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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 1, January/February 2019
AFRICA
43
Experiences from the University of Limpopo
The commitment of the University of Limpopo to a societal
reconstruction and development programme is evidenced
through a number of initiatives that have come about post 1994.
In the current classification, some of the social responsibility-
orientated activities are (the) university crèche, Meal-a-Day
initiative and Student Disability Unit (SDU); the CSIR White
Spaces project falls on the public good side, while the dinawa
project
falls in the category of community development.
Universities are communities of a kind
,
and so is the
University of Limpopo. The University has designated divisions
whose responsibilities include provision of legal advice/services
on a small scale, protection of life and property and ensuring
that the University community behaves within certain minimum
agreed standard and policies, access to health services, and
provision of professional counselling to its community. All these
are sufficient evidence that the University of Limpopo complies
with the expectations on
social justice and responsibility.
Dikgale Health and Demographic Surveillance
System (DHDSS)
The project started in 1996 under the leadership of Prof
Marriane Alberts, now emeritus professor in medical sciences,
when the first census was conducted, and covered approximately
8 000 people. However, DHDSS was expanded in 2010 and it
currently has in the region of 38 000 people under surveillance.
The main aim of the project was to monitor NCDs and
associated risk factors in a rural area that is undergoing rapid
changes in lifestyle.
An annual census update has been conducted since 1996 to
capture life events such as births, deaths and residence status,
education status and migration; but since 2011, causes of deaths
have been included. Fieldworkers are used to interview adults
in each household on health surveys covering prevalence of
and risk factors for chronic diseases, therefrom developing
intervention strategies for better management of chronic diseases
and reduction of attendant risk factors.
Of significance in this project is the added fact that regular
meetings are held with the Dikgale tribal authority at which the
main research findings are discussed, as well as informing the
community about any future research that is being planned in the
DHDSS. Beneficiaries are also University masters and doctoral
students whose projects are based at Dikgale village.
Ellisras Longitudinal Study project
The desire of the South African government to improve the
health of rural peoples requires that adequate baseline data
be made available to combat the emerging chronic diseases of
lifestyle, as they are becoming a major health burden in our
communities today. In November 1996, the Ellisras Longitudinal
Study (ELS) was initiated to monitor the growth, health and
lifestyle of a group of children in the Ellisras rural area over
time. Table 1 presents the data collected from then to date.
It is clear that the NCD profile is changing rapidly over
time among the Ellisras rural community children as they grow
older. For example, under-nutrition among Ellisras children
was over 50% in the period 1996 to 2003, with most children
in the ectomorph–mesomorph category.
13,14
The prevalence of
type 2 diabetes mellitus was non-existent in the same population
during the same period. However, the level of physical fitness
and physical activity was extremely low for girls compared to
boys and other children of the same age studied in urban areas.
15
The prevalence of tobacco smoking in the ELS increased from
4.9 to 17%.
16
Today, from the same ELS sample measured from November
to December 2015, the prevalence of obesity is high, particularly
among the females.
17
Furthermore, it was clear from the previous
analysis of this population that the prevalence of hypertension
was emerging and low.
13,18
Currently, the prevalence of diabetes
and hypertension are escalating in this Ellisras population.
19
The well-characterised ELS provides a unique opportunity
for mapping some of these changes, particularly in vulnerable
adolescents and young adults over time. The fact that ELS
subjects migrate to urban areas and sporadically return to
Ellisras rural areas provides a further unique opportunity
for investing the influence of urbanisation on the changing
magnitudes of NCD risk-factor profiles in the South African
population.
The overall performance of the health system in South Africa
since 1994 has been poor despite the development of good
policy and relatively high spending in proportion to the GDP.
Long-term health outcomes are shaped by factors largely outside
the health system: lifestyle, nutrition, education, diet, sexual
behaviour and exercise. Universities should play a central role in
uplifting the standard of living.
Conclusion
Social responsibility, public good and community development
are core functions for a university, which should be treated as
stand-alone roles, such as teaching, learning and research. They
are important functions for any university, not because they are
implied in the Higher Education Act 101 of 1997 but because
they can be used to advance social cohesion in communities and
improve health awareness and lifestyles.
Table 1. Research question data collected in the
Ellisras Longitudinal Study sample from 1996 to 2008/9
Survey
1996 1997 1998 1999 2000 2001 2002 2003 2005 2008/9
Anthropometrical
measurement
* ** ** ** ** ** * **
Blood pressure
** ** ** * *
Diet
*
*
Socio-economic
status
*
Glucose tolerance
*
Learning environ-
ment
* *
Educational achieve-
ment
(maths and English)
* * *
Aptitudes tests
(IQ test)
*
Tanner scale
* *
Questionnaire on
menarche
*
Physical activity
*
Fitness
* * * *
Smoking
* *
Alcohol and drugs
*
*One survey, **two surveys.