Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Bonitas 2022 contributions continued for 2023!

Bonitas Medical Fund, one of the leading medical schemes in South Africa, announced its 2023 product line up today. Lee Callakoppen, Principal Officer of Bonitas says, ‘Our average increases for the year would have been 5.9% – well below the current inflation rate of 7.6%. The good news is that we’ve put a price freeze on contributions for the first quarter of 2023, to offer our members some respite. This effectively means an increase of 4.8% over the 12 months. We have also shared exactly what members can expect to pay from 1 April 2023, so that they can make informed decisions. Bonitas celebrated its 40th anniversary this year and has evolved and expanded its capabilities over the past four decades in response to the needs of a growing membership base. ‘It’s always a delicate balancing act between keeping increases as low as possible while maintaining the stability of the Scheme,’ says Callakoppen. ‘The guidelines, set out by the Council for Medical Schemes (CMS) in Circular 44 of 2022, requested medical schemes to keep contribution increases for 2023 below CPI. However, over the past decade medical scheme contribution increases have outpaced inflation by around 4%. We are delighted to have kept these well below CPI itself. In fact, by applying very low contribution increases since December 2020, the Scheme has effectively passed R1.4 billion in savings back to members. And, with the challenges we’ve seen recently in the healthcare industry, we know that promoting sustainability is key. So, we’re happy to boast excellent financial indicators from high solvency ratios, strong reserves and a high claims-paying ability. Not only is the Scheme financially sound with over R7.4 billion in reserves but, over the last 36 months we have signed up 190 000 new members. This figure is significantly higher than the size of most schemes in the industry. Even better for sustainability is that the average age of our new members is around 15 years younger than the current membership. It reinforces the fact that we are succeeding in attracting a younger, healthier profile, which is coveted across the industry. The future of healthcare is anchored on primary and preventative care as well as sustaining well-being, as opposed to responding to illness. One of the key healthcare trends is the rise in non-communicable or lifestyle diseases, such as diabetes, high blood pressure and cancer. 80% of these conditions are caused by lifestyle risk factors which is why we offer a range of Managed Care programmes aimed at assisting members understand and manage their conditions. Cancer care Cancer prevalence is one of the key concerns facing South Africans and is increasing year on year. Last year, we announced our partnership with the South African Oncology Consortium – the largest network of oncologists in the country to enhance the offerings of our cancer programme including screening for early detection, treatment and palliative care. For 2023 we have restructured benefits to be unlimited for PMB cancers, on all options. Diabetes The latest data from the South African Health Quality Assessment, shows that Bonitas has an effective disease management programme and better outcomes than the industry standard for diabetic members, with improved metrics for Hb1Ac, statins and cholesterol. But, as we always look for ways to improve, we are proud to introduce a benefit of R51 000 per family per year for an insulin pump or continuous glucose monitor for type 1 diabetics over 18 years. Mental health We are pleased to announce that we’ve introduced an innovative new digital solution, called Panda, to support our members in managing their mental wellness. Panda, a free to download app, offers everything from audio sessions with peers and mental health experts to one-on-one virtual consultations with mental health professionals. We encourage our members to complete a mental health questionnaire in the Bonitas Member App to assess their mental health status. Panda will be available from October 2022. Benefit Booster Launched last year, the Benefit Booster was one of the most innovative changes to hit the medical schemes industry and aimed at supporting our preventative care strategy. It unlocked R446 million in additional benefits for members to extend their day-to-day benefits. For 2023, we’ve opted to adjust the benefits limits in line with utilisation with enhancements seen on several plans. Designated Service Provider (DSP) We implement networks to negotiate the most favourable tariffs for our members so they can avoid out-of-pocket expenses and get more value. These networks are carefully selected to maintain high levels of healthcare, aligned with our brand promise of providing quality healthcare. We have restructured our options to include a wider hospital network component. In 2023, 85% of our members will be within a 30km radius of a network hospital – with a presence across all nine provinces in line with the footprint of our member base. This includes a GP network of over 4 400 of the most efficient practices in the country, an extensive pharmacy network, with around 2 500 practices to dispense chronic, acute and over-the-counter medicine through Scriptpharm. Our dental network, through DENIS, is one of the largest on the continent – providing access to around 3 000 practices while our optical network through PPN gives members access to over 2 300 practices. Medicine formulary We have aligned our medicines formulary to the WHO’s Essential Medicines List (EDL) to promote affordability and accessibility to clinically approved medicines, in support of Universal Health Care and promotion of medicine adherence for our members. Hospital-at-home The technology-enabled Hospital-at-Home service brings all the essential elements of in-hospital care to a patient’s home, without moving away from evidence-based clinical protocols and state-of-the-art 24hr vital sign monitoring. 1 200 members have used the offering to date – equating to around 6 000 days in hospital. We are extending the offering to include: A programme for re-admissions, screening and disease prevention, alternative to stepdown facilities and kidney dialysis at home. Savings We’ve amended our rules to allow members to use their savings as they deem fit for

September 30, 2022

Essential check-ups for women

Non-communicable diseases (NCDs), known as lifestyle diseases, pose some of the biggest threats to the health of South Africans. They are a result of the way we live, combined with genetic, physiological, environmental and behavioural factors. The most common are hypertension (or high blood pressure), diabetes and obesity. It is imperative to have regular or annual check-ups. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, offers advice about these tests and others specifically for women. Weight and BMI Almost 70% of women in South Africa are overweight or obese. The Body Mass Indicator (BMI) is used to check if you are a healthy weight. To calculate your BMI: Divide your weight in kilograms (kg) by your height in metres (m) Then divide the answer by your height again Good to know Underweight <than 18.5 Normal weight 18.5 to 24.9 Overweight 25 to 29.9 Obese 30> Diabetes With over 4.6 million people in South Africa living with diabetes, it’s important to check your blood glucose. There are two main types of diabetes: Type 1 and Type 2. They are different conditions but are both serious and need to be treated and managed properly. One of the biggest problems with diabetes is when it remains undiagnosed. This can lead to blindness, heart attackstroke, kidney failure, impotence and amputation so it’s vital to be checked. Blood pressure Hypertension (high blood pressure) is when blood pressure stays elevated over time. It is often referred to as the ‘silent killer’ since nearly 33% of people who have it, don’t know it. If your blood pressure is too high, it puts extra strain on your arteries (and your heart) and if it’s not treated, hypertension can cause kidney failure, eye problems and heart disease. Good to know Range Normal 120/80 to 129/84 Upper end of Normal 130/85 to 139/89 Mild hypertension 140/90 to 159/99 Moderate hypertension 160/100 to 179/109 Severe hypertension More than 180/110 Besides testing for these three main NCDs, Dr Mkhatshwa also advocates specific checks for women. A Mammogram From the age of 18 you should do regular self-examination of your breasts, if you see or feel any changes, consult your doctor immediately. Early detection increases the chance of survival and can save your life. Some doctors recommend having a mammogram, every two years from the age of 40, others believe you only need to start at 50 years of age. A mammogram is a low-dose X-ray which radiologists analyse to look for changes in breast tissue. Although the greatest risk for breast cancer is age, women can get breast cancer from a very early age. Cervical cancer South Africa has a high rate of cervical cancer, this 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 save your life. Screening includes: Pap test (pap smear) which looks for cell changes (pre-cancers) in the cervix that may progress to cancer if not treated. The Human Papillomavirus (HPV) test. Looks for the virus that causes most cervical cancers It is recommended that between the ages of 21and 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 A vaccine has been developed to protect women from getting HPV. It is administered free of charge, annually, to girls between Grade 4 and 7 (9 to 12 years of age) in all government schools. The HPV vaccination can be a cost-effective strategy in lowering the cervical cancer risk among women in South Africa. Bone Density As you age, your bones become thinner and weaker. Over time this can lead to a condition called osteoporosis. If you’re aged 65 or older a bone density test is recommended. Called a DEXA scan, the frequency of this screening varies depending on your bone density and other risk factors. Your doctor may suggest you have this test earlier if you: Broke a bone in the past Have taken steroids for a long time Have rheumatoid arthritis Are underweight Have a parent who has broken a hip after a minor injury Treatment for osteoporosis is available – usually the first choice is Bisphosphonates. Colorectal Cancer Screening These tests look for cancer in the colon or rectum by checking for tissue growths, called polyps. If you don’t have an elevated risk for cancer, then you should start having these tests when you turn 45. A colonoscopy, where the doctor looks at your entire colon, should be done every 3-10 years depending on what is found during your exam. A Faecal Immunochemical Test (FIT) should happen annually. The FIT is also a screening test for colon cancer which tests for hidden blood in the stool, which can be an early sign of cancer. Skin Checks Skin cancer is caused by the abnormal growth of skin cells – usually on the skin that has been exposed to the sun but not always. There are three major types of skin cancer: Basal cell carcinoma, squamous cell carcinoma and melanoma. Examine your skin carefully at least once a month and, if you are prone to getting lots of moles, go to a dermatologist and have the mole ‘mapped.’ If skin cancers are found early and treated, they are almost always curable. If you have a history of skin cancer in your family have your skin checked regularly by a doctor. Remember early detection of any of these conditions can save your life, so remember to go for regular check-ups with your doctor.

August 19, 2022

ASTHMA

Asthma is one of the most common chronic illnesses, affecting over 339 million people worldwide. According to the World Health Organisation (WHO), asthma kills around 1 000 people every day and the prevalence is rising. South Africa is ranked 25th worldwide for asthma prevalence and is ranked fifth for asthma mortality. The lack of appropriate diagnosis, treatment or access to care may be important considerations in tackling asthma morbidity and mortality in South Africa. What is asthma? Asthma is one of the most common respiratory complaints in the world where your airways – known as bronchial rubes – become inflamed. This swelling or inflammation makes the airways extremely sensitive to irritations and increases their susceptibility to an allergic reaction. In an allergic reaction, the airways swell and the muscles around the airway tighten, making it difficult for air to move in and out of the lungs. It affects approximately one in 10 children (10%) and one in 20 adults (5%) and can occur for the first time at any age, even in adulthood. Although asthma usually begins before the age of five, a few children affected will ‘outgrow’ it during their teenage years but it usually persists if contracted in adulthood. Asthma tends to run in families, as do related allergic conditions like hay fever and eczema Signs and symptoms Asthma is often under-diagnosed and under-treated. If you fail to recognise and avoid triggers that lead to your tightened airways, you may have an asthma attack, feel respiratory distress or experience a life-threatening situation. So, it’s important that you know how to avoid the triggers and recognise the signs of this condition to enjoy a better quality of life. Symptoms can range from mild to more serious depending on the severity of the illness but include: Coughing that does not subside and gets worse at night Wheezing Shortness of breath Tightness or pain in the chest What causes asthma? The exact cause of the asthmatic process is not well understood but it is thought to be triggered off by an allergy or when the lungs are irritated by something in the air. Research shows that the risk facts are a combination of genetic predisposition and environmental exposure to inhaled substances and particles that may cause allergic reactions or irritate the airways. These include indoor allergens – such as dust mites and pet dander in the home, outdoor allergens – such as pollen and mould as well as tobacco smoke and air pollution. Other triggers can include cold air, stress or physical exercise. Certain medications, such as aspirin and other non-steroid anti-inflammatory drugs and beta-blockers (which are used to treat high blood pressure, heart conditions and migraine) can also set off an asthma attack. Factors associated with asthma prevalence or disease severity in South African children include the adoption of an urban lifestyle, atopy (a genetic predisposition),obesity, respiratory infection, or exposure to industrial pollution or tobacco smoke. Treating asthma Asthma can be life threatening when left untreated and cannot be cured but, with the right treatment most asthmatics will lead completely normal lives. The aim of treatment should be to make the lungs and breathing tubes as normal as possible so that there are minimal symptoms and as little disruption to ordinary life as possible. Get help Bonitas Medical Fund says, ‘If you are experiencing asthma symptoms or think you might have asthma, it is important for you to talk to your GP. This will help you establish if your symptoms are linked to asthma or whether something else is causing them.’

August 8, 2022

Dealing with Postpartum Depression – plus ways to deal with mental health after pregnancy

As a new mom, the birth of your baby is a beautiful and exciting time, but there is a darker side to childbirth. Postpartum depression affects about 15% of moms after delivery, and while it is a serious disorder it can be overcome through treatment. What is Postpartum depression? Feelings of anxiety, sadness and fatigue are common after birth and are often referred to as the ‘baby blues’ and should subside within the first two weeks. However, if these feelings stick around for longer, you could be experiencing postpartum depression. Restlessness, mood swings, insomnia, irritability, disconnection from your baby and feeling of worthlessness are all red flags for postpartum depression. Some moms feel guilty or ashamed to be feeling this way, however PPD can affect any woman. Don’t be afraid to reach out for help, as PDD is treatable through both medicated and unmedicated options. What should I do if I have the symptoms of Postpartum Depression? The good news is that PPD is treatable. There are a variety of common types of treatment, which depend on the type and severity of symptoms. Treatment can include counselling, therapy groups, antidepressants and hormone therapy. Self-help groups can be helpful, as it allows you to connect with others who have experienced similar problems and stop feelings of isolation. Recovery time will also vary from mother to mother, but untreated the disorder will last much longer and can interrupt mother-child bonding. Getting help does not mean you are a bad mother, it is important to reach out if you are feeling depressed. Postpartum Psychosis In rare cases moms can develop postpartum psychosis. This should be treated as a medical emergency, and it is essential that you receive help right away. Symptoms include paranoia, delusion and erratic/disorganised behaviour. How to deal with mental health after pregnancy Your mental health is critical to you and your child’s well-being. If you are worried about PPD it is important to get professional help. However, you can help your mood by slowly getting back into exercise, setting aside time for yourself and leaning on those around you for support. It is important to stay connected to family and friends so that you don’t feel alone.

July 8, 2022

A partnership to bring help to those who need it most

When you’re looking for positive, purposeful, swift action in a time of crisis there’s one organisation you know you can rely on. The Gift of the Givers Foundation is always ready to step in when needed, getting on with the job at hand with the minimum of fuss but with maximum results. ‘The Gift of the Givers needs no introduction,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘The organisation continues to go beyond the call of duty to bring humanitarian aid where needed. It has built its reputation on the principles we, as a corporate citizen, also value: Respect, care, professionalism and dedication. Their swift and problem solving response in the face of any disaster – be it a pandemic, fire, flood, earthquake, tsunami or war – is to be highly commended. And we are proud to announce that Bonitas will be partnering with them for the year ahead.’ For 30 years this extraordinary, non-governmental disaster response organisation has been responding to global challenges, in an effort to bring hope, life and restore dignity to the most vulnerable of people. Gift of the Givers primary focus is disaster response but other key areas of assistance include hunger alleviation, water provision, healthcare, education and social upliftment. Headed up by medical doctor, turned humanitarian, Dr Imtiaz Sooliman, Gift of the Givers has repaired and restocked hospitals, run clinics, sunk boreholes, dug wells, provided food and shelter to millions … and so much more. And, more recently, during the Covid-19 pandemic, KZN riots and water shortages in the Eastern Cape, the NGO brought relief to those who needed it most. ‘Our association with Gift of the Givers goes back a few years when we supported various projects on an ad hoc basis. However, recently we reassessed and realigned our CSI strategy to be in sync with our mantra: ‘A Medical Aid for South Africa’,’ says Callakoppen. ’This means us investing in the social upliftment of South Africans. And who better to partner with than this leading philanthropic organisation. The Bonitas values align with that of the Gift of the Givers and we look forward to working with them to provide relief to the most vulnerable and marginalised communities, specifically in the field of healthcare interventions.’ ‘We joined Bonitas as our medical scheme in 2019,’ says Dr Sooliman. ‘We worked with our financial advisors to find the most appropriate scheme and plan for our staff and have been impressed with their service, professionalism and how the member always comes first. As a paypoint for the Fund, we interact with the team regularly and, through these interactions, have realised there is synergy in our ethos. This led to us working alongside them on selected projects but we are thrilled they are formalising a partnership with us.’ Sooliman says the private sector plays a vital role in helping the organisation fulfil its humanitarian vision. ‘By working in partnership with like-minded and committed corporate partners, we have the ability to make a real difference in the lives of some of the most vulnerable people across South Africa, throughout Africa and the world.’ ‘We have handed over an initial R500 000k that will be used for healthcare related disasters,’ says Callakoppen, ‘However, additional funding has been set aside for specific healthcare related projects, such as hospital revamps, that are close to the hearts of both the Fund and Gift of the Givers.’ ‘I have been fortunate to meet Dr Sooliman on a few occasions and he has engaged with our Bonitas Board,’ says Callakoppen. ’It was humbling to learn more about the healthcare interventions they have put in place, the impact these have had and also just how much they can achieve in a day. He is passionate about the work they do and has a solid belief in the common humanity that unites us. This resonates throughout the organisation, leading with integrity and honesty. We look forward to the lessons we will learn while working alongside them on future projects.’

July 7, 2022

Stretching your medical aid benefits

Everyone is feeling the pinch and looking for ways to stretch their budget. This is true of healthcare too, especially when it comes to medical cover. It’s important to manage your medical expenses if you want your benefits to last. The smart move is to know what your plan offers and what you can do to avoid unnecessary out-of-pocket expenses. That way you can save money while managing your health. Lee Callakoppen, Principal Officer of Bonitas Medical Fund, give us some tips on how you stretch your medical aid benefits. Understand your plan and what it offers Knowledge is power and when it comes to medical aid this is especially true. Firstly, it’s important to make sure you have chosen the right plan for your healthcare needs. If you’re battling to make a decision, consult an independent broker. Brokers are accredited by the Council of Medical Schemes so are qualified to offer advice and support and there’s no extra charge for this service. Then, read through the plan you’ve selected and understand all the benefits, limits as well as any additional rules, regulations or added value benefits. Use DSPs or networks Using network doctors, specialists, hospitals or Designated Service Providers (DSPs) is essential if you want to make your medical aid last longer. It means you won’t be charged more than the negotiated preferential rates. Remember this includes knowing your scheme’s key providers, such as which ambulance to call in an emergency. Not using a DSP can result in a co-payment or non-payment for the service. Ask your pharmacist Consult your pharmacist for advice on over-the-counter medicine and/or switching to generic medicines. Using generic medicine, which has the same active ingredient, strength and dosage as the original brand but is less expensive, helps save costs. In addition, consider using a clinic or nurse practitioner to get your blood pressure screened, for your flu vaccination and other primary healthcare concerns – this saves on the consultation fee charged by your GP. Managed Care benefits Most schemes offer programmes to help you manage chronic conditions such as cancer, diabetes, HIV/AIDS and back and neck problems. These programmes are usually covered from the risk portion of your medical contribution and are not funded from your savings account. They help you use your benefits to maximum advantage while ensuring you receive quality care by using specific providers. Other benefits – such as maternity consultations, wellness benefits, preventative care and dentistry – are also paid from risk by some schemes. Again giving you more value for money and are in addition to your savings and day-to-day benefits. Boosting your benefits Carefully read through what your plan offers – especially when it comes to enhanced benefits – and choose wisely. Remember, not all additional benefits are equal. For example does your plan cover childhood vaccines from risk? If so, this is a saving of thousands of Rands, especially in the first 18 months of life This year, Bonitas invested R446 million in additional benefits through a benefit booster which is available on all plans, including the hospital plan (but excluding BonCap). Members tap in by completing a wellness assessment (which can be done online) and then have access to additional benefits which range from R940 and R2 730 (depending on the plan) to cover expenses such as: GP and specialist consultations Acute and over-the-counter medicine Biokineticist and physiotherapist consultations and treatment Paramedical services Alternative healthcare X-rays Blood tests Go virtual Look out for telemedicine or virtual consultation options which are around 60% cheaper than an average consult. A doctor will engage with you in a virtual video consultation on a medical issue and advise you on the most clinically appropriate steps for further care. Be inquisitive, ask questions Ahead of any procedure, in or out of hospital, ask the right questions. Check that your healthcare provider is on your scheme’s network in order to secure a better rate. Unless the procedure is an emergency, you will need to get pre-authorisation. At the same time, request a quote so you know, upfront, what the costs will be and whether you will be covered or if you are being expected to make a co-payment. If so, negotiate. Stay healthy With Non-Communicable Diseases (NCDs) or lifestyle disease fast becoming a pandemic in South Africa, it’s important to take care of your health by eating correctly, getting enough sleep, exercising and reducing your stress levels. ‘Health is the new wealth,’ says Callakoppen. ‘Your health is important, as are your finances, don’t take either for granted. When it comes to healthcare cover, invest time in researching and understanding the medical aid plan you’ve selected. Read the information sent to you, including the fine print to understand the Scheme Rules. If in doubt, phone the call centre, your broker or financial advisor. This will go a long way in helping you know your rights and making the most of your benefits.’

June 30, 2022

Advice from the experts

Are our children spreading the Coronavirus?

While there are widespread reports that children experience milder symptoms and suffer fewer complications from the coronavirus than adults, paediatricians are warning that the issue is much bigger than previously thought. “It seems that the number of children infected with the virus in South Africa is higher than what we believe it is. While it is true that children do not seem to be as adversely affected as adults by the virus, we are seeing a large number of children who are asymptomatic, and this is worrying because they could be spreading the virus,” cautions Dr Iqbal Karbanee, paediatrician and CEO of Paed-IQ BabyLine,a trusted telephonic medical advice service for the first 1000 days of a child’s life, starting from conception to birth and beyond. Data suggests that children under the age of 18 years represent about 8.5% of reported cases, with relatively few deaths compared to other age groups. News reports are now suggesting that children may also be more susceptible to the new strains of the virus, without serious consequences. However, there is very limited data available on the number of children who are asymptomatic. “This is why it is important for children to practice social distancing and hand-washing, even if they do not appear ill, as they can pass the disease on to family members, or others,” says Karbanee. People aged 60 and older or with existing health conditions remain the most vulnerable to the coronavirus. That includes people with conditions such as high blood pressure, diabetes, cancer, cardiovascular disease and chronic respiratory conditions. Dr Karbanee says that there have also been few pregnant women who have had complications as a result of the virus, and those who have had the virus have gone to have babies who have been fine. But should pregnant women consider getting the vaccine? “If you are a high risk patient and pregnant, I urge you to consider taking the vaccine, provided that you have discussed it with your doctor,” says Dr Karbanee, adding that high risk includes being overweight, being diabetic or having a lung disease. He says that, given the risk of complications from COVID-19 should a mom-to-be a high risk patient, the vaccine offers a relatively safe guard against the Coronavirus. “The vaccine is not a live virus-based vaccine, unlike the Polio vaccine for example. This vaccine is made from a protein extract from the virus, which, when you get exposure to it, lowers your risk of getting extreme symptoms. There have been very few side effects recorded by those who have taken the vaccine.” Karbanee says that each case should be seen on its individual merits and if pregnant women are concerned, they should discuss their worries and the possibility of getting the vaccine, with their doctor and medical team.

April 22, 2021

World Meningitis Day – clearing the myths and misconceptions

World Meningitis Day falls on 24 April and this year’s theme is TakeAction #DefeatMeningitis.1 Meningitis is an inflammation of the membranes around the brain and spinal cord.2 Because of the severity of meningitis and the fact that the disease can take a loved one’s life in under 24 hours1, the World Health Organization has approved a Global Roadmap to defeat meningitis by 20301. Invasive meningococcal disease (IMD) is caused by a bacterium which can lead to more serious manifestations, including meningitis and septic shock.3 p2,3 Although uncommon in South Africa, IMD is a devastating illness that largely affects young children.4 p80 If left untreated,severe long-term consequences can include deafness and brain damage leading to severe cognitive and functional problems, and in the case of septic shock, can include limb amputations.3 p3 According to Dr Nasiha Soofie, Medical Head at Sanofi Pasteur Vaccines: “When someone has IMD the most important thing is to act fast. Any delay in diagnosis and treatment claims lives and leaves many others with serious lifelong after-effects.” Unfortunately, not many people are aware about the disease, and symptoms can be confused with those of other diseases like the flu, malaria or COVID-19.1 “Because IMD most often affects children younger than 10, especially infants, the problem lies in the fact that these younger children are not always able to let you know when they are not feeling well and they can’t clearly communicate what symptoms they are experiencing,” says Dr Soofie. “These facts are all the more tragic, since IMD can be prevented by immunisation. The best way to protect your family is to make sure they are vaccinated. The meningococcal conjugate vaccine protects against four types of Meningococcal bacteria and is recommended for all infants and children,” says Dr Soofie. The vaccine can be given along with other childhood immunisations, and can also be used during pregnancy after first having a risk assessment and consultation with a healthcare professional. 5 p85f Saving a life is as easy as ensuring that you are aware of the signs and symptoms. Here are a few myths and facts about IMD that you should be aware of.6 Myth: IMD is easy to diagnose.6 Fact: IMD is often misdiagnosed as something less serious, because early symptoms are similar to flu and other common viral illnesses.6 Symptoms may include some combination of high fever, headache, stiff neck, confusion, nausea, vomiting, exhaustion, and a purplish rash.6 Myth: IMD is only dangerous in young children.6 Fact: While it is most common in infants younger than one, anyone can get IMD6. Also, adolescents, students and others who live in dormitories, and other young adults are at increased risk of getting IMD compared to children and older adults.6 Myth: Meningococcal vaccines can cause meningococcal disease.6 Fact: It is not possible to get IMD from vaccination6. Side-effects from vaccines are generally mild and uncommon, and may include redness or swelling at the site of injection which can last up to two days6. Meningococcal vaccines protect against the death toll and severe complications caused by IMD.6 Myth: Healthy adolescents and young adults don’t have to worry about getting IMD.6 Fact: IMD is rare, but the risk of getting it increases in adolescents and young adults6. The disease can progress rapidly, killing an otherwise healthy individual in 24–48 hours.6 Myth: Meningococcal disease is spread by casual contact with an infected person, such as shaking hands.6 Fact: Meningococcal meningitis is spread through air droplets and direct contact with an infected person6. It is not spread through casual contact.6 “The COVID-19 pandemic has resulted in some people missing their immunisations – and the number of IMD cases is expected to rise when people are able to gather in large groups again,” says Dr Soofie. Vaccination is recommended, especially for people at higher risk of IMD.5 p83L This includes people with a damaged immune system, healthy infants, young children attending creche and school children, university students, army recruits and others living in crowded conditions.5 83m “It’s often said that vaccines save lives, but this is not strictly true – it is vaccination that saves lives.7a It is imperative that a high level of vaccination coverage is achieved in those populations where they are recommended.7b This will provide protection for both the individual who is vaccinated, as well as for the communities they live in,7c” says Dr Soofie. This World Meningitis Day, take action to #DefeatMengitis. Speak to your doctor or pharmacist for further information about optimal protection against this devastating disease. Live Webinar event: For those wanting to learn more about meningitis, Sunday Times Connect in partnership with Sanofi Pasteur, will be holding a livestream event on Wednesday, 21 April from 13h00 – 14h00. To be part of the live webinar, register here: https://arenaevents.africa/webinar-registrations/world-meningitis-day-vaccination-and-meningococcal-meningitis/

April 14, 2021

Vaccines and the way forward

Bonitas Medical Fund, gives an update on Covid vaccines and how the Fund is positioned for the rollout to its members. Various scenarios have been presented regarding the speed of propagation of the third wave – the worst assumption is that it will be twice as fast as the second wave. The best case scenario is that the virus is 50% more transmissible than the second wave. Regardless, the urgency for the roll out of the various phases of the vaccination programme is undeniable. Unfortunately private procurement of the vaccine is currently prohibited but as procurement is opened to other entities, we will take every step to ensure we have access to vaccines for our members. We want to mitigate the risks of them contracting Covid-19 as well as getting seriously ill or dying, which is why we are working behind the scenes to ensure we are ready to roll out the vaccine to our eligible members. Medscheme (Bonitas’ administrator) is engaged and collaborating with the Department of Health (DoH), Business for SA, Board of Healthcare Funders (BHF) and various industry stakeholders in order to assist with the rollout from Phase 2. We are also in the process of requesting accreditation to set up private vaccination centres. This will ease access for our ‘at risk’ members and provide a broader footprint, including remote areas of the country. Our over 10 000 members, who are healthcare workers, have already started the vaccination programme in Phase 1. There are around 72 000 members who are classified as ‘Essential/Congregate workers’ and 185 000 high risk members who are either over 60 or have comorbidities. We intend beginning the Phase 2 rollout as soon as the vaccine is secured. The latest information on South Africa’s procurement of vaccines is that there are: 11 million doses of Johnson & Johnson (J&J) 20 million doses of Pfizer BioNTech A further 20 million doses of the J&J is being negotiated. This would be sufficient to cover the targeted 37 million adults in SA Through collaboration with one of our partners, Afrocentric Health, we will be able to administer up to 150 000 vaccinations per day. We are all familiar with the 3 Phase roll out plan as outlined by the DoH but there remains uncertainty about some definitions such as an essential worker – outlined in Phase Two: Essential workers, persons in congregate settings, persons over 60-years and persons over 18-years with comorbidities. The DoH announced from the onset that healthcare workers would be vaccinated in Phase 1. Phase 2’s priority group would include essential workers, persons in congregated settings, persons 60 years and older and persons over 18 with comorbidities. However, it has since been announced that, as a result of a shortage of the acquisition of vaccinations, these groups will be adapted in order of priority. As it stands on 8 April 2021 (subject to change), these groups include the following: Phase 2 Priority Group Definition Essential workers Teachers, police officers, miners, workers in security, retail food, funeral, banking and essential municipal and home affairs, border control and port health services Persons in congregate settings People in prisons, detention centres, shelters and care homes. In addition people working in the hospitality and tourism industry and education insititutions are also at risk Persons 60 years and older Persons older than 18 years with comorbidities Persons living with HIV, TB diabetics, chronic lung disease, cardiovascular disease, renal disease, obesity, etc What we have done is to ensure we know, upfront, who our high risk member population is and, once Phase 2 commences, we are able to ensure that all those who want to be vaccinated, will be. Together with our administrator, we have set up various processes to ensure we are able to achieve this goal to ensure peace of mind for our members.

April 14, 2021

Woman’s Health

Birth Control Side effects of birth control pills The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. If you have just started taking birth control pills you may experience a headache, dizziness, breast tenderness, nausea, breakthrough bleeding, mood changes or other side effects. Be patient, these side effects often go away after a few months. If they don’t you may want to talk to your doctor about your options. Some positive effects of taking birth control are lighter (and sometimes fewer) periods, milder menstrual cramps, and improved acne. Consult your doctor if you have questions about what type of birth control is right for you. Women’s Nutrition Unsaturated fats: the good, the bad and the uglyThe following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. There are two types of unsaturated fats, polyunsaturated fatty acids and monounsaturated fats. Polyunsaturated fats are found in most vegetable oils, flaxseeds and walnuts as well as in fatty fish such as salmon, and mackerel. Monounsaturated fats can be found in olives, avocados, hazelnuts, almonds, Brazil nuts, cashews, sesame seeds, pumpkin seeds, and olive, canola, and peanut oils. Both kinds of unsaturated fats may help lower your cholesterol and reduce your risk of heart disease. The bad fats, saturated and fatty acid fats should only be eaten on occasion. Lactose intolerant: the solution for getting your daily calcium intakeThe following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Lactose Intolerant? Scared of not getting enough calcium? Don’t worry; you can get calcium from eating foods that don’t contain lactose. These foods contain calcium, but are dairy free: Broccoli Leafy greens Canned salmon &sardines with edible bones Almonds Oranges Pinto Beans Tofu and soymilk Calcium-fortified breads Calcium fortified juices. Risks in Women Urinary tract infectionsThe following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. If you are experiencing a burning sensation when you urinate, or feeling the need for frequent urination, leaking a little urine or cloudy, dark, smelly or bloody urine you may have a urinary tract infection. To avoid getting a urinary tract infection: Drink plenty of water to flush out bacteria Don’t hold your urine when you need to go Wipe from front to back after a bowel movement Try to urinate after having sex to wash away bacteria Do not use feminine hygiene sprays and douches, which may irritate the urethra and possibly begin a case of urinary tract infection Try vitamin C supplements which increase the acidity level of your urine which helps decrease bacteria Wear cotton panties or underwear Breast cancer prevention The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Although you should have a mammogram and clinical breast exam every 1 to 2 years if you are 40 and older, there are ways to examine your breasts in between visits. This helps you become familiar with your breasts and breast tissue, so you are more likely to notice any changes over time. Women may start doing self-breast exams any time after the age of 20. Here are the steps: Look at your breasts in the mirror for any abnormal changes in colour, size or shape. While lying down or taking a shower use the pads of your fingers to press firmly into your breast and move your fingers in a circle around the whole breast. Check for any abnormal lumps or changes. By limiting the amount of alcohol, you drink, maintaining a healthy weight, staying physically active, and limiting the bad, saturated fats in your diet you may lower your risk of breast cancer. Heart attack warning signs and prevention The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. If you feel pressure or tightness in your chest, pain that goes from your chest into your jaw and/or left arm, or shortness of breath, you may be experiencing a heart attack. The most common symptom for both men and women is in fact tightness or pain in your chest; however, women are somewhat more likely to experience other common symptoms, specifically shortness of breath, nausea or vomiting, and back or jaw pain. Smoking, high cholesterol, high blood pressure, lack of exercise, stress and obesity are all risk factors for a heart attack. Quit smoking; exercise and maintain a healthy diet and weight to help decrease the risk. Also, talk to your doctor about whether aspirin could help reduce your personal risk of a heart attack. Aspirin may help keep your blood from forming clots that could eventually block arteries in the heart, causing a heart attack. Stroke warning signs The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. A stroke is a blood clot or a break in an artery that interrupts blood flow to part of the brain. Some symptoms of a stroke could be sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; and sudden trouble walking, dizziness or loss of balance. If these symptoms occur, get emergency medical help immediately. Act F.A.S.T if someone you know is experiencing signs and symptoms of a stroke. F. (Face) Ask the person to smile to see if one side droops.A. (Arms) Ask the person to raise both arms to see if one drifts downward.S. (Speech) Ask the person to say a sentence to see if their words are slurred and to see if they

April 9, 2021

IS PLASTIC SAFE FOR BABY?

Why you should be using eco-friendly baby products… Did you know that plastic is not only polluting our oceans, but scientific research has shown that it may even have detrimental effects on the health and development of our children? Exposure to phthalates, found in plastic, can impair brain development and has shown increased risks for child learning, attention and behavioural problems1. A recent global study of plastic toys has identified over 100 chemicals that may cause harm to children2. Millions of microplastic particles are also said to be released from polypropylene (plastic) baby bottles into baby formula during preparation 3. With so many negatives associated with plastic and more and more telling research published in the last decade, we really wonder why there is still SO MUCH plastic being sold and used by the little humans amongst us. Plastic bottles, plastic dummies, plastic teethers, plastic toys, plastic food storage containers and even plastic (synthetic) clothing… So what can we do? Although still a small community, parents are becoming increasingly aware of the plastic problem and wanting to make a change. They choose eco-friendly options because there are in fact many plastic alternatives available for baby and toddler: WOOD It’s as easy as going back to basics – before plastic, all our grandparents’ toys were made of wood. There are several wooden toy manufacturers in operation today and new companies are continually being established due to their recent increase in popularity. Wood is by far the most common eco-friendly choice for toys, games, puzzles, furniture and room decor. High quality woods are best, that are raw or untreated, or have a non-toxic finish like water-based stains or an organic coating like coconut oil. SILICONE The newest trend in the baby market is all things silicone: bowls, plates, spoons, storage containers, teethers and toys. This is because silicone is extremely durable and long-lasting; it’s also dishwasher, freezer, oven and microwave safe – making for easy parenting. The majority of silicone baby products are made of food-grade silicone that is BPA, BPS, PVC and phthalate free; in other words non-toxic and a great eco-friendly option. Some silicone baby bottles are however advertised as eco-friendly, but may be infused with polypropylene (plastic). BAMBOO Most commonly found in wash cloths, towels, swaddle blankets, bedding, cloth nappies, baby wipes and clothing. It is softer than cotton muslin, hypoallergenic, antibacterial and therefore the better choice for sensitive baby skin. You can also find bamboo items like baby drinking cups, plates, bowls, forks and spoons. Many of them however are not 100% organic because a plastic resin (although in small amounts) is sometimes needed to keep the bamboo fibres together to give it durability. COTTON The most familiar material used to make natural baby clothing, baby wipes, cloth nappies, swaddle blankets, bedding, towels, wash cloths and soft toys. Often advertised as 100% organic cotton or mixed with bamboo fibres – 70% bamboo, 30% cotton muslin. The benefits of using cotton fabric are similar to bamboo, making cotton ideal for sensitive baby skin. It is also more eco-friendly than synthetic fabrics like polyester, nylon, spandex, chiffon, fleece and satin; all of which contain plastic. Other eco-friendly alternatives for plastic include GLASS (baby bottles), WHEATSTRAW (dining sets and utensils), NATURAL RUBBER (baby bottle teats, dummies, teethers and toys) and RATTAN (the coolest new trend for natural baby furniture, decor and some toys). With so many eco-friendly options available for baby and toddler, parents can be reassured that they are able to raise their little ones in a non-toxic world, while building a plastic-free future. We hope you enjoyed our article. If you need help with natural parenting, visit our online shop at https://www.ecoella.co.za or follow us on social media (@ecoella.and.friends). References: Engel et al. (2020). Neurotoxicity of Ortho-Phthalates: Recommendations for Critical Policy Reforms to Protect Brain Development in Children. AJPH. https://doi.org/10.2105/AJPH.2020.306014 Aurisano et al. (2021). Chemicals of concern in plastic toys. Environment International. https://doi.org/10.1016/j.envint.2020.106194 Li et al. (2020). Microplastic release from the degradation of polypropylene feeding bottles during infant formula preparation. Nature Food. https://doi.org/10.1038/s43016-020-00171-y

April 8, 2021

The puzzle that is Autism

Autism, is currently referred to as Autism Spectrum Disorder (ASD) although people with ASD themselves consider Autism a neurodiversity rather than a disorder. Almost 2% of the world’s population is diagnosed as being on the Autistic spectrum. “Spectrum” because some people appear to be mildly affected and others profoundly so. Since each person is an individual and presents differently, the diagnostic process involves a number of professional assessments to identify strengths and areas of difficulty. Neurodiversity is not anyone’s fault and the causes of Autism are continuously being researched. There is no link whatsoever with vaccine treatments and the diagnosis of ASD. There does appear to be a genetic link, but the genes are not necessarily passed down from parents, since some genetic differences occur spontaneously. Autism can be understood from a medical perspective, as a condition with symptoms that can be improved but not cured, or from a more relevant social perspective, as an alternate way in which the world is experienced. It is not a sign that a person is ‘stupid’, defiant, sick, selfish, crazy, flawed or weird. All people are unique and that is why there are a number of professionals involved in the diagnosis. Paediatricians are perfectly positioned to follow a child’s developmental progress and although Autism isn’t fixed and changes over time, they may be the first professionals who detect neurodiversity in a child. Often paediatricians will refer their patients to other professionals if they detect a difference or delay in the child’s development. Parents can be overwhelmed by the process and feel isolated, but it’s important to remember that this team of professionals is there to support the entire family. Parents may also benefit from speaking to other parents in similar situations. A psychiatrist may assist with high levels of anxiety, attention difficulties, poor sleeping patterns, worries and extreme emotional fluctuations commonly experienced in Autism. There is no medical cure for Autism however prescribed medication is often helpful in reducing these difficulties. A psychiatrist will often refer their patients with Autism to a psychologist, to facilitate an understanding of Autism with the whole family and assist them to address difficulties with acceptance, emotional responses, behaviour and self-expression. People with Autism DO feel emotion and empathy but may battle to communicate those feelings. Psychologists are often also responsible for administering educational testing, to determine existing academic levels and potentials, for correct school placement. Success at school is largely dependent on the learner’s innate cognitive ability boosted by a support team and up-skilled educators. People with Autism often experience the sensory information in their environments differently to the way in which neurotypical people do. This has an impact on the way they behave in different environments and situations, as well as on their emotional resilience and well-being. This is why extremely picky eating; a strong need for predictability and structure; and specific skill sets and interests are often associated with Autism. Occupational therapists are a vital element in the team supporting children with Autism in this regard. The way in which sensory information is processed can fluctuate throughout the day, as well as from one situation to the next. Common responses for children with Autism include either “shutting down” and withdrawing from or avoiding engagement, or “melting down” and having temper tantrums or emotional outbursts and parents and teachers should understand and support this necessary ‘escape’. Neither of these is misbehaviour, but rather an instinctive response to the environment and the way in which sensory stimuli are being perceived. e.g. in a noisy chaotic place, noise reducing earphones may minimise the overload The use of Ayres Sensory Integration® in occupational therapy sessions goes a long way to helping children and adults with their ability to process the sensory information in their environments, thereby facilitating optimal function in daily activities whether they be daily hygiene activities, learning/work activities and/or social activities. A visual schedule at home and school is helpful for the child to anticipate what is coming during the day since people with Autism like predictability and structure and are thrown by unexpected changes in their routine. Occupational therapists can also provide support with motor and visual-perceptual development should this be required. Communication is another significant aspect to consider in the diagnosis of Autism. A speech therapist will support the development of communication skills for developing and maintaining relationships. Often more subtle aspects of communication are missed by a communication partner with Autism e.g sarcasm, facial expression, body language and tone of voice, leaving the person with ASD confused and excluded. While they may be able to define sarcasm for example, they may not realise when it is being used. Parents and teachers may need to point out social cues that have been missed. Fluctuating auditory perception and difficulty starting, maintaining and following a conversation can lead to communication breakdown. This is not necessarily related to the child’s understanding of the topic of conversation so rewording may be necessary. Learners with Autism favour facts and brevity over figurative and inferential information, impacting on academic comprehension and output, and social interaction. People with Autism are not deliberately rude but are to the point, often without an awareness of how their communication is perceived so it may be beneficial to discuss the effect of their own communication on others. Social norms are not always innate in neurodivergent children and adults. They may incessantly discuss a subject of their own interest and pay no attention to their conversation partner’s interest or disinterest in what is being said. Reciprocity in conversation may also be limited, leaving the listener with a sense of frustration and annoyance, shutting down opportunities for socialisation and relationship building. A speech therapist would encourage awareness and understanding of communication behaviours to minimise linguistic, social and emotional misunderstandings. Academic support teachers are the touchstone between learners with Autism, their specialist team and the school setting. They facilitate recommendations from the team to the school and vice versa to maximise the learning potential and happiness of the

April 7, 2021

How to support a child diagnosed with autism spectrum disorder: tips and strategies

After receiving an autism spectrum disorder (ASD) diagnosis, it can be overwhelming for the parents or caregivers of an autistic child to cope with the various challenges ASD may present. However, with the appropriate support structures and strategies in place, caring for an autistic child can become more manageable. Also read: Autism 101 – what is it and what should you look for? Support strategies for managing ASD Many autistic people are likely to experience communication difficulties, especially difficulties with social communication and understanding other people. Autistic children are also easily frustrated and made upset by unexpected events. Often, these feelings of frustration lead to intense meltdowns, and parents can help alleviate such feelings and prevent breakdowns by having support strategies in place. Prepare for future events Autistic children may become easily overwhelmed by minor changes in routine. Parents and children can benefit from preparation for the day’s or week’s events. Parents also need to ensure that structure and routine are upheld in the household so that the child knows exactly what to expect. Make use of visual aids Visual aids can assist autistic children in improving their skills in processing information, understanding and using language, and becoming more interactive within their environments. Visual aids can be used to communicate with autistic children to inform them of what is happening at present, what will happen during the day, and what will happen during the coming days. Examples of how to use visual aids include: Showing the child a picture of relatives who may visit Showing them photos of the dentist or doctor before a visit Creating a picture chart with the steps to follow when using the bathroom or getting dressed in the morning Not only are visual aids helpful for communicating information to autistic children, but they also help ensure that autistic children are well-informed of daily events. When children are informed, the likelihood of intense meltdowns is significantly reduced. Avoid sensory overload Sensory overload is commonly found in autistic children and is a contributing factor to meltdowns. Sensory overload means that autistic children may sometimes experience certain sounds, textures, tastes, lights, and sensations as painful and intolerable, which may lead to a meltdown. Parents can try to prevent a sensory overload by identifying their child’s specific trigger(s) and reducing the number of triggering stimuli in the environment. It may be helpful to reduce loud noise and avoid bright lights. Ease children into public spaces Trying to reduce noise and avoid bright lights is often impossible in public spaces like shopping malls or grocery stores. That is why it is essential to ease a child into visiting public spaces by starting with preparation using visual aids and very short visits. Once a child can manage a short trip, gradually increase the time of the visit. The same strategy can be used when visiting friends, family, or relatives. Autistic children may develop an attachment to a particular item, for example, a toy or a blanket. It may help to bring this item along when going into public spaces because it gives the child a sense of familiarity and comfort, which may help keep the child calm for the duration of the trip. Plan ahead when eating at restaurants Visiting a restaurant can be challenging for an autistic child. To make the outing manageable for a child, it may be helpful to do the following: Make a reservation at the restaurant ahead of time Visit restaurants during their quieter hours Request seating in a booth away from the play areas or bathrooms to reduce sensory stimulation Pre-order meals Request the bill before dessert to prevent the child from getting frustrated with waiting Additionally, parents should request permission to bring the child’s favourite food along, as some autistic children have very specific dietary preferences. Try rewards charts Some autistic children exhibit defiant behaviour, and, therefore, it is crucial to utilise strategies to encourage compliance. One strategy that can be used at home and at school to achieve cooperation is a rewards chart. Also read: How to reward your kids the right way Since many autistic children often have very particular interests, it is vital to ensure that the rewards chart is meaningful and appealing. For example, if a child has an intense obsession with a particular superhero, the rewards chart should incorporate that infatuation to gain a child’s interest and, consequently, compliance. When trying to encourage compliance from autistic children, parents are advised to provide as much praise as necessary and to reduce such praise gradually as children exhibit increased cooperation. Take care of yourself Lastly, parents are very often the primary caregivers of autistic children. To be able to give to others, your cup cannot be empty. It is, therefore, crucial that parents attend to their needs and mental wellbeing such that they are well-equipped to face the challenges that accompany caring for an autistic child. Parents should make time for self-care and join support groups to draw social support to prevent feelings of isolation they sometimes experience. Although the challenges are present, they do not make parenting any less rewarding. By implementing tips and tricks in your daily life, caring for an autistic child may become more manageable. by Dr Jeanné Roux – educational psychologist

April 1, 2021

15 Facts about the Covid vaccine

Although the vaccine rollout for healthcare workers has begun, myths and misinformation continue to circulate around its development, efficacy and just how the vaccine will help manage or mitigate the spread of the virus. We asked Lee Callakoppen, Principal Officer of Bonitas Medical Fund for 15 facts about the vaccine. #1. How does the Covid-19 vaccine work? The Covid-19 vaccines produce protection against the disease by developing an immune response to the SARS-Cov-2 virus. The vaccine stimulates an immune response to an antigen, a molecule found on the virus and provides a supply of ‘memory’ T- and B-lymphocytes that help fight that virus in the future. There are four types of Covid vaccines and they are all trying to achieve the same things: Immunity to the virus, reduction of symptoms if you are infected and being able to slow down or stop transmission. South Africa is currently using the Johnson & Johnson (J&J) single dose vaccine but, regardless of which vaccine you receive, you won’t reach full protection until around two weeks after the vaccination. Your immune system needs this time to develop the antibody response. #2. It is safe? Yes. The vaccine that is being used in South Africa is safe and has been given to millions of people around the world. Although it was developed very quickly to save lives, it has gone through the same rigorous processes as other vaccines. All medical products – including the Covid-19 vaccine – have to be approved by South African Health Products Regulatory Authority (SAHPRA) before they can be administered. #3. Are there any side effects? Some individuals vaccinated with the J&J vaccine have experienced temporary, mild side effects. They are similar to those experienced with other vaccines, such as soreness at the injection site, muscle pain, chills and a headache. Some also experienced fatigue and nausea. These are nothing to worry about and will disappear within a couple of days. #4. Can you be allergic to the vaccine? People who are prone to allergies should inform the healthcare personnel administering the vaccine beforehand. This, in order for them to observed and monitored for a longer period after receiving the vaccine. However, if you experience a severe allergic reaction after getting a Covid-19 vaccine, vaccination providers – or your healthcare provider – can provide care rapidly and call for emergency medical #5. Can you get Covid from the vaccine? No. None of the Covid-19 vaccines contain the live virus that causes the coronavirus. The J&J vaccine uses a harmless, modified form of the common cold virus in humans, called adenovirus. The vaccine will help your immune system fight the virus but will not infect you with it. #6. How effective is it? No vaccine is 100% effective but fortunately, the emerging data on Covid-19 vaccines have a high efficacy, at least against some of the variants. If a vaccine has 70% efficacy, it means a person vaccinated in a clinical trial is around two-thirds less likely to develop the disease than someone in the trial who didn’t receive the vaccine. Due to the severity of the virus, a 50% efficacy threshold was set for Covid-19 vaccine. #7. Am I forced to have the vaccine? No. Having the Covid-19 vaccination remains a personal choice as confirmed by President Cyril Ramaphosa. #8. Do I need the vaccine if I have already had Covid-19? Yes, the advice is that you should still be vaccinated even if you have had Covid-19 or if you have a positive antibody test. Research indicates that the natural immunity from having Covid does not last which means the best way of fighting the virus is a combination of being vaccinated and following the protocols. #9. Will I be immune after the vaccine and will this be forever? It is too soon to know how long the vaccine will last as it is still being researched. Of the people who have received the vaccine, we know that they have been protected from Covid-19 for at least 4 months. The risk of Covid-19 infection in vaccinated people cannot be completely eliminated. #10. Can you have the vaccine if you are pregnant or breast feeding? None of the vaccine trials included pregnant individuals, so direct knowledge is limited. However, the Centres for Disease Control and Prevention (CDC) as well as a number of other medical organisations agree that any of the currently authorised Covid-19 vaccines can be offered to people who are pregnant or breastfeeding. #11. Is it safe to be vaccinated if I’m living with HIV/Aids? Yes. There is some evidence that people living with HIV may be more vulnerable to developing severe Covid-19 symptoms and so getting vaccinated is even more critical if you are HIV positive. The Covid-19 vaccinations are the most powerful tools available to help prevent severe disease due to SARS-CoV-2. The vaccines are not live and are safe for people with compromised immune systems. It’s too early to tell how effective the vaccines will be at reducing transmission of Covid-19, but we do know that they are effective at preventing severe disease and death. #12. What does herd immunity mean? Herd immunity occurs when a large part of the population becomes immune to a virus, through vaccination or infection. South Africa’s Department of Health (DoH) is aiming to vaccinate 67% of the country’s population against Covid-19 – this equates to around 41 million people – to achieve herd immunity and slow down the rate of transmission of the virus. #13. How does the vaccination process work? Everyone over the age of 18 will be vaccinated in line with the Government’s Covid-19 vaccine roll out plan. You have to be registered on the national Electronic Vaccination Data System (EVDS) and then a 3-phase approach (starting with healthcare workers) is being adopted to ensure there will be enough vaccines to meet the demand. #14. Can you elaborate on the EVDS? The EVDS is based on a pre-vaccination registration and appointment system. Individuals have to

April 1, 2021

Making your medical aid benefits last

Around 9 million South Africans are members of medical aid schemes to ensure they have access to private healthcare. As each new year begins, members start with a clean slate, with new benefits and replenished savings. However, across the industry, members often complain that their benefits seem to ‘run out’ early on in the year. If you manage your medical expenses correctly you can avoid out-of-pocket expenses and limit the possibility of running out of benefits. Here are 8 tips from Lee Callakoppen, Principal Officer of Bonitas Medical Fund, on how to stretch your medical benefits to maximise your value. 1. Use DSPs or networks Medical schemes negotiate preferential rates with providers – known as Dedicated Service Providers (DSPs) – who have partnered with them. This allows schemes to ensure that members get the best quality services at the most cost-effective rate so that benefits are optimised and the scheme at large is sustainable. Using network doctors is an invaluable tool to helping make your medical aid last longer because it means you won’t be charged more than the negotiated amount. With over 6 000 GPs, Bonitas has the largest network in South Africa 2. Ask your pharmacist Buy over-the-counter medicine to treat less serious ailments and always, where possible, use generic medicine which has the same active ingredient, strength and dosage as the original brands and are just as effective. Pharmacists are able to provide sound medical advice on problems such as rashes, colds or illnesses that are not severe, simply ask! 3. Managed Care benefits Some schemes offer programmes to help you manage severe chronic conditions such as cancer, diabetes, HIV/AIDS and back and neck problems These programmes are usually covered from the risk portion of your medical contribution and are not funded from your savings account. They help you use your benefits to maximum advantage while ensuring you receive quality care by using specific providers. Other benefits – such as maternity consultations, wellness benefits, preventative care and dentistry – are also paid from risk by some schemes. Again giving you more value for money and are in addition to your savings and day-to-day benefits. Carefully read through what your plan offers and choose wisely to make sure you find the right plan to suit your specific healthcare needs. 4. Go virtual Look out for telemedicine or virtual consultation options – which are cheaper. A doctor will engage with you in a virtual video consultation on any medical issue and advise you on the most clinically appropriate steps for further care. 5. Be aware of consulting after hours In an emergency one has no choice but be aware that after hours consultations are expensive. 6. Know the facts If you do need to be hospitalised and it’s not an emergency, ensure that the healthcare practitioner is on your medical aid’s DSP list. Talk to your doctor or specialist to find out all the facts in terms of what they will be charging and compare this to what your scheme will cover. If the difference is substantial, negotiate. Approach your doctor and ask if he/she is prepared to adjust their fee. Alternatively, you can also check if there are other healthcare providers on your scheme’s network that will charge you a better rate. You can also avoid the unwelcome surprise of a co-payment or sub-limits by: Making sure you obtain pre-authorisation Making sure the medical practitioner uses the correct ICD-10 codes Getting a quote from the doctor, hospital and anaethetist and submit it to your medical aid to see which additional costs will apply (if any), what costs will be covered and how you can avoid these. 7. PMBs If you suffer from a Prescribed Minimum Benefit (PMB) condition, understand what benefits are provided as part of PMB conditions and use the service of a DSP to ensure your claims are paid from risk rather than from your medical savings account. 8. Keep moving One of the best ways to manage your health and the associated costs, is to live a healthy lifestyle and this includes getting enough exercise. Try different exercise routines and find one that works for you. Whether it is a regular short power walk, playing tennis or soccer, riding a bike or attending a yoga or pilates class, it will be beneficial to your mental and physical wellbeing. ‘Be informed’ says Callakoppen. ‘Your health is important, as are your finances, so take the time to research and understand the medical aid plan you’ve chosen. Even if you have not changed plans your benefits and savings differ year-on-year. Make sure you read the information sent to you, including the fine print to understand the Scheme Rules fully. If in doubt, phone the call centre, your broker or financial advisor. This will go a long way in helping you know your rights and making the most of your benefits.’

April 1, 2021

Plant-based pregnancy

As the wife of ultra-endurance triathlete and Ironman Africa Champion, Kyle Buckingham, Lauren, knows a thing or two about needing to look after her body and keep energy levels high. So when Kyle made the move to a fully plant-based diet over a year ago, Lauren, followed suit and honestly believes that this is what has contributed to her feeling so amazing through the last 6 months of her pregnancy. “From the time I found out I was pregnant at 5 weeks, nothing had changed,” says Lauren. “I didn’t even feel pregnant until I went into my 2nd month, after which I had occasional afternoon nausea until I went to bed. And just as fast as that feeling started it stopped on the first day of my 3rd month!” “I am still working as a sports massage therapist, dealing with athletes on a daily basis which requires a lot of my energy and input, and then just getting on with my normal daily things. I have yet to experience a drop in energy and I am into my 6th month now!” So how has Lauren coped with any cravings she has had during the past 6 months? “I have only had one craving so far and thankfully that only lasted two weeks. All I wanted was a cheese sandwich dipped in tomato soup! I was able to change dairy cheese for a vegan cheese option which was great, it was the weirdest combo, but I loved it!” While Lauren and Kyle made the switch to a plant-based diet quite quickly for Kyle’s training, Lauren realises that this might not be as easy for others. “If you are thinking of moving to a plant-based diet, I would suggest starting with either replacing one meal a week or possibly having one day a week that is only plant-based,” explains Lauren. “That way you can slowly get used to the various options and see what works for you.” “Fry’s started Meatless Monday’s which is a great place to start, they also have a few tasty recipes on their website that are super easy to try out!” What has been the biggest advantage that Lauren noticed since being on the plant-based diet? “Energy levels, when I made the switch my energy levels never dipped and throughout my whole pregnancy so far I have not gained extreme weight!” Here are some of Lauren’s favourite recipes for you to try out! Versatile Veggie Chilli by: Jamie Oliver INGREDIENTS – 500 g sweet potatoes 1 level teaspoon cayenne pepper , plus extra for sprinkling 1 heaped teaspoon ground cumin , plus extra for sprinkling 1 level teaspoon ground cinnamon , plus extra for sprinkling olive oil 1 onion 2 mixed-colour peppers 2 cloves of garlic 1 bunch of fresh coriander (30g) 2 fresh mixed-colour chillies 2 x 400 g tins of beans, such as kidney, chickpea, pinto, cannellini 2 x 400 g tins of quality plum tomatoes lime or lemon juice, or vinegar , to taste METHOD + Preheat the oven to 200˚C/400˚F/gas 6. Peel and chop the sweet potatoes into bite-sized chunks, then place onto a baking tray. Sprinkle with a pinch each of cayenne, cumin, cinnamon, sea salt and black pepper, drizzle with oil then toss to coat. Roast for 45 minutes to 1 hour, or until golden and tender. Peel and roughly chop the onion. Halve, deseed and roughly chop the peppers, then peel and finely slice the garlic. Pick the coriander leaves, finely chopping the stalks. Deseed and finely chop the chillies. Meanwhile, put 2 tablespoons of oil in a large pan over a medium-high heat, then add the onion, peppers and garlic, and cook for 5 minutes, stirring regularly. Add the coriander stalks, chillies and spices, and cook for a further 5 to 10 minutes, or until softened and starting to caramelise, stirring occasionally. Add the beans, juice and all. Tip in the tomatoes, breaking them up with the back of a spoon, then stir well. Bring to the boil, then reduce the heat to medium-low and leave to tick away for 25 to 30 minutes, or until thickened and reduced – keep an eye on it, and add a splash of water to loosen, if needed. Stir the roasted sweet potato through the chilli with most of the coriander leaves, then taste and adjust the seasoning, if needed. Finish with a squeeze of lime or lemon juice or a swig of vinegar, to taste, then scatter over the remaining coriander. Delicious served with guacamole and rice, or tortilla chips. SERVE with rice and pappadums Chunky Veg Yellow Thai Coconut Curry INGREDIENTS Yellow or Green Thai paste 1 can coconut milk (extra if necessary) 1 medium onion, diced ½ red bell pepper, roughly chopped (bite size) ½ yellow bell pepper, roughly chopped (bite size) 3-4 mixed courgette, chopped bite size pieces 1 cup chopped butternut (bite size) 2-3 carrot chopped (bite size) handful chopped baby spinach leaves Flexitarian optional -Add strips of tofu or calamari METHOD Add oil and Thai paste to pan allowing paste to warm and release flavours. Add can coconut milk and mix with paste. Bring to a simmer. Add onion, butternut and carrots first until semi firm (15-20min) with lid to keep moisture in. Add remaining veggies except the spinach, simmer about 30 min or until all veggie are soft enough to eat but not soft enough to mash. Al dente. Add spinach and stir together until wilted. Add extra coconut milk, water or oat milk to top up the sauce. Add tofu or calamari strips to pan and simmer in coconut milk until turns white. SERVE with sushi rice and pappadums.

March 30, 2021

Autism 101 – what is it and what should you look for?

What is autism? Autism spectrum disorder (ASD) is a range of developmental disorders that impair a person’s ability to communicate and interact with other people. As the name suggests, ASD refers to a broad range of conditions characterised by a person’s challenges with social skills, repetitive behaviours, speech, and nonverbal communication. Despite ASD consisting of a range of conditions, there are no subtypes since ASD may present very differently from person to person, along with differences in presentation among genders. How does autism present? Every person will have a different set of strengths and challenges but still fall under ASD. People diagnosed with ASD may present with more mild symptoms, while others may present with more severe symptoms – such individuals require significant support to function in their daily lives. As aforementioned, the presentation of ASD may differ between people in both severity and characteristics. People with ASD may also differ in their level of intelligence, as some have average or above-average intelligence while others may have a learning disability and require assistance with daily functioning. Common characteristics of ASD Characteristics that have been noted with some typicality include: Challenges with communication and interaction with others; Difficulties in reading social cues (i.e. how others may think or feel); Challenges in expressing their thoughts and feelings; Sensory sensitivity (e.g. bright lights, loud noises, etc.) which causes these individuals to become overwhelmed, stressed, or uncomfortable; Repetitive behaviours; Becoming anxious, upset, or angered by unfamiliar situations or changes in routine; Taking additional time to process information. Verbal ASD challenges It is common for roughly 40% of ASD individuals not to speak at all, while between 25 – 30% of others will develop language skills. Some language and speech challenges may include: Delayed speech development; Using a flat, robotic voice or speaking in a sing-song manner; Echolalia; Difficulties with pronouns, i.e. using I/me/he/she/they incorrectly; Rarely using physical gestures; An inability to stay on topic. Behavioural ASD challenges Autistic people may also display or engage in behaviours such as: Repetitive behaviours; Specific rituals; Fixation on certain activities, objects, or topics; Constant pacing back and forth; Fussy eating habits (many ASD individuals have textural issues); Not participating in pretend play; Impulsiveness; Aggression; An inability to pay attention or a short attention span; Clumsiness. What causes ASD? Several factors may influence the development of ASD, but there is no known singular cause. There have been rumoured causes of ASD such as diet, infections, or vaccines; however, each of these has not been conclusively proven to cause ASD. Typical comorbidities include medical challenges such as gastrointestinal disorders, seizures or sleep disorders, and mental health challenges such as anxiety, depression, and attention difficulties. How to identify autism Signs of ASD typically appear by the age of two to three years. Some children present with developmental delays as early as 18 months. In other rarer cases, ASD may be picked up by caregivers and teachers only later in the person’s life. Typically, when making a diagnosis of ASD, it will either have been identified by a doctor during early check-ups or when a parent becomes concerned and consults a multidisciplinary team of teachers, occupational therapists, psychiatrists, psychologists, and doctors. Also read: Might my child have ADHD? Signs of ASD Signs of ASD to which a parent/teacher may want to pay special attention include: Preference for solitary time; Avoidance of eye contact; No response to their given name by their first birthday; Lack of response to the emotions of others or appearing not to understand the emotions of others; An unwillingness to be comforted when upset; Avoidance or rejection of physical contact; Meeting of some developmental milestones but later losing them; Appearing to have a lack of facial expressions (i.e. smiling); Challenges with abstract thinking; Fixation on or a very clear preference for certain subjects; Challenges in making friends or maintaining friendships. Also read: Parental self-care If your child is experiencing one or a combination of these signs or symptoms, they may need professional help. Consult a psychiatrist or psychologist to determine the correct treatment and course of action for your child. by Dr Jeanné Roux – educational psychologist

March 26, 2021

Hospital Plans vs Hospital Insurance: Knowing the difference

In times of economic pressure we all relook our monthly expenses to see where we can save on costs but having access to quality healthcare remains a priority – even more so during a global pandemic. Hospital insurance may be cheaper than medical aid hospital plans but is definitely not the same product. We asked the Principal Officer of Bonitas Medical Fund, Lee Callakoppen, to help us understand the two different products offerings. Regulation ‘Firstly, before I take you through the benefits and possible shortfalls of hospital plans as opposed to hospital insurance, it is important to point out that hospital plans are part of the offerings provided by medical aids. This means the product is regulated and overseen by the Council of Medical Schemes and in accordance with the Medical Schemes Act 131 of 1998. Hospital insurance (or medical insurance) is part of the umbrella term, health insurance and includes hospital insurance, hospital cash back plan and gap cover. Hospital insurance is not part of a medical aid but is governed by the Financial Services Board (FSB) and the Long-term and Short-term Insurance Act,’ explains Callakoppen. Medical Aid Hospital Plans A hospital plan provides you with basic, yet important medical cover. The product differs from scheme to scheme but in essence this plan is offered by a not-for profit medical scheme and will cover you in hospital for emergency and planned procedures In the case of Bonitas – you also get access to some additional benefits for wellness and preventative care The hospital plan ensures that when you are admitted into hospital for a procedure or due to an accident or illness, your expenses are covered – within the limits set by your particular plan There are 27 chronic conditions that all medical aid plans must cover, so the hospital plan also covers these which are known as Prescribed Minimum Benefits (PMBs) This type of plan does not cover you for other day-to-day medical costs like visits to the doctor, specialist or medicine It is tax deductible Hospital Insurance Hospital insurance is not a medical aid, it pays you for the time you spent in hospital but not for the treatment you receive It provides cash benefits depending on the number of days you are in hospital due to illness or an accident The insurer pays the money directly to you, you are able to use the money however you please – to pay for daily household costs or the hospital, doctor and specialist bills This often seems more attractive than a hospital plan and has a cheaper monthly premium however, the daily amount you receive is often way below the medical expenses incurred while in hospital It is governed by the Short or Long-term Insurance Acts Does not cover Prescribed Minimum Benefits (PMBs) May include Personal Accident risk cover such as disability and loss of limbs, inability to work, salary protection, death and/or funeral covers Is not tax deductible The limitations of hospital insurance It is a set amount which might not cover your hospital or medical bills, leaving you financially short and, in some cases, has a waiting period New regulations state that pay-outs are limited per insured life, per hospital stay with an annual limit Typically people buy the policy that pays less than R1 000 per day If you have one of the top plans, the daily pay-out during your stay in hospital may sound like a lot of money however, it usually falls short of actual costs charged by hospitals, doctors and specialists For example, a caesarean birth costs around R30 000. This can be much more if complications occur. Remember that hospital insurance companies are ‘for profit’ unlike medical schemes who are ‘not for profit’. The recommendation by most financial advisors is that a hospital insurance product should be used in conjunction with medical aid, or hospital plan, as income replacement rather than medical aid cover. And what is GAP cover, how does it work? Callakoppen provides an update. Minding the gap At times there may be a shortfall between what the medical scheme pays and what the hospital or specialist charges. You are responsible for paying the difference There is an insurance policy called gap cover which you can take out to pay for this shortfall The amount you receive depends on your policy but there is an overall annual limit Some gap cover policies have a waiting period for certain conditions Most people usually take gap cover together with a medical aid hospital plan It is important to know that gap cover, like hospital insurance, is an insurance ‘policy’ and is registered as Short-Term insurance policies Gap cover premiums are not tax deductable ‘There has been a growth in health insurance products over the past few years and they appear to provide medical cover, but actually don’t,’ says Callakoppen. If you choose to take out health insurance, do so as complementary to medical aid, not a substitute. ‘My advice: Shop around to find the best plan that covers your health needs and suits your pocket. A number of Low Cost Benefit Options have been introduced by Medical Schemes – these offer more affordable plans that give you peace of mind in terms of access to quality healthcare. Interrogate the benefits you receive on the plan you are considering versus the monthly contributions but, above all, never compromise on your health.’

March 18, 2021

World Down Syndrome Day: What to expect parenting a child with Down Syndrome

Finding out that you will be a parent is an exciting time for many. But finding out you will be a parent to a child with Down Syndrome, is often met with shock. If you will be raising a child with Down Syndrome, it can be challenging, so make sure you have a good medical team who can support you. 18 March 2021: With the world observing World Down Syndrome Day (WDSD) on 21 March, it is a good time to demystify what parents can expect from the first few months of life if they are expecting a child with Down Syndrome. This is especially so given that there are many cultural taboos around talking about, or having a, child with Down Syndrome. “The most important thing to understand is that raising a child with Trisomy 21 is challenging, given that the entire family dynamic will be affected. High levels of support and understanding are essential,” says Dr Iqbal Karbanee, paediatrician and CEO of Paed-IQ BabyLine, a trusted telephonic medical advice service for the first 1000 days of a child’s life, starting from conception to birth and beyond. Down Syndrome is caused by the triplication (trisomy) of the 21st chromosome and affects approximately 1 in 800 newborns. According to Dr Karbanee, it is the commonest chromosomal abnormality. He says that there are many features of Down syndrome that can be picked up during pregnancy and screening is readily available. The screening is offered mostly in high risk cases of which the commonest is an older expectant mom. “If you are pregnant and are diagnosed, it can be a major shock and parents have to face the choice of carrying on with the pregnancy or not. This is an intensely personal decision and should be carefully considered after discussion with all involved, and importantly, also the medical team.” Babies affected by Down Syndrome have a higher risk of abnormalities affecting multiple systems of the body. Parents will need to understand that the newborn will require a cardiac assessment as well blood tests to ensure the body’s systems are functioning normally. Feeding can be a problem as low muscle tone is associated with Trisomy 21. “The best way to approach this is to ensure the medical team is involved often as regular follow-ups and check-ups will be important. You need to make sure you can trust your medical team; this will be essential to getting the help your baby needs,” says Dr Karbanee. He adds that if you already have other children in the family, the needs of the child with Down Syndrome will be different to other children and will require everyone to adjust accordingly. “Developmental milestones will be delayed so expect the baby to sit and crawl much later than normal. Special schooling will be necessary as well as ongoing visits for physiotherapy and possibly Occupational and Speech Therapy,” says Dr Karbanee. “Having said that, while having a child with Down syndrome may be a huge adjustment for the entire family, the good news is that children with Down syndrome tend to have a pleasant personality and parents report that they are a delight to the family. “Speak to your paediatrician about all of your concerns, fears, or expectations, as it is her or her role to co-ordinate the care of the child and ensure that the health of the child is optimised,” concludes Dr Karbanee. About Paed-IQ BabyLine Paed-IQ BabyLine is a trusted, telephonic medical helpline for pregnant moms and new families. With healthcare advice given by qualified, experienced and medically trained nurses, we aim to improve health outcomes during the first 1000 days of a child’s life, starting from conception to birth and beyond. We are there for mommies-to-be at all stages of their maternity journey as well as new parents or caregivers to young children. By offering early and appropriate medical intervention through advice, we have helped to safeguard the health of over 10000 children, and helped moms and families successfully navigate the medical concerns of their young children. Visit https://paediq.com/ for more.

March 18, 2021

Trimester two overview

Your second trimester begins in week 13 and ends at week 28. During this time your morning sickness will ease off, and initially your baby will be small enough that your body won’t be in too much discomfort, earning this trimester the nickname of the honeymoon period of pregnancy. During this trimester you’ll probably tell your family, friends and employees you’re expecting and your tummy will begin to show – time to upgrade your wardrobe! Your body during your second trimester During the second trimester the pregnancy you’ll hopefully notice that your morning sickness is easing up and your energy levels should begin to rise. While you will be feeling better don’t put pressure on yourself to exercise or socialise more than you’re comfortable with. This trimester your baby bump will go from barely noticeable to one that you may struggle to hide. Embrace your changing body and adapt your exercise plan to accommodate your baby, prenatal yoga and pilates classes are a great way to stay in shape, meet other moms-to-be and prepare for labour and delivery. A growing belly and breasts, Braxton Hicks contractions and leg cramps are all common pregnancy symptoms you may experience during this trimester. Not only this but you may experience dental issues, sore and swollen feet, and an achy back and/or pelvis. Your baby’s growth during the second trimester Your little one does lots of growing during your second trimester, and during this time you’ll begin to feel them moving around inside your belly (this is also known as quickening). Not only this, but during trimester two your baby’s ears develop to the point that they can hear your voice and other external sounds. During the second trimester your baby’s eyes and ears become more developed and you’ll soon be able to find out their gender on an ultrasound (if you want to!). Your baby’s muscle tone is also improving, they’ll be swallowing amniotic fluid and their sucking reflex will develop – they may even suck their own thumb. Important things to note during the second trimester At week 19 to 20 you’ll have an anatomy scan. In this scan your doctor will be able to see how your baby is developing, and if there is anything unusual that would be cause for concern. During this scan the doctors will also be able to tell you the gender of your baby – if you decide to be told you can start thinking of baby names! This trimester is also a good time to decide how and where you’d like to have your baby. Decide on if you like a hospital or home birth, and start putting together a birth plan.

March 16, 2021

What is Perinatal Distress… and what does it really look like?

Most of us have heard of perinatal distress, also known as postnatal depression or PND, but why is this common and treatable illness often misunderstood and underdiagnosed? I was propped up in bed trying to feed my one-week-old infant staring at a pamphlet titled: “Postnatal Depression”. I thought to myself, “oh that’s when a new mother lies in bed all day crying. I definitely don’t have that. I’m not even going to open this pamphlet. I’m exhausted, I have my hands full with a fussy baby, I don’t have time to read this and besides, I don’t have PND anyway.” Two months later, I was hospitalised for nearly two weeks, followed by months of therapy and medication. You guessed it: I had PND. This medical condition had gone undiagnosed long enough for it to ravage my body and mind, as well as tear a hole through our entire family. When I look back at that dark and difficult time, I often think to myself that if only I had understood then what PND truly looked like, this illness would never have been able to take such a powerful hold on my life. The jaw-dropping reality is that PND affects well over 10% of women within the first year of giving birth. Many of those women are never diagnosed and treated because they don’t know what PND is or may be too ashamed to seek help. Why do we know so little about PND? Let’s rewind a little. PND used to stand for Postnatal Depression, a mental health condition in which mothers would experience depression and anxiety after their baby’s birth. Fast forward to present day: PND now stands for Perinatal Distress, because experts now understand that this mental health condition can occur both before and after giving birth (yes you can have PND when you are pregnant!) and that mothers can experience a wide range of symptoms. These may include depression, anxiety, obsessive compulsive behaviours, sleep disorders, anger and more. In the most extreme cases (postnatal psychosis – a medical emergency) a mother may experience hallucinations or voices. The full list of symptoms is a long one, but may include some or all of the following: Feeling low, sad, tired, hopeless, alone, scared, angry, bored, irritable, guilty, on edge. Changes in appetite (either eating more or less than usual) Weight loss or gain Loss of interest in enjoyable activities; not looking forward to things. Lack of interest in the baby Panic attacks Overwhelming, scary thoughts. Even thoughts of harming yourself or the baby Changes in energy levels, sleep patterns or tiredness (hard to gauge with a new baby when you’re sleeping less anyway, but if you are unable to sleep when you are exhausted, there may be a problem) Mood swings, crying more often, restlessness and irritability Brain fuzz or racing thoughts Herein lies the Problem These symptoms cover most of the common emotions experienced by mothers in the perinatal period. Some of these symptoms are completely normal and result from extreme hormonal fluctuations associated with pregnancy and birth. However, these symptoms should only last for a couple of weeks after the baby is born (The Baby Blues). So how can a mother tell what is normal, and what is PND? A good rule is that if you feel like you’re not yourself, or you are not coping, have a chat to your healthcare provider. If you don’t feel like you can talk to your GP, obstetrician or clinic nurse, then turn to a trusted friend or family member. You do not have to suffer in silence. There are various treatment options available to you which are perfectly safe, both before and after giving birth. With the correct treatment, PND can be completely resolved. Left untreated, it may be fatal, to both a mother and her child. Why do most women have only a vague idea of what PND can actually look like? Because we don’t talk about it! Even in todays’ open-minded world of acceptance, there is still a heavy burden of societal stigma attached to a mother’s mental health. When a woman is pregnant or has a baby, she is expected to be happy! “You’ve been so blessed!”; “Enjoy every minute, they go by so fast!”; “You’ve got what you always wanted – you must be thrilled!” These are all phrases that most mothers have heard at some point. If she is struggling inwardly, she may feel guilty that she is not happy. Mothers are often wracked with insecurity, which they can keep well hidden. She may worry that she will be seen as ungrateful, or even unfit to be a mother. PND survivor Hayls Lieberthal wanted nothing more than to have a child, but as her pregnancy progressed, so did her self-doubt. “I was told all the time, ‘you are carrying life, you’re very blessed’ and ‘You have nothing to feel sad about!’” She vividly recalls a woman saying to her “look at you, you must be so excited!” and found herself lying behind a false smile: “I am so excited I can’t wait!” Meanwhile, on the inside all she could think was “I can’t do this.” From the moment your pregnancy is confirmed, healthcare professionals typically focus intensely on a mother and baby’s physical health, but less on a mother’s mental health. Even when a healthcare provider is aware of PND and asks the patient all the right questions, a mother may not divulge how she truly feels because she feels ashamed. After I had my first baby, I was overwhelmed by my new life and role. There were times that I thought I had made a terrible mistake, and that maybe I wasn’t cut out to be a mother after all. These feelings were shameful to me, and I didn’t feel like I could tell anyone. Little did I know that those feelings are incredibly common among new mothers, even mothers who do not have PND. The Truth about PND PND is not

March 15, 2021

When the stomach turns .. tummy bugs or COVID-19?

As South Africa nears the end of the second wave of Covid-19 and braces for a third, a stomach bug is circulating and spreading in schools and the community. Dr Morgan Mkhatshwa, head of operations at Bonitas Medical Fund, discusses the signs and symptoms of a stomach bug and common gastrointestinal (GI) viral infections versus the GI symptoms from Covid-19. He says, ‘Although the period between November and May usually coincides with an increase in diarrhoea and pneumonia cases, according to the MMC: Community Services and Health, Zahid Badroodien, it is significantly reduced with a 29% decrease in cases and a 15% decrease in hospital admissions. The decline is partially attributed to the increased adherence to health protocols for Covid-19 like hand-washing, sanitisation and wearing masks.’ However, the recent tummy bug that is circulating, is proof that the virus is still around, Dr Mkhatshwa talks about common GI viral infections and GI symptoms associated with Covid-19. What are the symptoms of a tummy bug? Stomach bugs (or stomach flu) are known as viral gastroenteritis and are characterised by the following symptoms: Diarrhoea Abdominal cramps Nausea Vomiting Fever Thirst Joint aches Headache General malaise How long does a stomach bug last? People typically develop stomach bug symptoms within 24 to 72 hours of being exposed to the virus. While most cases resolve in three to four days, it’s not uncommon to feel unwell for up to a week. How do I know if it’s food poisoning or a stomach virus? The symptoms of food poisoning and a stomach virus are very similar. However, food poisoning symptoms develop in as little as a few hours. Most people suspect food poisoning when symptoms develop shortly after eating food which may seem questionable. Covid and gastroenteritis Research consistently shows that approximately 10% of adults with Covid-19 report GI symptoms such as nausea, vomiting or diarrhea. Typically, patients will also have the more common upper respiratory symptoms that accompany Covid-19, such as a dry cough or difficulty breathing. How do you tell the difference between Covid-19 symptoms and ‘stomach flu’? So, how do you know which one you’re dealing with if you’re experiencing, for instance, a fever, vomiting, and diarrhoea? ‘Unfortunately, it is not always easy,’ says Dr Mkhatshwa, ‘if you have respiratory symptoms, (particularly chest pain) and loss of smell or taste, it is pretty clear cut. However, GI symptoms can occur on their own with Covid-19. A stomach bug also typically lasts only 72 hours while GI related symptoms with the coronavirus can last much longer.’ What should you do if you suspect the GI symptoms are in fact, Covid-19 related? Consult your doctor – via phone or virtually – to discuss your symptoms and if he/she feels you are displaying signs of the coronavirus infection, they will refer you for a Covid-19 test. How long are you contagious with a stomach bug? Stomach viruses are highly contagious and can spread quickly. People infected with a stomach virus are contagious from the moment they begin feeling ill and also for the first few days (up to 72 hours) after they recover. A stomach virus can spread in several different ways: Eating food or drinking liquids that have been contaminated with the virus Having direct or indirect mouth contact with an infected person or surface with the virus on it Unhygienic behaviour, such as not washing hands after toilet use, not washing fruits and vegetables before consumption The virus also inhabits the vomit and stools of people who have the infection How do you treat or get rid of a stomach bug? Supportive therapy that includes increased hydration, rest, electrolyte replenishment and medication for fever is usually all that is needed for viral illnesses. This is because viruses do not respond to antibiotics and simply need to run their course. If the infection is caused by bacteria, like Salmonella, an antibiotic may be prescribed. Viral gastroenteritis will typically resolve within a few days or less without medication. However, hydration is vital to a speedy recovery and prevention of complications. Here are a few steps you can take at home to aid recovery from a stomach virus or food poisoning: Try not to eat any solid foods until you feel better Suck on ice chips or take small sips of water to prevent dehydration Avoid juices or other beverages with a lot of sugar or sweeteners that can make diarrhea worse Ease yourself back into eating. Start with bland, easy-to-digest foods, such as toast and rice. Stop eating if a feeling of nausea returns Avoid dairy, caffeine, fatty foods and sugar until you feel better You should be cautious of taking over-the-counter medications, unless advised by a healthcare provider, as some can worsen the infection When to treat it seriously and consult a medical doctor? Seek medical attention if you have any of the following symptoms: A bloody stool or vomit Are unable to keep liquid down for 12-24 hours Feel dizzy or light-headed Have a fever above 40°C Are experiencing severe, unrelenting abdominal pain. Fortunately, thanks to the Covid-19 protocols which include wearing masks, social distancing and the washing and sanitising of hands the incidence of stomach bugs has been reduced. However, it is a virus and you may still be susceptible but remember it will run its course and you will recover. During the time you are experiencing symptoms rest, stay hydrated and stay away from others while you are still contagious.

March 10, 2021

Play has the power to help address kids’ anxiety

As restrictions around COVID-19 continue, parents continue to feel anxious – as do their children, who are facing yet another year of limited extra murals and social activities. Even though schools are open for the 2021 academic year, it’s under limiting conditions, which in turn is likely to increase anxiety among children. Anxiety manifests in various ways in children, including poor appetite, getting angry or irritable, worrying or having frequent negative thoughts, being fidgety, being clingy, or complaining of tummy aches or headaches. With the last year or so having thrust families into very different situations, with parents working from home and children kept distant from friends and teachers – whose facial expressions are hidden behind masks – anxiety is being seen in children as young as two years of age. This could be because they’re picking up on the stress their parents have experienced during the pandemic, or it could be that they’re accustomed to passive and isolated screen-bound activities, and they’re struggling to acclimatise to new interactions and activities on returning to school after a long break. “Children communicate and express themselves through play, which is a useful tool, both therapeutically and at home, to provide children with an arena in which to explore and express some of their emotions,” says Colleen Johnson, a Johannesburg child psychologist. “Playing with a child helps not only to connect with them on their level, but offers an opportunity to defuse power struggles, unearth some of their fears and insecurities, and to offer positive resolution through the medium of play. Playing with your child encourages secure attachment, connectedness and fun, which reduces feelings of anxiety.” Cape Town-based occupational therapist Anine van Schalkwyk suggests letting children play through scenarios that make them feel anxious. “Let them play through a situation after it’s happened, rather than asking them direct questions, like ‘how was your day’,” she suggests. “Give them the cues to build a situation, and let them allocate ‘roles’ to you and themselves. In creating the scenario, using their favourite toys, chances are that they’ll tell you the story of their day and what caused their anxiety – and you can help them talk through it.” Johnson adds that the type of play to help resolve anxiety depends on the child’s personality and specific needs at the time – children who are disorganised may benefit from structured play, such as building a LEGO® set together, following the visual instructions. Those that enjoy a less-structured type of play have the freedom to use LEGO® bricks to create builds that express their imaginations – or the issues that may be on their mind. “This helps reduce anxiety as the child feels safe by being able to follow specific guidelines towards a predictable outcome,” she explains. “However, allowing the child to engage in free play or fantasy play has tremendous benefits too, as the child feels in control of their environment, taking the lead and determining their own outcome.” The LEGO® Play Well Report, based of research conducted among children and families in multiple countries, including South Africa, found that parents believe that play develops a wide range of benefits, for their child, for themselves, and for the family unit as a whole. The research highlighted that 91% of respondents felt that play was important to help the family stay entertained, with 88% confirming that play helped them stay emotionally healthy. Van Schalkwyk emphasizes that parents should prioritise close contact play with their children – perhaps even more intensely than they would have before the pandemic, given that children are not getting the sensory and social input needed for appropriate development, because of rigorous social distancing in schools. “Hug your children tight, and often,” she says. “It’s a tough balancing act when you’re tired from working all day, but intense play is good for parents as well – it lowers adults’ anxiety too!”

March 9, 2021

Your second trimester – making the most of it

Your second trimester is from the beginning of week 13 until week 28, during this time your pregnancy will begin to show. However, you should feel like you have more energy than you did in trimester one. This is why this trimester is also nicknamed the honeymoon period of pregnancy – your baby isn’t big enough to make you uncomfortable and your pregnancy hormones should have eased up. During this time there are one or two things that you can keep in mind to make the most of this time while you’re feeling better, and to ensure that your baby (and you) are kept healthy and happy. Childbirth classes, preparing your mind and body Even if this isn’t your first baby, childbirth classes can help prepare you for what is to come. If you’re feeling anxious about labour and birth, these classes will help ease your worries, by informing you what is to come and how best to manage your mind and body coming up to, during birth and after birth. Prenatal exercise and a healthy lifestyle Stay fit and healthy during your pregnancy is important to both you and your baby. What you eat and regular exercise are both ways in which you can provide needed nutrition to your baby and keep yourself healthy. Low impact exercise, such yoga, swimming, walking and prenatal pilates can help improve your sleep, and increase your strength and muscle tone. Keeping active can even have the added benefit of helping prepare your body for labour and birth. Maternity wear and staying comfortable Not only is learning about your pregnancy and staying healthy essential but staying comfortable is also important. The second trimester is generally when your tummy will start looking and feeling bigger, so invest in some trousers that have more give in the waistline. Luckily certain fashion items, such as flowy dresses and layered knits, may even mean you can still keep using your pre-pregnancy clothes.

March 9, 2021

Covid and flu – should you still have the flu shot?

Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund unpacks the differences and similarities between ‘flu’ and Covid-19, how it affects your body and offers compelling reasons why you should consider getting the flu vaccine this year. Every year, seasonal influenza (flu) kills around 11 500 people in South Africa alone. To date, Covid-19 has resulted in around 50 000 deaths in South Africa. While the true mortality of Covid-19 will take some time to fully understand, the crude mortality ratio (the number of reported deaths divided by the reported cases) is between 3-4%. For seasonal flu, mortality is usually well below 0.1%. However, mortality is to a large extent determined by access to and quality of health care. How has Covid-19 impacted on the flu virus? The Covid-19 pandemic has, however, had a significant impact on the 2020 flu season where decreased flu activity has been reported. This is most likely related to lockdown and additional hygiene measures. Bearing in mind that The World Health Organization (WHO) has recommended flu vaccines for 2021, circulating flu viruses evolve constantly so an accurate prediction for the upcoming season is challenging. Should you still have a flu vaccine in 2021? Dr Mkhatshwa recommends you do. Flu vaccines have been shown to reduce the risk of influenza illness, hospitalisation and death. Not only will flu vaccinations reduce the risk of getting flu but is an important conservation measure for scarce health care resources which remains a concern with the ongoing the Covid-19 pandemic. The flu vaccine should be given sufficiently early to provide protection for the coming winter. A protective antibody response takes about 2 weeks to develop. As there is limited evidence on the safety and effectiveness of receiving these vaccines simultaneously, Dr Mkhatshwa recommends waiting at least 14 days between having the Covid-19 and flu vaccinations. How are Covid-19 and flu viruses similar? WHO says, ‘Firstly, Covid-19 and influenza viruses have a similar disease presentation. That is, they both cause respiratory disease, which presents as a wide range of illness from asymptomatic or mild through to severe disease and death. ‘Secondly, both viruses are transmitted by contact, droplets and any material that can carry infection. As a result, the same public health measures, such as hand hygiene and good respiratory etiquette (coughing into your elbow or into a tissue and immediately disposing of the tissue), are important actions all can take to prevent infection.’ What are the essential differences between Covid and flu? Flu is an acute viral respiratory infection, transmitted by the influenza virus. There are three types of influenza, namely Influenza A, B and C. Influenza C is less common and produces milder disease. WHO says there are important differences between the two viruses and how they spread. This has important implications for the public health measures that can be implemented to respond to each virus. The two are essentially different viruses with SARS-CoV-2 being a newly discovered coronavirus that causes Covid-19. The speed of transmission This is an important point of difference between flu and the coronavirus. Influenza has a shorter incubation period and can spread faster than Covid-19. Further, transmission in the first 3-5 days of illness, or potentially pre-symptomatic transmission, is a major driver of transmission for influenza. Although with Covid-19, people can be infected by someone 24-48 hours before the onset of symptoms – this is not the major driver of transmission. The severity of illness While the range of symptoms for the two viruses is similar, the fraction with severe disease appears to be different. For Covid-19, data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe, requiring oxygen and 5% are critical infections, requiring ventilation. These fractions of severe and critical infection would be higher than that of flu. Who is at risk? The Department of Health (DoH) together with the National Institute for Communicable Diseases (NICD) targeted the following groups for the 2021 campaign: Healthcare workers Individuals age >65 years People with comorbidities like heart disease, diabetes or lung disease Pregnant women People living with HIV and AIDS What are the signs and symptoms? In terms of symptoms, Covid-19 and flu can have varying degrees of signs and symptoms, ranging from none (asymptomatic) to severe symptoms. Common shared include: Fever or feeling feverish/chills, cough, shortness of breath or difficulty breathing, fatigue, sore throat, runny or stuffy nose, muscle pain or body aches, headache, some people may have vomiting and diarrhea, though this is more common in children than adults. Other signs and symptoms of Covid-19, different from flu, may include change in or loss of taste or smell. A Covid-19 test will confirm the diagnosis. Does the flu shot give me a mild flu? According to the Centre for Disease Control (CDC), ‘A flu shot cannot cause flu. Flu vaccines given with a needle are currently made either with flu vaccine viruses that have been ‘inactivated’ and are not infectious, or with no flu vaccine viruses at all. The most common side-effects from the shot are soreness, redness, tenderness or swelling where the shot was given. Serious allergic reactions to flu vaccines are very rare.’ Still not convinced? Flu viruses spread very quickly from person to person Even if the flu vaccine is not 100% effective against the current flu strain it will reduce your chances of getting the flu and, if you do get it, it will be a great deal milder More importantly, by having the flu vaccine you will protect others, via what is called ’herd immunity’. Others may be vulnerable family members such as small babies and the elderly as well as those who are immune compromised. While the world focuses on Covid-19, social distancing, wearing a mask and hand washing or sanitisation can help protect you from both Covid-19 and flu.

March 4, 2021

Keep on and power up immunity and antioxidants

The Covid-19 pandemic continues to teach us tough lessons and it’s an ongoing fight. The bigger picture is that whether we are travelling, at work, home or school, our bodies are continuously responding to tiny organisms that can cause disease. Germs like viruses and bacteria are everywhere, and it is our immune system which protects us. While there is no magic “healthy pill”, there are proven ways to boost our immunity superpowers. Proper face masking, frequent handwashing and sanitising and social distancing are a good start. But there’s more we can do to protect ourselves and our loved ones against threats to our health and wellbeing: Support your immune system with good nutrition that is packed with immune boosting nutrients and a variety of antioxidants. Eat at least two fruits and four portions of veggies a day. The deeper the yellow, orange, red or purple colours of fresh produce the better. Move more, especially if you are in a sedentary job. It has been shown that fewer sick days are taken by people who do regular aerobic exercise. Even 20 minutes of brisk walking for five or more days a week boosts our immunity. Sleep is essential for good health. Quality sleep helps us to be more resilient to everyday stress and, improves energy and moods. Supplement with protective antioxidants. A one-a-day, every day, immune boosting nutritional supplement like Nativa Immune Complex® contains a powerful combination of antioxidants, vitamins, mineral and herbals. These provide antioxidant protection and help strengthen natural immune defences. Around R126 for a month’s supply. Power up with extra Vitamin C when health needs or stress levels increase, if smoking, or during a change of season. High dose Vitamin C supports immune function and offers antioxidant protection to help maintain good health. Have a look at Nativa’s new Vitamin C range. It is suitable for children from 4 years old. 500 mg Vitamin C (from 4 years of age). 1000 mg Vitamin C (from 9 years of age). Around R80. Add in some sunshine power with Nativa Vitamin D3 which is essential for immunity, bone and brain health, and muscle function. Vitamin D3 is of value particularly for those who get little sun exposure or who have dark skins. 1000IU Vit-D (from 6 years of age) around R100. All products are available from Takealot, Dis-Chem, Clicks and selected pharmacies nationwide. WIN! Stand a chance to win a R500 Takealot voucher.

March 4, 2021

With you every step of the way Venavine® capsules and cream

What fun things do your legs help you do? When our legs are strong and healthy, we don’t give them a moment’s thought. But let them start being tired, heavy, crampy or swollen, then it’s time to give them special attention. Turns out, caring for legs early when they first ache for help will keep them happily twinkling along while you walk, run, carry the children, load the car, swim and dance. Why would legs complain in the first place, we’re all having such a great time, aren’t we? Well, if your working day keeps you seated for much of the time, or even if you are on your feet for most of the day, a medical condition can develop where the circulation of blood flow from the leg becomes impaired. The result is swollen legs, damaged veins, sensitive skin, and it can be painful. Tips to keep legs happy: When seated don’t ever cross your legs or scrunch them up, which puts pressure on veins and nerves. Stretch them to promote flexibility and get up and walk about at frequent intervals if you have a sedentary lifestyle. That relaxing walk around the neighbourhood is also a great idea. Here’s one from the professionals: Ballerinas lie down with legs raised to rest and drain them at the end of their day as part of their leg and foot care routine. Something for you and your legs to enjoy together: Soak in a hot bath. A scoop of Epsom Salts and some fragranced bath oil or foam adds to the feeling of indulgence and has a relaxing effect on muscles and veins. After bath, or even without bath, massage your legs by rubbing in easily absorbed Venavine® Intensive Cream. Massage combined with this specially formulated product improves circulation while giving a cooling and relaxing effect. Price: 125 ml around R117. Add a daily leg pick-me-up: Combine Venavine® Intensive Cream with a one-a-day Venavine® Capsule . It contains Red Vine Leaf Extract which has been well-studied for its use in supporting people with chronic venous insufficiency. The capsule should be taken for 12 weeks, but if symptoms do not improve after two weeks, consult a healthcare practitioner. Longer term use is possible in consultation with a doctor. Price: 30 capsules around R212 and 60 capsules around R382. Available from online suppliers like Takealot, Dis-Chem and Clicks and selected pharmacies nationwide. www.venavine.co.za Don’t forget to enter this month’s competition here!

March 1, 2021

EXPLICIT AND CRINGE-WORTHY WOMB STORIES UNCOVERED IN LIBRESSE’S CAMPAIGN

Feminine hygiene brand, Libresse, has launched its most intimate campaign, yet. The compelling initiative empowers women to explicitly share honest, cringe-worthy experiences of womanhood. From the profound diagnosis and fertility treatments, to severe menstrual cycles. The Womb Stories series, features women of various ages and commits to nullify common myths that exist around their complexities. In mid-February 2021, Libresse introduced the powerful stories on its digital pages, collaborating with the voices of ordinary women around the world. The campaign stems from the social misinterpretations, lack of knowledge and stigma that linger around the female body. Commonly, women are deprived to speak out in confidence and unapologetically about what really happens to their organs- the effects thereof and the process it takes to overcome it. Libresse, as a personal care brand identified this as a concern and set out to drive these important dialogues. It distinguished itself in an audacious manner, outlining and showcasing the gruesome nature to which the uterus and womb experience change. The choice of words used are blunt and the visuals portrayed mirror the pain felt during this intimate journey. Endometriosis, Menopause, Hysterectomy and miscarriages are some of the issues that are covered. “This campaign highlights that a woman’s journey with her body is not simplistic. It reveals the emotional, complicated and sometimes painful realities of women’s intimate experiences. We want to reverse the stigma that is often associated with uteruses, periods and vaginas by encouraging women to have open conversations about their bodies, says Mpho Nojiwa, Marketing Brand Manager of Libresse. The campaign will further launch Womb Table, a video segment that will gather doctors and experts, Dr Sindi Van Zyl, Dr Boitumelo Makaulule and Dr Chriselda Kananda to further discuss some of the issues that resonate with South African women.

February 26, 2021

New Head of Operations for Bonitas

Bonitas Medical Fund has announced the appointment of Dr Morgan Busuku Mkhatshwa as Head of Operations. Dr Mkhatshwa is a medical doctor with extensive experience in the healthcare sector. He has a proven track record of spearheading the introduction of enhanced comprehensive healthcare services and programmes including occupational healthcare services. In addition, he has led organisational restructuring efforts within highly unionised environments, launching accelerated business expansion and improvement initiatives to maximise revenue growth. Compassionate about management, business development and stakeholder engagement, he began his career as a science teacher before he pursued his medical studies. He worked as a medical officer before progressing to principal medical officer in the public service. He spent some time as Hospital Manager at Life Healthcare and went onto become MD of one of the divisions in the company. After Life Healthcare he joined Lenmed Health as Group Business Development Manager and later became Group Head of Operations. ‘We are delighted to have Dr Mkhatshwa joining our management team,’ said Lee Callakoppen, Principal Officer. ‘He brings with him a wealth of knowledge and expertise, not only as a medical doctor but also years of experience in strategic planning and execution, general operations management, project management, coaching and mentoring. We know he will be a valuable asset to our team and our members.’ Dr Mkhatshwa has a BSc. (Biological Sciences), Bachelor of Medicine and Surgery (MBChB), Hons BSc (Limnology), Master of Science (Medical Microbiology) and Master of Business Administration (MBA). Oher achievements include the completion of the Harvard Business School – General Management Program.

February 26, 2021

Cheese, full of goodness and a lunchbox fav

Versatile and delicious, it’s incredibly easy to make cheese one of your family’s three-a-day dairy options, every day. Like other dairy, cheese is also a firm favourite with kids. Used as a tasty topping, an essential ingredient and a go-to sandwich filler, cheese also stands alone as a nutritious and satiating snack. Packed with protein, calcium, phosphorus and other essential nutrients, cheese, in all its many varieties, deserves its place as a healthy food item in your family’s diet. Understanding the benefits of cheese, how to choose it and how to use it will help you to plan, shop and enjoy including cheese across breakfast, lunch and supper, and the snacks in between. Natural cheese is a fermented food, and while its exact origins are unknown, there is evidence from Ancient Rome and Ancient Egypt that the goodness of cheese has been recognised for thousands of years. Cheesemakers use milk, salt, beneficial bacteria and a natural enzyme known as rennet as the foundations for producing a vast array of cheeses. Different formulae and ageing processes result in different textures, flavours and colours that are all packed with goodness. Maretha Vermaak, the registered dietitian at Rediscover Dairy says, “Cheese can make a significant contribution to your daily nutrient requirements – from the protein that supports healthy bone and muscle development and repair of body tissue; to the dental protection we get from the calcium and phosphorus by having cheese directly after a meal. As parents who are concerned about good nutrition for our growing children, it is great that cheese is also so completely delicious.” When it comes to choosing the cheeses we include in our family’s meals and snacks, value for money is often top of mind. Luckily, today’s cheese options range all the way from luxury to everyday prices and there’s something to fit every budget. Proper storage of cheese also impacts on affordability because you want to avoid any food waste. Many cheeses freeze well, enabling you to buy specials or cheaper bulk options and safely freeze for later use. It often works well to buy a big block of a harder cheese such as cheddar or gouda, grate it all before its use-by-date and freeze the surplus for quick and easy use. Processed cheese spreads can be stored in the pantry until they are opened, and some varieties of cheeses, including sliced processed cheese, have longer shelf lives in the fridge. It’s always important to check the labels when it comes to storage and the nutrient content of a food item. Proper meal planning, and shopping for value for money can help you to include more cheese, more often. Another factor for many busy parents is convenience. The reality of our daily lives is that we often need fast solutions and time-savers. It helps to have nutritious options such as cheese on hand so that we can quickly prepare daily meals, snacks and lunchboxes. A good example of this is glass jar cheese spreads which are healthier options than many other bread spreads, or sliced or portioned cheese products that are grab-and-go, and a great way to control portions. When it comes to lunchboxes, cheese is always a winner, some tips include: Plan for lunchboxes – plan before you shop, and pack lunchboxes before the morning rush Involve your children – in preparing their school snacks and lunches. They learn about nutrition and how to share chores, and you can have fun together Keep it different – it may seem easier to keep doing one thing but embracing a variety of lunchbox foods encourages your children to try new foods as they develop and prevents boredom and lack of interest in eating their school lunches Aim for balance – growing children benefit from a variety of nutrients, even when it comes to snacks and lunchbox lunches. Make sure you are including protein sources like cheese, milk and yoghurt as well as carbohydrate sources like bread and crackers. Don’t forget to add fresh fruit and veg too. Hydration is essential – dehydration can have adverse effects on your child’s performance at school. Water and milk are top choices. Rather avoid sugary drinks. For more dairy ideas join the Rediscover Dairy Facebook page: www.facebook.com/RediscoverDAIRY

February 23, 2021

A FRESH TAKE ON FROZEN

While trying to juggle all of our roles and responsibilities, there is an increased need for convenience, affordability and reduction of waste that aligns with today’s strongest dietary and lifestyle trends. Fortunately, we can call upon the friends in our freezer to meet these needs, and more! However, there are still many misconceptions about the quality and nutritional value of frozen foods. McCain and Sea Harvest, both leaders in the frozen foods category, are here to dispel some of the common misconceptions when it comes to frozen foods: It’s fresh – Fresh produce forms part of a healthy diet as it contains nutrients that are essential for good health. However, there are some disadvantages. The limited shelf life increases the risk of expiring before consumption, which results in more frequent visits to the store and higher expenditure on fresh produce. When cooking with trusted frozen foods brands like McCain and Sea Harvest, you can rest assured that all their produce is harvested at its peak, sustainably sourced and snap frozen within hours to maintain freshness and lock in nutrients. “Freezing is a safe and natural way of preventing bacterial growth and enzyme activity and eliminates the need for undesirable chemical preservatives,” explains Catharina Bester, Marketing Manager: McCain Foodservice & Retail. It’s convenient – There’s no way around it, frozen meals are a win on a busy weeknight. The cleaning, chopping, crumbing and portioning has all been done for you. All you need to do is take it out of your freezer, heat according to the on-pack instructions, and serve. It’s healthy – Contrary to popular belief, freezing causes very little nutrient loss and preserves the vitamins and minerals in food – so all those fantastic nutrients end up on your dinner table, meaning you get a nutritional meal every time. Frozen produce is packed with nutritional value and provides the easiest way for you and your family to get your daily nutrition. It’s affordable – Frozen vegetables and fish have a much longer shelf-life than fresh produce so there’s less wastage, meaning you get more broccoli for your buck. It’s constantly available – Buying frozen food means you can enjoy your favourite vegetables and fish year-round. And, because of its longer shelf life, you can make sure you always have a quick dinner-time solution in the freezer! “You have enough on your plate right now but when it comes to cooking you want a quick and convenient solution that will still offer great nutrition to your family and requires minimal time spent in the kitchen. Sea Harvest and McCain are the friends in your freezer, bringing consumers the fun and creativity back into your kitchen. You get all the health benefits and delicious taste, without the hassle,” says Sea Harvest Marketing Manager, Jared Patel. Reimagine mealtimes with #FriendsInYourFreezer and stand a chance to WIN 1 of 10 PlayStation 5 consoles. T&C’s apply. For more information, visit www.friendsinyourfreezer.co.za, McCain Facebook, McCain Instagram, Sea Harvest Facebook or Sea Harvest Instagram. You can also download this fun activity book to keep the kids busy!

February 19, 2021

Teen Suicide Prevention during COVID19 – Talk, Listen & Connect

Teen Suicide Prevention Week (14 – 21 February 2021) highlights awareness especially around teen Depression. As the COVID-19 pandemic has worsened across the globe and increased stressors for many, the mental health of children and teens has been affected to a large extent. Suicide is the 3rd leading cause of death in 15 – 19 year olds (WHO, 2020). The South African Depression and Anxiety Group (SADAG) is focusing on creating awareness for Teen Depression and Suicide, as South African teens are at a particularly high risk as the mental health impact of COVID-19 has been immense. South African teens (OUTare especially at riskas they) navigate a new world of online learning or delayed learning, social isolation, loss, grief and trauma, with increased anxiety and depression. Psychiatrist and SADAG Board Chairperson, Dr Frans Korb, says “There is a myth that depression or suicide doesn’t affect teens or children, in fact it is very real and affects more young people than we know, with teens being a particular high risk for suicide. Depression is the leading cause of suicide, it doesn’t discriminate against age, gender, race, religion or socio-economic background.” SADAG has seen an increase in the number of calls to the Suicide Helplines, and we encourage parents, teachers and family members to know the warning signs of depression and to reach out for help as soon as possible. Now more than ever, parents need to connect and engage with their children – ask questions, listen carefully to understand, get to know what is happening in their teens lives and what they are feeling and thinking,connecting to help if you pick up any warning signs for depression or suicide before it is too late – it could save a life. There is still a lot of stigma and fear around suicide, and many parents and teachers are afraid that if they talk about suicide to teens that it would cause them to take their life. SADAG’s Operations Director, Cassey Chambers explains, “Research shows that talking about suicide with a young person DOES NOT cause them to have thoughts of suicide or kill themselves. But NOT talking about it can lead to thoughts of suicide turning into action. Talking about suicide and depression create an opportunity to discuss feelings and thoughts that might have otherwise remain hidden. Most teens who are thinking about suicide are often honest and relieved when asked direct questions about their suicide thoughts or feelings.” But informing and empowering parents and teachers on how to have these conversations with teens is the first step to preventing teen suicide. SADAG will be hosting 2 free online CONNECT Webinars – one for Teachers (24 February, 3:30pm) and for Parents (25 February, 1pm) with experts to unpack how to identify warning signs of teen depression and suicide at home and in the classroom, self-help tips to deal with depression, how to talk about suicide with a teen, developing a suicide safety plan, and how to connect to help. Visit www.sadag.org for more details about these free Connect Webinars and RSVP for your free seat today. Miss SA will be using her Instagram platform to focus on Teen Depression for #MindfulMondays on Monday the 15th February at 7pm. SADAG will also be hosting an online #FacebookFriday expert Q&A on Friday the 19th February at 1pm-2pm and again at 7pm-8pm answering all your questions on teen depression, suicide prevention and how to get help LIVE on @TheSADAG. “Even if you notice 1 warning sign, don’t wait or leave it. Talk today, listen and connect to help – it could save a life,” says SADAG’s, Cassey Chambers. Possible Warning Signs of suicide include: Talking about suicide or death – could be writing or drawing about death and dying, or posting pictures, quotes, or messages on social media Writing or sending goodbye letters or messages or posting goodbye messages on social media Saying things like “Everyone would be better off if I was dead” or “I wish I wasn’t here anymore” or “I don’t want to be here anymore” Giving away prized possessions Signs of depression such as moodiness, hopelessness, withdrawal, drastic change in their appetite and sleep, and loss of interest in usual activities Increased alcohol and/or other drug use Behavioural changes and taking excessive risks SADAG runs the country’s only Suicide Crisis Helpline (0800 567 567) which is open 24 hours a day, 7 days a week, sms 31393 and a counsellor will call back or you can visit the online toolkit for teen suicide prevention on www.sadag.org. There is always help!

February 16, 2021

The low down on Covid-19 test protocols

As South Africa finds itself starting to move out of the second wave of a Covid-19 outbreak, over 8 million Covid tests have been carried out in the public and private sector since the start of the pandemic. The global gold standard method to diagnose Covid is the Reverse Transcription Polymerase Chain Reaction (RT-PCR) test. It is currently the most accurate way to detect SARS-CoV-2, the virus that causes Covid-19. Will your medical aid pay for the test? According to Lee Callakoppen, Principal Officer of Bonitas Medical Fund, ‘Funding is in accordance with the Council for Medical Schemes (CMS) guidelines, all clinically appropriate and referred diagnostic testing for suspected Covid-19 cases will be funded as a Prescribed Minimum Benefit (PMB) condition.’ Bonitas pays for up to three Covid-19 diagnostic tests from risk, whether the result is positive or negative. However, this is subject to the member or beneficiary being referred by a registered healthcare practitioner (doctor or nurse). This referral is dependent upon whether the member is showing symptoms, has been in contact with anyone who has Covid-19 and prior to hospitalisation. It should be noted that laboratories will not normally accept walk-ins for testing and require a referral or request from a healthcare practitioner. This is to ensure that we don’t test unnecessarily and jeopardise the availability of these tests for those who really need them. ‘Despite the PCR being arguably the most accurate laboratory methods for detecting, tracking and studying the Coronavirus, there are limitations in its widespread use,’ says Callakoppen. ‘These include: Access to the test kits; the complexity of performing them; the need for specialised staff to administer them; potential global shortages; high costs; the requirement for laboratory equipment and the delayed turnaround times. For this reason, testing should only be done when it is clinically necessary.’ What about Rapid Antigen Tests Immunoassay devices that detect the SARS-CoV-2 antigen within 15-30 minutes have also been promoted as a possible solution when access to PCR tests is a challenge. An antigen – detected in the blood or any other fluid – is any substance that makes the immune system produce antibodies. Viruses and bacteria are antigens. However, these tests are not as accurate as the PCR tests and have shown variable performance during evaluations, with sensitivities ranging from 0 to 94%. Test specificity has been high, but sensitivity has been erratic, which we need to bear in mind. Why is specificity and sensitivity critical? Sensitivity is the percentage of true positives (e.g. 90% sensitivity = 90% of people who have the target disease will test positive). Specificity is the percentage of true negatives (e.g. 90% specificity = 90% of people who do not have the target disease will test negative). These allow you to rule conditions in or out but not definitively diagnose a condition. What does the Council for Medical Schemes (CMS) say? The CMS currently still advocates the PCR test to diagnose Covid-19. The World Health Organisation (WHO) has also previously advised that the role of these rapid antigen tests must be evaluated and are “not currently recommended for clinical diagnosis pending more evidence on test performance and operational utility”. However, the WHO has now approved the use of antigen tests (and this is the South African approach as well) as an alternative to the more expensive PCR tests. This is however, in certain defined scenarios such as testing confirmed people in communities where infections have been detected, screening of high risk groups and individuals and for contact tracing purposes. They have also provided conditional recommendations for the use of these tests such as screening at ports of entry, routine screening for employees at their place of work, schools, prior to certain urgent medical procedures, etc. The challenge with these tests is that they are most accurate in patients between 5 and 7 days after showing symptoms – therefore the timing of testing becomes critical in order to ensure accuracy of the result. What about Rapid Antibody Tests? Many countries, including South Africa, are using antibody or serology tests such as the ones offered at various drive-throughs. These can detect whether someone has previously been infected and estimate how widespread the infection is but they are not recommended for diagnosis of Covid-19. For this reason, these are not funded by Bonitas Medical Fund as the use for these tests is limited for purposes of government surveillance and research rather than diagnosing Covid-19. If individuals want to know whether they have previously had Covid-19, for their own information, this test would be able to confirm that – but it is not used to identify whether you currently have the infection. If these tests are done too soon after the infection, they produce incorrect results as the antibodies (IgM and IgG) will not be detectable. There is also no scientific evidence that it provides any immunity to another Covid infection. ‘What is clear is that laboratory testing plays a vital role in the diagnosis and the prevention of the spread of the virus,’ says Callakoppen. ‘Nevertheless, it is important to understand that the timing and correct use of the different types of tests is crucial to gain the best results. We reimburse up to three PCR or rapid antigen tests done in or out of hospital for our members and recommend that this protocol for testing remains, until further research is conducted and evidence provided.’

February 12, 2021

INTERNATIONAL CHILDHOOD CANCER DAY (15 FEBRUARY): EARLY DETECTION CAN SAVE LIVES!

Of the 800 to 1 000 children that are diagnosed with cancer in South Africa each year, more than half tragically go undiagnosed. Dr Charlotte Ingram, Medical Director at the SA Bone Marrow Registry (SABMR) says SA has among the highest childhood cancer mortality rates with two thirds of children never reaching a specialist treatment centre and when they do, their cancer is often at an advanced stage. “Many childhood cancers are treatable with cure rates of between 70% and 80% in well-resourced countries, while in contrast, eight in ten African children with cancer die without access to adequate care. Despite SA having an established oncology healthcare service, its infrastructure is overburdened, which is further impeded by low cancer awareness in the primary healthcare setting and widespread service delivery challenges.” She says unlike adult cancers, childhood cancer is difficult to prevent or screen for because the causative genetic and environmental factors are less understood, but if it is detected early, most children can be treated successfully. “Knowing what the early warning signs are is vital in order for treatment to commence as soon as possible. Unfortunately, among certain local ethnic groups, there is still a lot of stigma and myths that surround childhood cancer. Some of these include: Two of the most common childhood cancers in South Africa are leukaemia and lymphoma. Leukaemia is caused by a rise in the number of white blood cells in the body and accounts for a quarter of all childhood cancer cases in the country. Early symptoms include chronic fatigue, bone and joint pain, weakness, easy bleeding or bruising, recurrent nosebleeds, swollen lymph nodes, fever and unexplained weight-loss. Lymphoma is triggered by tumours that begin in the lymph glands, the spleen, thymus gland and bone marrow and can affect other organs throughout the body as well. Look out for painless swelling of lymph nodes in the neck, armpits or groin, persistent fatigue, fever, night sweats, weight-loss and itchy skin. If any of these signs or symptoms persist, its best to make an appointment with a doctor who will be able to conduct tests to rule out the possibility of blood-related cancers. Dr Ingram explains that in many cases, a bone marrow transplant, which is also referred to as a stem cell transplant is used to treat leukaemia and lymphoma and other blood and immune system diseases that affect the bone marrow. “Childhood cancers are different from those found in adults as most of them occur in developing cells such as bone marrow, blood, the kidneys and nervous system tissues. Chemotherapy kills both cancerous and healthy blood cells inside the bone marrow, which is why transferring a new, healthy set of blood stem cells by way of a bone marrow transplant, helps their immune systems to recover from the intense treatment. Replacing diseased or damaged cells with non-cancerous stem cells will help the body to make healthy cells. “At the moment, SA’s overall childhood cancer survival rate is at an unacceptably low 52%, nearly 30% less than in developed nations. In 2018, the World Health Organisation (WHO) established the Global Initiative for Childhood Cancer, which aims to achieve a global survival rate of at least 50% for all children diagnosed with cancer within the next decade. “To deliver on that promise, policymakers need to prioritise childhood cancer by: Debunking the misconceptions around childhood cancer among a large percentage of our population; Increasing our country’s capacity to deliver quality services for children living with the illness, along with access to care; Whilst also increasing the number of bone marrow donors. Currently, only 73 000 donors are part of the national registry, which is miniscule if you consider that more than 23 million people are eligible.” Do your bit by helping the SABMR spread awareness around childhood cancer this month by sharing its social media posts with family and friends: https://www.facebook.com/sabonemreg/ https://www.instagram.com/sabonemreg If you are between the ages of 16 and 45 and want to become a donor, contact the SABMR on 021 447 8638 or email: [email protected]. Financial donations can also be made via www.sabmr.co.za/donate to help boost funds for their Patient Assistance Programme.

February 12, 2021

Minimize added sugar in your child’s diet

It’s true. Your baby or toddler was born with a sweet tooth! Children this age naturally prefer sweet tasting foods, including breastmilk. Did you know that babyhood and toddlerhood are critical periods in shaping and influencing your child’s eating habits and taste preferences? Upon introducing solids, it’s important to offer a wide variety of textures and flavors. When it comes to food choices, quality matters most! After all, they have tiny tummies that can only hold so much at one time. Because of this, it’s especially important to offer foods that are rich in nutrients, without any undesirable extras, like added sugar or salt. Some foods naturally contain sugar, such as fruit, some vegetables and dairy products. Added sugar can be in obvious sources like desserts and sugary beverages. But added sugar can also sneak into less obvious sources including flavored yogurts, breakfast foods like cereals and waffles, and even condiments like spaghetti sauce and ketchup. While we want to include good-for-you sources of natural sugars (think fruits, vegetables and yogurts with no added sugar) in our baby or toddler’s diet, we do want to keep out the not so good-for you added sugars. Keeping the added sugars in your child’s diet to a minimum is important in helping reduce the risk of various health conditions. Unhealthy weight gain, tooth decay, and attention/behavioral issues have all been associated with excessive intake of added sugars. Because research shows diets with fewer added sugars are better for our health, there are new laws governing the inclusion of these on our food labels. Moving forward, the government will be requiring food manufacturers to include the amount (in grams) of added sugars on the Nutrition Facts Panel. This will give us a much better idea of what is actually in our foods, in terms of naturally occurring versus added sugar. Here are some other ways to limit your child’s intake of added sugars: Offer mostly whole foods. Serving foods in their natural state, such as fruits and veggies, allows you to know exactly what you are feeding your baby or tot. Processed foods like crackers and other packaged goods can be not- so- obvious harbors for added sugars, check labels and offer no added sugar versions. Be mindful of “kid-friendly” foods. Specific foods aimed towards kids, like yogurts and cereal bars, can still contain too much added sugar. Look for and choose products that don’t include any of these sugars. Be a food label decoder. In addition to seeing the word “sugar” on food labels and ingredients lists, other words can indicate the presence of a sugar that is not naturally occurring in the product. Examples of these include: honey, agave, fructose, dextrose, corn syrup, and molasses. Becoming familiar with the many names of sugar will help you better understand what is in specific products. Meal plan. Preparing meals at home gives you more control over what goes into the foods you make for you and your family. Avoid sugary drinks. Avoid offering your baby or toddler beverages that are high in sugar like fruit beverages, sodas and iced teas. Even though 100% fruit juices do not contain any added sugar, no fruit juice is recommended for infants younger than 12 months. For toddlers 1- 3 years of age the intake for fruit juice should be limited. Limiting your child’s exposure to added sugars will help contribute to a healthy start! We love… Super Smart Pouches: Retail Selling Price: R42,50 Nourish your growing tot with this tasty blend of organic bananas, beets, and strawberries. To help support brain health, each pouch contains 20mg of DHA and 100mg of choline making this pouch perfect for wholesome, on-the-go eating! Stockists: Happy Family Organics products are available at Baby City, Babies R Us, Wellness Warehouse, Clicks, Spar, Pick n Pay, Baby Boom, Dis-Chem, Medicare Pharmacies, Takealot, Babies Africa, Faithful To Nature.

February 12, 2021

Pregnancy and COVID

Looking back at last year, we had no idea how COVID-19 would change the way that we live. It has crept into every facet of our lives. We have had to change the way that we work, learn, bury our loved ones, and socialise. Nothing is “normal” anymore. COVID-19 has had a profound impact on women who are pregnant. The ability for pregnant women to receive health care and general support from friends and loved ones have changed drastically. Pregnancy is a time where a woman and her partner need to be supported and have their regular medical checkups to help them have a healthy baby. Our new normal does not allow for large baby showers, friends popping over for a chat and a cuddle of your baby. Grandparents can’t visit in hospital and in some NICU visitation to the baby is very limited. So how then does a woman and her partner prepare for pregnancy and the time when your baby comes home? Here are 5 topics to consider: Social distancing / Self Isolation during and after pregnancy: The current research suggests that women who contract COVID-19 while pregnant have an increased risk of severe illness and death compared to non-pregnant women. They also have an increased risk of having adverse pregnancy outcomes like prematurity. Over the last year we have learnt that it is almost impossible to have no risk of contracting COVID but if you do need to leave your house, you can consider the risk of the activity. This will allow you to plan and put in place ways to reduce the risks. There may even be some activities you will have to avoid. In general, the more people you have close and prolonged contact with will increase your risk of getting COVID-19. You also need to consider the actions of the people that you live with and how they are interacting with other people. The best way to protect yourselves from contracting COVID-19 is to limit interactions with people. Steps that you can take when you need to interact with others are: Wear a mask over your nose and mouth, try to keep about 2m away from other people, wash your hands with soap and water for at least 20 seconds and if indoors try to be in a well-ventilated room. Events like baby showers, shopping for baby items and visit of friends once baby is home, need to be rethought as to how to make it safer for you and your baby. Some baby shower ideas are online zoom parties or drive by and drop off the gifts and a note. What ever you decide to do, consider the risks and how to reduce them. My Breastpump has an online store where you can have breastfeeding items delivered to your home: https://bit.ly/3obw7vH Look after your health. Keep all your health care appointments. Talk to your health care provider about the safest way to deliver your baby. You might consider having a home birth with a Midwife or giving birth in hospital. Eat a health balanced diet and take all your vitamin and mineral supplements. Keep active so that you are strong for the delivery. Find online antenatal classes to help you prepare for your delivery. The class should include information on different delivery types, how to recover from delivery, information of how to care for your baby once you get back home and are breastfeeding. Finding out what your hospitals policies are around COVID. It is best to know what the hospital policy is regarding COVID testing before delivery, your partners ability to see your baby, what if you do have COVID and visitation during hospital stay for family members. This will help you to be prepared and to pack your maternity bag accordingly. Many hospitals are not allowing non-parents to visit in the maternity ward. This may be lonely and scary, but it does allow you and your partner to have a baby-moon, where you both can focus on getting to know your little one, gives you time to learn how to breast feed and allows you to rest and recover after your delivery. Learn as much as you can about breast feeding. Breast feeding, although it is natural, is a learnt skill that you and your baby will need to learn. It is important to know how to breastfeed, what is normal and learn as much about breastfeeding before you give birth. Include your partner so that he will be able to help you if and when you need it. There are many videos that you can watch on YouTube about breastfeeding with a deep latch. You can visit our website for more information on breastfeeding and expressing milk. It is highly recommended that you find a lactation consultant that can give you an online breastfeeding workshop while you are pregnant. This gives you the necessary information to breastfeed well and someone you know that can help you if you need the help. If you would like to book a consultation with Carey a SACLC please email [email protected] for more information on a breastfeeding workshop. Have a plan for when you get home. The first few weeks after the birth can be difficult due to sleep deprivation and learning to care for your new child. COVID-9 just makes it so much harder because we are all social distancing. Have a plan or ideas of how you are going to make life simpler for yourself. Firstly, let your family know about visitation and how you would like them to interact with your new baby. Let them know what you would like: No visit policy, Visit but you can only look though the window or you can visit but you must wear a mask and sanitise. Will you have someone in the house to help you? If so, will that person need to self-isolate before they move in? You can ask your friend s and family to support you by taking

February 10, 2021

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