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Hunger is a violation of children’s rights. An all-of-society response is needed

18 March 2022 | Story Dr Chantell Witten | Photo Supplied

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

UFS cardiologists and surgeons give children a beating heart

2015-04-23

Photo: René-Jean van der Berg

A team from the University of the Free State School for Medicine work daily unremittingly to save the lives of young children who have been born with heart defects by carrying out highly specialised interventions and operations on them. These operations, which are nowadays performed more and more frequently by cardiologists from the UFS School of Medicine, place the UFS on a similar footing to world-class cardiology and cardio-thoracic units.

One of the children is seven-month-old Montsheng Ketso who recently underwent a major heart operation to keep the left ventricle of her heart going artificially.

Montsheng was born with a rare, serious defect of the coronary artery, preventing the left ventricle from receiving enough blood to pump to the rest of the body.

This means that the heart muscle can suffer damage because these children essentially experience a heart attack at a very young age.

In a healthy heart, the left ventricle receives oxygenated blood from the left atrium. Then the left ventricle pumps this oxygen-rich blood to the aorta whence it flows to the rest of the body. The heart muscle normally receives blood supply from the oxygenated aorta blood, which in this case cannot happen.

Photo: René-Jean van der Berg

“She was very ill. I thought my baby was going to die,” says Mrs Bonizele Ketso, Montsheng’s mother.

She says that Montsheng became sick early in February, and she thought initially it was a tight chest or a cold. After a doctor examined and treated her baby, Montsheng still remained constantly ill, so the doctor referred her to Prof Stephen Brown, paediatric cardiologist at the UFS and attached to Universitas Hospital.

Here, Prof Brown immediately got his skilled team together as quickly as possible to diagnose the condition in order to operate on Montsheng.

During the operation, the blood flow was restored, but since Montsheng’s heart muscle was seriously damaged, the heart was unable to contract at the end of the operation. Then she was coupled to a heart-lung machine to allow the heart to rest and give the heart muscle chance to recover. The entire team of technologists and the dedicated anaesthetist, Dr Edwin Turton, kept a vigil day and night for several days.

Prof Francis Smit, chief specialist at the UFS Department of Cardiothoracic Surgery, explains that without this operation Montsheng would not have been able to celebrate her first birthday.

“After the surgery, these children can reach adulthood without further operations. Within two to three months after the operation, she will have a normal active life, although for about six months she will still use medication. Thereafter, she will be tiptop and shortly learn to crawl and walk.”

Mrs Ketso is looking forward enormously to seeing her daughter stand up and take her first steps. A dream which she thought would never come true.

“Write there that I really love these doctors.”

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