceptible to gum disease and pregnancy gingivitis (which about half of all women experience during pregnancy). Because of this it’s important that you look after your teeth and gums, and check in the dentist during your pregnancy.

April 22, 2024

Pregnancy, your body and your baby – week 14 of your pregnancy

Week 14 of your pregnancy and you’re in month four of your pregnancy with five to go – almost half way already. Trimester two of pregnancy means you should be feeling renewed levels of energy and you may even notice that your appetite has increased thanks to morning sickness slowly easing up. Your baby in week 14 Your baby is now the size of a peach, and now often moves her arms and legs – but you won’t be able to feel this yet. If you could see into your belly, you may even notice your little one sucking their thumb! Around this time the grasp reflex is evolving, and hair growth is starting as follicle under the skin, so that when they’re born your baby should have silky strands of hair. Your little one’s genitals are now also fully developed, but it’ll still be difficult to tell their gender on ultrasound. Your body in week 14 Luckily during your second trimester you’ll be feeling more yourself, with rising energy levels, breasts that are less tender and dissipating nausea. You’ll also probably starting to show a bit as well, however, some moms, especially those expecting multiples, may start showing sooner. This is because your uterus is rising out of the pelvic region and into your lower abdomen. During the second trimester you’ll also notice that you’ll start to put on weight, don’t be alarmed by this as it’s completely normal and healthy during a pregnancy. Things to take note of If you found that during your first trimester your pregnancy symptoms meant that you generally stayed away from exercise, embrace your renewed energy levels and start doing gentle exercises such as water aerobics, prenatal exercise classes and gentle walks. This’ll be beneficial to both you and your growing little one.

April 15, 2024

Pregnancy, your body and your baby – week 13 of your pregnancy

At week 13 of your pregnancy you are now in your second trimester. This trimester is often nicknamed the honeymoon period, as your pregnancy symptoms should have started easing up, and your baby is still small enough that you don’t feel uncomfortable. Your body at week 13 At week 13 your energy levels should start increasing, but if your nausea and fatigue don’t disappear just yet – don’t despair, some moms experience these for longer than others. This increase in energy won’t stick around forever, so make the most of this time while you can and tick important to-dos off your list. Your blood flow will also increase during this time, and because of this you may see blue streaks under your skin from your veins and experience an increase in libido. Your baby at week 13 Your baby is now the size of a lemon and her body proportion is slowly starting to change, although the head is still the biggest part of the body. Your baby is growing rapidly, and during this time, her intestines are moving from the umbilical cord into the stomach. Her eyelids are shut to protect the eyes as they develop and her vocal cords are also developing, so that when your baby is born she’ll be able to cry and laugh and eventually say her first word. Things to remember in this week Around this time is when some people choose to tell family, friends and employers that they’re expecting. You should pick when you feel most comfortable to tell everyone, however, this time is often chosen, as your risk of miscarriage will have decreased and you’ll have had your first pregnancy ultrasound, which should confirm that your baby is healthy.

April 8, 2024

Pregnancy, your body and your baby – week 12 of your pregnancy

This is now the last week of your first trimester, which is week 1 to 12. Your clothes are probably starting to feel a little tighter than they used to, but the good news is that some of the first-trimester pregnancy symptoms, such as morning sickness and fatigue should be easing up soon. During the first trimester, your baby will have grown from an egg to a fully formed baby (with lots of growing to do) and you’ll have had your first check-up and ultrasound. Your body at week 12 At week 12 you’ll probably notice that your morning sickness may start to subside. This is because the hCG hormone is starting to level off. However, not all moms are this lucky, as some experience nausea in their second trimester as well, or even throughout their whole pregnancy. Stomach pain, cramping and constipation are also pregnancy symptoms you may be experiencing. Not all women experience constipation, however, it is fairly common thanks to pregnancy hormones. If you experience sharp or severe pain, it’s important to seek medical help as quickly as possible. Things to keep in mind Throughout your pregnancy both your mental and physical wellbeing is important. Many articles on pregnancy neglect to explain the mental challenges that expecting moms can struggle with during this time. Pregnancy hormones, the added stresses of a new life growing inside you and previous or current depression and/or anxiety can mean that you may also struggle with antenatal depression and anxiety. Tell-tale signs of antenatal depression are feeling sad or anxious all the time, and lack of interest in things that used to. If you do feel that you’re struggling it’s important that you reach out to a health care provider and rely on family and friends for support. Joining a support group of moms, or moms-to-be in a similar position can also help you feel more at ease. Where is your baby at in week 12 Your growing baby is now roughly the size of a lime or a plum. At this point all your baby’s important features, body parts and organs are in place, they just have lots of growing and maturing to do. Your baby’s tiny developing bone marrow is starting to make white blood cells and their muscles and nervous system are maturing.

April 1, 2024

Pregnancy, your body and your baby – week 11 of your pregnancy

You are now almost at the end of trimester one, which is good news as the second trimester is often seen as easier than the first. Both you and your baby will have undergone many changes during these first 11 weeks, and you’ll have gone from a hoping-to-be-mom to an expecting one. Pregnancy has its ups and downs, so it’s important that you look after yourself (and by default your growing baby) at this time. How you’ll be feeling at week 11 At week 11 your baby bump may be beginning to show, but don’t worry if your baby bump isn’t showing yet, as this varies from pregnancy to pregnancy. It’s likely that if this is your first pregnancy and you don’t have multi babies inside you, you won’t start showing as quickly. If your morning sickness if beginning to ease you may notice that you’re feeling hungrier than normal. If this is the case, make sure that you fuel up on healthy snacks that are nutritious to both you and your growing baby. You may find that your cravings are completely different from what you’d normally eat, and your old favourite food is one you that makes you feel queasy. Hormones, senses that are heightened and a need for comfort food are all reasons behind these strange (but normal) pregnancy cravings and aversions. Your baby at week 11 Your baby is now the size of a lime or a fig, and their body is slowly starting to straighten out. At this point, your baby’s hands and feet, as well as their ears, nose and mouth are becoming more developed. Hair follicles are beginning to form, as well as nail beds and their reproductive organs are developing, however, you won’t be able to tell gender via ultrasound just yet.

March 22, 2024

TB – Serious but Curable

Tuberculosis (TB) is a serious public health issue in South Africa. 280 000 people fell ill with TB during 2022 and, of these, an estimated 54 200 died from the disease. South Africa is one of the 30 high burden TB countries, contributing 87% of the estimated cases worldwide. According to the Department of Health, the main driver of TB infection is HIV, with around 48% of TB patients living with HIV. As a member of the United Nations, South Africa has committed to reducing new TB cases by 80% by 2030, compared with 2015 levels. Clinical data presented by the World Health Organization (WHO) indicates that our country is meeting some of its targets but there are still too many people falling ill and dying. ‘It is important to remember that TB is curable’, says Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund. ‘However, we all need to be more aware of how contagious it is, the symptoms, the impact of the disease, the importance of getting medical attention and adhering to the treatment regimen.’ ‘TB also has a big impact on the economy, not only in terms of healthcare expenses but lost productivity – due to absenteeism and the direct and indirect costs to business. ‘We know that not everyone has access to private medical care but public healthcare facilities offer free testing and treatment. If you test positive for TB, the Department of Health will provide the necessary medication. Crucial to overcoming this disease is to follow and complete the treatment regimen as advised by your healthcare giver.’ Some TB facts: What is TB? It’s a disease that mainly affects the lungs but can also be found in any other body organ. It is caused by an organism (germ) called Mycobacterium Tuberculosis which is found in the sputum (a mixture of salvia and mucus) coughed up by someone with TB of the lungs. The organism (germ) usually destroys the soft tissue of the lungs resulting in difficulty breathing and blood can be coughed up in severe cases. If untreated, TB can cause death. How is TB contracted? The disease is passed on from one person to another. The germs spread into the air via microscopic droplets if an infected person sneezes, coughs or releases saliva. The incubation period is 6 weeks. TB Symptoms If you are concerned about your health or having been exposed, you must get tested urgently. Symptoms of the TB include: Excessive coughing – a cough that has been present for more than two weeks and is productive, (a cough that has phlegm) Chest pains Loss of appetite and weight Low grade fever Night sweats Chills Coughing up blood In children the symptoms may present as a cough for 2 weeks or more, loss of energy and appetite and quite often a mild fever. Who is most at risk of contracting TB? People living with HIV/AIDS Living in the same house as someone who has had or has TB Anyone who has had active TB in the last two years Those with diabetes Residents of informal settlements Children under five The undernourished Alcoholics and smokers Mineworkers Prisoners Pregnant women Can you have TB and not be sick? TB can be ‘latent’, in other words it’s in your body but not active and therefore you not capable of spreading it. However, if your immune system becomes weak, the TB can become active and you become ill. Having HIV/AIDS is a key factor in the TB epidemic which is why it is so important that the people living with HIV are screened and treated. How is TB diagnosed? Diagnosis of TB is quite complex since many symptoms can be quite similar to those of other common lung diseases. South Africa has moved towards more intensive and active methods of identifying cases, for example by screening all those attending primary health clinics. TB testing and treatment is free. The Mantoux Tuberculin Skin Test (TST) and blood tests do not differentiate between latent and active TB which means a sputum sample needs to be taken or a chest X-ray. Treating TB TB is definitely treatable. However, medication must be started as soon as possible, and it must be taken regularly – as per the instructions. Also important is to finish the course of medication. It takes six months for TB to be cured completely but, within 2 weeks of starting treatment, the person will no longer spread the disease. Treatment must be completed. If treatment is missed, the risk of a drug resistant strain of TB is possible, which is difficult to treat and requires a longer treatment period. How can TB be prevented? People on TB medication must complete their treatment, this prevents the spread of TB Cover your mouth and nose when coughing or sneezing Wash hands with soap and water Immunise of all babies at a clinic within 1 year of birth Keep your body healthy by eating balanced meals and exercising Stop smoking Keep your windows open in your home if living with someone with TB – fresh air blows the TB germs away and sunshine kills the TB germs. TB in the workplace If any employees display TB symptoms, they should stay home and limit contact with others as much as possible until the results from a TB test are known. Once a person has been on TB treatment for 2 weeks, they are no longer infectious and can continue to work.

March 20, 2024

Pregnancy, your body and your baby – week 10 of your pregnancy

At week ten, you are officially a quarter of the way through your 40-week pregnancy with only a few more weeks left of trimester one. In your first trimester, you won’t look it but your body will have gone through many changes to accommodate your growing baby. This trimester its particularly important to keep taking prenatal vitamins containing folic acid as your babies spinal tube and organs develop. Your baby at week 10 Your little baby is now the size of a strawberry and is now referred to as a fetus and not an embryo. She is growing rapidly inside you and is slowly started forming bones and ligaments, their little arms and legs are slowly becoming more functional and your baby’s jawbone is also started developing. Nerves are starting to form in their spine and her kidneys are starting to function. Your body at week 10 At week ten your baby bump may be starting to show, but it may be a few weeks before your family and friends notice or you decide to tell anyone. Because of your slowly growing baby belly, it may be a good idea to invest in your first few items of maternity wear, as pants that are too tight around your waist is an added discomfort that you shouldn’t have to deal with. You’ll still be managing a variety of pregnancy symptoms, from morning sickness to frequent urination. You may still be struggling with fatigue, but thankfully this pregnancy symptom should lessen in your second trimester. Things to keep in mind Week ten (between week 10 and 12) is roughly the time that you would choose to have your baby genetically tested. Genetic testing isn’t required but it is a good option to consider so that parents-to-be are alerted to potential genetic disorders before birth. A genetic test is particularly important if you have hereditary genetic problems in your family, or if you and your partners are carriers for a particular disorder.

March 15, 2024

Pregnancy, your body and your baby – week 9 of your pregnancy

At week 9 of your pregnancy, you’re probably more aware than ever of your growing baby inside of you, as the first two months of pregnancy are now behind you. You may be dealing with a variety of different pregnancy symptoms as your baby slowly grows bigger. Your baby at week 9 At 9 weeks in, your baby is looking more human, with mini arms and legs developing, and the tail which was initially present is slowly disappearing. Your baby is now the size of a grape or a cherry and her facial features are also becoming more prominent. At week nine your baby is also becoming more active and beginning to move around. However, you won’t be able to see or feel this just yet – but it’ll be visible on ultrasound. If you’re struggling with painful breasts, a maternity or sports bra can offer you more support and help alleviate some of your uncomfortableness. When your body becomes more used to your pregnancy hormones, it’s likely that some of your pain may ease, but throughout your pregnancy, it’s a good idea to find clothes that you feel comfortable in. How you’re feeling at 9 weeks At nine weeks you may be feeling a variety of emotions, alongside the many other pregnancy symptoms, such as morning sickness, which peaks at around week 9. Your symptoms may be particularly difficult to deal with if you’re still keeping your pregnancy quiet from your colleges and friends, but if you are struggling emotionally open up to your partner or health care provider. Things to keep in mind At this point, it may be a good idea to chat to your doctor about possibly restructuring your exercise routine. It could be a good time to start incorporating prenatal yoga or pilates as these activities help you get ready for labour and childbirth. Staying active is also a great way to keep healthy during your pregnancy, but depending on what activities you did before getting pregnant, you may need to think about adjusting your training program.

March 8, 2024

Pregnancy, your body and your baby – week 8 of your pregnancy

It’s week 8 of your pregnancy and your baby is beginning to look more like a little human. You’ll probably be feeling many of the first-trimester pregnancy symptoms but you shouldn’t be showing just yet, so enjoy your flat figure while it lasts! Your body at week 8 Even if you don’t outwardly look pregnant, you’re definitely feeling it. Your first trimester brings morning sickness (not just in the morning!), tender breasts, fatigue, pregnancy cramps and a heightened sense of smell. Dealing with morning sickness and fatigue its important that you remember to stick to a healthy lifestyle. Eating well, exercising often and trying to make sure you get enough sleep. It’s important that you take prenatal vitamins during this time as well. Where your baby is at Your baby is now roughly the size of a bean or a raspberry. They are becoming more distinctly human, developing arms and legs. Their digestive system also develops around this time. If you get an ultrasound you may notice that your baby has a disproportionate body, with a large head – this is because the upper body develops faster than the lower. However, in 32 weeks time, your baby will be a normal-sized little-human. Things to remember Your first prenatal check-up around this time, where you may have blood tests and an early ultrasound to check your baby’s growth and heart rate. If you have lots of questions for your doctor it is a good idea to write them down, so you don’t forget when you arrive – especially if this is your first pregnancy. During the first trimester, you are at higher risk for a miscarriage. It is estimated that 1 in 8 women experience miscarriages, often before they realise they are pregnant. Signs of a miscarriage are cramping and pain in the lower back and abdomen, as well as light spotting to heavy bleeding. If you suspect miscarriage, it is important that you contact your doctor so that they can help you during this time.

March 1, 2024

World Hearing Day

World Hearing Day is an annual event organised by the World Health Organization (WHO). Held on 3 March, it’s a global campaign to raise awareness around the prevention of hearing loss and the importance of hearing health and ear care. To help create more awareness, Bonitas Medical Fund is offering free online hearing screening for all South Africans, over the age of 18. Hearing loss is an under-diagnosed medical condition that significantly impacts the physical and mental health of those who have any degree of hearing difficulty. Disabling hearing loss is often called the ‘invisible epidemic.’ It affects more than three million South Africans and over 1.5 billion people globally. With the theme ‘Changing mindsets: Let’s make ear and hearing care a reality for all!’ World Hearing Day emphasises the significance of early identification and interventions in preventing hearing loss. Hearing is vital in that it connects individuals to their surroundings, enabling communication, learning and social interaction. Yet millions of people, worldwide, face hearing challenges which can impact their quality of life. Free online hearing test ‘Last year we partnered with hearConnect and introduced a free online hearing screener for members on our website,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘Through this partnership we have extended this functionality and made it available to all South Africans.’ How it works The online, validated, speech-in-noise hearing test, uses the latest in audiological technology combined with the highest standards of clinical expertise. Go to https://www.bonitas.co.za/hearing-screening and, in just two minutes, you can test your hearing status. All you need is access to a computer or your mobile, headphones or earphones, a quiet area and then you’re all set to take the test. Post the test If the screening test indicates you are experiencing hearing loss, hearConnect is available to guide you through the next steps. Alternatively, make an appointment with an audiologist, consult your GP and/or visit the nearest clinic. What causes hearing loss? Hearing loss can come about as you age or as a result of loud noises, illnesses and disease, genetics and trauma (contact sport). Other factors, such as too much earwax, also reduce your ability to hear. Hearing loss repercussions One of the biggest concerns associated with hearing loss, when it is not treated properly, is the long-term impact it has on the quality of life. Prevention and early detection are important, after all, hearing is the foundation for speech and language development, as well as learning and communication. There are many challenges associated with hearing loss. These include language development that impacts our ability to read, write, spell and concentrate. It affects social skills resulting in isolation, depression, loneliness, cognitive impairment, unemployment and an increased risk of dementia. World Hearing Day underscores the need for accessible and affordable hearing care services and encourages everyone to prioritise their hearing health. ‘As a medical scheme we know that patients with untreated hearing loss experience more inpatient stays compared to those without hearing loss,’ says Callakoppen. ‘There is a 17% increased risk of emergency department visits, readmissions and rate of hospitalisation as well as longer hospital stays. ‘Our partnership with hearConnect includes a full audiology benefit management programme on selected plans for our members to ensure they maintain ear health. This includes a follow up with ongoing treatment steps if hearing loss is detected.’

March 1, 2024

Key facts about Cholera

South Africa had recorded at least 46 suspected cholera cases in the first month of 2024. According to the Minister of Health, three of these cases were due to cross-border travel. With these outbreaks making headline news, Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund has put together eight key facts about cholera. Researchers have estimated that each year there are around 1.3 to 4.0 million reported cases of cholera, resulting in between 21 000 to 143 000 deaths. However, general consensus is that this is under-estimated because of low reporting and limited laboratory services. What is Cholera? Cholera is an acute diarrhoea disease caused by the bacterium Vibrio cholerae. It can either be mild or without symptoms or severe and life-threatening if left untreated. Who is at risk? The highest at-risk populations are more often in underdeveloped countries where poor sanitation and inadequate hygiene practices contribute to its spread, especially in areas with limited access to clean water and proper sanitation facilities. Cholera can be endemic or epidemic. A cholera-endemic area is where confirmed cholera cases were detected but not brought in from somewhere else. A cholera outbreak/epidemic can occur in both endemic countries and in countries where cholera does not regularly occur. How is it spread? It is primarily spread through contaminated water and food. Ingesting water or food contaminated with faeces containing the bacterium can lead to infection. It is not likely that cholera is spread directly from one person to another. What are the symptoms? The symptoms of cholera typically include profuse watery diarrhoea, vomiting, and dehydration. In severe cases, rapid fluid loss can lead to electrolyte imbalances, muscle cramps and shock. Without prompt treatment, severe dehydration can be fatal within hours. How long before you show symptoms? It takes between 12 hours and 5 days for a person to show symptoms – which could include acute watery diarrhoea with severe dehydration. How serious is it? According to the World Health Organization (WHO) only around 25% of infected persons become symptomatic. Of these, 10 – 20% experience severe disease. How do you treat Cholera? Cholera can be effectively treated with rehydration therapy, which involves replacing lost fluids and electrolytes. This can be orally – in non-severe cases – or via intravenous fluids for more severe cases. Antibiotics may also be prescribed to shorten the duration of illness and reduce the severity of symptoms. Immediate treatment in an outbreak is essential which is not always the case in poverty -stricken areas. Can you prevent Cholera? Yes, you can, it involves improving sanitation and hygiene practices, ensuring access to clean water, and promoting proper food handling and preparation. Measures such as boiling, filtering or treating water with chlorine tablets can help reduce the risk of contamination. Additionally, practising good hand hygiene, especially before eating or preparing food, can help prevent the spread of the disease. A global strategy on cholera control was launched in 2017: ‘Ending cholera: a global roadmap to 2030’, had a target to reduce cholera deaths by 90% as well as timely access to healthcare services during outbreaks. Remember, your GP should be your first port of call for all your healthcare needs. Bonitas believes there needs to be coordination of care and encourages you to see your GP who can refer you to a specialist or auxiliary provider as and if the need arises.

February 28, 2024

Talking about HPV and cervical cancer

The theme for 2024 Cervical Cancer Awareness is, ‘Learn. Prevent. Screen.’ South Africa has a high rate of cervical cancer which has been attributed to the fact that not enough women are screened regularly. Screening can detect early changes in the cervix, which can be treated and may save your life. Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund, gives the low down on cervical cancer – caused by persistent infection with the Human Papillomavirus (HPV), why it is essential to screen for the virus and the development of a vaccine to help prevent it. Why a vaccine against HPV? HPV infects the cells of the cervix and, in some cases, the virus can persist – leading to abnormal changes in the cells that may eventually become cancerous. Over 99% of all cervical cancers are caused by persistent infection of high-risk types of HPV, including HPV-16 and HPV-18. ‘For this reason, we have expanded our preventative care benefits to include the HPV vaccine across all plans, to help prevent cervical cancers,’ says Dr Hadebe. ‘As recommended by The World Health Organization (WHO), this is 2 doses for females aged 9 to 14 years and 3 doses for females aged 15 to 26 years per lifetime’. Screening for HPV and cervical cancer Screening is also essential to mitigate the risk of developing cervical cancer. Screening aims to identify cervical cell changes and detect early cervical cancers before they cause symptoms. Two screening tests help with detection: Pap test (Pap Smear) Cervical cancer is usually a slow-growing cancer that may not have immediate symptoms but can be found with regular pap smear tests (a procedure in which cells are scraped from the cervix and looked at under a microscope). The test looks for cell changes (pre-cancers) in the cervix that may progress to cancer if not treated. HPV test Looks for the virus, particularly HPV-16 and HPV-18 that cause 90% of cervical cancers. It is recommended that between the ages of 21 and 65, women should have a pap smear every two years and, from the age of 30 onwards, a pap smear and HPV test can be done every 5 years. Signs and symptoms The symptoms of the HPV virus can include: Lesions on the genital area as well as darker lesions on other parts of the body, to painful bumps on your upper limbs and skin growths on the balls of the feet and heels. Staging of cervical cancer Just like other cancers, cervical cancer is graded according to the severity. From in situ, which means it hasn’t spread to nearby tissue, through stage one: It’s still in the original organ and is small. If it progresses it spreads to the surrounding lymph nodes and, in the most severe form, the cancer has metastasized to surrounding tissues and other lymph nodes. As cervical cancer develops, the following may occur: Abnormal bleeding, for example bleeding after sex Pelvic pain unrelated to the menstrual cycle Heavy or unusual discharge Increased urinary frequency Pain during urination ‘Cervical cancer is the most prevalent cancer among women after breast cancer,’ says Dr Hadebe. ‘Yet it has a good chance of being cured, if diagnosed at an early stage and treated promptly. Which is why, it’s important to have regular pap smears to detect any changes in the cervix and to vaccinate young girls to protect them against possible HPV infection.’

February 26, 2024

Pregnancy, your body and your baby – week seven of your pregnancy

By now you probably know that you’re pregnant, but some moms only find out during this week or later. Even if you haven’t started looking outwardly pregnant, there is a good chance you’re definitely feeling it, with the likes of fatigue and morning sickness. Your baby is going rapidly day-to-day, with continued brain and body development for the next 33 weeks. Where your body is at This week you’ll likely be feeling some or all of the symptoms generally experienced during the first trimester of pregnancy. It’s important throughout your pregnancy that you maintain a healthy lifestyle, even if doing so feels tough at times. Eating the correct foods and taking prenatal vitamins will ensure that your baby gets the correct nutrients from you. It is important to remember that during pregnancy your needs will change, so you should keep this in mind when tailoring your diet. Miscarriage and ectopic pregnancies are both serious complications that can happen during early pregnancy. Miscarriage is the spontaneous loss of the foetus before week 20, unfortunately, this is not reversible and is usually due to abnormal development. Ectopic pregnancy often shows around 7 weeks and is when the fertilised egg implants outside of the uterus. Unfortunately, neither complication can be reversed, and losing a baby early in pregnancy is likely to be very traumatic for the mom-to-be and family. It’s important that you seek medical and psychological support if you are struggling post ectopic pregnancy or miscarriage. What your baby is doing Your baby is now the size of a blueberry but is shaped more like a tadpole than a human, however, their tail is getting smaller and will soon disappear. At this point, your baby has continued to develop limbs, facial features, spinal cord and lungs, heart and kidney.

February 19, 2024

Pregnancy, your body and your baby – week six of your pregnancy

Week 6 of your pregnancy At week 6 of your pregnancy you’ll most likely know that you’re pregnant now, although some mom’s realise as quickly as 3 weeks or as late as 12. Every week your body is changing to accommodate for your growing little one. Your body at 6 weeks 6 weeks in and you may be experiencing a range of pregnancy hormones. One of the most common and challenging first trimester pregnancy symptoms is morning sickness, although these waves of nausea can strike at any time. It is important to eat bland foods little and often. Even though this nausea may be uncomfortable to deal with, it’s nothing to worry about unless you can’t keep any food down throughout the day. Fatigue is another unpleasant aspect of pregnancy that you may have started experiencing in your first trimester. Napping often, letting others take over some of your chores and work, as well as keeping hydrated are ways in which you can help yourself. Your pregnancy fatigue may be worse during your first and third trimesters. Exercise and a healthy diet are also important (at this point and throughout your pregnancy) and you’ll probably be able to do most of the exercise you’re used to – just stay away from anything heated (such as heated yoga) or high risk. Your baby at 6 weeks Your baby is now the size of a pea, still tiny enough that you won’t be able to spot a tell-tale pregnancy bump. Your uterus has begun expanding to accommodate your new baby, and may have started pressing down on your bladder (que the frequent urge to use the bathroom). Inside you, your baby is starting to look more like a little human, and her eyes, nose, ears as well as limbs have started slowly forming. Liver, kidneys and lungs are also starting to take shape.

February 12, 2024

10 ways to manage your medical expenses

‘As you begin 2024 with a clean slate in terms of medical aid benefits, it’s a good time to look at ways to manage medical expenses,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. Here are 10 tips to empower yourself in managing medical expenses. Designated Service Providers (DSPs) and networks Healthcare costs in South Africa are generally unregulated which means providers are free to charge any tariff. ‘Using DSPs and hospital networks means that favourable tariffs for members have been negotiated,’ explains Callakoppen. ‘Using networks also means you can reduce or eliminate co-payments.’ Tariffs and rates of payments The Scheme Rate is the amount a scheme will pay for specific treatments and procedures. However, 100% of the scheme rate doesn’t necessarily mean 100% of the account will be paid. Ask for a quote from your practitioner and/or hospital ahead of any procedure. If there is a major discrepancy, try and negotiate an adjusted fee. The value-add benefits Make use of the free wellness screening and testing offered by your medical aid. There has been an intensified drive to detect, prevent or manage various chronic conditions as well as vaccinate against potential diseases and conditions. ‘After completing an online wellness questionnaire or a wellness screening, you are able to access the ‘Benefit Booster’ providing access of up to R5 000 in additional funds to use for out-of-hospital expenses.’ The Bonitas ‘Be Better Benefit’ includes an annual wellness screening, per beneficiary, to check blood pressure, blood glucose, BMI and cholesterol. It’s about being on the right path to good health and wellness. Other benefits include Flu vaccines, HIV tests, lipograms, mammograms, prostate screening, pap smears, pneumococcal vaccines, whooping cough boosters, HPV vaccines, stool tests for colon cancer, dental fissure sealants, online hearing screenings and contraceptives. Ask your pharmacists Ask your pharmacists for over-the-counter medications for less serious illnesses. Pharmacists are able to provide sound medical advice about problems like rashes, colds or illnesses that are not severe. Also use generic medications where possible. A generic’s active ingredient or drug content is identical but is between 30% and 80% cheaper. Managed Care The prevalence of Non-Communicable Diseases (NCDs) has been increasing year-on-year, so have mental health issues, which is a risk factor for NCDs and vice versa. For this reason, it is important to make full use the Care programmes your medical aid offers. ‘At Bonitas we offer support for NCDs through a range of Care programmes including Audiology, HIV/AIDS, cancer, diabetes, mental health, back and neck, hip and knee replacements as well as hospital-at-home.’ Remember to pre-authorise Pre-authorisation is required for all hospital admissions, out-of-hospital screenings and procedures. Always ask if there are any co-payments or sub-limits that will apply and how to avoid these. For planned procedures, make sure you use a DSP or check whether the procedure can be in the doctor’s rooms or a day clinic. Be aware of consulting after hours Be careful about using after-hours consultations or emergency rooms unless it’s absolutely necessary. In a bona fide medical emergency, one has no choice and this usually results in admission to hospital. Manage your chronic medicine correctly The golden rule for chronic illness benefits is to try to use the medication on the scheme’s formulary and to obtain this from a specified pharmacy, either on the network or a DSP. PMBs Make sure you understand what is covered under Prescribed Minimum Benefits (PMBs) and to use a DSP to ensure that claims are paid from risk, not from your medical savings account. Gap Cover Gap Cover is designed to cover the difference or part of the difference between what the medical scheme pays and the service provider charges for in-hospital procedures/treatment and specified outpatient procedures. Ensuring you ‘work smarter’ with the benefits and medical expenses during the year, is a win-win situation for your health and pocket.

February 7, 2024

Pregnancy, your body and your baby – week five of your pregnancy

Week five of your pregnancy is the week that many women find out that they are pregnant. You’ll notice the skipped period and your pregnancy test will come out positive, you’ll also start to notice some pregnancy symptoms if you hadn’t already. Your body at 5 weeks pregnant This week you’ll notice pregnancy symptoms, and this is just the beginning of a huge number of changes you’ll feel taking place in your body. At this point your pregnancy hormones will probably be affecting you, making you feel nauseous, your breasts tender. You could also be experiencing spotting and cramping, as well as frequent urination and cravings. The pregnancy hormone, human chorionic gonadotropin (hCG), is responsible for many of these changes, and this hormone is why your test shows up positive. Not only will your body physically change, but you’ll probably be dealing with mental changes as well. No only can your changing hormones cause your moods to fluctuate, but finding out you’re pregnant can also be an emotional experience. Remember any emotions are valid, even if you’re feeling overwhelmed and confused, as opposed to excited. If you’re struggling it’s important to reach out to those around you or seek professional help. Your baby at 5 weeks pregnant Your baby is now roughly the size of orange or apple seed and her tiny face is already starting to form, even though she looks more like a tadpole than a human. During this time your baby’s neural tube is developing – this will become their spine and brain – which is why folic acid is so important at this point. Folic acid taken daily reduces the risk of spinal tube defects. By 5 weeks your little one’s heart will have also started beating. If your pregnancy is healthy, you won’t be having an ultrasound before 8 or 9 weeks of pregnancy, so it’ll be a few more weeks before you get to see your baby.

February 5, 2024

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