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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

First Dementia Care Mapper in Africa receives international award
2015-11-17

The first Dementia Care Mapper from Africa,
Dr Sanet du Toit.

Photo: iFlair Photography

“In one facility, four elders who needed minimal assistance to eat were provided with an opportunity to sit at a separate table, and enjoy their breakfast as preferred – that is, to spread bread with butter, jam or marmite; to add their own milk and sugar to their tea.”

Dr Sanet du Toit
described a scenario where staff members at an old-age home implemented recommendations she made following an observation she conducted.

“We do not think twice about doing this but, within institutional care settings, these ’normal’ routines are often replaced with practices that could be viewed as ‘time savers’. For example: everyone gets milky, sweet tea to drink,” she explains.

Yet, by creating an environment where the elderly living with dementia were at liberty to determine the amount of milk in their tea, active participation meant an improved well-being.

She was honoured with the International Association of Homes and Services for the Aging (IAHSA) Award for Excellence in Applied Research on 1 September 2015, at a joint conference held by the Aged & Community Services Australia (ACSA) and IAHSA in Perth.

This exceptional Occupational Therapist from the University of the Free State (UFS) emerged as the first Dementia Mapper from Africa. Dementia Care Mapping is a method used internationally to assess with the purpose of improving the quality of care given to residents in institutionalised settings.

The IAHSA award acknowledged her person-centered care training and research in South African residential care facilities while working at the UFS as a senior lecturer from 2003 to 2013. Currently, she is based at the University of Sydney, but remains an affiliated lecturer at the UFS Department of Occupational Therapy.

In 1992, she graduated with a BA in Occupational Therapy at the UFS, and went on to further her studies at various institutions. Also, she is one of the founding directors of the Eden Alternative South Africa, an advocacy for older persons’ rights within old-age homes. Over the years, Dr du Toit has won numerous awards for her research.

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