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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

UFS doctors fight childhood cancer
2016-09-02

Description: Childhood cancer  Tags: Childhood cancer

Prof David Stones and Dr Jan du Plessis of the
University of Free State’s paediatric oncology ward
are helping little lives, one patient at a time.
Photo: Nonsindiso Qwabe

Of 23 paediatric oncology specialists nationally, Prof David Stones and Dr Jan du Plessis of the University of Free State are the only ones in the province.

Committed to giving holistic care to their patients, the two doctors specialise in all types of childhood cancers, the most common being leukaemia, brain tumour, and nephroblastoma.

They describe the childhood malignancy as a lethal disease, unpredictability being its harshest trait. “With cancer, you can just never know. It precipitates and multiplies, and leads to the failure of other organs. You can just always hope, and keep trying,” said Du Plessis.

The paediatric oncology unit of the Universitas Academic Hospital, their unit, is the liveliest floor in the entire building. It is also the third busiest in South Africa, serving a demographic that spans the Free State and Northern Cape, as well as parts of North West, Eastern Cape and Lesotho.

Each year, the unit receives more than 100 new childhood cancer patients. In 2015, the unit had 113 newly diagnosed patients, an increase from 93 in 2014.

Lack of knowledge poses a serious challenge
According to the two experts, the lack of insight and awareness of the disease remain a big challenge to fighting it. “It is frustrating. Parents and family members don’t know anything about it. Nurses and doctors aren’t always clinically trained to pick up the early warning signs. By the time a diagnosis is made, life and death is on a 50% margin,” Stones said.

Poverty, a lack of resources, overcrowding and a range of health issues are other factors that have a profound effect on the diagnosis and treatment of the disease.

Making a contribution that will last
With a desire to see an improvement on life outcomes in the health sector, the team is focusing on educating the country’s doctors of tomorrow. Their unit is the only one in the country that actively involves medical students in an oncology unit, giving them practical experience and exposure to the individual cases each patient presents. They have also produced a substantial amount of research literature on childhood malignancies in South Africa as a developing country.

Driven by passion to see a better South Africa
The doctors are passionate about the work they do, and remain hopeful there will be a change in the incidence of childhood cancer   not just in decreased levels of the disease, but also in the overall state of well-being of young South Africans.

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