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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

UFS keeps the power on
2015-06-24

 

At a recent Emergency Power Indaba held on the Bloemfontein Campus, support structures at the university met to discuss the Business Continuity Intervention Plan to manage load shedding on the three campuses of the UFS.

Currently, 35 generators serving 55 of the buildings have already been installed as a back-up power supply on the three campuses of the university. According to Anton Calitz, Electrical Engineer at the UFS, the running cost to produce a kWh of electricity with a diesel generator amounts to approximately three times the cost at which the UFS buys electricity from Centlec.

Planned additional generators will attract in excess of R4 million in operating costs per year. For 2015, the UFS senior leadership approved R11 million, spread over the three campuses. Remaining requirements will be spread out over the next three years. University Estates is also looking at renewable energy sources.

On the Bloemfontein Campus, 26 generators serving forty-one buildings are in operation. On South Campus, two generators were installed at the new Education Building and at the ICT Server Room. Lecture halls, the Arena, the Administration Building, and the library will be added later in 2015. Eight generators serving 12 buildings are in operation on the Qwaqwa Campus. In 2015, the Humanities Building, Lecture Halls and the heat pump room will also be equipped with generators.

Most buildings will be supplied only with partial emergency power. In rare cases, entire buildings will be supplied because the cost of connecting is lower than re-wiring for partial demand. According to Nico Janse van Rensburg, Senior Director at University Estates, emergency power will be limited to lighting and power points only. No allowances will be made for air-conditioning.

“Most area lighting will also be connected to emergency power,” he said.

Where spare capacity is available on existing emergency power generators, requests received for additional connections will be added, where possible, within the guidelines. The following spaces will receive preference:
- Lecture halls with the lights, data projectors, and computers running
- Laboratories for practical academic work and sensitive research projects
- Academic research equipment that is sensitive to interruptions
- Buildings hosting regular events

According to Janse van Rensburg, all further needs will be investigated. Staff can forward all emergency power supply needs to Anton Calitz at calitzja@ufs.ac.za

Staff and students can also manage load shedding in the following ways:

1. Carry a small torch with you at all times, in case you are on a stairwell or other dark area when the lights go out. You can also use the flashlight app on your phone. Download it before any load shedding occurs. This can come in handy if the lights go out suddenly, and you cannot find a flashlight. Load-shedding after dark imposes even more pressure on our Campus Security staff. We can assist them with our vigilance and preparedness by carrying portable lights with us at all times and by assisting colleagues.
2. Candles pose a serious safety risk. Rather use battery- or solar-powered lights during load shedding.
3. Ensure that your vehicle always has fuel in the tank, because petrol stations cannot pump fuel during power outages.
4. Ensure that you have enough cash, because ATMs cannot operate without electricity.
5. The UFS Sasol Library has study venues available which students can use during load shedding.
6. When arranging events which are highly dependent on power supply, especially at night, organisers should consult the load-shedding schedule before determining dates and preferably also make back-up arrangements. If generators are a necessity, the financial impact should be taken into consideration.

The senior leadership also approved a list of buildings to be equipped with emergency power supplies.

More about load shedding at the UFS:
Getting out of the dark
More information, guidelines and contact information

 

 

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