**15. Adapting current medical interventions and training to reflect context**

As depicted above, **Figure 5**, the current interventions work differently for the poor and the rich. The poor often have no choice to change their environment, be it living or working environment, they live in unsafe neighbourhoods where it is unsafe to walk let alone access to a gym. Many church services are held at night. The poor are not safe to attend these spiritual opportunities depriving them of a freely available healing tool-spirituality. They eat what is cheap and this is often high in unsaturated fats, and they often miss check-ups due to transport costs etc.

It is therefore easier for the well to do who get diagnosed with cardiovascular diseases to get back to the optimal health line. The current CVD interventions are pro rich. How can we make them pro poor? Doing so would mean addressing environmental and psychosocial factors and economic and health system factors. Context matters. The training of medical personnel should incorporate locally available nutrition that promotes health without making the poor sink into deeper poverty if they want to stay healthy. The currently recommended healthy diet should be high in fibre, green vegetables, fruit the year round, fish and low

#### **Figure 5.**

*The current interventions and their effect on health including heart health depending on whether one is rich or poor.*

processed foods and fat [24]. Can the average township person afford this? Locally available foods e.g., seasonal fruits, wild vegetables, peanut butter and insects are all good for heart health and should be widely promoted and made easily available.
