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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

Conference: Expanded ARV treatment

2005-03-02

VENUE: University of the Free State, Bloemfontein, South Africa
DATE: 30 March 2005 - 1 April 2005

ARV Programme as on 24Feb Download Word document
Programme Special events Download Word document

Official web site www.fshealth.gov.za/subsites/arvc

Rationale for the Conference
At the time of the planned Conference, much ground would have been covered, both in the Free State and in South Africa, in respect of the expanded public sector ARV treatment programme in respect of research, experiences in practice, training of staff, treatment of patients, lessons learned, successes and failures, etc. The time would then be quite opportune to share these in a systematic manner with other provinces and countries, as well as with the large variety of stakeholders and role players in the ARV and related domains, be they academics and researchers, policy makers and service/facility managers, the variety of caregivers, and the community organisations and affected patients.

The Conference and current research
The proposed Conference is, firstly, directly linked to the current research on the public sector roll-out of ARV treatment in the Free State conducted by several research institutions (e.g. CIET, CHSR&D, UCT Lung Institute). Secondly, the Conference could and would serve as a forum for other research groups in the country and further a field to report and share knowledge and experiences on ARV treatment and related initiatives. Lastly, the Conference will stage a golden opportunity for researchers and scientists, on the one hand, and policy makers, managers, and caregivers (as knowledge users), on the other hand, to engage in cross-disciplinary discourse on this mutual and topical theme.

Theme of Conference
Expanded ARV treatment in the Free State: sharing experiences

Focus
The focus is primarily on public sector ARV treatment in the Free State, but also initiatives/activities/perspectives of relevance to the Free State elsewhere in the country at large and further a field, as well as relevant ARV initiatives in the public, private, NGO and FBO sectors. Bear in mind, however, that ARV treatment is but part of a much more comprehensive approach to HIV and AIDS. The Conference will, therefore, not narrowly focus on the ARV treatment programme only. The broader context, other relevant dimensions, and a comprehensive approach to the challenges of HIV, AIDS and TB are of equal importance.

The purpose of the Conference
Enhance meaningful exchange, mutual understanding and collaboration among researchers, scientists, policy makers, managers and practitioners in the field of ARV treatment and related fields.

Share experiences in the various spheres of ARV treatment and related spheres (policy, management, practice, research, training, public-private-civil society sectors).

Record, reflect and report on the establishment of the ARV treatment programme in the Free State, and in within the context of the comprehensive HIV/AIDS programme.

Disseminate important research results on ARV treatment and related themes to health policy makers, managers, practitioners, communities and to the research community.

Stimulate discourse among various disciplines and various stakeholders/role players involved in ARV treatment and related programmes.

Sensitise and acquaint researchers to the requirements of policy makers, managers and practitioners in respect of ARV treatment and related fields.

Facilitate the implementation of research results in ARV treatment policy, programmes and practice.

Dissemination of Conference-related information
Information generated during the Conference could feed into policy, management and practice of ARV treatment, the training accompanying such programme, and the existing body of knowledge. After the Conference the information will be disseminated via the Internet and by scientific and popular publications.

Date and duration
Set for 30 & 31 March & 1 April 2005; to commence at 09:00 on the first day (30 March) and to end at 16:30 (1 April) the third day.

Format and scope of Conference
Alternating plenary, parallel sessions and debates focused on topical issues and interest groups. The Conference will strive to be maximally interactive and participative.

Themes and topics to cover:

Policy, management and health services/practice (various levels and contexts – clinical treatment, information, IT systems, pharmacy, laboratories, nutrition)
Research covering all relevant disciplines and diverse dimensions of ARV treatment and related themes
Training and evaluation of training
Patients, communities and civil society organisations
Public, private, NGO, FBO initiatives and partnerships

Emphasis will be on the Free State, however, with of significant involvement from other provinces, SADC countries, and countries further a field. The thrust will be to export lessons and experiences from the Free State, but also to import lessons and experiences from other provinces, countries and sectors.

Presenters
Key presenters from the Free State, other provinces, South Africa, from the private, FBO and NGO sectors, and from several other countries

Delegates
About half of the delegates will be Free State stakeholders and role players (all levels and all contexts). The other half will be role players and stakeholders in the ARV and related fields from other provinces, the national level, and other countries, as well as from the private, public and non-governmental sectors.

Focused workshops
Provision will be made for half-a-day or one-day workshop initiatives on the third day (1 April 2005).

Enquiries
For more information please contact:

Prof Dingie van Rensburg
Centre for Health Systems Research & Development
University of the Free State
PO Box 339
Bloenfontein
SOUTH AFRICA
9300

Contact:
Carin van Vuuren
Conference Organiser
Centre for Health Systems Research & Development
University of the Free State
P.O.Box 339
Bloemfontein
South Africa
9300
Tel +27 (0) 51 401 2181
Fax +27 (0) 51 4480370
Cell 0832932890
e-mail: arvconference.hum@mail.uovs.ac.za

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