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Dr Lucia Meko
Dr Lucia Meko believes that face-to-face engagement helps students become more empathetic, culturally aware health professionals.

In South Africa, the streets often tell stories of contrasts where wealth and poverty, tradition and modernity, and diverse cultures meet at the same intersection. It is a place where neighbours may speak different languages, worship in different ways, and sit down to very different meals. These everyday differences do not just influence how people live – they shape what ends up on their plates.

According to Dr Lucia Meko, Senior Lecturer and Head of the Department of Nutrition and Dietetics at the University of the Free State (UFS), dietitians play an important role in such a diverse landscape. “Their mission is to empower individuals and communities to make informed, healthy food choices that support long-term well-being. According to the Health Professions Council of South Africa (HPCSA), dietitians are trained to provide personalised nutrition counselling aimed at preventing and managing diet-related diseases,” she says.

“This means that whether someone is dealing with diabetes, high blood pressure, or simply trying to improve their eating habits, a dietitian can offer guidance tailored to their unique needs and circumstances.”

However, Dr Meko believes that while theory is important, many students only truly understand the reality of their future clients when they experience it first-hand. At the UFS, students do not have to wait until the end of their degrees to gain this insight. Community service learning begins in their very first year.

This approach immerses students in the communities they will eventually serve, offering a practical education that goes beyond textbooks. By working directly with communities, students gain a deeper appreciation of the challenges individuals face in making healthy food choices,” she says.

“These experiences help shape well-rounded professionals who are not only knowledgeable but also empathetic and culturally aware,” adds Dr Meko.

Unlike traditional volunteering, this is structured learning with clear outcomes. Students apply classroom theory to real-world issues while simultaneously giving back. Through this process, students develop critical thinking, cultural competence, and the ability to communicate health information in ways that are relevant and respectful,” she explains.

 

What really happens on the ground

To understand what this looks like in practice, Dr Meko points to a research study conducted by the department. It examines the experiences of fourth-year students during a Community Nutrition Module internship. This internship is one of eight work-integrated learning (WIL) components in the module.

In this particular placement, students work in Ward 51 in Mangaung, visiting homes and engaging directly with residents. During each visit, they profile the community member’s demographics, measure nutritional status (using weight and height), and assess dietary patterns. Afterward, they offer tailored dietary counselling.

Beyond individual visits, students also explore the broader food environment: visiting supermarkets, vegetable gardens, early childhood centres, and street vendors all form part of their learning.

Importantly, this programme is not one-sided. Feedback from both students and community members is gathered to improve the experience and assess its impact.

So far, early findings are promising. Students not only learned; they were transformed. Interestingly, students mostly showed appreciation for their own privileges in comparison to the disadvantaged communities they visited,” says Dr Meko. One student reflected: “It humbled me and made me very grateful for all that I have, because I think we really lose sight of that sometimes.”

After a township tour, another student admitted: This was very insightful, as we often have stereotypes about the way people live and what people eat, simply because of where they live.”

In a cooking activity, students were challenged to apply dietary guidelines in real kitchens. The outcome? A deeper understanding of the barriers faced by many. “Dietetic guidelines we have given to some patients were really put into perspective, as cooking with less salt is not as easy as we think,” says Dr Meko, quoting student feedback.

Some even used what they learned in other placements. One student took a simple grocery list she developed during her internship to the hospital setting: “It is the most practical way to influence someone to shop differently.”

Others were inspired to continue working in food access. “I was impressed with the size of the vegetable gardens and was also inspired to be part of projects like these in the future,” shared another student.

Perhaps one of the most powerful observations came from a student who said: “I feel empowered but also sad to see that this is how most of the country is living and that we can make a difference, no matter how small.”

 

A lasting impact for both student and community

For Dr Meko, this is exactly what service learning should achieve. “While lectures and textbooks can teach the theory behind intercultural competence, it’s the face-to-face interactions – listening to people’s stories, understanding their struggles, and working alongside them – that truly bring those lessons to life.”

She adds that this kind of learning also builds stronger, more respectful relationships between the university and the communities it serves. “It fosters partnerships built on mutual respect, shared goals, and the exchange of knowledge and resources – locally and beyond.”

Community service learning is not just a tick-box exercise. In the UFS Department of Nutrition and Dietetics, it is a meaningful bridge between knowledge and empathy, between theory and reality, and – most importantly – between future dietitians and the people whose lives they hope to improve.

News Archive

A position statement by the School of Medicine, UFS, regarding the crisis in health care in the Free State
2009-05-27

The executive management of the School of Medicine (SOM) at the University of the Free State (UFS) and its senior members wish to express their grave concern at the way the financial crisis in the Free State has negatively impacted on the provision of health care to the population. The unavailability of goods and services at every level of care has become so severely compromised that the staff of the SOM can no longer remain silent on this issue. By remaining silent it may be construed that we are either indifferent to, or even accepting the situation. Neither is true. The SOM can in no way condone, sanction or accept the current situation of health care in the Free State.

Other concerns expressed by the SOM include:

  • Medical services have been severely compromised due to the disintegrating primary health care system in the FS. This has resulted in patients who were in need of more advanced levels of medical care not being referred appropriately or timeously to level two hospitals and from there for tertiary care. Inpatient as well as outpatient numbers are steadily declining and the tendency now is to fill fewer beds with critically ill or terminally ill patients. It is also becoming increasingly difficult to find suitable patients for training and examination purposes.
     
  • It becomes more difficult to attract and retain experienced and suitably qualified medical specialists interested in an academic career, due to the inability to provide prospective career opportunities. This is particularly the case in the surgical disciplines.
     
  • It is also becoming more difficult to attract and appoint highly qualified registrars (future specialists) since the reputation of this SOM has been compromised by the negative publicity created by the financial difficulties of the FSDoH. Registrars form the backbone of the clinical work force in all teaching hospitals. If vacant posts cannot be filled in time service provision, as well as undergraduate teaching are severely jeopardised.
     
  • As a direct consequence of the rationing of health care, fewer surgical procedures are being performed. The point may soon be reached where registrars in the surgical disciplines may not get sufficient hands-on experience to allow them to qualify within the required time frame.
     
  • Non-payment of accounts to service providers and suppliers including the National Health Laboratory Services (NHLS), maintenance contracts and industry will severely compromises health care and future loyalty, goodwill and provision of critical services.
     
  • The dwindling number of qualified and experienced nurses in the public (and private) health care sector is an ongoing unresolved issue. Despite the fact that primary health care is mainly nurse-driven, nursing colleges were closed during the previous decade. These colleges must now be re-commissioned at high cost adding to the financial burden.
     
  • The morale of health care workers at all levels of health care has reached an all-time low
     
  • It is becoming increasingly difficult to conduct meaningful research in all disciplines due to staff shortages and lack of funding.

See attachment for the full statement on by the School of Medicine, regarding the crisis in health care in the Free State.

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt.stg@ufs.ac.za
26 May 2009
 

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