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Friday Letters: How low income black working class households are vulnerable to metabolic syndrome

By Maboni Malose Mmatli

Death comes for us all. But it visits and threatens black life more, black working class in particular, than any other race or class. This class lives in isolation from civilisation. We live in remote areas away from dignified services and resources. This is not coincidental but was orchestrated (successfully so) by the apartheid government. The Group Areas Act of 1950, under the apartheid government perpetuated residential segregation that forcibly moved millions of black South Africans into poor, overcrowded and uninhabitable rural areas as a means to successfully control the economic and political power of black South Africans.

To date, the majority of black people in South Africa belong to the low income working class and continue to live in these isolated and poor rural areas. It is in these areas where there is no information about life essentials and basic necessities (even post-apartheid). Because of geographical location of these communities, workers have to wake up during ungodly hours of the early mornings, leave their kids and go catch the 5am bus or train to work in white dominated suburbs (for peanuts) and come back with a 6pm bus or train (that arrives at home later than 7pm) after the sun has set. Because of this, they have no time for family and any form of exercise.

During the morning preparations, they have no time for a proper breakfast and will resort to amagwinya in town (God knows what they eat for lunch, if they do) and when they come back late at night, they eat pap with whatever seshebo is available. They then become vulnerable to certain diseases because of the diet (which is dominated by starch, oil and carbohydrates) and lack of proper physical exercise (because we have no time and exercise is a luxury). Because the communities has no information or knowledge about healthy diet and lifestyle!

Metabolic syndrome is a name for a group of risk factors operating corporately and/or simultaneously to cause or increase a person’s chances to a number of health problems (e.g. diabetes, heart diseases, cholesterol, stroke, etc.). These health problems are the reasons for a large number of South African deaths. According to the Department of Health, 1 in 12 people have been diagnosed with the silent killer – Diabetes (which is one of the subsequent conditions linked with the syndrome).

How many more of us have the disease or others like it, without our knowledge? Our risk of heart disease, diabetes and stroke increases with the number of metabolic risk factors that one has. The risk of having these syndromes is closely linked to being overweight, obesity, tobacco usage and a lack of physical activity. Women are said to be at higher risk when compared to men. It is these diseases (syndrome), that the low income black working class is at risk of. Now for us, what causes or perpetuates these risks? We tend to become overweight because of the type and kind of food we eat and that we are never settled and resting. We resort to convenient but unhealthy fast foods such as kotas, chips, pies, atchaar and magwinya, so that we don’t get to be late at work and risk losing our jobs. These ‘convenient’ foods are filled with oil and fat, and with our lack of physical exercise, the fat builds up and we become overweight and eventually obese. All these factors put us at higher risk of diabetes and other risk factors.

When one is diabetic, they cannot tell because the symptoms are only more concerning after a long period of living with it. At this point in time, the disease is already dominant but manageable. This is because from the moment a person was affected, the body was fighting the disease internally without your knowledge. When the blood-sugar level of a person rises, the body would regulate it by using the pancreas to release insulin, which then drives the blood-sugar levels to homeostasis. After prolonged periods of this repeated rise and fall, the body accumulates too much insulin and start to become insulin resistant. This means the body can no longer take any more insulin and this is where complications commence – the pancreas becomes damaged (and cannot function optimally) and the affected individual starts showing symptoms such as fatigue and frequent urination.

Without proper management of the disease, the affected individual can lose a body organ(s). This happens because blood capillaries are filled with blood that is high in sugar and starts to clot. Because of these clots, oxygen-rich blood does not adequately get supplied to organs and they die out and end up being amputated.

The effects of these syndromes further extend to economic implications. Because we are sick, we now need to monitor and maintain the disease/syndrome through eating healthy food (which we cannot afford), we start being absent at work and it leads to our eventual termination and joblessness. And, because we are vulnerable to these diseases, life insurance companies charge us higher than other groups. All these require that we cough up extra money (which we do not have).

To live a healthy and long life, we need to make healthy lifestyle adjustments. We must eat healthy; less salt, less starch, less carbohydrates, more fruits and vegetables and avoid eating a lot of sugary foods, a lot of red meat, alcohol and carbonated beverages. We must, further, grow our own vegetables through backyard vegetable gardens and feed ourselves and families. Thandeka Nhlapo, who is 22 years of age and has been living with diabetes for more than five (5) years had this to share: “My advice to those who are newly diagnosed with the disease, don’t see it as a death sentence. Eat healthy food, exercise and do not be shy to check your blood-sugar levels and treat yourself in public. I also repeat the above advice to those who do not have the disease. I add to that by saying they should get screened regularly and stay informed of their health”.

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