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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

Hearing loss a silent public health crisis in South Africa
2017-03-27

Description: Hearing loss a silent public health crisis in South Africa Tags: Hearing, Deaf, World Hearing Day
Dr Magteld Smith engages on the topic of hearing loss
and how it coincides with the commemoration of
World Hearing awareness during the month of March.
Photo: Oteng Mpete 

Communication is a principal challenge for people with hearing loss. It can be difficult to negotiate everyday interactions, whether in the workplace, on the street, in classrooms, courts, during consultations with health professionals, or even when contacting the police. The World Health Organisation’s (WHO) World Hearing Day is an annual advocacy event held each year on 3 March to raise awareness and promote ear and hearing care across the world. In many countries this awareness campaign usually starts on 3 March but many continue to create awareness for the full month of March. 

Hearing loss is a global reality
According to Dr Magteld Smith, a researcher at the University of the Free State (UFS) School of Medicine’s Department of Otorhinolaryngology, unaddressed hearing loss poses a high cost for the economy globally and has a significant impact on the lives of those affected. Interventions to address hearing loss are available in South Africa but are not accessible or affordable for most citizens. This is partly because not only persons with hearing loss but also people with disabilities experience barriers in accessing services that many of us take for granted, including health, education, employment, and transport as well as information. These difficulties are exacerbated in less-advantaged communities.

“WHO estimates that there are more than 360 million persons with hearing loss globally. The statistics in South Africa are unreliable due to the different definitions used by Statistics South Africa and the absence of training of the officials who conduct and collect statistics concerning hearing loss in South Africa,” says Dr Smith. 

According to Dr Smith, analysis from retrospective studies reflects that about 17 out of 1 000 infants are born daily in South Africa with severe to profound hearing loss. However, Dr Smith states that the number could be higher because of late diagnosis, high levels of undiagnosed and untreated hearing loss. This excludes young adults, adults and the elderly as well as children with acquired (become deaf after birth) hearing loss.

Crisis that needs urgent intervention 
Dr Smith says hearing loss is an emergency which the South African government fails to prioritise. She says that research published confirms that the risk compounding the projected increase in hearing loss that comes with an ageing population. This is a looming and silent public-health crisis.
She believes that the government should take urgent action to align research-spending with the current and projected size and impact of hearing loss. It should also collaborate across related conditions, such as vision, neurodegenerative diseases and neurological conditions. Furthermore, the government needs, and is obligated, to deliver more accessible and integrated services and develop quality standards that take account of the whole pathway – linking public health, clinical and social needs.

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