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18 March 2022 | Story Dr Chantell Witten | Photo Supplied
Dr Chantell Witten is from the Division Health Science Education, Faculty of Health Sciences, at the University of the Free State

Opinion article by Dr Chantell Witten, Division Health Science Education, Faculty of Health Sciences, University of the Free State (UFS). 
As we count down to Human Rights Day commemorated annually on 21 March, we are acutely aware of the failures of the state to realise and satisfy the human rights enshrined in our Constitution and Bill of Rights, especially for children.
Since the dawn of democracy in South Africa in 1994 the country has struggled with a persistent high level of child malnutrition measured as stunting, when children are too short for their age.  This is not just shortness of height but it is a proxy for compromised health and a risk factor for lower cognitive development, lower education attainment and lower future productivity both in work output and in earning capabilities. Unhealthy children are likely to be our future unhealthy adults and compromised human development.

Protect children from hunger

It is for this reason that all efforts must be explored to protect children from hunger. Since the outbreak of the COVID-19 pandemic more than two years ago, there have been huge negative impacts on global health and development which are bearing down on the youngest members of the planet, our children. These impacts on children are costing their lives now and well into the future. South Africa has the largest social protection programme for children on the African continent with a child support grant that benefits more than 12 million children under the age of 18 years. On 23 February 2022, Finance Minister Enoch Godongwana announced that the child support grant would increase from R460 to R480 per month as from 1 April. A mere 4% increase, against a year-on-year food and non-alcoholic beverages inflation of 5.5%, rendering the already measly child support grant ineffective to keep hunger at bay, much less to address the nutrition that children need to grow and be healthy. In Section 28 of the Bill of Rights in our Constitution states that “every child has the right to basic nutrition, shelter, health care and social services, as well as the right to be protected from maltreatment, neglect, abuse or degradation”. But the high levels of child malnutrition, almost one in three children are stunted, while one in four households reported child hunger. This is a result of the failure to protect children.

One of South Africa’s leading civil society organisations, the Black Sash, undertook research with the South African Medical Research Council to explore how households receiving the child support grant managed with respect to food procurement and dietary patterns. I was approached to assist with child nutrition data interpretation and policy implications. It was not surprising to find that all 12 households included in this qualitative study were not able to cope or meet their food needs. These households’ food purchasing patterns were insufficient in quantity and in dietary quality. All household members were not able to eat regularly or sufficiently to keep hunger at bay. Even for children, hunger was a norm. Even for a household of a single mother and her five-year-old child, the child support grant was not enough to buy enough food, and other essentials like electricity, toiletries and cleaning materials. This was a huge cause for concern, given the context of COVID and the need to wash hands and surfaces regularly.

Trauma of  caregivers to provide food

The nutrition evaluation of the foods that were purchased was lacking in diversity, nutrient-density and low-quality foods, raising the issue of food safety as well. Poor households dependent on the child support grant, even with multiple grants, was not enough to buy enough food for all the household members. Many adults are forced to go without meals or reduce the amount of food they eat and to rely on food relief efforts like soup kitchens, food packs and food charity. The most heart-wrenching finding is the constant experience of trauma faced by caregivers to provide food for their hungry children. Caregivers expressed feelings of shame and guilt knowing that their children are hungry, for sending their children to ask for food from neighbours and community members. The constant cries for food would drive caregivers to ‘hit the children and send them to bed’. Sleeping is an escape from hunger and having to deal with hunger. These households are under severe psychological strain, re-emphasising that hungry people are angry people. This is not conducive for optimal child care and highlights hunger as a driver of child ‘maltreatment, neglect, abuse or degradation’ as listed in the Bill of Rights.

While caregivers are resourceful in trying to stretch the food budget by buying cheaper, smaller quantities of food products, giving small children many smaller snack foods and taking cash loans to buy foods, these efforts do not shield or protect children from the physical and psychological harm of hunger. A whole-of-society response is needed to create more provision efforts like community out-reach kitchens, food drives and donations, macro-policy initiatives to subsidise food for grant recipients, promotion and support of food gardens and to push government to institute a Basic Income Grant for unemployed persons 18-59 years of age. The child support grant is not enough to protect children from chronic hunger which itself is ‘maltreatment, neglect, abuse or degradation’ as enshrined in the South African Bill of Rights.

News Archive

Ethics at the heart of healthcare practice
2017-05-17

Description: Ethics at the heart of healthcare practice Tags: Ethics at the heart of healthcare practice

Prof Gert van Zyl during the launch of Health
Ethics for Healthcare Practitioners with
Prof Laetus Lategan at the Central
University of Technology.
Photo: Supplied

The Central University of Technology (CUT) in partnership with the University of the Free State (UFS) launched a newly published book: Health Ethics for Healthcare Practitioners that aims to raise awareness among healthcare practitioners and patients about various unethical challenges faced by healthcare services in both the private and public sectors.

Prof Laetus Lategan, Director of Research Development and Postgraduate Studies at CUT, and Prof Gert van Zyl, Dean of the UFS Faculty of Health Sciences, are the co-editors of the book intended to provide a moral guide to healthcare professionals when dealing with their patients. 

Holistic approach to healthcare practice

Their work places renewed emphasis on the importance of healthcare ethics. This is due to a diversifying range of healthcare services and the imminent collapse of the public healthcare service sector; most notably in developing countries. The authors particularly focus on how their findings can be integrated into real-life situations.  

The book looks at modern-day healthcare ethics and how they apply to both patients and healthcare practitioners including doctors, professional nurses and therapists. It is an elaborate reference book that will help healthcare practitioners to make informed decisions should they be faced with ethical dilemmas in their practices and assist them to gain a better understanding and devise solutions to problems faced by communities.

Academic journey and partnerships forged
Prof Van Zyl said the book had been a joyful journey of collaboration between the two universities, a journey of academic colleagues who become friends. He explained that they wanted to focus on creating new approaches to healthcare from an ethical perspective, to provide a guide and reference on ethics, not only to healthcare practitioners, but also to patients. “We hope this book will make a difference in healthcare delivery,” he concluded.

Prof Lategan said modern science needed to become more interdisciplinary, which would transcend the way science was conceived. “The essence of healthcare is to be of service to other people and have relationships with other people. I think it’s high time for us to start caring for one another, especially in the academic environment. If we are really looking after the health of other people, whether it is mental, spiritual or physical health, it starts with caring for other people.”

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