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02 June 2025 | Story Leonie Bolleurs | Photo Supplied
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

Emotional health of vulnerable children needs urgent intervention
2014-02-04



In South Africa, thousands of children under the age of 18 are orphaned as a result of HIV/Aids. Experts are worried that these orphans and vulnerable children will experience serious socio-emotional problems and behaviour disorders, should urgent intervention programmes not be implemented urgently.

A study was undertaken by the Centre for Development Support at the UFS, in conjunction with Stellenbosch University and the Houston University in America. The research found that in the Free State province alone, about 15% of orphans and vulnerable children showed signs of psychiatric disorders. Almost half of the children in the study showed signs of abnormal or maladjusted behavioural functioning.

The research team believes that the South African government and the numerous non-governmental organisations put too much emphasis on the physical needs of orphaned and vulnerable children and that their socio-emotional or mental wellbeing receives very little attention.

The nominal financial grant is a welcome relief for some of the needs of this risk group. Researchers are worried, though, that the lack of reliable and culturally-sensitive diagnostic methods for the early detection of psychiatric disorders may pose a challenge when the children reach puberty.

The current study is focusing on the detection of emotional behavioural problems even before adolescence. Questionnaires were distributed across the Free State at clinics, schools and non-governmental organisations dealing with these children. The questionnaires enabled researchers to establish the children's socio-emotional needs.

"Overcrowding in houses where orphans and vulnerable children often live is directly linked to poor socio-emotional health in children," says Prof Lochner Marais from the Centre for Development Support. "The state institutions offering programmes for orphans and vulnerable children overemphasise the physical and/or financial needs of these children. The programme provides, for example, food for the children, grants for the [foster] parents, assistance with school clothes and ensures clinic visits for the children. Of these, only the supply of food has a direct impact on the improved mental health of children."

The study provides, for the first time, a profile of the state of mind of this group, as well as the emotional impact of HIV/Aids – an "urgent matter" according to Dr Carla Sharp from the University of Houston's Department of Psychology. According to Dr Sharp, much more could be done to assist foster parents in addressing the emotional needs of these children. The early detection of behavioural disorders should be the key in intervention programmes.

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