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18 June 2020 | Story Dr Chantell Witten | Photo Supplied
Dr Chantell Witten.

On 26 March 2020, the President declared a national lockdown in response to the COVID-19 pandemic as it started to emerge in South Africa. Since then and several weeks into the lockdown, Statistics South Africa (2020) has provided evidence which many intuitively knew would be more devastating to households than the coronavirus itself – loss of income and the negative effects that follow hunger. Stats SA reported that the percentage of respondents receiving no income increased from 5,2% before the lockdown to 15,4% by the sixth week of the national lockdown. Given that the majority of South Africans depend on the informal labour market, such as informal traders and casual workers, this lack of income would hit millions of households. Furthermore, Stats SA also reported a decrease in formal wage/salary earners for the same period, from 76,6% before the national lockdown to 66,7% by the sixth week of national lockdown.

While South Africa is food secure at national level, millions of households are food insecure. According to the United Nations Food and Agriculture Organization’s (FAO) 1996 definition of food security, this simply means that there is not enough food at all times for all the people in a household to have physical and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life.  In short, people are hungry and at greater risk for ill health – physically, emotionally, and spiritually.  A hungry man is an angry man. Likewise, a hungry nation is an angry nation.

In July 2019, the measurement of extreme poverty – the food poverty line (FPL) – was raised to R561 (using April 2019 prices) per person per month, which was up from R547 last year. This is the amount of money that Stats SA calculates an individual requires “to afford the minimum required daily energy intake” of 2 100 calories per day. Before the onset of the COVID-19 pandemic, South Africa already had a precarious food and nutrition situation, especially for young children. South Africa’s child stunting levels – an indication of chronic and long-term food insecurity – increased from 21% in 2008 to 27% in 2016.  With COVID-19 and the subsequent lockdown, child malnutrition rates are expected to increase. Stunting not only affects a child’s health, making them more susceptible to disease and infection, but also impairs their mental and physical development – meaning that children who suffer from stunting are less likely to achieve their full height and cognitive potentials as adults.  

What can we do to address this food situation or prevent it from worsening?
The 2020 Global Nutrition Report recognises and asserts that inequality and globalisation are major drivers of food insecurity. As individuals and as collectives, we need to continue to advocate for and support calls to continue raising the child support grant to help households stay above the poverty line.  Millions of households in South Africa are supported by social grants; in solidarity, we need to appreciate the safety net that these social grants provide to vulnerable households. Advocate for and support initiatives to safeguard child health and nutrition, including efforts to promote, protect, and support breastfeeding in neonatal care, postnatal care, and ongoing support to breastfeeding mothers.  Breastfeeding remains the most cost-effective health intervention for infants and young children, supporting optimal growth and development and providing long-term health benefits into adulthood. Advocate for and support initiatives to coordinate sustainable food support to vulnerable households, including, among others, food distribution, food vouchers, onsite feeding, home gardening, and tax-free food baskets.  These efforts would be our collective solidarity to support and protect vulnerable households as we enter the global economic recession as a result of COVID-19.

How can we protect our households’ food and nutrition security? 
COVID-19 brings with it much uncertainty and many unintended negative effects.  While we seek out strategies to support mental well-being and emotional resilience, we also need to remain physically healthy.  Good nutrition is fundamental to good health and well-being. South Africa has a set of ten healthy eating guidelines that promote the principles of eating more unprocessed foods, eating more vegetables and fruit, reducing the use of fats and oils and reducing the intake of sugar and salt.  Good nutrition starts with good food and sometimes good food can cost more, so it is important to use your food budget wisely.  The food budget includes food eaten at home, as well as funds spent on food eaten outside of the home, eating take-outs, foods bought online, and food eaten away from home.  Planning your meals in advance and sticking to a food plan will limit opportunities to spend money on items that are not on the plan; planning ahead also means you can take advantage of good prices, especially as food prices are on the increase and will continue to increase. Bulking up when prices are low and on special, making use of combo buying, e.g. buy three and pay for two, and buying directly from food producers such as co-ops, all help to save money in the long run.  Meat, fish, and especially seafood are the most expensive food items; rather use eggs, chicken, and less expense meat cuts for your meals.  Legumes such as dried beans, peas, and soya are less expensive with great nutritional value.  Explore these less-known group of foods with many great health benefits, such as no fat, more fibre, and lots of vitamins and minerals.

In an effort to eat more fresh vegetables and fruit, starting a home garden is a great family challenge and a definite way of keeping food costs low. And as we navigate the new normal post-COVID times ahead, let us keep mealtimes and meal preparation a fun family activity. Discovering new foods and new tastes can be as exciting as travelling to a new place.  Stay safe, stay healthy! 

Opinion article by Dr Chantell Witten, Division of Health Professions Education, University of the Free State.


News Archive

UFS cardiac team leading with project
2017-05-31

 Description: Cardiac team read more Tags: Cardiac team read more

Prof Peter Schultheiss of the Charité University in Berlin,
Germany, visited the Robert WM Frater Centre for
Cardiovascular Research at the UFS for a study regarding
cardiomyopathy, a significant cause of fatal heart failure
among Africans. From the left are Dr Glen Taylor,
Dr Danie Buys, Prof Makoali Makatoko,
Prof Schultheiss and Prof Francis Smit.
Photo: Rulanzen Martin

A team of cardiac doctors associated with the Robert WM Frater Cardiovascular Research Centre at the University of the Free State’s (UFS) Faculty of Health Sciences has commenced with a pioneering research project regarding idiopathic dilating cardiomyopathy.  

An Afrocentric research focus
Prof Francis Smit, Head of the Department of Cardiothoracic Surgery at the UFS and Head of the Frater Centre, describes dilating cardiomyopathy as a heart muscle disease that is quite common, particularly among people of African descent. The disease weakens the heart muscle, which in turn leads to heart failure.

“To date there is no curable treatment for this condition and 50% of patients that have shown heart failure, died within a period of five years. The causes of this condition have been unknown in the majority of patients. But over the past few years major strides have been made where virus infections of the heart muscle or myocarditis have been identified as a possible underlying cause. Various genetic diseases are also linked to it,” says Prof Smit.

International collaborations ensure success
According to Prof Smit, the project is being run in conjunction with Prof Heinz-Peter Schultheiss of the Charité University and the Institute for Cardiac Diagnostics and Therapy in Berlin, Germany.

“We have been working on the project over the past 18 months and I have twice visited Prof Schultheiss in Germany. He is now visiting us in Bloemfontein. We have established a collaborative project focused on patients in central South Africa”.
Prof Schultheiss is a world leader regarding the diagnosis, pathology and treatment of dilating cardiomyopathy, says Prof Smit.

“He brings a lifetime of research experience to Bloemfontein and is internationally renowned as the father of myocardial or heart muscle biopsies.

“His pioneering work on the discipline has led to diagnostic accuracy that has induced purposeful and personalised treatment of dilating cardiomyopathy and has brought about dramatic changes in some subsets of patients’ life expectancy and their cure.”

Solving problems close to home
According to Prof Mokoali Makatoko, Head of the Department of Cardiology, there are more than 1500 new cases of heart failure identified annually at the Universitas Academic Hospital, of which approximately 30% are attributed to cardiomyopathy. “With the use of endomyocardial biopsies the team hopes to treat viruses unique to Southern Africa as well as other underlying causes of dilating cardiomyopathy.”

Prof Stephen Brown, Head of Paediatric Cardiology at the Universitas Academic Hospital, says children suffering from this disease never reach a mature age and those under his supervision will also be undergoing these tests. Various other departments at the UFS will also participate in this project. Profs Makatoko and Brown did the first four endomyocardial biopsies under the management of Prof Schultheiss during the past week. The results will be available in the coming weeks after which the project will be officially launched and patient recruitment will start in earnest.

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