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Child malnutrition – human rights violation and slow violence against children

14 April 2021 | Story Dr Chantell Witten | Photo Supplied

A decade ago, Rob Nixon, a professor in the humanities and environment studies at Princeton University in the US, introduced the concept of slow violence in the context of climate change and environmentalism, explaining slow violence as violence that occurs gradually and out of sight, a violence of delayed destruction that is dispersed across time and space, an attritional violence that is typically not viewed as violence, at all. While profound, Professor Nixon’s concept of ”out-of-sight violence” and ”violence of delayed destruction” was challenged by Professor Thom Davies from the University of Nottingham in the UK who urged scholars to instead ask the question: ”out of sight to whom?” He argued that structural inequality mutated into noxious instances of immediate slow but pervasive violence by those who have endured toxic landscapes and unhealthy physical environments.

Reflecting on the impact of COVID-19 in the context of persistent hunger in South Africa’s cities, Dr Gareth Haysom from the University of Cape Town, challenged us as society to recognise the ”slow violence“ of hunger and food insecurity that are also often “experienced in private, incremental and accretive ways that are often invisible”. But as urged by Professor Davies, the question of child hunger and malnutrition in South Africa is really, to whom is this hunger and malnutrition invisible?

Malnutrition and its debilitating consequences have been studied and known about as far back as the 1950s. In 1976, Stoch and Smyth from the then Child Psychiatric Unit and Department of Paediatrics and Child Health at the University of Cape Town reported on a 15-year developmental study conducted from 1955 to 1970 on the effects of severe undernutrition during infancy on subsequent physical growth and intellectual functioning on coloured children from the Cape Flats concluded that the effects of severe undernutrition during infancy on subsequent brain growth and intellectual development confirmed gross retardation of intellect in the undernourished group when compared to the controls. Furthermore, the study concluded that given the abnormal performance of the control group that there was much evidence to suggest that the controls were also suboptimal in terms of nutritional status and intellectual functioning. This means that in general the nutritional status of coloured children on the Cape Flats was poor. Fast forward to 2021, and child nutrition in South Africa is still sub-optimal.

South Africa’s nutrition indicators have worsened

The most recent data from 2016 National Demographic Health Survey showed that 27% of children under the age of five years are stunted or too short for their age. This equates to more than 1.5 million children whose health and development is compromised and who have a lower chance of reaching their full potential even into their adult years. While many countries of the same economic development status have improved their nutrition indicators, South Africa’s nutrition indicators have worsened. South Africa has been identified as one of the countries with high levels of multiple forms of malnutrition manifested in high levels of stunting, childhood obesity and multiple micronutrient deficiencies, the most notable being vitamin A deficiency. These multiple forms of malnutrition cast a long shadow of ill-health and delayed development. of children, robbing them of quality of life and years of life in their childhood and their adult years. Malnutrition has a double cost on quality of life and additional health costs consuming resources that could have been spent on better food.

The right to have access to sufficient food is embedded in Section 26 and 27 of our Constitution and the right to adequate nutrition for children is stipulated in section 28. The Bill of Rights enshrined in the Constitution states that “every citizen has a right to have access to sufficient food, water and social security” and that “the State must take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of this right”. Before the onslaught of COVID-19, we as health and social care professionals, have been acutely aware that a significant number of South Africans do not have access to sufficient food and go hungry on a daily basis. Malnutrition is well-documented in South Africa and unfortunately is progressively getting worse.

SA has not prioritised children or the realisation of their human rights to food and nutrition

Better nutrition can only be achieved when food and care are available to young children but in the context of rising food prices, limited maternal support and a difficult psychosocial environment, mothers are not able to provide their children with a health-enabling environment. Our high levels of stunting and obesity levels reflect the chronic situation of poor-quality and inadequate diets coupled with poor caring practices. While these poor dietary practices are often individualised and focused on mothers, there are many systemic and structural barriers for families to access affordable and nutritious diets. The food environment is shaped by a profit-centred food system that comes at the cost of people’s health and well-being. Children have always being the prime focus of the food industry, from the promotion of maternal supplements to improved maternal nutrition for the developing foetus, to the promotion of infant formula as a convenient and easy-to-use alternative to breastfeeding, to the manipulative marketing of foods for and to children.

Child nutrition has become a global tracking indicator for both human and economic development. Sadly, our lack of progress over the past 20 years clearly illustrates that we, as a country, have not prioritised children or the realisation of their human rights to food and nutrition. The findings of the 2020 Child Gauge gives us, as a country, the opportunity to stop the violations of children’s rights and to end the slow violence of child malnutrition.

News Archive

Inaugural lecture: Prof Robert Bragg, Dept. of Microbial, Biochemical and Food Biotechnology

2006-05-17

Attending the inaugural lecture were in front from the left Prof Robert Bragg (lecturer at the Department of Microbial, Biochemical and Food Biotechnology) and Frederick Fourie (Rector and Vice-Chancellor). At the back from the left were Prof James du Preez (Departmental Chairperson: Department of Microbial, Biochemical and Food Biotechnology) and Prof Herman van Schalkwyk (Dean: Faculty of Natural and Agricultural Sciences). Photo: Stephen Collett

A summary of an inaugural lecture delivered by Prof Robert Bragg at the University of the Free State:

CONTROL OF INFECTIOUS AVIAN DISEASES – LESSONS FOR MAN?

Prof Robert R Bragg
Department of Microbial, Biochemical and Food Biotechnology
University of the Free State

“Many of the lessons learnt in disease control in poultry will have application on human medicine,” said Prof Robert Bragg, lecturer at the University of the Free State’s (UFS) Department of Microbial, Biochemical and Food Biotechnology during his inaugural lecture.

Prof Bragg said the development of vaccines remains the main stay of disease control in humans as well as in avian species. Disease control can not rely on vaccination alone and other disease-control options must be examined.

“With the increasing problems of antibiotic resistance, the use of disinfection and bio security are becoming more important,” he said.

“Avian influenza (AI) is an example of a disease which can spread from birds to humans. Hopefully this virus will not develop human to human transmission,” said Prof Bragg.

According to Prof Bragg, South Africa is not on the migration route of water birds, which are the main transmitters of AI. “This makes South Africa one of the countries less likely to get the disease,” he said.

If the AI virus does develop human to human transmission, it could make the 1918 flu pandemic pale into insignificance. During the 1918 flu pandemic, the virus had a mortality rate of only 3%, yet more than 50 million people died.

Although the AI virus has not developed human-to-human transmission, all human cases have been related to direct contact with infected birds. The mortality rate in humans who have contracted this virus is 67%.

“Apart from the obvious fears for the human population, this virus is a very serious poultry pathogen and can cause 100% mortality in poultry populations. Poultry meat and egg production is the staple protein source in most countries around the world. The virus is currently devastating the poultry industry world-wide,” said Prof Bragg.

Prof Bragg’s research activities on avian diseases started off with the investigation of diseases in poultry. “The average life cycle of a broiler chicken is 42 days. After this short time, they are slaughtered. As a result of the short generation time in poultry, one can observe changes in microbial populations as a result of the use of vaccines, antibiotics and disinfectants,” said Prof Bragg.

“Much of my research effort has been directed towards the control of infectious coryza in layers, which is caused by the bacterium Avibacterium paragallinarum. This disease is a type of sinusitis in the layer chickens and can cause a drop in egg product of up to 40%,” said Prof Bragg.

The vaccines used around the world in an attempt to control this disease are all inactivated vaccines. One of the most important points is the selection of the correct strains of the bacterium to use in the vaccine.

Prof Bragg established that in South Africa, there are four different serovars of the bacterium and one of these, the serovar C-3 strain, was believed to be unique to Southern Africa. He also recently discovered this serovar for the first time in Israel, thus indicating that this serovar might have a wider distribution than originally believed.

Vaccines used in this country did not contain this serovar. Prof Bragg established that the long term use of vaccines not containing the local South African strain resulted in a shift in the population distribution of the pathogen.

Prof Bragg’s research activities also include disease control in parrots and pigeons. “One of the main research projects in my group is on the disease in parrots caused by the circovirus Beak and Feather Disease virus. This virus causes serious problems in the parrot breeding industry in this country. This virus is also threatening the highly endangered and endemic Cape Parrot,” said Prof Bragg.

Prof Bragg’s research group is currently working on the development of a DNA vaccine which will assist in the control of the disease, not only in the parrot breeding industry, but also to help the highly endangered Cape Parrot in its battle for survival.

“Not all of our research efforts are directed towards infectious coryza or the Beak and Feather Disease virus. One of my Masters students is currently investigating the cell receptors involved in the binding of Newcastle Disease virus to cancerous cells and normal cells of humans. This work will also eventually lead to a possible treatment of cancer in humans and will assist with the development of a recombinant vaccine for Newcastle disease virus,” said Prof Bragg.

We are also currently investigating an “unknown” virus which causes disease problems in poultry in the Western Cape,” said Prof Bragg.

“Although disinfection has been extensively used in the poultry industry, it has only been done at the pre-placement stage. In other words, disinfectants are used before the birds are placed into the house. Once the birds are placed, all use of disinfectants stops,” said Prof Bragg.

“Disinfection and bio security can be seen as the ‘Cinderella’ of disease control in poultry. This is also true for human medicine. One just has to look at the high numbers of people who die from hospital-acquired infections to realise that disinfection is not a concept which is really clear in human health care,” said Prof Bragg.

Much research has been done in the control of diseases through vaccination and through the use of antibiotics. “These pillars of disease control are, however, starting to crumble and more effort is needed on disinfection and bio security,” said Prof Bragg.

Prof Bragg has been working in close co-operation with a chemical manufacturing company in Stellenbosch to develop a unique disinfectant which his highly effective yet not toxic to the birds.

As a result of this unique product, he has developed the continual disinfection program for use in poultry. In this program the disinfectant is used throughout the production cycle of the birds. It is also used to ensure that there is excellent pre-placement disinfection.

“The program is extensively used for the control of infectious diseases in the parrot-breeding industry in South Africa and the product has been registered in 15 countries around the world with registration in the USA in the final process,” said Prof Bragg.

“Although the problem of plasmid mediated resistance to disinfectants is starting to rear its ugly head, this has allowed for the opening of a new research field which my group will hopefully exploit in the near future,” he said.

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