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Fighting cultural perceptions to prevent NCDs – the CHIPs programme, Cape Town

December 02, 2013

Published in News

On a steely storm filled Friday afternoon, an energetic dance troupe from the Tshinga Township Primary School welcomed the GACD to the Sports Science Institute of South Africa.

The children are all part of a programme called Healthnutz, which uses a high-energy traditional dance choreographed by the school’s physical education teacher to introduce fitness at an early level. The programme is being run in a number of primary schools in the Cape Town area.

Miss Rakhula, the school’s physical education and dance teacher explained the programme:

“In my class there were kids who were obese. They were sick. HIV & everything. I had to give them ARVs in the morning and all those things. So what did I do? I saw that these kids can’t jump, they can’t throw, and they can’t do anything. I noticed the kids would tell me I can’t jump, I can’t move. They needed help. I thought we must teach the children who to dance, jump and play, do the warming up and down and so on. So they joined me in the Sports Science programme. Other schools are now asking help from my school.”
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Questioned by GACD researchers about how culturally they were allowed to introduce so much sport into the curriculum in place of science and academic subjects, Ms Rakhula explained:

“In our timetable we have two days in the week for physical education. It’s no good just to have reading, reading, reading if they can’t stay awake. Some of the kids perform better due to the exercise.”

Cape Town has some of the highest incident rates of diabetes, hypertension and smoking related illnesses in the country. Notably, the highest smoking rates in a concentrated area anywhere in the world are found in Cape Town, according to doctors from the city’s Victoria Hospital.

Professor Lugizma from the University of the Western Cape explained how the programme has been sending health care messages that have been taken into the heart of Cape Town’s townships. The university’s key project worked in Khayelitsha Township. Khayelitsha meaning ‘‘new home’‘ in Nkosa is the biggest black township (over 400,000 residents) in the Cape Town area. It’s a sub district with the largest numbers of HIV/AIDS, chronic NCDs and also injuries in the area, a quadruple burden of disease.

“Poor knowledge of nutrition, people’s perceptions of portion sizes, poor cooking practices and issues of cultural perceptions of food all contribute to higher NCD rates. At the time we had issues around HIV/AIDS and peoples’ perceptions of losing weight meant you may have AIDS,” Lugizma explained.

The project uses innovative ways to get the health messages through community health workers to the people.

“How did we get the heath messages to the streets? We used drama performances around diabetes. We brought them to the taxi ranks, to queues in the towns. People do not go to health facilities for check ups, so we went to them. We gave them information about food choices and health and lifestyle. They developed community health clubs, where community health workers were trained on conducting fitness sessions and measuring blood pressure and weight. “

The highlight of the tour was an exclusive line dance performance from the “Live it Up” grannies. With an average age of 75, the dance troupe has opened schools and appears regularly in the local press. Dressed in full cowboy gear, the ladies took some time out to explain the benefits of the programme. When questioned why they practise twice a week and have been practising together for over a decade they replied, “Because we love it!” Friendships have been formed and intricate dance routines learned to perfection, all of which aid memory and keep fitness as a social event.

The key, surely to the CHIPs (Community Health Intervention Programme) sustaining success, is making exercise and health checks a social occasion and embedding them into the DNA of community life.

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