Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Ten tips for flu and Covid-19 vaccines

The seasons are changing and with winter on its way, which heralds the start of the ‘flu season’. We chat to Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund on why a flu vaccine is recommended, not just by the Scheme but also the World Health Organization (WHO). 1.Why should I get a flu vaccine? Although the flu vaccine will not eliminate your risk of developing flu, it helps reduce your chances of severe infection. Annually, seasonal influenza (flu) kills around 11 500 people in South Africa which is why it is a good precautionary measure to take. 2.How are Covid-19 and flu viruses similar? WHO says that Covid-19 and influenza viruses are similar in disease presentation. ‘Firstly, they both cause respiratory disease, which presents 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 social distancing is recommended.’ 3.What are the essential differences between Covid-19 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. Covid-19 and influenza are essentially different viruses with SARS-CoV-2 being a newly discovered coronavirus that causes Covid-19. 4.Why do I need a flu shot every year? The flu virus changes every year, this means last year’s vaccine will not keep you safe this year. The vaccine helps your immune system fight off the virus by producing antibodies – the soldiers in your body that battle the flu virus. 5.What vaccines have been developed for 2022? The flu vaccines available for this year are: The Vaxigrip Tetra, Influvac and Influvac Tetra. 6.Can I get the flu vaccine and a Covid-19 vaccine together? As per the National Covid-19 Vaccination Programme Circular 3 of 2022, the answer is yes. However, it is recommended that if you decide to have both vaccines at the same time, then one should be on the left arm and one on the right. 7.Who should get a flu vaccine? It is recommended that anyone in the High-risk groups including: Healthcare workers Individuals over 65 years of age Individuals with chronic diseases – or comorbidities – for example: Cardiac disease, hypertension, stroke, diabetes, asthma, chronic obstructive pulmonary disease, kidney diseases, etc. Pregnant women People living with HIV/AIDS 8.Who should NOT have the flu vaccine? Individuals who are allergic to eggs or egg proteins as the manufacturing process for the vaccine involves the use of chicken eggs Infants under 6 months of age – the vaccines are not licensed for use in such young children Individuals who may have had a severe reaction to a flu vaccine in the past – if you are unsure discuss with your healthcare provider Individuals who may be suffering from flu symptoms already 9.Will the flu shot give me a mild flu? According to the Centre for Disease Control (CDC), ‘A flu shot cannot cause flu. Flu vaccines are currently made either with flu vaccine viruses that have been ‘inactivated’ and are not infectious or with no flu vaccine viruses at all. The most common side-effects from the vaccine are soreness, redness, tenderness or swelling where the shot was given. Serious allergic reactions to flu vaccines are very rare.’ 10.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 risk of getting flu and, if you do get it, it will be a great deal milder. More importantly, by having the flu vaccine you protect others, who may be vulnerable family members, small babies, the elderly or those who are immune compromised. As with Covid-19, the more people vaccinated the closer we can get to ’herd immunity’.

March 25, 2022

SYMPHYSIS PUBIS DYSFUNCTION (SPD) AND HOW TO DEAL WITH IT

Symphysis pubis dysfunction or SPD is pain in your pelvis, which is caused by the relaxing of ligaments in the pelvic bones too early before birth. Many aspects of pregnancy can cause discomfort, and SPD is one of them. Here are the signs of SPD and what you can do if you think you to alleviate your discomfort if you are suffering from it. What is SPD and what causes it? Not all moms-to-be will experience SPD but it is thought to be fairly common in pregnancy. SPD is a pain in the symphysis pubis (which can range from moderate to serve) caused by the relaxing and stretching of the ligaments around the pelvic bone. Pain can be brought on by opening your legs, walking up stairs or even turning over in bed, and this may be accompanied by a clicking/grinding sensation in the pubic area. The cause of SPD in pregnancy is the hormone relaxin, aptly named as it relaxes your joints and ligaments to make it easier for your baby to come out at birth. SPD happens when these hormones come into play too early. Not only that but you’re shifting centre of as your baby grows, which can cause main in your lower back and pelvis as your body shifts to accommodate your little one. What can I do to relieve SPD Living with SPD can be uncomfortable at best, so you may be wondering what you can do to help alleviate some pain. Being fit before pregnancy can help, as stronger glute and abdominal muscles can help support your pelvis. Physiotherapy can help manage SPD pain, as a physio will be able to work with you as your pregnancy and pain levels change. Speak to your doctor first, as they may have recommendations for you. Your pelvis should return to normal between 4 and 12 weeks after birth

March 23, 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.

March 15, 2022

Medical aid contribution increases: The deferred increase debate

Traditionally, medical aid schemes implement fee increases from 1 January every year. However, the last two years have seen new trends emerge because of the Covid-19 pandemic. These include deferral of increases, dipping into reserves to reduce increases and announcing delayed increases above CPI. What does this mean for consumers? Globally people are feeling the financial pinch and South Africa is no different. High inflation has increased the cost of food, fuel and utilities. Salary increases, if any, are below CPI and many South Africans have lost their jobs. More so than ever, everyone is looking for value for money and better benefits, especially when it comes to healthcare. The balancing act Lee Callakoppen, Principal Officer of Bonitas Medical Fund says, ‘the delicate balancing act between maintaining the sustainability of the Scheme, while ensuring our members have access to affordable, quality healthcare is a core focus. Last year, we were the only Scheme to announce a 0% increase on one of our plans – the BonFit option. This was followed by the industry’s first ever reduction in a premium of 7,9% on our BonStart Plan in 2022.’ What using reserves meant for members ‘We opted to utilise around 3.2% – or R600 million – of the Scheme’s reserves to help limit contribution increases to below CPI for around 82% of our members for 2022. Contribution increases would have been closer to pre-pandemic levels of CPI + 4% if we had opted not to use some of our reserves. Deferred increases vs using reserves This move was in line with the Council of Medical Schemes (CMS) Circular 42 of 2021 which suggested the utilisation of reserves to cushion members against increasing costs. However, despite the guidelines, several schemes opted to defer increases from January to later in the year. These deferred increases range from 5.5 to 7.9%. In general, medical schemes need to keep their contribution increases as close to the rate at which the cost of providing healthcare escalates. The challenge is that most healthcare costs in South Africa are not regulated, which means providers are free to charge as they see fit. And the consumer bears the brunt. An example is the cost of Covid-19 PCR tests, which was finally standardised earlier this year. Consumers in for a rough ride Statistics SA cited CPI at 5,9% in December 2021, 0,4% higher than the month before. This trend is expected to continue with National Treasury projecting headline inflation (the change in CPI) at 4.8% in 2022 and 4.4% in 2023. So, consumers are in for tougher times. Is there freedom to change schemes with deferment? Callakoppen explains that the deferment of increases creates an anomaly for companies, medical scheme members and consumers. ‘Traditionally, members are free to change their options once a year during an open period. However, when a deferred increase arises, this open period does not always come with it. This complicates matters for companies which allow their staff to choose between various medical schemes. If an employee chooses to stay with a scheme offering a deferred increase, it is difficult and sometimes impossible, to switch to another plan. This is compounded by the fact that when these deferred increases take place – they are often above CPI and do not always include an increase in benefits – so members effectively pay more for less. Know what you are getting ‘By announcing our contribution increases in January, our members know what they will be paying for their medical aid from the outset of the year. This means they can plan and, if necessary, adjust their options accordingly to suit both their healthcare needs and their budgets. With the scenario of deferred increases, our advice is for companies to consider a mid-year open period to allow employees to change schemes or options to benefit already cash-strapped employees,” he added. The downside of deferred increases The past year has shown that the actual contribution increases experienced by members, after the deferment period, is typically higher than the industry average. An example is a Scheme that offered a contribution deferment for the first 6 months of 2021 but then applied a 5.9% contribution increase, when the industry average was 4.6%. Contribution increase percentages cannot be looked at in isolation without looking at the Rand value of the contribution. “Based on our analysis, we feel that a deferment strategy is not ideal. It merely utilises scheme reserves to provide a short-term contribution relief to members who subsequently experience an above market related contribution increase. This results in members being worse off compared to the scheme that applied a lower, market related contribution increase from the beginning of the year. Schemes implementing a contribution deferment are already applying above market average contribution increases. Callakoppen says that no matter whether a scheme has chosen to increase contributions or defer them, South Africans need to make sure they get the healthcare cover they need. “No two people or families are alike, medical needs differ, as do finances which is why you need to get cover that suits your health needs and budget. It’s important to interrogate what is being offered, to understand what is covered and any added benefits being offered which won’t impact your savings, before finalising your decision.”

March 10, 2022

GESTATIONAL HYPERTENSION, WHAT IS IT AND HOW CAN I AVOID IT?

Gestational hypertension is high blood pressure (the pressure of your blood on the walls of your blood vessels) during the later part of pregnancy, as opposed to chronic hypertension which is high blood pressure outside of pregnancy. Hypertension affects about 6 – 8 % of pregnant women, and unfortunately can negatively affect you and your baby. How will I know if I have gestational hypertension? You are more at risk if you’re carrying twins, are overweight, had high blood pressure, kidney disease or diabetes before becoming pregnant or are older than 40 or younger than 20.Gestational hypertension is high blood pressure in the second half of pregnancy and some moms may not even realise that they have it – which is why regular check ups are important. Unfortunately, high blood pressure during pregnancy can develop into preeclampsia. If left untreated, preeclampsia can lead to serious complications and even death. The most effective treatment of this is delivery of your baby (if possible). Symptoms of preeclampsia include headaches, nausea and excessive protein in your urine, with the most common first sign being a rise in blood pressure. How can I avoid or treat hypertension? Although there isn’t anything you can do to prevent hypertension(some variables such as age and number of babies you’re carrying is uncontrollable), you can try to keep yourself (and your baby) as healthy as possible during your pregnancy to help you control your blood pressure. Knowing your blood pressure level before getting pregnant, reducing your salt intake and regular exercise are all things you can do to help stay healthy and aware of your body’s condition. Going for regular checkups during your pregnancy will also help let you catch any problems early.

March 8, 2022

Obesity considered a global epidemic by WHO

Obesity is one of the biggest health challenges facing the world today, affecting around 800 million people, with millions more at risk. The prevalence of obesity has tripled over the past four decades, imposing an enormous burden on people’s health as well as the healthcare system. According to a World Health Organization (WHO) report, more than a quarter of South Africans live with obesity, making the country among the top 20% of the most obese nations in the world! Studies by the SA Medical Research Council indicate that nearly half of all South Africans are overweight. Even more shocking, is the fact that 22% of children between 1 and 9 are overweight or obese. The pandemic, lockdown and increased sedentary lifestyle has made the situation worse Dr Morgan Mkhatshwa,Head of Operations at Bonitas Medical Fund says, for overweight or obese people it’s not just an issue of vanity or fitting into a pair of jeans. ‘Risks associated with obesity include: Significantly contributing to the development of cardiovascular disease, type 2 diabetes, hypertension (high blood pressure), cancer (particularly colon, prostate and breast), sleep apnoea, degenerative joint disease, digestive tract diseases (gallstones), mental health and dermatological disorders. What determines if you are obese or not? Your Body Mass Indicator (BMI) calculator checks if you’re at a healthy weight. Here’s how to calculate yours: Divide your weight in kilograms (kg) by your height in metres (m²) If your BMI is over 25 you are considered overweight, at 30+ you’re classified as obese. There are detractors of BMI on its own The BMI screening may not be the best option for bulky, body-builder or stocky men for example. This is because it does not distinguish between lean muscle mass and body fat. Best practice is to measure body fat percentage along with the BMI calculation. This provides a better indication of one’s body composition. ‘Obesity is a chronic and progressive disease,’ says Dr Mkhatshwa,‘Urbanisation and the lifestyle associated with it, is one of the main contributing factors.’ There are two reasons for this: Lack of exercise: Cities are often over-populated, there are too few public spaces for physical activity and many residents use transport to commute Poor nutrition. Changes in diet include more processed and refined food, an increase in high-fat and high-sugar diets, less fruit and vegetables, less complex carbohydrates and fibre Although obesity is often associated with poor lifestyle choices, lack of motivation or unhealthy habits – it isn’t always the case. In America, where 40% of adults are obese, obesity has been recognised as a disease by the American Medical Association for nearly a decade. Despite this, they are still seeing most treatment approaches for obesity focus solely on behavioural therapy. The stigma and assumptions like this continue to create barriers that have limited better obesity care. The origin of obesity is complex and poorly understood, but includes nutritional, physiological, psychological and genetic factors. Environmental factors such as a sedentary lifestyle and excess calorie consumption can cause obesity Genetic studies with adopted children have demonstrated that they have similar BMIs to their biologic parents but not their adoptive parents. Twin studies also demonstrate a genetic influence on BMI Secondary causes of obesity can result from medications (eg. antipsychotics, steroids and anti-viral drugs) and endocrine disorders like Cushing’s syndrome and hypothyroidism According to the International Journal of Obesity, adults with obesity (BMI ≥ 30) incur 42% higher medical costs per capita and are nearly two times more likely to die before age 70 than adults with a healthy weight. They also say that health care providers play a vital role in the prevention, treatment and control of obesity. They recommend that multicomponent behavioural interventions, pharmacotherapy and bariatric (stomach shrinking) surgery are all effective strategies that support clinically significant weight loss. Obesity as with other co-morbidities, was also a poor prognostic factor for Covid-19 hospitalisations The general consensus regarding self-monitoring though is through: Calorie restriction: Reducing your intake by 500-1000 kcal per day will reduce total body weight by an average of 8% over a year Exercise: 30 minutes a day will yield health benefits, but 60 – 80 minutes will assist in weight loss and additional benefits Behaviour modification: Goal setting, self-monitoring and modification of one’s environment to enhance behaviours that will support weight management ‘The reality’, says Dr Mkhatshwa, ‘is that obesity and concomitant lifestyle diseases have become a pandemic in South Africa. Diabetes 2 is amongst these and has significant health implications. Managing this disease is imperative. We offer a diabetes management programme to help people understand this long-term condition and empower them to make the right decisions to stay healthy. This includes access to specialised diabetes doctors, dieticians, podiatrists and diabetic educators to effectively manage of diabetes. However, if you are not on a medical aid, there are several diabetic support groups.’ ‘Everybody needs to act’. It’s time to increase awareness of the root causes of obesity and encourage advocacy for change.

March 4, 2022

Advice from the experts

Intense allergy season predicted amid raging COVID-19 pandemic

The latter part of August typically signals the arrival of the pollen season, which this year, could prove more troublesome during the pandemic as tree pollen counts start to surge throughout most of the country. The highest counts to date have been seen in Johannesburg, Pretoria and Cape Town from cypress, casuarina, poplar, rhus, oak and olive trees. Plane trees, which are prolific in all cities, as well as buddleja, which tends to reach high numbers in Bloemfontein, are now also entering their flowering season, therefore it’s only a matter of time before symptoms are triggered in those regions. Prof Jonny Peter, who heads up the UCT Lung Institute’s Allergy and Immunology Unit says the Coronavirus could make allergy sufferers hyperaware of every sneeze and sniffle as some symptoms overlap. “Hay fever is activated by airborne allergens, such as pollen, which leads to a runny and itchy nose, scratchy throat, as well as allergic conjunctivitis in the eyes. While COVID-19 and hay fever share certain symptoms, there are some key differences. In COVID-19, fevers, body aches and headache are common, but these are rarely associated with seasonal allergies. In contrast, an itchy nose or eyes and sneezing signal allergy symptoms and are not common in Coronavirus infections. “Shared symptoms may include a runny nose or nasal congestion, an intermittent cough, sore throat and fatigue. In asthmatics, very high pollen counts may trigger exacerbations with shortness of breath or difficulty breathing in some individuals. Fortunately, Coronavirus does not commonly trigger worsening asthma. If your symptoms do worsen, it’s advisable to consult your doctor especially if you have a known sensitivity to pollen. “It’s also likely to have symptoms of both COVID-19 and seasonal allergies at the same time, which will affect each person differently. Some may experience mild symptoms, while others could have more severe symptoms.” SA’s pollen seasons vary across the country’s biomes, which is why the UCT Lung Institute is trying to establish pollen monitoring stations in all the provinces. Pollen allergy sufferers who are allergic to both trees and grasses usually have the toughest time in September and October as it’s the time of year when grass and tree pollen overlaps. That means a double dose of misery for people who are allergic to both. The grass pollen season can last for up to nine months of the year in certain parts of the country like the highveld, which only comes to an end in May. Prof Peter says as pollen levels rise it’s important to continue managing allergies during the pandemic with antihistamines, corticosteroid nasal sprays and inhalers. Here he answers some of the burning questions allergy sufferers have that will help them to manage their condition better during the pandemic: Q: Does having hay fever/allergic rhinitis pose an increased risk of severe COVID-19 complications? A: No. Current research does not indicate that allergic rhinitis or even well-controlled asthma increases either the risk of being infected with Coronavirus or the chance of developing severe disease. In fact, there have been reports that allergic rhinitis and some treatments used for allergic diseases may be protective, although the data is still emerging. Q: Will wearing a mask reduce hay fever symptoms? A: Perhaps. I think it is going to be an interesting aspect of the current pandemic and maybe a silver-lining. Masks may offer some protection against seasonal allergies since they can prevent larger particles from being inhaled. However, smaller pollen particles are still likely to get through the covering, therefore masks should not be your only form of protection. Keep in mind that pollen is a fine powder, microscopic in size and can travel deep into the nose and lungs. The higher the concentration of pollen in the air, the greater the chance of an allergic reaction. It’s also important to wash your mask after each use, because it could be carrying pollen. Q: Does COVID-19 exacerbate asthma symptoms? A: Emerging data suggests that this is unlikely. There are several viral infections that are a common cause for asthma exacerbations, including the common cold rhinoviruses and the respiratory syncytial virus (RSV). Interestingly, the SARsCoV2 or COVID-19 virus does not seem to be a major driver of asthma exacerbations. However, always remember to wear a mask in public to prevent the transmission of the Coronavirus. Q: Is there a way to reduce hay fever symptoms during the pandemic? A: It is impossible to completely avoid exposure to pollen. However, the second best option is to regularly check the pollen counts for your area on www.pollencount.co.za and to limit time outdoors when counts are high. Using a portable air filter in one or more rooms in your home will also help to filter pollen and dust. Use a high efficiency particulate filter (HEPA) for best results. Keeping windows and doors closed in the morning to midday when pollen counts rise will also help. The lowest pollen counts are usually in the late afternoon to early evening. When outdoors, avoid activities such as moving the lawn or raking leaves that will stir up pollen. Equally important is to remove clothes you’ve worn outside and to wash your skin and hair to remove pollen. Rather use a tumble dryer to dry clothes and bedding as pollen can stick to sheets and towels when hung outside. One of the main reasons to monitor pollen levels in SA is international data that suggests pollen seasons are becoming longer and more intense due to climate change (warmer temperatures cause plants to begin producing and releasing pollen earlier, making hay fever seasons longer). Air pollution is also increasing, which further aggravates allergy symptoms from pollen and fungal spores. “As COVID-19 is likely to be with us for a long time, it’s important to learn about the risks and how to keep allergies under control to prevent asthma episodes. There has never been a more important time to know what is in the air we are breathing.” If you are among the 17.5 million South Africans that suffer from

September 25, 2020

Bonitas takes the edge off contribution increases

Financially solid, younger new members, two new plans, virtual healthcare and a renewed focus on Managed Care for chronic diseases are just a few of the insights from the Bonitas 2021 product launch. But it is the annual contribution increases which are highly anticipated and the moment of truth for all medical schemes. Lee Callakoppen, Principal Officer of Bonitas Medical Fund announced an unprecedented 0% increase on its BonFit Select plan and a weighted increase of 4.6% across all plans. The highest increase is 7.1%. ‘Members on our growth options, which contribute to 91% of business, will only experience an increase on 3.9%. I think, looking at the pricing and the benefit richness we offer in comparison to the market, the changes for 2021 will be well received.’ He says, ‘The guidelines received from the Council for Medical Schemes (CMS), clearly highlighted that medical schemes should limit contribution increases as far as possible. We crunched numbers and worked tirelessly to find the sweet-spot between sustainability and ensuring affordability. Not an easy task, especially in a weakened economy. We took a responsible stance, with a long-term view, to ensure that our members wouldn’t have to pay the price of a low increase for 2021 in the coming years. One of our core considerations was finding ways to ensure members could get access to full healthcare cover and avoid out-of-pocket expenses and co-payments.’ Pricing and technology Seven of our current options are priced between R1 500 and R3 000 which is where the medical scheme market is experiencing growth currently. Member behaviour has changed significantly and demand is for innovation, accessibility and technology. This has the benefit of attracting, a younger, target audience and driving sustainability. We can’t talk about 2020 without mentioning Covid-19. Key trends that emerged from a medical schemes perspective were: Changes to benefit structures and PMBs Lower than anticipated investment income as markets slumped Changes in claiming patterns in terms of seasonality and volume, due to the lockdown measures that came into effect And a Consumer Price Index that was lower than previous years which is expected to be at around 3.9% in 2021 In an industry like ours, it’s challenging to be different – to innovate, disrupt…to be better. But not impossible. The Fund needed to make short-term decisions with the long-term view and sustainability in mind. One of the highlights over the past few years, has been the introduction of four Efficiency Discounted Options (EDOs). Plans whereby members use network healthcare providers and pay around 15% less for the same benefits. The EDOs cover over 74 000 lives and the principal members who join are around 10 years younger than the average Bonitas member. 2021 – changes, contribution increases and enhancements Over the past five years, we have proactively driven innovative product design, actuarial modelling and constant engagement with various stakeholders. We believe we offer the ultimate split risk solution, with a comprehensive product range and diversified membership base. To stay at the forefront of innovation we have introduced: Edge – a new category driven by technology, intelligence and innovation, with two plans called BonStart and BonStart Plus. These are designed for economically active singles or couples, living in the larger metros. The plans include access to: A private hospital network and full cover for emergencies; PMB chronic medicine; excellent day-to-day benefits including unlimited GP consultations; layers of virtual care, dental and optical benefits; preventative care; wellness screenings; contraceptives and more. The cost: R1 452 and R1 731 respectively for the principal member. Managed Care One of the leading trends worldwide is the rise in non-communicable diseases, such as diabetes, high blood pressure and oncology. In fact, during this global pandemic, the impact lifestyle diseases and comorbidities had on Covid-19 patients was put in the spotlight. 20% of our members have multiple comorbidities which means, even without the pandemic, we need a stronger focus on preventing and managing lifestyle behaviours. Poor diet, smoking and lack of exercise are the three lifestyle factors that contribute to over 80% of chronic conditions. Managed Care continues to be a focus to empower members to take charge of their health and support them along the way. Home-based care During Covid-19, home-based care received renewed interest and focus. This dovetails with our strategy to move more care to the home and out of hospital. As an example, post-surgery or mild pneumonia, treatment can be effectively provided at home through the assistance of nurses. Not only is home-based care a cost effective delivery of care but it also promotes healing. Studies show that patients recover faster in their comfort of their own home. Day hospitals We believe the use of day hospitals and clinics should be encouraged, where possible. Some procedures such as cataract surgery, circumcisions and scopes are better suited to be performed in day hospitals or clinics versus larger hospitals. There is minimum disruption to members, speedier recovery times, less risk of infection and day hospital are also a more cost effective alternative. Technology One of the key learnings has been adapting to a new way of working – with virtual technology at the forefront. The WhatsApp channel we introduced has the most room for potential. This platform is convenient for members and allows them to manage their medical aid through live chats. Virtual Care There was a positive response to the launch of the new Bonitas Member Mobile App and free virtual care for all South Africans. This provided access to GP consultations for a range of conditions, including Covid-19, as well as free delivery for chronic medicine. At the heart of the model is the GP. This aligns to our care coordination initiatives, ensuring members receive the right level of care and support in managing their conditions. It allows access to a virtual nurse, advice in an emergency, auxiliary and home- based care, ensuring members have comprehensive support for any condition, in any circumstance, through our virtual based model. We’re pleased to announce that this model is unique and

September 23, 2020

PCOS: You’re Not Alone – A Plea for Ovarian Health Consciousness

Acne, weight problems, excess hair, irregular periods – what if it’s all connected? This new ovarian health research asks you to take a minute for yourself and reflect … Every day, millions of women of every age and culture look at themselves in the mirror and see something that no one else does. We see that little bit of weight no diet or lifestyle changes seem to be able to fix. The excess oil, unwanted hairs and pimples that just won’t go away. We look straight past the beauty that’s there and see the girl who needs medication to have a normal period. Or the woman who’s umpteenth pregnancy test has come back negative. And we ask: why me? Why can’t I be normal? Funny thing is, that’s almost all of us. We just don’t talk about it. And perhaps it’s time that changed. Turns out, you’re not alone Over the past few years, doctors and researchers have been looking into a poorly understood and underdiagnosed ovarian health condition, known as Polycystic Ovary Syndrome (PCOS). And we’ve made a few startling discoveries along the way. PCOS impacts your ovaries and can cause infertility, and it’s usually only discovered when a woman struggles to conceive. But new research says that PCOS can show up at any age and as some of the most common “everyday” symptoms women experience today: Irregular, missed (or absent) menstrual cycles Weight loss or weight gain (the kind that you feel you can’t control) Acne, pimples and oily skin Excess hair growth And, in later life, difficulty falling pregnant Recognise these? The message is: You’re not alone. Research has shown 1 in every 10 women might have PCOS. What is PCOS really? New studies show that PCOS actually starts with your metabolism. Researchers realised that the bodies of most women with PCOS have trouble processing insulin, the hormone it uses to extract and store the energy from carbohydrates. And if your body struggles with insulin, it builds up in your blood and triggers your ovaries to overproduce androgen (male hormone). The technical term for that is hyperandrogenism, and you can probably already guess its symptoms: acne, excess hair growth, weight problems, irregular periods and infertility. Suddenly it all makes sense. You’re not weird or different. It’s more common than you think. And you can get help right now. If you think you might have PCOS Now, of course, not every pimple or stray hair indicates a serious underlying cause. But if you’ve really been battling with one or more of these conditions, the good news is you can get yourself tested and know for sure. Your doctor or gynae will be able to advise. And it doesn’t matter what age you are. In your teens, you might just want some answers about your weight, acne, hair growth and those times you missed your period. Or, if you want to start a family, you might already have some trouble conceiving. Even later in life, if you’ve had some of these symptoms and just want to make sure the insulin part doesn’t become something more serious (yes, PCOS has been linked to diabetes). Just know, PCOS can be managed. In fact, we at Lamelle Pharmaceuticals have developed an exciting new product specifically to complement the treatment of PCOS and promote ovarian health. Have a look: INTRODUCING: ALL-NEW OVARIA Using an inspired blend of ingredients, including a naturally-occurring sugar that’s part of the vitamin B family, Ovaria is a brand-new ovarian-health nutritional supplement whose ingredients are proven to be just as effective as traditional treatments (metformin or glucophage) for PCOS, but without any of the side effects. The naturally-occurring ingredients in Ovaria bind to cell receptors, activating the signalling pathways that regulate thyroid hormones and, most importantly, insulin in the body. This means Ovaria helps normalise blood insulin levels, which normalises androgen and improves the symptoms of PCOS. THE INGREDIENTS IN OVARIA ARE PROVEN TO Increase ovulation rate in 16 weeks Increase menstruation cycles Reduce hirsutism (excess hair growth) by 29% in 6 months THE BENEFITS OF OVARIA Improves ovulation to enhance fertility in women Normalises the menstrual cycle – in case of period problems Improves insulin resistance – useful for managing weight problems Improves blood glucose level (fasting glucose) Reduces hirsutism – used for hair growth problems Reduces the severity of acne – used for acne problems Improves insulin resistance, reducing type 2 diabetes risk and its complications Reduces blood androgens – used for acne, excess hair and sebum NEW OVARIA FOR A HEALTHY LIFESTYLE Ovaria is a nutritional supplement that comes in powder form. Choose from two flavours – orange or peach. You simply tear open the sachet, mix the content with water and drink, once per day. Ovaria contains 4000mg of Myo-Inositol, the required daily dose clinically proven to be effective in the treatment of PCOS symptoms. Doctors will have more information on PCOS. And Ovaria is available from reputable pharmacies – or simply order it online via Lamelle’s health store: https://lamelle.co.za/health-store. RSP: R350.00

September 18, 2020

Dairy, centrepiece of the Kid’s food table

From infancy through the teen years, children have particular nutritional needs to support their healthy growth. The culture of food they grow up in, and their food choices in the home and at school, also influence whether or not they will be lifelong healthy eaters. Unfortunately, there is probably no greater aspect of our daily lives that is more inundated by misinformation and fads than our food. In the midst of constantly changing, attention-grabbing ‘trends’ and the plethora of ‘latest miracle foods’, there’s a real danger that the sensible, balanced nutritional needs of children get put on the backburner. The wake-up call for South African families is in our cold hard statistics which reveal a double burden of disease with persistent stunting and wasting, as well as rising child obesity. Under-nutrition, which results in stunting and wasting that have lifetime impacts, remains a significant problem in South Africa’s low-income communities. The problem is, unfortunately, expected to be exacerbated by the ongoing economic impacts of Covid19. Obesity is a major health risk, predisposing us to diseases such as Type 2 diabetes and hypertension. Dietary intake associated with under- or overweight impact on both the physical growth and cognitive development of children who are then unable to realise their full potential in life. Through the celebration of milk’s inclusion in school nutrition programmes, the 21st World School Milk Day on 30 September 2020 is a reminder that other food and health concerns should never eclipse the need for meeting our children’s needs for daily eating regimes that promote their healthy growth. Maretha Vermaak, the registered dietitian at Rediscover Dairy says, “Over so many decades, scientific research has confirmed that dairy offers a unique food matrix of bio-available nutrients that supports healthy development in children. Milk, maas, yogurt and cheese offer specific diversity and versatility, so that it is easy to find dairy options for children and ensure that your family meets the recommendation of 2 to 3 portions of dairy a day.” Scientifically sound nutritional information is essential for families and schools. This empowers them to make good food choices and prioritise the nutritional needs of children. Understanding that calcium-rich dairy plays a vital role in bone development, not only for small children but during the teen years when bone density development is accelerated, helps parents to make sure that the family gets enough of the key nutrients provided by dairy. Dairy is not only a calcium-provider for healthy bones and teeth. It is an important source of affordable, high quality protein and is packed with vitamins such as A, B2, and B12, as well as potassium and zinc. Dairy Ideas for Kids No matter their income, many South African families fall short of the recommendations for 2 to 3 servings of dairy a day. However, given the versatility of dairy, it is really easy to include it in meals, snacks and drinks. Add milk or maas to oats and other porridges Add dairy to every lunchbox – cheese wedges and cheese as sandwich filling; small yoghurts; cottage cheese and yoghurt-based dips for vegetables and crackers A simple toasted cheese sandwich is a firm favourite among children Make delicious smoothies with milk and yoghurt with fresh fruits Add milk or buttermilk and cheeses to scrambled eggs and omelettes Melted cheese topping is always a winner that goes with many savoury dishes, vegetables and bread Bake with milk, buttermilk and yoghurt. Top cakes and muffins with cream cheese icing to add more nutrients to your treat Make easy frozen yoghurt popsicles or pots for healthy treats Replace sweetened cold drinks with milk or milkshakes made with fruits or flavoured milk “Parents need to remember that when it comes to eating behaviour, they are the most powerful role models,” says Vermaak, “One of the easiest ways to ensure your kids consume enough dairy is to make sure it is available at home and for them to see you enjoying dairy too.” Through its Consumer Education Project (CEP), Rediscover Dairy partners with National School Nutrition Programme (NSNP) of the Department of Basic Education (DBE) to highlight World School Milk Day. The NSNP includes dairy once a week in their school feeding programme to support South African children most vulnerable to stunting and wasting. The CEP makes fun information and teacher resources available for Grades R to 7 at http://www.dairykids.co.za/ Parents who are home-schooling due to COVID-19 can download curriculum-aligned interactive posters, worksheets, fact sheets and teaching guides. Children learn all about the healthy eating, SA’s food-based dietary guidelines, the role of dairy in healthy eating and the farm-to-table processing of dairy. For more dairy ideas join the Rediscover Dairy Facebook page: www.facebook.com/RediscoverDAIRY

September 16, 2020

Elective surgeries – the disruption, the trends and back to business unusual

On 9 September, South Africa recorded 1990 new cases of the pandemic in 24 hours. The country has now slipped to the eighth worst affected nation in the world in terms of the number of Covid-19 infections. In spite of this elective surgery has been given the green light and its back to business – albeit with strict protocols in place to safeguard staff as well as patients. Almost five months ago elective surgeries came to a standstill. This was reflected in claiming patterns in the private healthcare sector during lockdown – a disruption of the norm globally. In South Africa, elective surgery in both the private and public healthcare space and specialists’ visits are just two of the areas which have been affected by Covid-19. The link between the two is clear: Fewer specialists’ visits mean fewer referrals for surgery. So what exactly is elective surgery? The term can be ambiguous. It does not mean, as the name implies, that the surgery is optional but rather that it doesn’t need to be performed immediately. It can be scheduled at the patient’s and surgeon’s convenience. Some of these surgeries are necessary to prolong life, for example an angioplasty or, as in most cases, improve the quality of life. In brief, elective surgery is ‘A planned, non-emergency surgical procedure.’ Elective surgeries dropped by over half According to Lee Callakoppen, Principal Officer of Bonitas Medical Fund, ‘there has been a 60% reduction in hospital authorisation requests compared to 2019. A study release in March predicted that an estimated 28.4 million elective surgeries worldwide, would be cancelled during the 12 weeks of peak disruption due to the global pandemic. This has been a similar experience to other industry role players and is predominantly due to a combination of member fears related to Covid-19, lockdown and provider caution.’ Surgeries delayed not cancelled The postponement of surgeries was done to prevent patients taking up hospital beds and to avoid unnecessarily exposure to the virus – a strategy that worked well to flatten the curve. Surgeries were delayed based on provider discretion and subsequent patient engagement. Callakoppen says, ‘Providers are best placed to make these clinical decisions in the interests of their patients. If the procedures were emergencies or urgently required to enable member quality of life, those would have proceeded.’ The public sector too experienced backlogs in terms of elective surgeries. Examples are procedures including but not limited to, cataracts, orthopaedic surgeries, scopes, caesarean sections, tonsillectomies and adenoidectomies. BHF cautioned funders In July, The Board of Healthcare Funders (BHF) and its members in the healthcare funding space requested members of medical schemes to proceed with caution in scheduling elective surgical procedures. Dr Rajesh Patel, Head of Benefit and Risk at the BHF, said, ‘While the relaxation of the lockdown restrictions is good news for people, the country and the economy at large, we are still in the eye of the storm.’ The way forward? ‘As we move toward Level one, elective surgeries are almost back to normal,’ says Callakoppen. ‘It’s time to address the backlog of surgeries not considered emergency during lockdown. These include slow-growing cancers, orthopaedic and spine surgeries, airway surgeries, surgeries for non-cancerous tumours as well heart surgeries. We caution against a rush of elective surgeries though. Any surgery has an impact on the immune system which means the patient has a greater risk of contracting Covid-19 and developing complications from it. ‘It must further be noted that in some instances surgery is often recommended by specialists as one of the key courses of action. But we have noted that managed care protocols, in many instances, improve clinical outcomes with lower risk to the patient. One such example of this is spinal surgery, which is often unsuccessful. From a Bonitas perspective, we have noted that in the back and neck programme which enforces functional rehabilitation has been far more effective for our members. In addition, the risk to the member is significantly lower.’ Bonitas recommends the following is taken into account: That elective surgeries should only be resumed in instances where not having the procedure will severely impact the members’ health and quality of life That the current state of a patient’s healthcare is assessed – individuals with chronic conditions such as diabetes, asthma HIV/AIDS and hypertension, are at high-risk of developing Covid-19 complications The patient’s age is taken into consideration (older individuals are identified as one of the most vulnerable groups) The impact of waiting on the patient’s healthcare outcomes (for example, is it essential that the surgery takes place now or can it safely be deferred for a few months) Alternative care protocols – in some cases surgery, which should be a last resort, is prescribed without considering other treatment protocols such as rehabilitation. The most common examples of this include back and spine procedures, elective c-sections as well hip and knee replacements The use of day hospitals and clinics, where possible, to limit the possible chance of infection We may have flattened the curve but we are by no means out of the woods. Current Covid-19 cases in South Africa prove that. What is happening in hospitals? ‘Surgeries are being resumed responsibly with due collaboration and consideration exercised between the surgeon, the patient and hospital staff,’ says Callakoppen. Where there are capacity constraints, surgeries will be classified in terms of priority at the various hospitals. Pre-operative screening will continue. Facilities will continue to utilise separate zones for Covid-19 positive patients, Persons Under Investigation (PUI) and those for whom the status is unknown at the point of admission. Surgeries will be carefully planned and scheduled. Specialist visits on the up ‘Consultations are starting to increase once again but providers in general are likely to remain prudent. However we urge people who have not had their necessary annual check-ups, particularly our high risk members, to consult with their doctors. There may be members who have put these consultations on hold and are now more comfortable to visit a specialist. But care coordination

September 11, 2020

Physical touch & newborns – why is this so important

The birth of your baby is a beautiful and special moment in both of your lives. You may be wondering about your newborn’s senses, while they are born with all necessary senses, some are less precise than others and develop as your baby grows. Physical touch is an important aspect of your child’s growth, coming from your womb, where they are tightly cocooned in your womb. Skin to skin contact offers benefits to both you and your baby, and touch is one of the senses that can help comfort your baby, making them feel more secure and helping strengthen the bond between the two of you. Why is touch important? Touch enables your baby to learn more about the world, bond with their mother and learn communication skills, as touch and body language will be the first way that you can ‘speak’ to one another. Breastfeeding is an important part of this, as your baby then spends time in her mother’s arms. The benefits of touch goes beyond the physical. Contact between mom and baby has been shown to lower cortisol levels, which in turn benefits the functioning of the immune system. Children that are deprived of touch can be more aggressive with other conduct disorder problems. What is swaddling? Coming from a tightly packed womb, you’ll find that your baby is comforted by touch and close cuddles. Swaddling your baby in a blanket is also another technique that you can use on young babies to help them feel more secure, as it stops them from upsetting themselves from their own startle reflex. It’s important that your newborn finds their new world a comfortable and soothing place. Swaddling is an old technique, and beyond helping your little one feel safe and secure, your baby is likely to sleep better and will be kept nice and cosy in their blanket. If you decide to swaddle your baby it’s best to do so from birth, as opposed to introducing it when they are older as this can increase the risk of Sudden Infant Death Syndrome. Using the proper techniques when swaddling is also important, as incorrect wrapping can lead to issues.

September 8, 2020

Does your pantry have a nutrition gap?

‘Flu epidemics have us thinking hard about what foods to buy to support our family’s immunity and supply the best nutritional value for money. When shopping for the pantry, remember that our bodies not only need proteins, carbohydrates and fats, but also vitamins and minerals. Refined carbs and saturated fats are generally affordable and typically part of Western style meals, but protein is often perceived to be more expensive. Correct levels of all vitamins and minerals, although needed in smaller amounts, are difficult to ensure even in a so-called balanced diet, so people tend to buy a variety of nutritional supplements. Lifegain® ALL-IN-ONE Advanced Nutritional Supplement is therefore a good choice, particularly when seasonal changes might leave your body requiring extra nutritional support. Lifegain® (click through to www.lifegain.co.za) costs just over R12.42 a serving a day*. It is high in protein with 15 g per serving from the triple protein blend of soy protein, milk protein concentrate and whey protein isolate, and high in energy. 24 vitamins and minerals, omega-3 fatty acids, fibre and Glutamine further support immune and digestive health. There is no equivalent all-in-one supplement that provides the whole body with the high levels of nutrients that Lifegain® does. We usually can’t do anything about stressful events, but we can control good nutrition to help us through it. For nearly 20 years Lifegain has been supporting the healthy and those whose nutritional needs are higher due to age, injury, hospitalisation or illness. Just add two level scoops of powder to 200 ml of milk, water, juice or smoothies Available from selected pharmacies and retail outlets nationwide and online from Takealot, Clicks and Dis-Chem. * Lifegain® 33-serving tins in vanilla, strawberry or chocolate flavours, at around R409.95 = R12.42 a serving. Lifegain® 10-serving tins in vanilla, cappuccino, strawberry and chocolate, and Lifegain® Junior, both around R169.95 = R17 a serving.

September 3, 2020

How does my diet affect my pregnancy?

A healthy diet is always important, but during pregnancy you are eating for both you and your baby so it’s critical that you remain healthy. Eating poorly during pregnancy can have a long term impact on your baby’s health growing up. So that being said, what foods should you be eating during pregnancy? If you eat healthily already you won’t need to go onto a special diet during pregnancy, but it’s important to get the right nutrients for you and your baby through a balanced diet. Don’t be alarmed if you find yourself hungrier than usual, but even if you are expecting twins you won’t need to eat for two. It is also important to note that weight gain during pregnancy is normal, so don’t be alarmed by this. Eating schedules differ between moms, however, it is generally recommended that you eat smaller amounts more frequently when pregnant, especially if you are struggling with morning sickness. What to eat when you’re expecting Fruit and veggies are your friend during pregnancy. Providing much needed vitamins and minerals, as well as fibre which helps with digestion and keeps you feeling fuller for longer. Protein is another important nutrient, and you should try to include it in your diet everyday as it helps your baby grow strong. Sources of protein include nuts, beans, pulses, eggs, lean meat and fish. However, raw, cured and uncooked meat are all risky to consume during pregnancy as they can cause toxoplasmosis. Another important source of energy is carbohydrates, specifically whole grains. They contain vitamin B, fibre and iron, which are all important for the baby’s growth and staying healthy. These include oatmeal, wholewheat pasta and bread, potatoes and maize. If you are suffering from morning sickness, these blander foods fill you and can be eaten little and often. Foods that are rich in calcium should also be eaten regularly. Dairy foods, such as milk, cheese and yogurt are all options containing calcium as well as protein and vitamin D. That being said, some cheeses (such as soft cheese like brie) should be avoided as they can contain harmful (although rare) listeria bacteria. What foods should be avoided during pregnancy There are certain foods that you should take care to avoid during pregnancy. As mentioned, rare meats and certain cheeses should be avoided. Liver and raw fish (i.e sushi) are also on the to-avoid list. Consuming too much caffeine can also affect the baby negatively. Coffee is the obvious drink to avoid, but be aware that soft drinks, green tea, certain energy drinks and chocolate all contain caffeine.

September 1, 2020

Sugar, comorbidities and my family

We all know how important it is to eat healthily. But have you ever given thought to how much sugar you and your family consumes daily? These are trying times we are in, the current global pandemic has raised more awareness of health issues than ever before. People are now, for the first time, learning about comorbidities and how it affects their health especially when there is a serious virus doing the rounds. We asked Owen Dunderdale, registered South African Dietitian and online coach to define comorbidities as more people become aware of the term however lack the understanding of it. “Conditions which exist simultaneously that may be related to a common medical illness. An example of this would be someone with Metabolic Syndrome. The person may be obese, have high blood pressure, type 2 diabetes and have cardiovascular disease, concurrently. These are all preventable through maintaining a healthy weight, exercising regularly and eating according to healthy nutritional guidelines. If the person changed their lifestyle, their overall health will drastically improve.” explains Dunderdale. “People who have comorbidities will most likely suffer a more severe case of COVID-19 than someone who is healthy. The higher the severity of the illness, the higher the incidence of mortality.”, he says. Changing one’s lifestyle and eating habits is no easy task, it takes determination, lots of understanding the reasons why you started the lifestyle change in the first place and then sticking to that new change. Health should always be the forefront for many changes. Luckily, Delite Foods locally produces products that can counteract these lifestyle issues and make it easier for one to adapt without even realizing it. Dunderdale mentions, “In order to lead a healthy lifestyle, it’s important to use products that are calorie controlled and/or are sugar-free. The World Health Organization recommends that we don’t consume more than 5-10 teaspoons of sugar/day (25-50g sugar). Why would someone consume products that are high in sugar when there are healthy, sugar-free alternatives that taste the same? I highly recommend using sugar free products. According to statistics published in 2016, the obesity rates in South Africa are increasing rapidly, with almost 70% of women and 40% of men either overweight or obese. Using sugar-free products decreases your daily calorie intake, which has a role to play in maintaining a healthy weight. Therefore, switching to sugar-free products will inevitably lower the rate of obesity. Whether you’re healthy, overweight or obese, you should be controlling your daily sugar intake and using sugar-free alternatives.”. Smart sips for the family With such knowledge and insight, where does one even start? We suggest starting with healthier drinks options. Let’s start with your daily intake of water and milk. We all know that we should be drinking about 8 glasses of water a day, yet for some of us – just the thought of a colourless and tasteless drink is quite unappealing to say the least. Kudos to those who have managed to enjoy drinking the recommended amount each day! Here are 6 smart tips to encourage the intake of healthier drink options for yourself and your kids to enjoy as recommended by Dunderdale: 1. Flavoured water (Add a 5g sachet of Delite Foods Tantalize Powdered Soft Drink to a litre of water/sparkling water). Flavoured water is almost certainly going to increase a child’s fluid consumption. 2. Add Tantalize Flavoured Syrup to milk to create a delicious flavoured milk drink. 3. Make ice flavoured ice lollies using Delite Foods products. (more useful during the summer months). 4. Keep them happy by using the Tantalize Milky Mix to make a glass of chocolate milk or warm cup of hot chocolate. 5. Keep everyone hydrated with flavoured ice tea by simply brewing some rooibos tea bags and a sachet of Tantalize Powdered Soft Drink together for the ultimate thirst-quencher. 6. Kids enjoy flavoured drinks, so keep a jug of water and a colourful cup on the dining room table at all times. Stay connected and engage with us on Facebook, Instagram and Twitter.

August 31, 2020

The 5 C’s of allergy management amidst the Corona pandemic

Allergies, the common cold and other viral flu-like illnesses share many features that are also common to COVID-19. For example, coughing or shortness of breath is associated with many viral illnesses as well as asthma. A runny nose occurs in both allergic rhinitis (hayfever) and the common cold. However, high temperatures, muscle pains and fatigue, which are common to COVID-19 and influenza, do not form part of the presentation asthma or hayfever. Another important clue to remember is that seasonal allergies tend to wax and wane, whereas in a viral illness, such as flu or COVID-19, symptoms steadily worsen. Most common presenting symptoms Asthma Hayfever Common cold Influenza COVID-19 Shortness of breath Runny nose and sneezing Runny nose and sneezing High temperature High temperature Cough Itchy and watery eyes Sore throat Cough Cough Wheezing Post-nasal drip Fatigue Fatigue Coughing Headaches Shortness of breath Congestion Muscle pains Muscle pains Diarrhoea Sore throat Headache Nausea, vomiting, diarrhoea Control any underlying allergic conditions and continue chronic prescribed medication Asthma too, needs to be well under control during this period. Although research has shown that mild to moderate asthma does not put one into a higher COVID risk category, poorly controlled asthma may lead to certain COVID-related complications. For this reason, good asthma control to prevent asthma exacerbations is key. According to numerous international allergy societies, regular asthma medications required for asthma control such as inhaled glucocorticoids, and montelukasts should not be discontinued during the COVID-19 pandemic. Because allergic rhinitis (hayfever) presents with sneezing, a runny nose, post-nasal drip and associated itchy eyes, it may be easy to mistake these symptoms for COVID. For this reason, it is important to control allergies, perhaps even to take anti-histamine and nasal steroid medication ahead of allergy season to prevent mistaking COVID-19 for allergies. Further incentive to good allergy control during the COVID epidemic is that nasal and eye itchiness will present a challenge to mask-wearing and not touching ones’ face. In summary, as stated by the American College of Allergy, Asthma and Immunology: “There is no data that continuing these allergy and asthma medications will have any effect on increasing your risk of getting the COVID-19 infection or if you get the infection, lead to a worse outcome. It is important to control your allergy and asthma symptoms’’. Caution needs to be exercised when using a nebuliser The use of nebulisers is not recommended during the COVID pandemic as they have been found to increase the risk of aerosol spread of the virus particles. Alternative options to nebulisers are asthma pumps, in young children with a spacer attached, to deliver bronchodilator medication. Consult your doctor if you have concerns If you or your child experiences any symptoms of chest tightness, difficulty breathing or wheezing, please consult your GP. Doctors are still seeing the ‘usual’ winter respiratory illnesses, and so any worrying symptoms should please be discussed with your healthcare provider. Should you develop symptoms suggestive of COVID, or have a positive COVID result, it is imperative that you make your doctor is aware so that the appropriate management steps can be taken. Cover your nose and mouth with a mask, observe social distancing and wash your hands At this stage, these simple measures are our most effective defence against COVID-19! Take care and stay safe!

August 31, 2020

Covid-19 is hurting children’s mental health – here’s how to help

If you’re worried about how your children will weather the Covid-19 storm, you’re not alone! e The pandemic and lockdown have changed children’s lives in many ways. Especially now with schools closing again – disrupted routines, uncertainty, and parental anxiety scan have an impact on children’s mental health. We spoke to counselling psychologist Reabetsoe Buys about the mental health effects she is seeing in kids, and tips for how you can protect their mental health now and in the future. The effects of Covid-19 and subsequent lockdown on children Children may not be able to handle, or be interested in too much detail. They may n develop a sense of fear around the virus – fear of getting sick, and in particular worry about how it might affect their parents and grandparents. The lockdown had left children more socially isolated and spending much more time at home with the family. “Almost overnight children had to stop going to school and visiting friends and relatives over the weekends. Not only is this very confusing for them, but it has given rise to feelings of uncertainty and vulnerability,” says Reabetsoe. These fears and uncertainties can affect children in different ways. Reabetsoe says you may have noticed: Increased anxiety, clinginess, and fear Emotional outbursts, anger, and irritability Changes in sleeping and eating habits Bodily complaints like stomach aches or headaches which seem to have no medical basis Regression, such as being afraid to be sleep in their own room Feelings of sadness and loneliness, as they miss school and friends Helping your kids cope “Fortunately, children are much more resilient than we think, so as a parent/guardian try not to panic when your child shows any changes in how they function during this time,” says Reabetsoe. Here are ways you can help your child cope: COVID-19 concerns and worry Find out what they already know. Then you’ll be able to fill in the gaps. But if they don’t seem interested or their questions are few, that’s also OK. Talk about COVID-19 openly and truthfully – make sure you provide factual information in a calm manner. Provide context. Inform them that children don’t get as sick as adults, who get symptoms similar to those of a cold or flu. Also explain that most people who get the virus do recover and do this reassuringly. Focus on the positives. Talk about the measures being taken to keep people safe and healthy, and that by washing their hands often, wearing masks, taking their vitamins, and getting enough sleep, they’ll stay healthy and strong – be a good role model and let them see you doing these protective activities often Regarding the lockdown Give them space to share their fears: allow your child to tell you what they’re thinking and feeling. Check in with them regularly and let them know they can always come to you for answers or talk about what scares them. Empathise and normalise their feelings. Reassure them that they are safe and taken care of – extra hugs and love can go a long way! Share age-appropriate information with them so that they understand the limitations (e.g. we cannot go out because we need to make sure we keep safe in our home). Routine, structure, and consistency create a sense of stability and security. Give them specific things to do to feel in control – get them involved in planning fun activities which the family can do together. Make time for fresh air and exercise. Do not stress over schoolwork if it becomes unmanageable at the moment, especially when children are young – it is already a stressful time! Set up video playdates so your child can be in touch with friends, cousins and other family members. Selfcare is of the essence Parents are experiencing their own stresses around health, safety, finances, family and the uncertain future. Children are sensitive to their parents’ feelings of stress and anxiety. Try to take care of yourself and manage your own stress and anxiety as best you can. Make time to connect with other adults and nurture those relationships and get help when you need it. Ask for a helping hand for your kids While we are still trying to navigate these trying times, it is just as important to keep an eye on changes which might indicate a significant impact on mental health and well-being. If symptoms persist or worsen, reach out for assistance or support. Many therapists are conducting virtual sessions for adults and children. Help is always near South African Depression and Anxiety Group (SADAG), (011) 234 4837 Lifeline SA: 086 132 2322. Anton Keet, Head of Risk Services at 1Life

August 28, 2020

Should you test your child’s DNA?

To test or not to test… In countries like Norway and Finland, it is standard practice to test every new born baby for various genetic disorders. Conditions like Cystic Fibrosis, Sickle Cell Anaemia, Duchenne Muscular dystrophy, Tay-Sachs Disease, Phenylketonuria, and Thalassemia which are caused by a single gene mutation and respond well to early treatment which can prevent potentially serious complications or permanent disability. In other countries, for example Kuwait, compulsory DNA testing was over-ruled after being challenged in court, in favour of protecting the right to personal liberty and privacy. However, few diseases are the result of a single genetic mutation. Instead, multiple genes interact with each other and with environmental factors to influence the child’s risk of illness and the severity of any given disease or condition. This means that it is possible to make changes to the child’s diet and conditions to influence whether or not these conditions will manifest. Every parent at some stage worries about whether they have passed on a hereditary disease to their child, and the truth is that their susceptibility to those conditions is indicated in many of today’s DNA tests. Nonetheless, this information is not necessarily doom and gloom. The focus of precision medicine, which includes DNA testing is to use this information to avoid these conditions setting in. Prevention is more effective once one knows the risks. “Genetic tests can help parents to make informed lifestyle choices for infants and young children. For example, these tests can help identify the likely cause of digestive issues, to avoid further symptoms and promote healthy digestion” says Dr Christa North, nutrigenomics specialist at Genway. What lifestyle DNA testing will enable you to know about your child The risk of nutritional deficiencies can be identified in DNA test results. This way you can work out exactly which nutritional supplements should be given to the child. The Geneway Genediet test explains which food types are best suited to his / her system and which should be avoided DNA tests explain a child’s circadian rhythm and give insights regarding their optimal sleep times and needs. The Geneway Genesport test explains whether one’s body is better positioned for anaerobic (power/ strength) or aerobic (endurance) sports, as well as how well their body will respond to exercise. This explains their sport potential and will help guide you on how to manage this aspect of their development. New DNA tests identify the strengths and weaknesses of each person’s immune system and give indications of how these can be addressed for optimal health The onset of Diabetes in children has increased tremendously in the past decade. Testing the child’s DNA helps explain his / her predisposition for this condition so that parents can structure their diet accordingly, and know the signs to look out for. The details are in the DNA Here are a few of the genes that are tested by South African DNA testing company Geneway and what they indicate: MTHFR – Switching genes on / of. Sometimes your child’s focus is great, other days s/he has major anxiety, complains about headaches or is simply just grumpy. Even autism is a possibility….. COMT – “laid-back or tense?” The gene that determines whether your child is cheerful and focused or quickly irritated, impatient, has a high pain sensitivity and sleep is a challenge DAO – “sensitivity to certain foods” You know your child is allergic to ‘something’ or sometimes you feel like he / she is allergic to ‘everything’, but cannot figure out what? GSTs – “Detox issues” Chemicals and smells make your child feel sick and they probably will develop grey hair early. In addition, they are more vulnerable to DNA damage. MAO-A – mood swings & carb cravings This gene helps govern the levels of dopamine and serotonin, brain chemicals that affect mood, aggression, productivity, vulnerability to addictions, self-confidence, sleep and carb cravings! NOS3 – heart issues Are heart problems on the way? Cold hands and feet can indicate that blood flow and blood vessel formation are affected. PEMT – liver and brain issues No! Your child is not made to be a vegetarian! In addition, gallbladder problems and muscle pain are common. APOE – want to play rugby? The ApoE gene promotes repair and growth in brain cells after traumatic injuries such as concussions. Contact sports are not a good idea HFE – “iron man” Iron deficiency is the most common nutrient deficiency in the world, however, the opposite, an iron overload, can have far more devastating consequences. Too much iron in the body causes liver disease, fatigue, weight loss, abdominal pain and has an effect on normal puberty development. F2 & F5 – blood clotting issues Blood clotting disorders, heart disease and strokes. Diseases that start young but are often only diagnosed when too late To test or not to test The information obtained in DNA tests can be used to dramatically improve a child’s quality of life if this is accompanied by proper medical interpretation and thorough recommendations. You as a parent will be in a position to make more informed choices regarding their health, wellness, sport and diet if you are equipped with detailed information. What is important is to ensure that a qualified healthcare provider interprets and presents the results to you. DNA reports are highly detailed, and while some international companies do offer a test and report (without consultation) a professional consultation is highly recommended to ensure that both you the parents and your child gets the full benefit of the test. More information is available at https://www.geneway.co.za/ or call (012) 346 2469

August 25, 2020

Stimulating your baby’s senses

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. Believe it or not your baby will learn a lot in their first year of life. One way you can help them learn is to provide stimulation for them in different forms. This can be done in a variety of ways such as stimulating their vision and hearing or through touch and movement. Remember to spend some time every day working to help your baby explore the world around them. Stimulating your baby’s visionThe 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. Make eye contact with your baby during times when their eyes are open. Look them right in the eye. They recognize faces very early in life, especially yours! This helps them develop their memory. Use a mirror to let your baby stare at his or herself. They will enjoy looking at “another” baby and watching the movements it makes. Stick out your tongue for your baby or make funny faces. Starting at 2 days old newborns can begin to mimic simple facial movements as they begin to develop problem solving skills. Hold up two pictures for your baby to look at. They should be similar, but with some sort of difference between the two – maybe one has a house and the other doesn’t. Even young babies will look back and forth between the two to try and figure out the difference between them. This can help them develop letter recognition and reading skills later on. Stimulating your baby with laughing and singingThe 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. Find ways to get your baby laughing. This can be through methods like gentle tickling, blowing on their arms and tummy, or making funny faces. As they get older you can joke around more too. Laughter is great for babies! Sing songs to your baby. Learn as many as you can or make up your own words to songs you already know. Play music to your baby. This can be Bach or Mozart or even the Beatles. Learning music rhythms may help them learn math skills later on. Talk away. In other words, have a silly, fun conversation with your baby. Chat away and pause at places where your baby would speak in the conversation. As your baby grows, they will learn to start chatting to fill in the spaces you leave. Be sure to make eye contact and smile a lot! Play peek-a-boo, it’s great for getting babies to giggle and laugh – it also teaches them that objects can disappear and then come back. Physical activities for your babyThe 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. Turn yourself into a playground by lying on the floor and letting your baby crawl all over you. This will help boost their problem-solving skills and coordination. Teach them to move to music. You can teach them to do the twist, twist and shout or even twirl like a ballerina. This helps them develop skills like balance and coordination as well as a sense of rhythm. Create an obstacle course by laying toys, boxes or sofa cushions on the floor and then show your baby how to crawl over and around or under the items. This helps with problem-solving, strength and coordination. Play pick-up by allowing them to drop toys or pieces of wadded up paper off their highchair into a bucket or other safe container. This helps them learn and explore the laws of gravity. Newborn hearingThe 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. Newborns can hear immediately upon birth and are able to distinguish their mother’s voice above all else. If your baby does not seem to react to your voice or does not startle with a loud noise, be sure to tell your paediatrician.

August 17, 2020

Childhood Poisoning

A small child exposed to a potentially poisonous substance causes great anxiety in parents. In South Africa, just under half of the calls to the Poisons Information Helpline relate to accidental poisoning in children under the age of 5 years. Fortunately, accidental poisoning is seldom fatal; childhood poisoning contributed only 0.3% to deaths in children under the age of 5 years for 2017 in South Africa. Accidental poisoning is commonest in children under five years, with a peak at two years of age. At this age, children are becoming more mobile, they like to explore, and copy older children and adults, but they do not yet recognise danger. For a pre-school child, home is the main living environment, so exposures to household substances are common. Household substances include cleaning agents such as bleaches and soaps, which can cause a local chemical (burn) injury. Cosmetics are common in the home, but unlikely to cause significant poisoning. Common medicines that children can find at home if they are not stored safely include flu remedies, pain medication, antihistamines, tablets for heart and mental health conditions. These can cause serious poisoning in small children. Homes such as those seen in informal settlements may have paraffin and pesticides which are easily accessible. Pesticides can be swallowed, breathed in or absorbed through the skin. Toddlers often find rat pellets and granules which have been mixed with food and put out behind cupboards and on the floor. Poor ventilation after fumigation can also result in poisoning. Paraffin is the single most common substance to cause poisoning in children. Many parents decant paraffin into smaller juice bottles, which children confuse with water, particularly in the hot summer months when they are thirsty. Just a small sip can cause harm to the lungs resulting in shortness of breath and breathing difficulty. Other factors may influence the risk of childhood poisoning. Family stress plays an important role. Overcrowding, moving home or holidays away from home, lack of child supervision, single or unemployed parents, and anxiety or depression in parents increases the risk of poisoning for the child. Grandparents’ homes may be particularly risky to the under-5s if adult medicines are kept in unprotected places. Potential causes of harm are not limited to the home, as substances in the environment such as plants, mushrooms, snakes and spiders can also result in poisoning. Assessing the risk for my child Exposure does not necessarily mean poisoning. A substance may not be poisonous at all, or too little may have been taken to cause harm. If you suspect your child has been poisoned, find the container; identify the exact name of the substance, the amount taken, the time since exposure and note how the child is doing. Do this first, then consider calling the 24/7 Poisons Information Helpline, 0861 555 777. What first aid can I do immediately? Rinse the child’s mouth out with water and offer a few sips of water to drink if necessary. Forcing a child to drink a cup of milk or making them vomit is not advised as it can do more harm than good. Remove all contaminated clothes. Exposed skin should be washed thoroughly, as soon as possible, with soap under a constant stream of water that drains away, so use a shower, not a bath. Eyes should be washed with water for many minutes, with the eyelids held apart. If the child is unconscious, turn them onto their side and gently tilt the chin up (the recovery position). If a poisonous gas or smoke has been breathed in, move the child to fresh air. What might happen at the clinic or hospital? A child with poisoning is usually seen quickly at the clinic or hospital. If the child has taken a lot of a particular poison, and is seen within an hour of drinking it, a mixture of charcoal and water may be given to the child to drink which binds to the poison inside the stomach; this should only be done by a health worker. Most poisons have no antidote, so treatment is guided by symptoms (e.g. treating pain) and aimed at supporting the function of affected body organs (e.g. oxygen for difficulty in breathing, fluids if significant diarrhoea and vomiting etc). Children mostly recover well from poisoning. How can I prevent poisoning in my home? Always store potential poisons out of sight and reach of children, like in a locked cupboard or in a wire cage with a padlock, high up where children can’t reach. Always put medicines away immediately after use. Remember that childproof containers are not 100% childproof. Never refer to medicines as sweets. It makes them more attractive to a child. Avoid taking medicines in front of children. They love to imitate adults, especially their parents. Do not share medicines. Do not store medicines in handbags. Dispose of unnecessary medicines. Unused medicines should be returned to the local clinic or pharmacy and must not be thrown away in the dustbin where children may find them. Be especially careful when visiting other homes, as medicines may not be stored as safely as in your home. Buy pesticides from shops and in proper packaging with all the warning labels. Always wear gloves when using pesticides. Always leave chemicals and detergents in their original containers; don’t transfer them to cooldrink bottles. Keep loose batteries and battery-controlled devices away from children and place a piece of sticky tape over the battery case. Teach your children about the dangers of eating anything from the garden. If your child has been poisoned, call the 24/7 Poisons Information Helpline, 0861 555 777.

August 14, 2020

Cancelling your medical aid should be a last resort

When your income is threatened, reduced or, in the worst-case scenario has dried up, deciding where to spend and where to save becomes critical. In circumstances such as retrenchment, or periods of reduced employment, it may be tempting to consider quick-fix solutions and take a break from your medical aid but, during a global pandemic, you may want to think twice. ‘South Africans are faced with many challenges during this tough time and we are aware of the financial implications the lockdown has placed on everyone,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘The pandemic has put a spotlight on the need for quality healthcare, which means a decision to cancel your medical aid is not recommended and should not be taken lightly.’ Let’s consider the costs involved if you are not on medical aid, become infected with the Coronavirus and are admitted to a private hospital. Cost realities The cost for a patient spending two weeks in a general ward for the treatment of COVID-19 is around R99 201. But if that patient is transferred to ICU for a period of two weeks, the cost rises to about R392 340. These costs include specialists, pathology, radiology and allied services. The alternative: Public healthcare. However, the exponential spike in the number of COVID-19 cases has meant that hospitals are overcrowded, resulting in a shortage of staff, equipment and ventilators. ‘Our advice is to consider your specific medical needs, as well as your budget, when deciding how to proceed, particularly if you have chronic conditions or are at greater risk. Buying down is definitely a key consideration, or look at network options which offer marked savings. The Bonitas Select Plans, for example, are priced 15% cheaper than non-network options. In addition, we strongly advise that you consider benefit richness against your contributions.’ Key questions to ask yourself include: Does my medical aid offer additional benefits that are paid from risk rather than savings or day-to-day benefits? Does my medical aid offer alternatives like virtual GP consultations, chronic medicine delivery and online antenatal classes to deal with the concerns posed by the lockdown? Another big factor to consider when it comes to COVID-19 medical care is comorbidities, or the coexistence of two or more diseases or disorders. ’The Minister of Health, Dr Zweli Mkhize, warned early on in the pandemic that South Africa has a significant burden of non-communicable diseases, or chronic conditions, with diabetes and hypertension topping the list,’ says Callakoppen. Projections are highly uncertain at this time but our actuarial team has estimated around 30%, or 215 851, members of the Bonitas population are at risk of contracting COVID-19, based on comorbidities. The conservative financial impact to the Scheme could potentially exceed R450m, in addition to annual claims costs, which amounts to R15bn. Although there is a high level of uncertainty around the level of care required, we project that COVID-19 cases will be managed as follows: 20% requiring hospitalisation 5% requiring treatment in ICU What will the consequences be on members if they cancel their policies? ‘Unfortunately, members who resign from the Fund are unable to access healthcare benefits. There are strict rules and regulations governing the medical aid industry, in place to protect both members and the financial sustainability of medical schemes.’ Cancelling your membership This should be your last resort. If you do cancel, try to rejoin or join a new scheme within three months otherwise the new scheme can impose: A three months’ general waiting period A 12 months’ exclusion from cover for any existing medical condition Late joiner penalties on all people over 35 years of age. Before you make any important decisions, it might be worth considering what options are available to you, what your priorities are and where you cannot afford to fall short. It is also advisable to speak to your medical aid provider to find out what they can offer you. Joining a medical aid now Callakoppen says they have a seen a marked increase in queries about joining the Fund. Waiting periods apply as normal with a 12 month’s exclusion cause. However, Prescribed Minimum Benefits (PMBs) are covered immediately, this includes COVID-19. ‘Medical aids have needed to adapt during the pandemic, offering added value to members including education, advice, virtual care, etc. COVID-19 has meant we have to be more innovative and re-evaluate the way we consult with members. The need for social distancing has accelerated access to virtual care to protect health practitioners as well as patients. As a Fund, we continue to explore new ways to ensure our member have access to quality healthcare at all times.’ Added value is essential, particularly during this tough economic time and we’ve introduced a range of elements to support members on a clinical, emotional and financial basis. These include: Introducing free 24/7 virtual care with GPs to all South Africans through the Bonitas app. We have had over 33 000 downloads of the app over the past six weeks Through our partner, Pharmacy Direct, we offer home delivery of chronic medication and, during COVID-19, six month prescriptions are being delivered. Around 187 995 members are enrolled on the chronic medicine programme, of these over 55% use the home delivery service Setting up a dedicated Rapid Response Unit in our managed care team to address COVID-19 concerns and support members who are Persons Under Investigation, test positive or are in recovery Creating a COVID-19 hub on our website so that members have access to accurate information on the Coronavirus and the steps they can take to protect themselves and their loved ones Creating a corporate return to work programme to support employer groups with daily screenings, occupational health and safety, etc Creating isiXhosa, isiZulu, isiSetswana and Afrikaans videos to help educate on steps to take to curb the spread of COVID-19 Launching new self-service channels through the Bonitas app and WhatsApp that allow members to access statements and tax certificates, submit and view claims and access electronic membership cards. There is also a

August 13, 2020

Guidance for raising a child with food allergies

Raising a child with food allergies can be daunting and definitely requires extra time, attention, and effort. There are, however, a number of measures you can take to alleviate stress while maintaining a safe eating environment for your baby. Know that you are not alone in this effort. According to the Centre for Disease Control (CDC), food allergies are on the rise, with about 1 in 13, or 8 %, of children being allergic to at least one food. The good news is that the rise in food allergies has led to increased allergy awareness, education, regulation, and labelling; as well as more allergy-friendly restaurants and food allergy policies in schools and day cares. First and foremost, always be your own detective when it comes to food allergens, and never make assumptions based on word of mouth or past experiences. Reading labels (when available) is critical but know that food ingredients and menu items can change, even in longstanding products. Keep in mind that allergens may not be obvious – they can (and do) hide in coatings, thickeners, spices, natural flavours and other ingredients found in fresh, frozen, refrigerated and shelf-stable foods, salad bars and restaurant meals. Did you know that germ, seitan, and tabbouleh all contain wheat? When in doubt, ask! Ask the staff of grocery stores, restaurants and food manufacturing companies to get all the facts. Also keep an eye open for market recalls due to cross contact, which is when an allergen comes into contact with, and therefore contaminates, another food or food product. Cross contact can occur in manufacturing facilities, restaurant deep fryers, deli meat blade slicers, ice cream scoops, prep bowls, even the cutting boards in your own home. Cross contact is a serious issue, as even a tiny amount of an allergen is enough to cause a reaction in some people. Strategies for eating at home Preparing more foods at home is a smart strategy for maintaining greater control over your child’s food sources, minimising cross contact, and limiting their processed food consumption. Not to mention that limiting processed foods is generally an additional boost to their good health since processed foods tend to be higher in salt, sugar, and fat. When food shopping, read labels carefully. Foods containing major allergens must clearly declare those allergens on the label. The allergen will be stated either in parenthesis after a particular ingredient (for example, albumin (egg), lecithin (soy)) or listed at the very end of the ingredient list proceeding the word “contains” (for example, “Contains egg and soy”). Strategies for eating out When eating out, there is no shame in speaking with your waiter about your child’s dietary restrictions and asking for a detailed ingredients list. If a waiter cannot answer your questions, then ask to speak with the chef or a manager. The chef knows exactly what goes into each dish, and in many cases, they will be able to create a dish not listed on the menu, or change one of the dishes on the menu to accommodate your child’s allergy. We also recommend, when feasible, calling a restaurant in advance, during slower service times – such as at 11am before the lunch rush, or 5pm before the dinner rush – to plan ahead. Managing a food allergy may seem daunting at times, but there are some simple steps you can incorporate into your daily life to both protect your child, and maintain your sanity. Basic steps you can take to protect your child: Read food labels Always check ingredient lists. Don’t hesitate to ask chefs, waiters and manufacturers about any unfamiliar or ambiguous ingredients (like spices or natural flavours). Inform anyone handling your child’s food about specific allergies Educate caregivers and schools about your child’s specific allergies and be ready to strategise with them. It is very important that your child’s teachers, principal and friends know about their allergy. If your child is of an age where they visit or sleep over at friends without your presence, talk to their friend’s parents, and pack them a lunch box or home-prepped dinner to ensure they don’t eat anything they’re not supposed to (this will also help out the other parent who may be nervous about cooking for a child with allergies). Be prepared to combat exposure to an allergen Keep antihistamine and epinephrine (if prescribed by your physician) with you (or with your child if they are away from you) at all times. Consult with your paediatrician and/or allergist to have a plan of action in place should exposure to an allergen occur. Ensure you have the necessary medication in various places, so that you can get quick access regardless of where you are. For example, keep medication at home in the first aid kit, keep some in your handbag for when you are out, in the cubby hole of your car and ensure your child’s teacher has a supply and knows how to issue it to your child. Older children should also carry their own medication with them and should be taught when and how to take it if necessary. Avoid riskier food choices Buffets, bakeries and restaurants with pre-made foods are full of potential allergy pitfalls. Ask questions, or avoid these establishments altogether. Spread the word Carry cards that list your child’s food allergies and hand them out to caregivers, waiters, chefs, family members, babysitters and more! For severe allergies, you might also want to have an allergy medical alert bracelet made for your child. Plan ahead! And take special precautions when traveling Call restaurants in advance and speak to the manager to find out if your child’s food needs can be accommodated. Pack safe, non-perishable foods and snacks just in case. Also be sure to notify airline attendants, hotel agents, and visiting family members of any allergies when traveling (if traveling abroad, you can purchase translation cards made for this purpose). Cook at home more often and eat fewer processed foods Taking these steps alone will lessen the risk

August 12, 2020

Naturally why women won’t suffer in silence anymore

Because it’s not common knowledge, it’s hard to imagine that 30% of women suffer from menorrhagia or heavy menstrual bleeding every month. Painful symptoms and discomfort are just some of the things these ladies contend with behind closed doors despite their busy lives. A South African based company, 3Sixty Biomedicine believes that too many women suffer from this kind of commonplace health issue without realizing that they’re not alone and that there are more natural treatments and alternatives available to them. Symptoms of menorrhagia include soaking through one or more sanitary pads or tampons every hour for several consecutive hours, needing to use double sanitary protection to control your menstrual flow, needing to wake up to change sanitary protection during the night, bleeding for longer than a week and passing large blood clots. In most cases it’s accompanied by mild to severe cramps lasting from 12 to 72 hours as well as nausea, vomiting, fatigue headaches and diarrhea. Some patients even complain about pain in the hips, lower back, inner thighs and pressure in the abdomen. Debilitating symptoms like these add pressure to the lives of busy women but interestingly the condition is largely undertreated. For those who do seek medical intervention, there are several treatments that can be administered depending on a woman’s age, coexisting medical conditions, family history and desire for fertility. These include contraceptives, non-steroidal anti-inflammatory drugs, tranexamic acid or even surgery such as a hysterectomy. However, with a growing shift and demand for more natural treatments by consumers and medical practitioners – companies like 3Sixty Biomedicine are in the ideal position to offer relief to consumers from a myriad of common but often neglected women’s health issues based on natural ingredients with the added benefit of minimal side effects. The herb capsella bursa-pastoris, also known as shepherd’s purse, is a perfect example of how natural ingredients can be used in alternative treatments. This plant has been shown to significantly reduce the blood flow volumes for women suffering from heavy menstrual bleeding, containing compounds such as tannins, acetylcholine, thiamine, and flavonoids. This herb has been used for decades to treat uterine bleeding and post-partum hemorrhaging and because it has been shown to increase smooth muscle contraction in the uterus, it also facilitates the regulation of menstrual blood flow. The good news for heavy menstrual bleeding sufferers is that there is now an alternative product to assist with management of this condition; with 3Sixty Biomedicine having introduced a natural remedy into the market. SA consumers can get Salome Heavy Menstrual Bleeding, a natural product with 400mg dry extract of capsella bursa pastoris, for the reduction of heavy menstrual bleeding in women with regular menstrual cycles after serious conditions have been excluded by a medical doctor from Takealot.com and 3Sixty Biomedicine’s website, as well as independent pharmacies nationwide. This means that women who suffer from this debilitating and inconvenient condition can finally be able to manage it naturally without the risk of complications or undesirable side effects. For more information about Salome Heavy Menstrual Bleeding and the rest of the Salome range, go to www.3SixtyBioMedicine.co.za or connect on social media: Facebook: Salome Range Twitter: @SalomeRange Instagram: SalomeRange

August 10, 2020

Collaboration addresses the challenges of COVID-19

‘Collaboration between all the stakeholders is the cornerstone of tackling the coronavirus pandemic,’ this according to Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘This includes engaging both the public and private healthcare sector to find a way forward to address the challenges faced by South Africans. Negotiations, strategising and robust discussion with The Council for Medical Schemes(CMS), The Board of Healthcare Funders (BHF), hospital groups, healthcare practitioners and strategic healthcare service providers will enable us to find the best possible solution during this pandemic.’ Callakoppen highlights some of the key challenges facing consumers and the way forward. COVID-19 testing Challenge: Costs and availability of Coronavirus tests Solution: Negotiation and co-ordination to manage tests and a payment plan put in place Our administrator and business partners are collaborating with the National Institute for Communicable Diseases (NICD), the Department of Health (DoH), pathology laboratories and the Radiology Society of South Africa to try to monitor and manage the availability and cost of tests. In addition, we are collaborating on the provision and delivery of medicines and co-ordination of treatment available in order to ensure sustained, quality healthcare is available to all members. Bonitas covers COVID-19 as a Prescribed Minimum Benefit (PMB), paying for up to three PCR tests from risk – regardless of the result. ‘One of the problems has been a shortage of tests in South Africa and we have urged our members to follow the guidelines from the Government and the World Health Organization, only testing when absolutely necessary, such as when they have come into contact with a known COVID-19 positive case, are showing symptoms and have received a referral from a healthcare practitioner for a test,’ Callakoppen says. This step aims to ensure that tests are reserved for those who really need them. These measures also go a long way in helping to curb misuse of tests and mistaking the symptoms of other respiratory illnesses for COVID-19. ‘We note that as the number of COVID-19 positive cases increase, there is a significant increase in the number of tests conducted. However, again we strongly urge the public to only test when absolutely necessary or when advised by their Healthcare practitioner to do so, as a shortage of tests could have a much more far-reaching impact on the spread of the disease.’ Addressing affordability Challenge: Helping cash-strapped members continue paying their medical aid premiums Solution: Proactive application to CMS for concessions and looking for ways to add value to our members and South Africans ‘The economy and livelihoods of many South Africans have been adversely impacted by the pandemic. We definitely sympathise with this and, as the cost of living continues to increase it was very clear to us that affordability of medical aid, as well as daily living expenses, would become a concern. We began engaging with the CMS prior to the issuing of the CMS Circular 28 of 2020 containing COVID-19 Medical Schemes Industry Guidelines to try and offer our members some respite from the harsh economic impact. However, as medical schemes we are highly regulated in terms of our operations. As such there is a lack of parity between the level of relief we would have liked to offer our members to the level of relief that was approved.’ CMS issued an additional industry circular in April 2020, outlining how medical schemes can apply for exemptions to the Medical Schemes Act to launch lifelines to members, such as contribution holidays or accessing their medical savings accounts to cover premiums. The R160bn medical scheme market covers about 8.9-million members, most of whom are subsidised by their employers. Callakoppen says, ‘The CMS regulates the industry and has been very specific in terms of what medical aids may and may not do. Schemes are required to request exemptions from the Medical Schemes Act to relax certain credit management policies through the CMS. ‘We approached the CMS in April with requests for concessions and have implemented those they approved. At present, our concessions include allowing contributions to be funded from savings. In addition, we have special concessions in place for members who belong to employer groups.’ Despite the regulatory environment, Bonitas has been agile in its approach. ‘We used the challenges of the current landscape to become more innovative in terms of what we can do, within our environment, to assist our members and South Africans at large with some relief. We therefore introduced free virtual GP consultations to all South Africans through the Bonitas Member App so that they would continue to have access to healthcare during this time. We continue to keep the issue, of how members are impacted due to the economic challenges, top of mind and this informs your strategies to respond and address the challenges consumers are experiencing. Hospital beds Challenge: Shortage of high care and ICU beds Solution: Negotiations to have access to facilities outside of network hospitals and standardised tariffs Together with Medscheme, our administrator, we have implemented tariff enhancements to ensure that sub-acute and day hospitals can accommodate admissions where provincial licence exemptions have been granted, when the time comes. There are about 25 800 adult acute beds in the private sector and about 3 700 day hospital and sub-acute hospital beds that stable patients could be sent to. In addition, there are 3 600 dedicated paediatric beds nationally. ‘As a Fund we have negotiated with hospital groups to ensure that members do not have to go to a network hospital during this time when private hospitals may experience capacity constraints. Our key mandate is to act in the best interests of our members at all times and as such we strive to ensure that they have access.’ Virtual Care 24/7 for everyone Challenge: How to maintain your health during the Government’s call to stay at home and social distancing Solution: Virtual Care Early in April, Bonitas launched its Virtual Care, offering it to all South Africans, at no cost, during the COVID-19 crisis. These virtual medical consultations, with GPs and

August 7, 2020

Painful period cramps to be a thing of the past

Dysmenorrhea, the technical term for extreme period pain, is a common women’s health issue that impacts up to 20% of women with their menstrual cramping being severe enough to interfere with daily activities, according to the American Academy of Family Physicians. Symptoms typically begin in adolescence and may lead to school and work absenteeism, as well as limitations on social, academic, and sports activities. Since the start of 2020, an innovative South African based pharmaceutical company, 3Sixty Biomedicine, has been searching for treatments to assist females suffering from common but often neglected women’s health issues. 3Sixty Biomedicine’s latest product within the Salome range will hopefully be the answer to most women’s battle with painful menstrual cramping, even those as young as 13 years old. The new Salome Menstrual Pain product was launched and made available to South African consumers on Takealot.com, independent pharmacies nationwide and 3Sixty Biomedicine’s website in July, draws on natural ingredients and includes yarrow (Achillea millefolium) which has antispasmodic, anti-inflammatory & analgesic effects which may provide relief for spasm associated with menstrual periods known as dysmenorrhoea. Primary dysmenorrhoea is defined as painful cramps that occur with menstruation and although estimates of its prevalence vary widely, it is the most common gynecologic problem in women of all ages and races. Primary dysmenorrhea is thought to be caused by excessive levels of prostaglandins – hormones that make your uterus contract during menstruation and childbirth. The pain results from the release of these hormones when the lining (endometrium) is sloughing off during your menstrual period. The symptoms of menstrual pain may include lower abdominal or pelvic pain with or without radiation to the back and the pain usually occurs at the onset of menstrual flow and typically lasts 8 to 72 hours. “Nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended as the first line treatment for primary dysmenorrhoea. We are delighted to now provide women, from as young as 13 years old, with a safe alternative option to manage painful menstrual cramping that includes natural ingredients and is available in a user-friendly capsule pack online and at pharmacies countrywide. As a business we are passionate about breaking the silence on common women’s health issues. Too often conditions like menstrual cramps, PCOS and heavy menstrual bleeding are often considered taboo and are not spoken about or even treated – leaving millions of women suffering in silence and worse yet – not allowing them to reach their full potential. We want to be part of the solution by not only providing natural remedies that assist women with treating their health issues, but by also offering women educational platforms that connect them to other women and health experts via our social media channels to help #BreaktheSilence and reassure them that they are not alone”, explained 3Sixty Biomedicine’s CEO, Walter Mbatha. For more information about Salome Menstrual Pain and the rest of the Salome range, go to www.3SixtyBioMedicine.co.za or connect on social media: Facebook: Salome Range Twitter: @SalomeRange Instagram: SalomeRange *Sourced information from: https://medbroadcast.com/condition/getcondition/dysmenorrhea#:~:text=Primary%20dysmenorrhea%20is%20thought%20to,off%20during%20your%20menstrual%20period.

August 7, 2020

BREASTFEEDING & COVID-19: BUSTING THE MYTHS

We’ve had an overload of fake news over the past pandemic months. One of the most damaging falsehoods to emerge has been that COVID-19 + moms can transmit the virus through breastmilk to their little ones, and should stop breastfeeding. Spokesperson for ADSA (The Association for Dietetics in South Africa), Andiswa Ngqaka, a registered dietitian says, “There are anecdotes from various countries indicating that this misinformation is causing moms to avoid breastfeeding during the pandemic. While some may see infant formula as a ‘safer alternative’ during this time, this is not the case. Breastmilk is the safest and most nutritious food for babies, and COVID-19 does not change that.” There is no evidence of COVID-19 transmission through breastmilk As the medical profession’s foremost experts in nutrition, registered dietitians are constantly keeping up to date with the latest scientific evidence. Worldwide, there is currently no evidence that breastfed babies have been infected by mothers who have tested positive to COVID-19. Andiswa explains, “The WHO cites one study where there was a detection of non-infectious COVID-19 viral RNA in breastmilk, and this is definitely not the same thing as finding viable and infective virus. Therefore, there is unanimous agreement across international health organisations that moms can have complete peace of mind breastfeeding their children through the pandemic, even if they are COVID-19 + or suspect they might be infected. The benefits of skin-to-skin contact with your baby and breastfeeding as normal are overwhelmingly immune-boosting and protective of your baby’s health.” Lisanne du Plessis, Associate Professor at Stellenbosch University and ADSA spokesperson, gives her top 5 tips for breastfeeding moms during the pandemic: Mothers should breastfeed on demand, whenever baby wants to breastfeed, day and night. Breastfeed exclusively for 6 months. Breastmilk provides all the food and water that babies need during this time. Breastmilk also protects babies against sickness or infection. Do not give any other food or liquids to babies, not even water, during the first 6 months of life. Even during very hot weather, breastmilk will satisfy babies’ thirst. Giving babies under 6 months anything other than breastmilk will cause them to suckle less, will reduce the amount of breastmilk that a mother produces and may make babies sick. Practice hygienic measures to protect moms and babies against COVID-19 and other harmful bacteria and viruses in our environments. Breastfeeding is food security for babies Breastfeeding from birth supports the healthy development of babies and plays an important role in prevention of all forms of childhood malnutrition including wasting, stunting, obesity and underweight and micronutrient deficiencies. Breastmilk protects against many infections including COVID-19. At a time when many South African families are facing serious food shortages, breastmilk provides complete food security for babies under 6 months, and boosts nutrition and health for other young ones. Breastfeeding saves on the food budget, making more money available to feed the family. When it comes to food, you can’t get anything safer, more convenient and more economical than breastmilk. “It would make good sense to see a boost in breastfeeding across South Africa at this time,” says Lisanne. What precautions should a COVID-19 + mom take? The WHO provides the following breastfeeding guidelines if you suspect or know you have COVID-19: Wash hands frequently with soap and water for at least 20 seconds or use alcohol-based hand rub and especially before touching the baby; Wear a medical mask during any contact with the baby, including while feeding; Sneeze or cough into a tissue. Then dispose of it immediately and wash hands for at least 20 seconds again; Routinely clean and disinfect surfaces that you have touched. It is vital that partners, family and friends support breastfeeding moms who may be COVID-19 infected. They need to understand that there is no evidence that the virus is transmitted through breastmilk, and that by continuing breastfeeding, the mother is doing the best she can do to protect her baby from COVID-19. What should happen if you’re just too ill to breastfeed? Andiswa says, “If you’re too ill to breastfeed, try to express your milk for your baby and give it with a clean cup or spoon and cup. Expressing breastmilk is important to sustain your milk production so that you can carry on breastfeeding when you recover. If you can’t express your breastmilk, you can consider donor human milk. Wet nursing is another option if culturally acceptable to you. Your last option would be to provide a breastmilk substitute. Reunite with your baby as soon as your recover. Get support if you need help re-lactating and bonding with your baby.” Get Messages for Mothers – M4M A global pandemic is certainly not the easiest time to be a new mom and the mom of young children. Mothering babies and small children is often an isolating experience at the best of times, so now, with social distancing and staying-at-home, you may need to make some extra efforts to ensure you are well-supported at this critical parenting time. Grow Great, a campaign to prevent stunting by 2030, partnered with other NGOs Embrace, ilifa labantwana and the Perinatal Mental Health Project, to launch Messages4Mothers, a new digital platform to connect with South African moms during the pandemic. Messages for Mothers can be accessed at M4M or you can connect with Grow Great on social media @GrowGreatza on both Twitter and Facebook. Grow Great Communications Specialist, Duduzile Mkhize says, “Some of the biggest concerns for mothers are around how they can safely continue to breastfeed their children while dealing with COVID-19. Some mothers are essential workers and they worry about how they can continue to keep their families safe. Mothers of small children worry about taking them for immunisations as they fear clinics might not be safe. Pregnant mothers who have to go for checks ups also worry about this. COVID-19 lockdown has caused a lot of anxiety for many people, so many mothers ask questions about how to cope with anxiety and depression.” You’re not alone On a daily basis,

August 6, 2020

Teddy Bear hugs bring comfort to littlies

One of the biggest challenges for foundation phase teachers during Covid-19 restrictions has been the inability to show appropriate physical affection to pupils. High fives, hugs and physical touch are more likely to be used by children in the foundation phase, and teachers often make use of appropriate physical touch to comfort and contain the emotions of these children. The absence of this interaction and the changes brought about by Covid-19 restrictions has left many children feeling anxious. As a way to bridge the gap between Covid-19 restrictions and the need to comfort their small learners, HeronBridge Pre-Preparatory has implemented the Teddy Bear Initiative. How this works: Each child is required to bring a reasonably sized teddy bear from home with them to school daily. This helps with the settling in process and provides a sense of familiarity and comfort as a transitional object that reminds children of a safe place. During different times of the day, the teacher implements “ Teddy Bear Time” where the class as a whole holds their teddy bears, hugs them tightly then releases, and repeats this process. Physical compression through squeezing and then releasing something is a way to activate then relax muscle groups. When repeated, this activity helps the body to find a rhythm and the mind to re-focus. It is a cognitive behavioural process, that reduces panic, regulates breathing, lowers cortisol levels (responsible for panic) and subsequently reduces anxiety. If at anytime during the day a child is feeling distressed, the teacher can ask the child to pick up their teddy, hug it tightly, release and repeat, while maintaining eye contact. “It has been so lovely to see the children finding comfort in their teddy bear hugs throughout the day,” says Wendy Beyneveldt, Pre-Preparatory Head at HeronBridge College. “At a time when things are so chaotic, we want to make sure that we are creating a happy, loving and safe learning environment for all our children, the Teddy Bear initiative helps us to do that.”

August 4, 2020

C-section questions, answered

One of the biggest decisions you’ll make about your baby’s birth is whether to have a vaginal birth or a Caesarean section, also known as a c-section. Neither method is objectively better than the other, some moms need to have c-sections for physical or health reasons, or decide that they would rather opt for a c-section for personal reasons. Focusing on the c-section, we’ll let you know what you can expect when having one and what the average recovery time is. When making this decision you should consult with your health practitioner, but it won’t hurt to know more about what is happening to your body during the process so that you can make the most informed decision for you and your baby. So what exactly is a c-section? C-section is the surgical delivery of a baby. During the process you doctors will cut into your abdomen and your uterus and lift your baby out of this. As you are having a major surgery, you’ll typically have an epidural. This way you’re numb, but still awake so you can experience the magic of your baby’s birth. Both c-sections and vaginal births have their pros and cons. You’re likely to take longer to recover from a c-section birth and you’ll probably feel pain in the incision area for a few weeks. As it’s a surgery, there’s a risk of damage to surround organs, infection and excessive bleeding. Make sure to consult with professionals about what works best for you and your baby before making a choice. When is a c-section necessary? Some moms elect to have c-sections before the time, whilst others may need to have an emergency c-section due to complications that arise during birth. If you are expecting twins, have high blood pressure, diabetes or have an infectious disease, such as HIV or genital herpes you’ll schedule your c-section ahead of time. Unplanned c-sections are necessary if your labour doesn’t start or stalls, if you become too exhausted or your baby goes into distress, if the umbilical cord slips into the birth canal before the baby (as there is a risk of the baby’s air supply being cut off) or if your uterus ruptures. How long will I take to recover from a c-section? Don’t expect too much of yourself after having a c-section, you’ll typically spend around 3 to 4 days in hospital and take about 4 to 6 weeks recovery time at home before you start feeling normal again. Some moms experience muscle or incision pain for a few months following the c -section.

August 3, 2020

Boosting the immune system during the pandemic

The outbreak of the global coronavirus pandemic earlier this year had caused much anxiety and uncertainty for many. It has been a roller-coaster of emotions for parents since lockdown started and the decision to implement home-schooling either by distant-learning or privately was something no parent was prepared for. The pandemic shifted the roles and responsibilities of parents alike, adding “home-school teacher” to the already long list of roles. Public schools in South Africa are set to close from 27 July to late August with the exceptions of grades 12s and 7s. Grade 12s will only take a week’s break and return on 3rd August 2020. Grade 7s will get a two-week break returning on 10th August 2020.President Cyril Ramaphosa, said that the decision to close schools was not taken lightly by the government. The decision to reopen schools has been met with mixed reviews as parent’s stress over the wellbeing and safety of their children and family. Boosting the immunity during the pandemic has been a high priority according to pharmacies. Parents have been taking extra precautionary measures to ensure that their little ones stay healthy and well. We asked registered Pharmacist, Ashleigh Bruce for advice on what parents can do to boost their kids immune system during this pandemic, “The whole family should be taking Vitamin C and Zinc supplements daily”, says Ms Bruce. Not forgetting the basic and simple action of washing the hands often and sanitizing. The Delite Foods jelly range is packed with Vitamin C! An oblivious way to ensure kids get the Vitamin C they need without them realising it. She has also advised on trying DIYs, meditation and yoga as a form of self-care distraction to manage your stress and emotions during this difficult time. Stay connected and engage with us on Facebook, Instagram and Twitter.

July 31, 2020

COVID-19 and Allergies

The coronavirus pandemic is a time of anxiety for most people, particularly those with existing health concerns. Millions of South Africans live with long-term conditions, including coeliac disease and allergic disorders such as eczema (atopic dermatitis), hay fever (allergic rhinitis) and asthma, one of the most common chronic diseases affecting children. According to Professor Michael Levin, Head of Allergy at Red Cross War Memorial Children’s Hospital and CEO of Allergy Foundation South Africa (AFSA) there is potentially harmful misinformation around coronavirus and allergies circulating. “Patients are unsure about symptoms and whether their allergies increase the risk of serious COVID-19 complications. We want to reassure people and enable them to manage their allergies as well as possible during this time. To do this, we’re providing factual, up-to-date resources and support for allergy patients and caregivers, thanks to the generous support of Sanofi.” Professor Levin stresses that people with allergies and asthma should always take good care of themselves, whether or not there is a pandemic. “It is conservatively estimated that 80% of asthma deaths could be prevented with better treatment and access to medication. Not managing your condition does not only negatively impact your health, it can be fatal.” Dr Candice Royal of the KidsAllergy Paediatric and Allergy Centre in Cape Town, agrees the most important message for allergy sufferers is to continue good care. “Allergic disorders are systemic diseases and should not be looked at in isolation. They can be well-managed with education, correct medication and ongoing support from your healthcare professional. Whilst people with uncontrolled asthma may be in a high-risk group for severe illness from COVID-19, recent studies have shown this is not the case in well-controlled asthmatics.” Continue to take and seek treatment, safely: “Do not to stop taking prescribed allergy or asthma medications, including inhaled or oral corticosteroids. Find ways to access care and medication that limits potential exposure to the virus. For example, have medication delivered, or send someone to collect. A telephone appointment with your doctor may be an option than going to the clinic or surgery.” Symptoms of allergies and COVID-19 can be similar, which has been a source of concern for many. Coughing for example, is common to asthma and coronavirus; yet fever, body aches and pains which are usually experienced during coronavirus, are rarely related to asthma. Speak to your healthcare provider for clarity or refer to AFSA’s useful symptoms checklist – www.allergyfoundation.co.za/covid-19-symptoms. “If you have asthma, continuing to control it could help you defend against the virus. Taking prescribed controller therapy daily, whether you have symptoms or not, helps repair swelling and inflammation in the lungs so that you’re better able to fight off viruses – including the coronavirus,” says Dr Royal. “There is no evidence that the use of inhaled or nasal steroids increases one’s risk of contracting COVID-19, and using them regularly might even help prevent you from getting the infection or from suffering with more severe symptoms.” Nebulisers are not recommended, as they can increase the risk to those around you. Professor Levin advises using an asthma pump with a spacer, rather than a nebulizer. “Spacers deliver medication to the airways more effectively than a pump on its own.” For people with skin or eye allergies, itching may mean touching and potentially increased infection risk. To prevent this, experts recommend regular skincare and steroid use as needed whilst also maintaining excellent hygiene measures – washing hands regularly, always wearing a mask and maintaining social distance. Allergy care may change for people who become infected with COVID-19. According to Dr Motohiro Ebisawa, President of the World Allergy Foundation, “Professional help is essential to understanding what is causing symptoms such as shortness of breath, chest tightness, or difficulty breathing. Patients should not assume these symptoms are either from their asthma or COVID-19 but consult their physicians immediately in case emergency care is needed.” For further information and free, up-to-date resources on allergies and COVID-19 – including asthma, allergies and COVID-19; coronavirus and asthmatic children; coronavirus and coeliac disease and a useful symptoms checklist – visit www.allergyfoundation.co.za/covid-19-and-allergy For further information visit www.allergyfoundation.co.za, follow @SAallergy on social media or contact Lynn Kämpf, Business Manager of the Allergy Foundation South Africa on [email protected].

July 31, 2020

Food security for children starts at the breast – support breastfeeding

South Africa has one of the lowest breastfeeding rates in the world. Not because women do not understand the importance of breastfeeding for their children but because women face a hostile environment to care for their children. This World Breastfeeding Week, observed from 01 to 07 August, the South African Civil Society for Women’s, Adolescents’ and Children’s Health (SACSoWACH) are focusing on creating an environment that enables and supports women to breastfeed successfully. Due to our current global crises, with the engulfing COVID-19 pandemic and the subsequent economic crash, women are bearing the brunt of job losses. Female-headed households, especially, are experiencing a financial shock,1 adding to the burden of finding food for their families and caring for their children. In South Africa, nearly one in two households are headed by women, skewing the need to provide unfairly on mothers. South Africa is known as ‘the fatherless nation’ as it has one of the highest numbers of absent fathers in the world. It is estimated that nine million children in South Africa grow up without fathers.2,3 In a recent media report, even our Springbok captain has had to call on men to support and eradicate the scourge of abuse and violence against women.4 Breastfeeding is excellent for infants and young children as a food source, for immunity and for neurocognitive development, and emotional self-regulation.5 “The first step to creating a supportive and safe environment for women and children is the essential provision of food for pregnant women and breastfeeding mothers. Safety and protection for moms, as the life-carrier and carer of children, is non-negotiable,” explains Dr Tshepo Motsepe, First Lady of South Africa, patron of the Coalition, passionate breastfeeding activist and humanitarian. The high rates of violence in South Africa cannot be ignored. Breastfeeding is associated with less violence in societies.5 Research also shows that 80% of rapists are the product of absent fathers.3 Young men who grow up without involved fathers are more likely to develop ‘hyper-masculine’ behaviours such as aggression and emotional instabilities. In contrast, young women are more likely to develop lower self-esteem and become victims of violence.3 Many hungry and stunted children live in fatherless homes1 where suicide is more likely in these individuals.3 “We need fathers and empowered men to step up and invest in the future of our society. Children are our future; the outcomes we want for tomorrow begins with what we do today. We call on all men to set an example and provide emotional and financial support, as far as possible, for the family and breastfeeding partners. This will help women to breastfeed exclusively and relieve them of the pressure to return to work too early,” explains Patrick Shivuri, Maternal and Child Health Programme Manager from Save the Children and a father himself. “Food security for infants and young children starts at the breast. Breastmilk is a living food; it protects against many infections that include COVID-19. If we want to protect children’s health, we need to protect and support their mothers,” adds Dr Chantell Witten, nutrition lead for SACSoWACH and lecturer at the University of the Free State. This has never been more relevant in a time when food is scarce and financial resources constrained. “Reducing Gender-Based Violence starts with protecting, promoting and supporting breastfeeding mothers at all cost. Paternal presence both emotionally and financially is a long-term investment for a healthy and less violent South Africa,” ends Precious Robinson, SACSOWACH chairperson and health advocate from Right to Care. In celebration of World Breastfeeding Week, SACSoWACH will host a breastfeeding dialogue on Thursday, 06 August 2020. The discussion will be live-streamed on their website; please visit www.sacsowach.org.za to find out more and sign up.

July 31, 2020

COVID-19 is taking its toll on SA’s mental health

Fear and anxiety have gripped the globe as COVID-19 continues to take its toll on human life, economies and society at large. Experts are becoming increasingly concerned about the psychological effects of the epidemic, particularly on the poor, elderly, children and teens, and frontline healthcare workers. Abdurahmaan Kenny, mental health portfolio manager at Pharma Dynamics, says levels of distress are bound to increase as more South Africans become infected, lose their income and social isolation becomes a way of life beyond the lockdown. “Vulnerable populations, such as the elderly, those with mental health conditions and pre-existing health concerns are likely to experience higher levels of psychological distress due to the major threat that the outbreak poses to their own personal health. “Another high distress category is likely to include the poor who rely on odd jobs to make a living. Staying at home means they cannot provide for themselves or their families. “Doctors and nurses, particularly those at the frontline of the crisis, may experience secondary traumatic stress (STS) reactions—a by-product of working in a traumatic environment. “Equally, parents who are dealing with childcare responsibilities during school closures and work-from-home obligations may experience greater levels of anxiety as they try to juggle it all while taking care of elderly parents and reassuring their children.” He says that stress during the outbreak can include fear and concern about one’s own health and the health of loved ones, which is completely normal. More detrimental changes to watch out for include sleeplessness, difficulty concentrating, feelings of hopelessness, suicidal thoughts and worsening of chronic health problems. Those with pre-existing mental health conditions are also encouraged to continue with their treatment. Should their symptoms worsen, they should contact their healthcare provider (remotely if possible). Advice to parents “Arming yourself with the real facts about COVID-19 and the risk that it poses to yourself and your family can make the outbreak less stressful. If you remain calm and provide reassurance, children will follow your lead. However, teens are likely to be exposed to more communication from friends and social media, which may lead to excessive worry or sadness, unhealthy eating or sleeping habits or acting out. “Keep the lines of communication open between you and your children. Answer questions they may have around COVID-19 based on facts provided by credible organisations such as the World Health Organisation (WHO) or the SA government (sacoronavirus.co.za). Share advice on how to cope with stress and try stick to a routine with educational, fun and relaxing activities to make the days meaningful. “Be a role model to your children. Limit your news coverage of the outbreak to once a day, including social media. Stick to a wholesome routine of your own by getting enough sleep, eating healthily, exercising and connecting with friends and family. Your children will take their cue from you.” Feature Supporting frontline responders “Many of our doctors, nurses and other healthcare personnel will be directly involved in the diagnosis, treatment and care of people with COVID-19, which places an extraordinary burden on them both physically and mentally. “It is vital that they remain focused by taking care of their own health in order to continue to respond to the outbreak. “Take regular breaks, eat right, practice deep breathing and relaxation techniques, get enough sleep and work in teams to help ease the burden. Also ensure that childcare, household and pet care responsibilities are in hand while you’re on duty. Communicate with loved ones, even if it’s just once during a shift. Helping those in quarantine “For the 112 people who have been released from quarantine in Polokwane, many of whom have been separated from their families for more than 65 days (first while being in lockdown in China for 51 days and then another 14 days in SA), a range of emotions may follow. “These could include feelings of relief, stress from constant monitoring for signs and symptoms, sadness, frustration and even anger. Guilt about not being at home and caring for children or other emotional or mental health challenges may surface. Families should be extra supportive and allow those returning from quarantine time to adjust. “It can also be traumatic being separated from loved ones after testing positive for COVID-19. Remain in contact as much as you can via phone or video calling to provide patients with the love and support they need.” Kenny says knowing how to respond to these challenges when they arise will help you to stay mentally focused while caring for those closest to you. “For now, we need to embrace the new rhythm of life and the chance it gives us to connect with others in different ways.” As a leading provider of central nervous system (CNS) medication for the treatment of depression, anxiety and bipolar disorders, amongst others, Pharma Dynamics is committed to the mental wellbeing of all South Africans. The company advocates for prevention services, early identification and intervention for those at risk. Those who feel mentally overwhelmed by COVID-19 or experience signs of depression can contact Pharma Dynamics’ toll-free helpline on 0800 205 026, which is operated by trained counsellors who are on call from 8am to 8pm, seven days a week. The call centre is a critical service to the public and is therefore operational during the lockdown. Also visit www.letstalkmh.co.za for additional tips and videos to ensure mental well-being during the lockdown. The public is also being encouraged to share photos and ideas of their own on the platform to help others get through this challenging time.

July 30, 2020

Easy tomato soup with cheesy bread dippers

This comforting tomato soup can be made in less than 20 minutes and enjoyed by both you and your toddler. Don’t forget to make the cheesy bread dippers – sure to be the most fun part of the meal for your toddler! This meal is suitable for toddlers 12 months+. Makes four small and two adult servings. What you’ll need Ingredients for soup: 1 tablespoon olive oil 1/2 cup chopped onion 2 cloves garlic, minced 1 tin diced tomatoes 1 cup low-sodium vegetable broth / vegetable stock 1/2 teaspoon dried basil Pepper to taste (optional) 1/2 cup plain Greek yogurt Ingredients for cheesy bread dippers 4 slices of whole wheat bread 1 tablespoon butter or olive oil 1/2 cup shredded mozzarella cheese 2 teaspoons Italian spice mix How to make it: In a medium pot, heat olive oil over medium heat. Add the onion and garlic and cook until tender, roughly 4 minutes. Add in the tomatoes, broth, basil and pepper. Bring to a boil, then reduce heat and simmer for 10-15 minutes. Meanwhile, you can make the cheesy bread dippers. Heat the oven to a broil and line a baking sheet with tin foil. Butter or oil one side of the bread and place it (butter side up) on the baking sheet. Broil until golden brown. Remove from oven, carefully flip the bread over and sprinkle the non-cooked side with cheese and Italian spice mix. Place back under the broiler and heat until cheese is golden brown. Let cool and then cut into 2-inch strips. When soup is done, add in the yogurt and using a blender or hand immersion blender, blend the soup until smooth and creamy. Let cool slightly and then serve the soup with the cheesy bread dippers. Always check with your child’s doctor first if you have any questions about introducing new foods and textures. Launched on Mother’s Day 2006, Happy Family Organics is one of the largest and fastest growing organic food brands to offer a comprehensive line of nutritious foods for babies, toddlers, kids and their mothers. Constantly innovating, Happy Family strives to offer families the right nutrition for every stage of development, and is on a mission to change the trajectory of children’s health through nutrition. Happy Family Organics products are available at all Baby City stores, Babies R Us, Wellness Warehouse, Selected Clicks, Selected Spars, Selected Pick N Pay stores, Selected Baby Boom, selected Dis-Chem and selected Medicare pharmacies, and online from Takealot.com, Babiesafrica.com and Faithful to Nature.

July 28, 2020

Five brain-boosting foods and drinks

Our bodies need “fuel” for every organ, and the brain is no exception. Giving our brains the right food can aid concentration and memory greatly, both of which are necessary for studying and completing tasks and assignments. In today’s article, we discuss five of the best foods and drinks for boosting brain function. Fatty fish Omega-3 is a type of fatty acid that is most commonly found in fatty fish like salmon. Our brain cells consist mostly of fat, 50% of which is the same kind as omega-3 fatty acids! By eating fatty fish or taking omega-3 supplements, your brain maintains optimal levels of fat. It also helps strengthen the structure of the brain cells themselves, both of which result in optimal brain function. These acids also increase blood flow, which is essential for optimal organ performance. One last benefit of this fatty acid is that it increases the amount of grey matter in your brain, which is the other component of the nerve cells (the other is fat), and more grey matter means better cognitive function. Younger children might not enjoy the taste of fish like salmon, so be sure to incorporate an omega-3 supplement in their daily vitamin regimen! Nuts Nuts contain high levels of something called antioxidants, which are natural compounds that slow down oxidation. Oxidation is a naturally occurring process that can damage the body’s cells. With particular regard to the brain, oxidation negatively affects our cognitive function, and consequently our ability to focus, learn and remember. By consuming foods high in antioxidants, we can improve these cognitive functions that are critical for academic success. Antioxidants can also be found in blueberries. Here, they take the form of something called anthocyanin, which is a type of flavonoid. Flavonoids are molecules that give food its colour, and they contain high levels of antioxidants. Blueberries also improve cell-signalling (how brain cells communicate with one another). Good cell signalling is essential for making and storing both short-term and long-term memory, both of which are crucial for studying and writing tests and examinations. Also read: Do’s and Don’ts for Making Healthy Food Choices During the Lockdown Leafy greens Leafy greens like lettuce and spinach contain a compound called carotenoids. These are similar to the flavonoids found in blueberries as they are the compound which gives food its colour and, like flavonoids, they also contain antioxidants and help improve cell signalling. When digested and absorbed, carotenoids often migrate to the frontal cortex, which is the region of the brain that is responsible for such functions as problem-solving and memory – in essence, it is the “control panel” of our brain, so keeping it healthy is essential for optimal cognitive functioning! Unlike many other foods, chopping and cooking foods that are rich in carotenoids actually increases the strength of the nutrients when they enter the bloodstream, so be sure to incorporate plenty of steamed spinach or cooked kale in your child’s diet. Water We all know hydration is important given that our body’s cells consist of 60% – 70% water, but it’s particularly important for our brains. This is because dehydration leads to a lack of sufficient water in our cells which, in turn, leads to poor organ function. In the brain, this means reduced/impaired cognitive function, particularly the brain’s ability to create short-term and long-term memories. As a result of this, we are unable to convert the information we are learning into memories, and if we are unable to create these memories in the first place, we’re unable to recall them later on. Experts recommend drinking 6 – 8 glasses of water a day, but fewer are needed depending on your child’s age (generally one 235 ml cup for every year of the child’s age): Green tea Green tea contains a compound called L-theanine, which is an amino acid (amino acids are compounds that make up the proteins in your body’s cells). L-theanine is thought to increase GABA activity (GABA is a brain chemical that reduces the activity of brain cells). Higher levels of GABA tend to make people feel more relaxed, which leads to decreased stress, which in turn helps improve concentration. L-theanine also increases your brain’s alpha waves, which are a type of brain activity that is thought to aid mental coordination, calmness, alertness, and learning, all of which are essential for studying. Now, green tea might not be to the taste of younger children, but certainly, teens might enjoy the flavour, so give it a go! by Jacqui Smit

July 24, 2020

Tips for keeping coughs and colds away

Winter is an incredibly beautiful season. Apart from the inconvenience that the seasonal weather can bring, in a country where drinking water is often scarce, the rain is always welcome! Less welcome, however are the germs and nasties that creep into our homes. With people coughing and spluttering all around us during winter, it’s important to step up our own personal hygiene. This rings particularly true in the current circumstances we find ourselves in. With Covid-19 still very much a part of our daily lives, keeping germs at bay, is now more important than ever. What can you do to prevent catching a cold or flu this winter? Wash hands religiously With the number of people catching the flu virus at an all-time high, it’s important to keep the spread of germs to a minimum. Wash your hands regularly – particularly after a cough or sneeze, with warm, soapy water for at least 20 seconds. Also, keep hand sanitiser gel and wipes within easy reach if necessary. Vital Baby’s Hygiene Hand & Face Wipes (R35.00) are great to keep in the car, at home and in your handbag. They’re gentle enough to use on baby’s face, and effective at removing germs and dirt. Cough into elbows This is one that both adults and kids can adopt. Encourage coughing and sneezing into the elbow crease rather than hands. Sneezing into hands can spread germs even more as we use them to do so much. Make up a silly song If your child doesn’t like washing their hands for long, or with soap, make it fun. Make up a silly song or find one on the internet that encourages them to do it thoroughly. For example, make up words to the tune of ‘Row your boat’ such as: Wash, wash, wash your hands, make them nice and clean, scrub the germs and wash them off, dry them in between. Get rid of the snot Help to clear little noses using a nasal decongester. This handy little device helps to remove snot quickly, efficiently when they are sniffling and unable to do it themselves. Sterilise after use to make sure it remains hygienic. Stay active Staying active and taking regular exercise can also boost your immune system. Encourage your child to play outside, take them to a park, or head to an activity centre where they can tear around without worrying about the weather. Watch out for fevers If your child has caught a cold, keep an eye on their general health. Take their temperature regularly and their body temperature seems hotter than normal, offer the correct dosage of children’s paracetamol and ibuprofen to keep their temperature under control. Try to focus on fruit and veg We all know that eating a balanced diet packed full of fruit and veggies can give our immune system a boost. During the winter months, try to sneak even more into your child’s diet. If they reject it, hide them in their favourite meals or sauces. Get enough rest Ok, ok, so if you’re a parent, don’t laugh at this suggestion! We know that sleep might be something that you struggle to get enough of, but it really does affect wellbeing. If you think your child is coming down with something, cancel some plans and encourage them to get plenty of downtime. Take the idea on board for yourself too; switch off your phone and try to get an early night. Even an hour extra can really help with your own energy levels. We hope that you manage to stay healthy this winter! Follow Vital Baby on social media: @vitalbabysa Vital Baby products are available at Clicks, Babies R Us, Loot, Baby City, Takealot and at www.babiesafrica.com.

July 23, 2020

Mental strength when you need it

The pandemic has shown us we are more resilient than we think Covid-19 has had devastating effects on the people of South Africa and the world over. As the rate of infection continues to skyrocket, especially in our urban centres, people are starting to grow more fearful of what the future holds. This is on the backdrop of an already ailing economy where our country’s official unemployment rate surpassed 30% in June. Despite the government’s Covid-19 economic stimulus and relief package, the unemployment rate is projected to peak anywhere between 41% and 54% as a result of the lockdown. Projections by the International Monetary Fund suggest that debt repayments will account for more than 80% of our GDP by the end of next year. These statistics paint a gloomy portrait. At the start of 2020, we never thought we’d be forced to retreat into our homes in an attempt to survive this ruthless virus, and social distancing wasn’t even a part of our lexicon. We didn’t anticipate such a sudden, severe threat to our lives and livelihoods. Adjusting to this new way of life and pervading sense of uncertainty has been challenging. It’s easy to lose perspective, to forget what we’re trying to accomplish, to feel scared and alone. The irony, however, is that the physical distancing forced us into a space of introspection, and we were able to connect on a deeper level with not just ourselves but each other. This sense of connection is what drew us closer together, because we were able to see that we might not physically be with one another, but we’re in this together, united in a common cause to overcome an invisible enemy. Sometimes when we feel overwhelmed – whether it’s about our health, children, finances or broader social issues – it helps to have a friendly reminder that adversity is a test of strength, and that we are much stronger than we think. Metropolitan’s Three Word Stories campaign did just that. The radio and social media campaign ran on Ukhozi FM, Thobela FM, Lesedi FM, Umhlobo Wenene and Motsweding FM, which have a combined listenership of around 22 million people, and hundreds of thousands of followers on Facebook and Twitter. By encouraging listeners to speak openly about their concerns, Metropolitan’s Three Word Stories sought to build resilience and inspire mental strength to help us cope with the stresses of a new and uncertain world. It created a much-needed platform for us to share our experiences and gain wisdom through our collective knowledge. The conversations emphasised that mental health is essential for our wellbeing. It eased our anxiety about the future by helping us find ways to navigate new challenges. Sharing our stories reminded us that we already have the fortitude to handle whatever life throws at us, especially when we’re there for one another. The voices we heard during the campaign spoke to our resilience, our shared humanity, our deep connection to everyone in South Africa and the world. We needed reminding. Jane Mokoena from Limpopo shared how – amidst the difficulties presented by the pandemic – she was able to use the time at home to reconnect with her children. Anna Maake from the Free State said that the turbulent past few months were reminiscent of her humble beginnings. She was reminded of her innate strength and resilience, which helped her get through dark times before – and reminded her that she will again get through this. Financial concerns featured prominently in stories such as: ‘Smart Money Goals” Should we be trying to save more? How should we restructure our finances? How can we pull ourselves out of debt? What can we do to help others while we wait out the storm? How do we balance the need to stay safe with the need to earn a living? Hearing these fears articulated let us know that there are thousands of people in similar situations who are willing to listen and help. So is Metropolitan. Take comfort: we’re here for you and will continue to be for the long run. But more importantly, we hope the insight we were able to share into the hearts and minds of ordinary South Africans during this campaign helped remind them just how strong, capable and resilient they are. Post-Covid our lives are likely to be forever changed, but what will remain is our ability to overcome whatever challenges we encounter. We’re all strong, but we’re stronger together, and even though we can’t always be with one another, we have more friends than we realise. Continue to stay safe and strong, South Africa, and remember that the only thing we should be spreading right now is our love for our country, one another, our families and ourselves. By Nontokozo Madonsela, Chief Marketing Officer for Momentum Metropolitan

July 22, 2020

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