MASERU – The 2014 Lesotho Demographic and Health Survey (LDHS) says about half of Lesotho’s 1.8 million people do not know the symptoms of sugar diabetes.
The study says the majority of those diagnosed with diabetes and have been prescribed to take diabetes treatment have opted to use herbs from traditional healers.
Last week, thepost spoke to Dr Kabelo Mputsoe, Head of Non-Communicable Diseases Section and the focal person in cancer prevention and control programme in the Ministry of Health to mark Diabetes Week. Below are excerpts from the interview.
Why is there a need to have an awareness campaign on diabetes?
First of all, we have to understand what sugar diabetes is so that we can have our own assessment of whether we need to up our campaign or not.
Sugar diabetes is a chronic disease that occurs when there’s not enough insulin to move the sugar into body cells, which is where the sugar is used for energy.
This occurs when the body does not produce enough insulin or when it cannot effectively use the insulin it has produced to help the body metabolise the sugar that is formed from the food we eat.
Insulin is a hormone that regulates blood sugar, which gives us the energy we need to live. Unable to get into the cells to be burned as energy, the sugar can build up to harmful levels in the blood. So, now that we understand what sugar diabetes is, we have to understand what cases sugar diabetes also to see if there is an urgent need to raise the level of our campaign against the disease. Apart from the fact that it is hereditary, sugar diabetes is caused by tobacco smoking, (excessive) drinking of alcoholic beverages and soft drinks, lack of physical activity and poor diet.
What has prompted you to raise the awareness of the disease?
We have studies that show the extent to which Basotho are at risk of having sugar diabetes. In 2012, with the assistance of the World Health Organisation, we had a Non-Communicable Diseases Risk Survey and sugar diabetes is one of the non-communicable diseases.
The survey showed that four percent of the population has sugar diabetes, an increment from 2002’s 1.5 percent prevalence.
It has more than doubled in 10 years and this is a concern that requires every one of us, including you in the media, to stand up and fight against this disease.
What could have contributed to this increase?
We have to put it plainly that our behaviour as Basotho does not promote good health. For example, the survey shows that a quarter of the population (of 1.8 million people) is smoking tobacco.
Also 35 percent of the people drink alcohol. The studies further reveal that most people who have diabetes are women despite that the majority of them do not smoke and do not drink alcohol.
Why are most women at risk or are already diabetic?
The answer is simple, many women despise physical activity. They do not engage in physical activity but they are the ones who eat unhealthy foods that have a lot of sugar.
They eat fatty foods and like to taste foods as they prepare them for their families.
This has created a problem of obesity among Lesotho women. 32 percent of our women are obese compared to only eight percent of men who are obese.
The number of obese women is four times greater than the number of obese men. This country has a serious problem of people who do not engage in physical activities.
The study shows that 44 percent of the population do not engage in physical activity and 56.7 percent of them are women. Smoking of tobacco and alcohol drinking contribute immensely in the rise in sugar diabetes. The studies show that 30.7 percent of both sexes drink alcohol and 47.3 of them are men.
Also 24.5 percent of the population smoke tobacco and 48.7 percent of them are men. Also the
Body Mass Index has shown that 60 percent of Basotho women are overweight, meaning that their body weight is over 30kg per metre square.
The normal weight should be between 17 and 25kg per metre square. This requires a call for action.
What should be done to reverse this?
There is a need to make people conscious about their health needs, especially in relation to sugar diabetes. People should know the nutritional value of the food they eat.
One should eat at least five servings of fruits and vegetables a day. This was mastered by our ancient Basotho who depended on vegetables and fruits and we Basotho of today eat too much fat and sweets.
We also have to continue promoting physical activities. Burn that fat in your body.
We have people who are always in their cars because they do not want to walk. This is time for us to walk, use cycling as our mode of transport and ride on horseback because by so doing we will be engaged in physical activity.
We have already entered into agreements with several stakeholders especially clubs or physical activity associations that promote going to the gyms and other activities.
We have hikers also who have approached us to form partnerships. Also the Ministry of Sports is contributing immensely in promoting sport.
How is your relationship with nutritionists from the Ministry of Agriculture and other sectors in the fight against diabetes?
We have that sector in the Ministry of Health. However, we have working relations with other nutritionists whose job is to teach about the value of the food we eat.
Our relationship is not only based on the fight against sugar diabetes but in the fight against other diseases as well.
To what extent can you say the people understand or don’t understand sugar diabetes?
We can say people have heard about the disease but many don’t even know about its symptoms.
The Lesotho Demographic and Health Survey shows that 91 percent of women have heard about sugar diabetes and 87 percent of men have heard about it.
However, four in 10 of women don’t know any symptoms of diabetes. That says there is a gap that has to be filled by you and me. Some of them have not heard about it at all.
The district of Maseru is the one that has more people who have some knowledge about sugar diabetes with 96 percent of people who have heard about it. Thaba-Tseka is the lowest.
The survey also shows that 98 percent of the people who have attended school beyond secondary education have some knowledge about the disease and 83 percent of those who have not been to school at all heard about it.
This also shows that not being educated denies one an opportunity to learn about diseases like sugar diabetes.
Do you think your ministry has done enough to sensitise the nation and to advocate for healthy lifestyles?
We are trying but there are some shortcomings. It should be a normal practice at health centres that when a patient arrives they should be tested for diabetes exactly the way their blood pressure is measured.
If you are not asked to test for diabetes at the clinic when you enter it means that we are not yet there as the ministry.
Something is missing. It is true that we have advertised it a lot in almost every health centre with educational literature that includes pamphlets and other materials but I think it’s high time that people know their status through testing at the clinics.
Now, the studies show that 83.3 percent of women who go to the clinics have never been tested for diabetes and 86.7 percent of men.
So far 53 percent of patients have been advised by health professionals to be on special diet. 40.1 percent were advised to lose weight, 25 percent to stop smoking and 47 percent to engage in physical activity.
However, despite these efforts by the ministry the media is promoting the use of herbs instead of prescribed treatment and as a result 15.8 percent of our patients have opted to go to traditional healers.
Lesotho’s own brandy
ROMA-“Go, eat your food with rejoicing, and drink your wine with a cheerful heart, for already the true God has found pleasure in your works,” so says the Big Book.
Driven by that divine, Mohapi Pule has gone a step further – by coming up with a new type of brandy – to make you merry.
The brandy, Mountain Spels Brandy, will make the heart of the dying man rejoice.
“The healthy nutrients in fruits that make brandy, end up in you when you drink it,” he said.
Pule studied nutrition at the National University of Lesotho.
His brandy is made by fermenting fruits into wine. The wine is then distilled into a brandy. It carries the flavour and the aroma of the original fruits.
The story began when Pule was born in Quthing, Mphaki. He was born to a hardworking mother who brew traditional beer like no other.
“She brew beer well before I was born. She is still making it to this day,” he said.
His passion for brewing was probably “born” even before he was born. Mothers have a hidden way of passing not just their looks but their passions to their children.
As he grew up, he found that he was still intertwined with his mom’s brewing business in one way or another.
“Mostly, I am expected to fetch water for the brewing process. That, I still do to this day when I visit home,” he says.
Two decades later, Pule found himself in the Roma Valley, doing BSc in Nutrition.
“At some point, I found that I had lost purpose in life. There was not a thing that I could say, well, I was passionate about this thing or that thing.”
That situation, of course, threw him into some serious soul-searching.
It brought him back to his roots.
“During this period, I recalled that when I was younger, I used to imagine helping my mom do the packaging of the beer she was making and helping distribute it countrywide,” he said.
From a young age, the issue of subsistence business didn’t appeal to him. But that imagination came and passed. Now here he was, worried that he might not amount to anything in life.
Then, boom! An idea came!
What if he produced an alcoholic drink?
He could have thought about anything to do as a business but, lo and behold! He thought about his mother’s passion!
One of the things he loves about alcoholic beverages is that they are popular.
“I haven’t seen products as popular as alcoholic drinks,” he said.
He might be wrong or right but the reality is, the rest of the world has for generations found delight in alcoholic beverages – some to the extent of overdoing it to their injury!
“Mabele khunoana ralitlhaku thabisa lihoho. Mabele u tsoa kae e le khale re u batla re sa u thole? Ueeeena mabeeeele!” (Loosely translated beer brewed from sorghum make men happy. We’ve been looking for you from afar, you sorghum. In short, this is a praise poem for the Sesotho sorghum brew).
But then came the most difficult part. Which specific beverages should he focus on and how would he do it?
He decided that he would focus on ciders. He realised that not many people in Lesotho were making ciders.
He started experimenting at home and realized how difficult the process was. He just couldn’t get it right. To worsen matters, he also did not have the right equipment.
But like most successful innovators, he just knew that he had to start his business right away.
Pule says he then learnt about other forms of beverages: the spirits. Spirits are very high in alcohol content. Here we are talking the likes of whiskey, vodka and brandy.
He was particularly interested in vodka. He went into one NUL laboratory and, with necessary permission, began testing a number of spirits and doing a lot of research about them.
He began saving some of the money he earned from the National Manpower Development Secretariat in the form of student allowance so he could buy equipment. Saving was not easy. The subsistence money was already not that much. Having to share it with a business was asking a little too much.
But Pule was so determined that he did it, bought equipment that allowed him to develop what he thought was “vodka”.
However, after buying the equipment he immediately realised that the equipment was to make brandy not vodka.
“Now I was forced to get into brandy by chance,” he said.
It was a mistake that he has never regretted having realised that there are very few individuals who were making brandy in Lesotho.
Pule had to throw himself fully into experiments. He read books about brandy production. He even enrolled for an online course on distillation.
In the end, he began to see some light.
“I began to feel some difference in the taste of my produce,” he said. “When I shared my produce with my lecturers, they were over the moon!”
With that encouragement, Pule began packaging his brandy and is now selling it to family and friends.
“My small equipment means that I can’t produce much. However, If I were to get bigger equipment, things would be much better.”
ROMA – ’MATUMANE Matela, a National University of Lesotho (NUL)-trained nutritionist, is an example of how a nutritionist should think and act.
Matela makes and sells ready-to-cook vegetables out of produce from her own farm or produce she preferably buys from local farms.
“When I make a dish, as a nutritionist, I make choices that ensure a typical package is packed with nutrition,” Matela said.
Today, we examine an interesting story of the lady who is determined to ensure that you eat healthy despite your busy schedule.
It started with her experiences in life.
She describes herself as an extremely busy woman.
She likes getting things done.
As the busy amongst us will say, the busier you become, the less you watch your diet.
She couldn’t escape the trap!
“My busy schedule meant that I ended up eating junk and I was gaining weight,” she said.
With time, she came to her senses.
As a nutritionist, she recalled that the best way to preach was to preach by example.
So, was she preaching what she practised?
Clearly, she wasn’t.
She had to find an option to maintain the busy schedule and eat healthy at the same time.
The beautiful thing about nutrition is that the healthiest foods are the closest to us: fruits and vegetables.
Some scientists even claim that our bodies seem to be designed to thrive on fruits and vegetables.
“Have you ever wondered why looking at a ripe raw peach on a tree is mouth-watering but looking at a fat cow isn’t?” asked one scientist.
Well, whether we were designed for fruits and vegetables or not, the truth is that they are good for our bodies.
That’s what good science tells us.
And we somehow “know it” too if you have heard about anything called intuition.
So one day she found herself increasingly eating fruits and vegetables.
It’s easier to change a religion than a diet, they say.
So it is commendable that she changed her diet at all.
“The idea was to chop as much vegetables as possible and put them in a fridge so that in future, I will just pull them out and cook.”
She wasn’t proposing something new.
Who amongst us doesn’t enjoy the convenience of just pulling up chopped frozen vegetables and cooking?
Little did she know that what she was doing was putting her on a path to a brilliant business.
It took a post on a social media to achieve just that.
“I took a pic of the chopped and packaged vegetables and posted them on my social media account. The reaction was swift. I began getting questions like, “how much?””
It immediately dawned on her that she could be sitting on a great business idea, after all.
So she gave it a try and started selling.
To her surprise, people started buying.
In fact, “I get orders for my products almost on a daily basis.”
That is how interested people really are.
This to an extent that her business now gets up to four irregular employees, she included, when the demand is high.
She said her training in Agriculture, Home Economics and Nutrition has helped her to give a thought into what she was doing.
For instance, where possible, she grows her own crops and sells them as first preference.
She has grown spinach, butternut, green pepper, onion, herbs and beans.
She is also in the process of renting more fields to grow more vegetables.
Then she empowers Basotho producers by requesting them to supply.
Going for foreign produce is the last resort.
Look at her packages and you realise something.
The “7 colours” proverb comes alive.
Those seven colours (several colours actually) may have been designed to appeal to your eyes but that is just the tip of the iceberg.
The colours of vegetables mean a lot in terms of nutrition.
Each colour gives you something different.
So, the more colours in one meal, the merrier.
To drive this home, let’s go a scientific route for a second.
Red, Blue and Purple: These vegetables contain substances that are good at reducing the risk of stroke, cancer and memory problems.
White: The likes of onion or garlic may help lower your risk of high blood pressure, high cholesterol, cancer and heart disease.
Orange and Yellow: Carrots immediately come to mind.
These vegetables contain substances called carotenoids which may help improve your immune system and help to improve the health of your eyes.
Basotho, it would appear, have long known a thing or two about the relationship between carrots and eyes.
Hence the famous saying, “o jele lihoete” (they ate carrots), often applied to good sportsmen or women with symbolically “good eyesight”.
Green: Green is life. Green vegetables come packed with chlorophyll, a chemical that scientists believe can boost your immune system, eliminate fungus in your body, clean your blood, lead to healthy intestines and give you boundless energy.
As a bonus, her Home Economics background is such that she is armed with a host of recipes for each of the packages she sells.
She has great dreams for the future.
“I want to see my products decorating the shelves of big supermarkets,” she said.
A new, co-operative chain store
ROMA – ’MAKUENA Lesiea is spearheading the creation of a cooperative chain store that will sell Lesotho products only.
The store is being developed under the National University of Lesotho (NUL) Innovation Hub and it will be incubated by the Hub.
“Have you seen it? Basotho are producing like never before,” Lesiea said.
“However, their products are hard to see in the markets. We want to change all that.”
The store, she said, will open branches in all districts of Lesotho, starting from Maseru.
Visit any supermarket in Lesotho and check the products on the shelves.
You will be shocked to realise that, in general, just one percent of them are made in Lesotho.
The other 99 percent comes from elsewhere.
Is it because Basotho are not producing or can’t produce at all?
“Having worked directly with the NUL Innovation Hub and the Tsa Mahlale TV programme under the Hub, I have travelled the depth and breadth of Lesotho and I was amazed at the amount of work Basotho are doing,” she said.
What is the problem?
Basotho products are not given sufficient platforms to prove themselves.
“Credit where it is due, some shops are beginning to accept and sell Basotho products,” she said.
“However, they are barely making a dent because Basotho products, being at their infancy, cannot receive full attention unless by a store that is designed to give them full attention.”
Such a store doesn’t exist.
She said the idea is not to compete with any of the existing stores because “we are getting into a new territory altogether, we are addressing a different market”.
So listen to Lesiea as she presents some features of the store that will surely persuade you to join the bandwagon:
- Customer and producer confidence: The store, she said, will achieve two things.
First, when they see masses of Lesotho-made products in one place, Basotho customers will slowly grow confidence in them.
The confidence will shoot to the roof when the customers experience that many of the products made in Lesotho are already way ahead of foreign competitors in terms of quality.
Secondly, the store will give Basotho producers an assurance that their products have, at least, one store that is willing to take them, dark or blue.
More production will come from such assurance.
- Selling “everything”: The store will sell everything from fruits and vegetables to processed foodstuffs to clothing and building materials (if Thabure car will be in production by then, it will be on the shelves too).
“Suppose what we want to sell is not locally made, we will never cross the border, any border, to find its equivalence. We will encourage Basotho to produce it until they do.”
- We mean business: whereas Basotho are beginning to produce, their products are still all over the place.
You bump across them in some few willing stores, in expos and trade shows, or as being sold by individual resellers. Those are good efforts, but they are not enough. In fact, many in Lesotho have come to see producing and selling as being more of an art, a hobby, a therapy or a hustling than a business, “so we are seriously moving away from such a casual approach, we mean business this time around.”
- Ownership: So when you enter this store, you could be purchasing a product made by you in a store owned by you. What a difference!
- Reasonable standards: the store will only demand reasonable standards. As a struggling Mosotho, try taking your products to some of the local shops and you are, at worst, turned away without reason or, at best, given a long list of standards you must meet before they can take your product.
“In our case, as long as your products are reasonably of good quality, you are in. NUL Innovation Hub is already testing many Basotho products. We won’t ignore quality, but we won’t use it as a way to prevent Basotho products from growing either.”
- A cooperative chainstore: From contributing as little as M50 per month, members will use a continuous financing model to ensure that the store doesn’t just end in Maseru but reaches the ten districts of Lesotho.
Each branch will start at a medium scale in order to grow along with Basotho products. We won’t ask for investors to come from anywhere, “we will be investors ourselves.”
- An export launch pad. “We are often told to export our produce. The obvious question is, if you haven’t convinced your own people to consume your own products, how can you convince people in other lands to do so? Why should they take you seriously?”
However, the store is not meant to be a local store forever.
It will be a means by which we export our products to other countries in the future.
When we export the store to Soweto, we export it along with products from Lesotho.
Don’t say no because we have seen Chinese shops and Indian shops and, of course, South African shops, filled to the brim with Chinese products and Indian products and South African products in many countries.
“If they can do it,” Lesiea ended, “so can we.”
“Because if it is there in some of us, it is there in all of us.”
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