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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

Media: ANC can learn a lesson from Moshoeshoe

2006-05-20

27/05/2006 20:32 - (SA)
ANC can learn a lesson from Moshoeshoe
ON 2004, the University of the Free State turned 100 years old. As part of its centenary celebrations, the idea of the Moshoeshoe Memorial Lecture was mooted as part of another idea: to promote the study of the meaning of Moshoeshoe.

This lecture comes at a critical point in South Africa's still-new democracy. There are indications that the value of public engagement that Moshoeshoe prized highly through his lipitso [community gatherings], and now also a prized feature in our democracy, may be under serious threat. It is for this reason that I would like to dedicate this lecture to all those in our country and elsewhere who daily or weekly, or however frequently, have had the courage to express their considered opinions on pressing matters facing our society. They may be columnists, editors, commentators, artists of all kinds, academics and writers of letters to the editor, non-violent protesters with their placards and cartoonists who put a mirror in front of our eyes.

There is a remarkable story of how Moshoeshoe dealt with Mzilikazi, the aggressor who attacked Thaba Bosiu and failed. So when Mzilikazi retreated from Thaba Bosiu with a bruised ego after failing to take over the mountain, Moshoeshoe, in an unexpected turn of events, sent him cattle to return home bruised but grateful for the generosity of a victorious target of his aggression. At least he would not starve along the way. It was a devastating act of magnanimity which signalled a phenomenal role change.

"If only you had asked," Moshoeshoe seemed to be saying, "I could have given you some cattle. Have them anyway."

It was impossible for Mzilikazi not to have felt ashamed. At the same time, he could still present himself to his people as one who was so feared that even in defeat he was given cattle. At any rate, he never returned.

I look at our situation in South Africa and find that the wisdom of Moshoeshoe's method produced one of the defining moments that led to South Africa's momentous transition to democracy. Part of Nelson Mandela's legacy is precisely this: what I have called counter-intuitive leadership and the immense possibilities it offers for re-imagining whole societies.

A number of events in the past 12 months have made me wonder whether we are faced with a new situation that may have arisen. An increasing number of highly intelligent, sensitive and highly committed South Africans across the class, racial and cultural spectrum confess to feeling uncertain and vulnerable as never before since 1994. When indomitable optimists confess to having a sense of things unhinging, the misery of anxiety spreads. It must have something to do with an accumulation of events that convey the sense of impending implosion. It is the sense that events are spiralling out of control and no one among the leadership of the country seems to have a handle on things.

I should mention the one event that has dominated the national scene continuously for many months now. It is, of course, the trying events around the recent trial and acquittal of Jacob Zuma. The aftermath continues to dominate the news and public discourse. What, really, have we learnt or are learning from it all? It is probably too early to tell. Yet the drama seems far from over, promising to keep us all without relief, and in a state of anguish. It seems poised to reveal more faultlines in our national life than answers and solutions.

We need a mechanism that will affirm the different positions of the contestants validating their honesty in a way that will give the public confidence that real solutions are possible. It is this kind of openness, which never comes easily, that leads to breakthrough solutions, of the kind Moshoeshoe's wisdom symbolises.

Who will take this courageous step? What is clear is that a complex democracy like South Africa's cannot survive a single authority. Only multiple authorities within a constitutional framework have a real chance. I want to press this matter further.

Could it be that part of the problem is that we are unable to deal with the notion of "opposition". We are horrified that any of us could become "the opposition". In reality, it is time we began to anticipate the arrival of a moment when there was no longer a single [overwhelmingly] dominant political force as is currently the case. Such is the course of change. The measure of the maturity of the current political environment will be in how it can create conditions that anticipate that moment rather than ones that seek to prevent it. This is the formidable challenge of a popular post-apartheid political movement.

Can it conceptually anticipate a future when it is no longer overwhelmingly in control, in the form in which it currently is and resist, counter-intuitively, the temptation to prevent such an eventuality? Successfully resisting such an option would enable its current vision and its ultimate legacy to our country to manifest itself in different articulations of itself, which then contend for social influence.

In this way, the vision never really dies, it simply evolves into higher, more complex forms of itself. If the resulting versions are what is called "the opposition" that should not be such a bad thing - unless we want to invent another name for it. The image of flying ants going off to start other similar settlements is not so inappropriate.

I do not wish to suggest that the nuptial flights of the alliance partners are about to occur: only that it is a mark of leadership foresight to anticipate them conceptually. Any political movement that has visions of itself as a perpetual entity should look at the compelling evidence of history. Few have survived those defining moments when they should have been more elastic, and that because they were not, did not live to see the next day.

I believe we may have reached a moment not fundamentally different from the sobering, yet uplifting and vision-making, nation-building realities that led to Kempton Park in the early 1990s. The difference between then and now is that the black majority is not facing white compatriots across the negotiating table. Rather, it is facing itself: perhaps really for the first time since 1994. It is not a time for repeating old platitudes. Could we apply to ourselves the same degree of inventiveness and rigorous negotiation we displayed up to the adoption or our Constitution?

Morena Moshoeshoe faced similarly formative challenges. He seems to have been a great listener. No problem was too insignificant that it could not be addressed. He seems to have networked actively across the spectrum of society. He seems to have kept a close eye on the world beyond Lesotho, forming strong friendships and alliances, weighing his options constantly. He seems to have had patience and forbearance. He had tons of data before him before he could propose the unexpected. He tells us across the years that moments of renewal demand no less.

This is an editied version of the inaugural Moshoeshoe Memorial Lecture presented by Univeristy of Cape Town vice-chancellor Professor Ndebele at the University of the Free State on Thursday. Perspectives on Leadership Challenges In South Africa

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