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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

First doctorate in Thoracic Surgery in Africa awarded
2009-05-12

The University of the Free State (UFS) has become the first university in Africa to award a Ph.D. degree in Thoracic Surgery. The degree was conferred on Prof. Anthony Linegar from the university’s Department of Cardiothoracic Surgery during its recent graduation ceremony.

Thoracic surgery is a challenging subspecialty of cardiothoracic surgery. It began in South Africa in the 1940s and is a broad medico-surgical specialist discipline that involves the diagnosis, operative and peri-operative treatment of acquired and congenital non-cardiac ailments of the chest.

Prof. Linegar became the first academic to conduct a mixed methods analysis of this surgical specialty, which included a systematic review of all the research done in this field in South Africa. The title of his thesis is A Model for the Development of Thoracic Surgery in Central South Africa. The research was based on the hypothesis of a performance gap between the burden of disease in the community and the actual service provision. It makes use of systems theory and project management concepts to develop a model aimed at the development of thoracic surgery.

The research proved that there is a significant under provision of clinical services in thoracic surgery. This was quantified to a factor of 20 times less than should be the case, in diseases such as lung and oesophagus cancer. According to Prof. Linegar, there are multiple reasons for this. Listed amongst these reasons is the fact that thoracic surgery is not part of the undergraduate education in medical training. There tends to be a low level of awareness amongst clinicians as to what the thoracic surgeon offers their patients. The diagnostic and referral patterns in primary and secondary health facilities, where diseases must be picked up and referred early, are not functioning well in this regard. In addition, relatively few cardiothoracic surgeons express an interest in thoracic surgery.

Prof. Linegar’s model is named the ATLAS Mode, which is an acronym for the Advancement of Thoracic Surgery through Analysis and Strategic Planning. It includes the raising of awareness of the role of the specialist thoracic surgeon in the treatment of patients with thoracic diseases as part of the solution to the problem. Furthermore, it aims to develop an accessible and sustainable specialist service that adequately provides for the needs of the community, and that is appropriately represented in health administration circles.

His promoters were Prof. Gert van Zyl, Head of the School of Medicine at the UFS, Prof. Peter Goldstraw, from the Imperial College of London, United Kingdom (UK) and Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the UFS.

Prof. Linegar has been with the UFS since 2004, is a graduate from Stellenbosch University in 1984 and completed his postgraduate training in Cardiothoracic Surgery at the University of Cape Town. He was granted a Fellowship in Thoracic Surgery at the Royal Brompton Hospital in London, UK and has since held consultant positions at the UFS, Stellenbosch University and in private practice. He has been involved in registrar training since returning from the UK in 1994 and has extensive experience in intensive care medicine. He has published widely, has presented papers at many international conferences, has been invited as a speaker on many occasions and has won awards for best presentation on three occasions.

Media Release
Issued by: Lacea Loader
Assistant Director: Media Liaison
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: loaderl.stg@ufs.ac.za  
12 May 2009
 

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