(Published - 8 October 2018)

“It’s useless just to do something as a duty - you really need to be committed, to like what you are doing, and only then you will be productive. But it also helps to devote yourself to something that can make a difference.”

So says the University of the Western Cape’s (UWC) Emeritus Professor Thandi Puoane. And she walks the talk - her lifetime of devotion to public health research, education and service earned her the 2018 Public Health Innovation and Lifetime Achievement (PHILA) Award from the Public Health Association of South Africa (PHASA). Prof Puoane received the award at the PHASA Conference in Parys, North-West Province, in September 2018.

“A lot of the time we do work because we’re passionate about it, but we’re not aware that it is being recognised,” Prof Puoane says. “So I was overwhelmed by the excitement showed by the audience when I was presented the award, and thankful to those who nominated me.”

Originally trained as a nurse, Thandi Puoane has extensive experience in nursing, research, nutrition and chronic diseases. She has worked with several provincial departments of health, developing programmes and establishing monitoring and evaluation systems to improve programme implementation.

“Building healthy communities through working with community health workers for the prevention of risk factors for non-communicable diseases is a difficult job - but it’s something that I’m glad to have been given the chance to do.”

Prof Puoane’s particular focus has been on nutrition, and the twin scourges of under-nutrition and obesity - both prevalent in South Africa.

She wrote her thesis on obesity, culture and family functioning, and she understands that diet isn’t a simple choice, even for educated people - there are cultural issues involved, as well as (perhaps more importantly) economic ones.

“People might want to be round or obese to show how affluent they are,” she notes, “ and some might not want to lose weight because weight loss is associated with personal problems and HIV. So people prefer to be round and be respected, rather than being healthy.”

When it comes to the economics of a healthy diet, though, choice is less of a factor - the poor often have to resort to less expensive foods that are more filling (particularly ones with high quantities of fat, sugar and starch, such as fast food, snacks and desserts).

“Malnutrition, diabetes, hypertension and cancer are increasingly becoming prevalent among poor South Africans as a result of eating unhealthy, energy dense food,” she says. “More often than not, this is all they can afford. About 14 million people go to bed hungry in South Africa every day. So the reality is that poor people are more concerned with filling stomachs and feeding their families than monitoring what they eat.”

Or, to put it another way, “What’s in your purse dictates what’s on your plate”.

Prof Puoane and Public Health: A Lifelong Journey

“I was inspired to move into public health and to work with the under-served population because I understand exactly where they come from, what they eat and why they do the things they are doing,” she explains, “because I was raised in a similar environment.”

Thandi Puoane was born in Mpumalanga, where her parents were residing, but was raised by her grandmother in KwaZulu-Natal, where she attended school (she boarded at St Augustine High School). After matric she went for nursing training at Baragwanath hospital (now Chris Hani), particularly due to financial reasons  - nurses received a stipend that helped her assist her parents to pay school fees for her siblings.

“After I completed nurses training I worked at the hospitals and colleges of nursing, teaching nurses while studying for a degree with the University of South Africa,” she recalls. “I began to read widely and became interested in community health - and was stimulated to study further.”

Awarded a USAID study grant that sought to assist disadvantaged students during the Apartheid era, she pursued a Masters and a Doctorate degree in Public Health at the University of California at Berkeley.

“On my return to South Africa I was so surprised when I looked at people, even those within my family: everyone was bigger! And there were problems with weight! Talking with people it became very evident that they don’t know what to eat.”

Prof Puoane spent twelve years at the UWC School of Public Health (SOPH), starting in 1998 as a post-doc, and leaving the next year for the South African Medical Research Council (MRC), before returning in February 2002 and finally “retiring” in 2014 (as Prof Emeritus, she’s still associated with the SOPH, and retirement hasn’t slowed down her pace of research and collaboration at all).

“I enjoyed my time at the MRC, but I missed the student interaction,” she explains. “Given where I come from, knowing that students need to be mentored, it made sense to be at the School of Public Health.”

What she’s enjoyed most about her career (so far) is working with people - being a mentor, a mother and a supervisor to many young public health professionals, and producing fresh generations of public health workers and academics.

So what does she tell her mentees?

“Choose a field of work that you like, do it well and excel, and be known in it - and value, listen to and respect the people you work with.

“No matter how difficult things may be, just remember: where there’s a will, there’s a way - and if you know where you want to go and what you want to do, and like what you are doing, you can achieve your dreams.”