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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

Early nutrition impacts on burden of disease
2017-11-15


 Description: Corinna Walsh read more Tags: Corinna Walsh read more

Prof Corinna Walsh during her inaugural lecture on ‘Nutrition in Transition’.
Photo: Stephen Collett 

“The first 1 000 days, from conception to two years, is a critical time to ensure that the early environment is optimal to guarantee the best outcomes,” Prof Corinna Walsh, Professor in the Department of Nutrition and Dietetics at the University of Free State (UFS), said. She delivered her inaugural lecture on Nutrition in Transition on 30 October 2017. 

During her lecture, Prof Walsh explained how an unfavourable early environment impacts on the health and well-being of both children and adults. She gave an overview of the prevalence of hunger and food insecurity in the Free State, and described the shift that has occurred from healthier traditional diets to more unhealthy Western diets accompanied by sedentary lifestyles. These patterns are closely linked to the triple burden of malnutrition, including undernutrition, micro-nutrient malnutrition, and obesity. Finally, Prof Walsh highlighted the double burden of disease, focusing on chronic lifestyle diseases on the one hand, and infectious diseases such as HIV/AIDS and TB on the other hand.

“Preparing for this lecture has given me the opportunity to reflect on the almost thirty years of my research journey, a process that I thoroughly enjoyed,” said Prof Walsh.

“It was a privilege to share the work of my research team with fellow colleagues as well as with family and friends,” she said. Prof Walsh is a National Research Foundation C-rated researcher and also served on the Board of the Medical Research Council from 2005 to 2010.

Foundations for health, growth established early
The first 1 000-day window focuses on the time between conception and the second birthday. “This is a critical period for growth and development,” Prof Walsh said. It is a unique period, as the foundations for health, growth, and neuro-development are established. It also focused on the implications of malnutrition, which is the biggest risk factor contributing to the global burden of disease.


Research identifies burden of disease
Her research has made a considerable contribution to identifying the burden of disease in the Free State. “It focuses on both malnutrition and infectious diseases such as HIV and TB on the one hand, and chronic lifestyle diseases such as obesity, diabetes, and hypertension on the other,” she said. The research team have also implemented a number of interventions to address these challenges, including programmes that have assessed the impact of nutrition-education programmes, household food gardens, and nutrition supplementation.

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