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Literacy is a luxury that many of us take for granted. That is why SADAG created SPEAKING BOOKS and revolutionized the way healthcare information is delivered to low literacy communities.

The customizable 16-page book, read by local celebrity audio recordings, ensures that vital health and social messages can be seen, heard, read and understood by everyone across the world.

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While most of us are tucked up in bed, an often unseen army is keeping services ticking over, often to the detriment of their health and social life. Helen Grange spoke to five night shift workers to see how they cope WHEN the sun starts setting, most of us are going home after a hard day's work. But that's when a different set of workers is gearing up to take over the reins, to run the city and its infrastructure throughout the night until the next morning. These are the people manning hospitals, trauma centres, late-night bars, or beavering away preparing shops and roads for daylight hours. They are solving IT problems or attending to night-time travellers. Question is, how do they cope with inverted or disrupted sleep patterns, apart from the inevitable alienation from family and friends who keep normal hours? A new report states that night shifts can cause health concerns if continued for a long period. Researchers at the University of Pennsylvania in the US found that sleep loss might be responsible for injury to and loss of neurons, which are essential for alertness and optimal intellect. "We've always assumed full recovery of cognition following short and long-term sleep loss," researcher Dr Sigrid Veasey said in an interview "But some of the research in humans has shown that attention span and several other aspects of cognition may not normalise even with three days of recovery sleep, raising the question of lasting injury in the brain." THE RESTAURATEUR Andre Schubert Andre has been in the restaurant industry for 30 years, first as a waiter, then as manager and now as owner of the Market restaurant in Greyville, Durban. He is well used to night work. "Late-night work was the most difficult. As a manager I would start around 4pm and work until around 4.30am to 5am, six days a week, and I had to make time for staff and management meetings during the day" he says. But irrespective of the time Andre got home, the alarm was set for Ham. Then he'd have a light breakfast, cycle or drive to the beach and surf for two hours, whatever the conditions. He'd eat a late lunch, and do some home chores or admin before heading for work. "Now that I'm older, I do gym rather than surf. Regular exercise is of utmost importance." Tiredness came only from stress, not late hours, said Andre. "I seldom slept for more than five hours anyway. Afternoon sleeps were a no-no as I'd always get more tired later. The only way to combat stress is to eat well - I have been a vegetarian for 22 years - and exercise. In my case, I have a good life coach." Only recently did Andre start taking regular leave. "I have discovered that it's better to take short bits of leave a few times a year. If you wait too long before taking a break you end up exhausted and hating your job." Late-night hospitality work has many stressors, Andre says, from staff problems and theft to inconsiderate customers, and the later the restaurant is open, the more alcohol becomes a problem. "Every waiter or manager will tell you about those customers who will nurse the last round until the sun comes up, then leave without even a thank you, let alone a tip." But the real pressure is keeping your product consistent until 4am. 'As the evening progresses, everyone gets more tired and they lose their sense of humour or focus." As for your home life, you see your family in passing. "You miss weddings, friends' birthday parties, family dinners. You don't have weekends, so you end up being a sort of lone ranger. I only know of one restaurateur my age who has not been divorced. It's like having a long-distance relationship with someone you live with!" Andre, now married, has changed his hours to live a more balanced life, but still finds it hard to go to bed before midnight. THE DJ Mac G (MACGYVER MUKWEVHO) Mac G presents a show on radio station 94.7 Highveld Stereo from lOpm to lam. Previously, he presented 94 Hits in a Row from 6pm to midnight on Saturdays and 6pm to 9pm on Sundays. He started his radio career in graveyard slots, having hosted a variety of late-night weekend shows for YFM. When he is not in the studio, Mac G DJs at late-night gigs and tours the country extensively "I get really tired on Mondays, because the weekend takes its toll on me, especially if I've had one too many gigs," he says, adding that it's the gigs rather than his show that take the most out of him. "If I'm not at work I'm DJing at an event or party and some of them can get out of hand," he says. During the week, he can survive on relatively little sleep and wakes up by 8am. For Mac G, the downside of working at night is missing friends. "Working unusual hours means you don't see friends as often as you'd like. It can be frustrating when our times clash frequently" he says. Still, he would find it hard to revert to normal working hours. "Working night shifts are my normal hours," he says. "Your normal hours are abnormal to me." The perk is that "you're never stuck in traffic". To combat tiredness, Mac G makes a point of sticking to a healthy diet. "No matter what hours you keep I think it's important to be a healthy eater" THE FLIGHT ATTENDANT Maryke van Deventer Maryke's shifts differ every day, and can start any time between 4.45am and 3pm. Her normal schedule is six days on call, then one or two days off, usually in the week because of high flight volumes over weekends. "Wake-up time is never the same, and nor is sleep time. I wake up about three hours before a flight if I'm at home, and about one and a half hours if I'm in another location. Tiredness can kick in at any time because your body doesn't have a set routine. By day six of flying, lack of sleep has caught up with me," says the 26-year-old single woman. To combat it, Maryke takes a vitamin B complex daily and "I always have a stash of Bioplus and Vita-thion or Liviton". Time off is precious, she says, and is used to catch up on sleep or do errands. "For other people, making a call to the bank is simple, but we don't operate out of an office and we do up to four domestic flights a day, so there is no chance to do these kinds of chores." Being single makes it easier to cope. 'Any customer service industry demands odd times, and public holidays and weekends don't really exist. But for people with children it's not easy at all. It is difficult to juggle a routine for your child as well as your own irregular schedule." Maryke says the perks make the bouts of fatigue worth it. "I meet hundreds of people from all over. We almost never have the same crew, so your colleagues are different every day as well. I get to see different views 'from the top' every day, and I absolutely love travelling and exploring new destinations." To keep going, though, you have to find a way to eat healthily especially when you eat at odd times and often can't cook for yourself. Exercise is also crucial, Maryke says. "Most crew have countrywide gym memberships, or they go for a walk or run, or do some floor work in their hotel rooms." When she does have time off, Maryke finds that for the first few days her body clock is "confused". "Then you fall into normal sleep again. The challenge is getting back into irregular times again," she says. THE PARAMEDIC Diane Laatz Diane works 12-hour shifts, from 7pm to lam (alternating with lam to 7pm day shifts). If a call comes in just before the end of her shift, she may end the shift three hours later, depending on the patient's condition. If she's on night shift, she'll wake up at 5.15pm to prepare food and get ready. "I often feel tired because I normally don't get a chance to catch up on sleep. So when I'm off, I sleep," says 29-year-old Diane, who is single. Catching up on sleep is challenging because Diane is doing her Master's degree part-time, so must catch up on studying or assignments when she's off. On night shifts, drunk-driving accidents are the most common call-outs. "We also deal with a lot of medical cases where patients need stabilisation at home and transport to an emergency centre. "On the plus side, night shifts are generally quieter than day shifts," she says, "so you get some time to socialise with other paramedics or police officers." Finding time to visit friends is rare, she says. "Sometimes I'm just too tired to make the effort to socialise anyway" Working unusual hours means it's difficult to have healthy meals, so most paramedics fall into the habit of getting takeaways while on shift. Shift work has definitely affected her sleeping patterns, Diane says. "I find it very difficult to fall asleep at regular hours and will be up most the night, yet wake up early There is no routine in my sleep at all. I feel tired and sleep-deprived all the time." ME CRISIS COUNSELLOR Jabs Ndlovu This 24-year-old is a volunteer counsellor for the South African Depression and Anxiety Group (Sadag). She may spend a day at the Sadag call centre, and then take crisis calls at home between 8pm and 8am. The helpline is diverted to her cellphone at night, and she tries to snatch about five hours of sleep inbetween calls. Jabs is also studying for her honours in psychology through Unisa. "I wake up between 4am and 5am, because it takes a while for my body to adjust. I'm not a morning person," says Jabs, who is single and lives at home with her parents. Fatigue does plague her, she says, "so over weekends I relax my body and mind by doing minimal activities and listening to music. I have learnt ways of destressing and I use these every day so that I don't burn out. "And there are counsellors who can relieve me should I ever need to take a break." Sometimes Jabs is on duty over weekends, too. These stints are the most challenging because suicidal feelings and drunkenness peak over weekends. "Last year I had a teen who'd overdosed, and by 10pm regretted it. When she called the line, I told her to wake her mother up. The mother was shocked and I ended up with two patients on my hands." The random times and lengths of calls are a challenge. "Sometimes I'll be having dinner and my food gets cold because a call takes longer than expected, or I'll have to miss a church service. Sometimes I have the irritation of sexual callers calling the helpline in the early morning." On more challenging days, Jabs drinks an extra cup of coffee. Although she may sleep in at weekends, Jabs says she's a night owl. "My sleeping hours have been the same since high school. I just cope with less hours of sleep."

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