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17 September 2020 | Story Prof Corina Walsh | Photo Sonia du Toit (Kaleidoscope Studios)
Prof Corinna Walsh is from the Department of Nutrition and Dietetics and an NRF C-rated researcher at the University of the Free State.

The COVID-19 pandemic highlighted the challenges of food insecurity, hunger, and malnutrition that existed prior to the outbreak, but which are now affecting more individuals and households. During June 2020, three organisations – the Nutrition Society of South Africa (NSSA), the Association for Dietetics in South Africa (ADSA), and Dietetics-Nutrition is a Profession (DIP) – joined forces to call on the government to address malnutrition in all its forms. Prof Corinna Walsh from the Department of Nutrition and Dietetics at the University of the Free State (UFS) is the President of the Nutrition Society of South Africa, which aims to advance the scientific study of nutrition to promote appropriate strategies for the improvement of nutrition well-being. 

The call confirms that good nutrition is an essential part of an individual’s defence against disease and explains that malnutrition, in the forms of both over- and undernutrition, is closely related to an increased risk of illness and death, which has a considerable economic and societal impact. The Coronavirus pandemic has emphasised the importance of food security and nutritional well-being for all South Africans and has exposed the vulnerability and weaknesses of our food systems. 

How big is the problem of malnutrition in South Africa and what impact has the Coronavirus had on this situation?

The call highlights that undernutrition co-exists with the rising incidence of overweight and obesity (frequently in the same household) and resultant non-communicable diseases (NCDs) such as type 2 diabetes mellitus and hypertension. In South Africa, more than a quarter of the female adult population is overweight and more than a third is obese; it is estimated that 269 000 NCD-related deaths occur in the country annually. Obesity and NCDs are regarded as major risk factors for COVID-19 hospital admissions and complications. Over the past 20 years, the prevalence of chronic undernutrition in children has not improved, with 27% of children under the age of five being chronically undernourished. Chronic undernutrition in children manifests as impaired growth, referred to as stunting. By the age of two, this impaired growth and deficits in development become more difficult to reverse, resulting in intellectual impairment that compromises children’s school performance and employment prospects. Chronic undernutrition in children furthermore increases their future risk of obesity and non-communicable chronic diseases in adolescence and adulthood.

Although the nutrition situation in the country had been of concern prior to the pandemic, the acute nature and vast extent of the lockdown brought the plight of individuals and communities to the forefront. In addition to hunger and food insecurity and the resultant undernutrition, the pandemic also placed a focus on non-communicable chronic diseases such as obesity, hypertension, and diabetes. These comorbidities, mostly related to overnutrition, are seen to be associated with a more severe form of COVID-19 infection, as well as an increased risk of hospitalisation and death.

 With South Africa’s current economic challenges and the rise of unemployment, is the situation of malnutrition and food insecurity bound to worsen?

Food, water, sanitation, and social security are under severe pressure due to the pandemic. All of these factors are directly related to an increased risk of malnutrition. Further underlying causes of malnutrition include poverty, unemployment, and inequality, which require interventions over the medium and long term. 

The initial hard lockdown had an immediate and acute impact on households and communities in many ways. With regard to food and nutrition, these include interrupted access to food due to restrictions on travelling and informal trading; discontinuation of food and nutrition social programmes such as the National School Nutrition Programme and feeding at early childhood development programmes; increases in food prices and food expenditure; and reduced or lost income.

The pandemic came at a time when global food security and food systems were already under strain due to natural disasters, climate change and other challenges, exacerbating the need to transform food systems to be sustainable and resilient. 

What interventions are suggested to address the problem of malnutrition?

Food relief and social relief interventions, such as food parcels and social grants, could address the more immediate needs, but broader actions are required to address the underlying causes of malnutrition. 

An important first step in the fight against malnutrition will be to recognise the severity of the situation and the need for coordinated strategic efforts to address the underlying factors that contribute to malnutrition, such as insufficient access to food, affordability of fresh foods, poor health services, and a lack of safe water and sanitation. Food security and nutrition should therefore be addressed collectively with interventions aimed at tackling these factors. It will require concerted efforts from the government, the private sector and civil society to address the immediate, underlying, and structural causes of undernutrition. In view of this, the call proposes that interventions include the following:
-           Prioritise nutrition on policy agendas related to health and social security, including a regulatory framework to support access to healthy and affordable foods. Consideration can be given to a basket of subsidised healthy foods and greater regulation of prices of basic foodstuffs.
-           Provide strategic direction and ensure coordinated and aligned programming to address food and nutrition security in collaboration with other sectors, including civil society organisations. Interventions to ensure optimal nutrition should extend beyond the health-care system and should draw on complementary sectors such as agriculture, social protection, early childhood development, education, water, and sanitation.
-           Coordinate an adequate and targeted food and social relief approach, prioritising the most vulnerable and needy for short-term mitigation. Food relief should be standardised and tailored to the nutritional needs of targeted beneficiaries, especially children. 
-           Progress towards universal health coverage to ensure access to quality, essential health care. Focus on delivery of preventive nutrition services as part of the transformation and strengthening of the health system, integrating nutrition into universal health coverage as an indispensable prerequisite for longer-term benefit.
-           Prioritise the challenges faced by specific populations, including the elderly, women (especially women of childbearing age), children, and those with pre-existing medical conditions (most notably HIV/AIDS, TB, and NCDs), drawing on local structures to identify those most in need. 
-           Implement well-funded coordinated strategies to actively address the main drivers of malnutrition, paying attention to food, nutrition, and health, backed by responsive social protection mechanisms.
-           Improve access to quality nutrition care through investment in human resources to increase the number of qualified nutrition professionals, as well as education opportunities for other cadres of workers who provide nutrition services in primary care settings. Each point of contact with the health system should be recognised as an opportunity to direct caregivers to nutrition care and support services, with efficient referral pathways between sectors.
-           Promote nutrition education of the public through targeted and relevant nutrition messaging and communication campaigns.

Opinion article by Prof Corinna Walsh of the Department of Nutrition and Dietetics and an NRF C-rated researcher, University of the Free State.

 

News Archive

Resource Manual on Trafficking in Persons for Judicial Officers sees the light
2012-03-27

 

Judge Connie Mocumi, President of the South African Chapter of the International Association of Women Judges (SAC-IAWJ), during the launch of the Resource Manual on Trafficking in Persons for Judicial Officers.
Photo: Leonie Bolleurs
27 March 2012

On Human Rights Day the Department of Criminal and Medical Law in the Faculty of Law at the University of the Free State (UFS) hosted the launch of the Resource Manual on Trafficking in Persons for Judicial Officers compiled by the South African Chapter of the International Association of Women Judges (SAC-IAWJ).

The manual, which will be used by members of the South African judiciary, will equip officials in adjudicating the multifaceted crime of human trafficking.

“Presiding officers must be sensitised about the complexity of the crime. Human trafficking has many faces and presents itself in different ways. A person may for example be trafficked for sexual exploitation, forced labour, the removal of body parts, as well as forced marriages. Expert knowledge is needed to handle these cases effectively in court,” said Dr Kruger, also responsible for the human trafficking initiative in the Unit for Children's Rights at the UFS.

Prior to the launch, a total number of 300 judicial officers, including six judges from the Southern African Development Community (SADC) received training on human trafficking. After receiving this training, the officers were sensitised to scrutinise domestic violence cases as well as inter-country adoption cases in order to identify possible human trafficking activities.

As keynote speaker at the launch, Dr Beatri Kruger from the Department of Criminal and Medical Law at the UFS, said that human traffickers were running operations like a well-oiled machine. They have abundant and sophisticated resources and often bribe corrupt officials to further their criminal activities. In South Africa, people combating human trafficking struggle with a lack of resources as well as comprehensive legislation. Most cases are prosecuted under the Children’s Act and the Sexual Offences Amendment Act of 2007. Unfortunately, this legislation still leaves a gap in the prosecuting of perpetrators. Only trafficking cases where where children are trafficked can be prosecuted under the Children’s Act. In terms of the Sexual Offences Amendment Act perpetrators can be prosecuted for trafficking persons for sexual exploitation only, and not for labour of other forms of trafficking. Therefore the comprehensive Prevention and Combating of Trafficking in Persons Bill 2010 needs to be finalised to cover all forms of trafficking.

There are more slaves today than at any time in the history of humankind. “To combat this serious problem, we need to follow a holistic approach,” said Dr Kruger. This includes prevention (raising awareness), effective prosecution and suitable punishment, the protection of victims, and partnering with all relevant stakeholders, including people in the communities. Community members are often whistle blowers of this crime.

The President of the SAC-IAWJ, Judge Connie Mocumi, handed copies of the manual, a three-year project, to judicial officers present at the launch. The manual covers, among others, the definition of trafficking in persons, trafficking in persons in South Africa and the Southern African region, a legislative framework, victims’ rights and criminal proceedings.

“It is critical that judicial officers appreciate the phenomenon of trafficking in persons in its broader socio-economic context. Therein lays the ability to deal competently with the often-nuanced manifestation of this scourge. The incapacity to recognise these nuances can deny victims access to justice. In that regard, the manual, amongst others, is to become an important empowering adjudication tool for judicial officers,” said Judge Mocumi.

More copies will be printed and be ready for distribution by the beginning of May this year.

Judge Belinda van Heerden, who also attended the launch, said: “There is progress on the judicial and legislative front to bring wrongdoers to book. This manual will go a long way in giving judicial officers insight into the problem.”

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