Since I arrived in my village almost two years ago, teachers have told me that many children at my school go to bed hungry, wake up hungry, and often have only one meal a day-the meager meal provided by the school nutrition programme. Looking around, I believed that was true for some of the learners, but I couldn’t imagine that most of them didn’t have food at home. Maybe I was in denial-I didn’t want to believe it.
The fact is that I am surrounded by hunger.
No, children aren’t wasting away before my eyes from acute malnutrition. Instead, from birth they are set on a trajectory of chronic malnutrition, evidenced by low weight-for-height (underweight), or low height-for-age (stunting). Their unfocused eyes in the first hours of school, heads dropping towards their desks, and slow, shuffled movements prior to the school serving the lunch at 10am tell me that most do not have breakfast. These kids are hungry.
And some are dying.
In fact, 1 in 15 children die before they reach 5 years of age in South Africa. One third of those children die when they are severely malnourished, and 60% are underweight.
Their death certificates don’t state that they died from malnutrition. No, instead they die from things children should be able to overcome. A 14 year old in a friend’s village died a few weeks ago from a dog bite. Not rabies, just an infection from a dog bite. In a nearby village, a two year old passed away last year from an unspecified illness. A friend of mine told me about a horrible incident at her school, where a first grader accidentally killed a fellow first grader by hitting her in the head with a rock. A last weekend, there was a funeral in my village for a learner from one of my schools. He was “sick for a long time”, which translates into “he had HIV”.
Kids shouldn’t be dying from dog bites, bumps to the head, or preventable and treatable illnesses. This happens when kids are chronically malnourished, suffering from protein-energy deficiency. 2.7 million children in South Africa live in homes where there is child hunger. Overall, 12 million South Africans are considered food insecure, and 4 million of those are on the brink of starvation. These are just a few of the stories….but it’s happening every day.
Earlier this week, I recorded the height and weights of all of our Grade R, or kindergarten, learners. We are in the process of identifying who our Orphans and Vulnerable Children (OVCs) are, in order to support them through the school gardens. Finding out the orphans is relatively easy, because the social workers keep track of them and provide a stipend for families who take in an orphan. But the vulnerable children often fall through the cracks. It is up to the school to identify them, and without a standard, it is difficult. I can look at the kids who come to school barefoot, or without coats in the winter, or who wear the same uniform day after day, and I know they are vulnerable. But almost every child in my school is painfully thin-how do I determine who is going hungry? I can’t ask them; they won’t say. So I worked with the principal and decided that we would record their heights and weights and compare them to international standards to determine which children are stunted and which children are underweight.
Out of 39 learners, 18 fall below the 5th percentile in either height or weight. If a learner is at the 5th percentile, it means that 95 percent of children their age in the world are taller or heavier than they are. Nearly half of the class is stunted or underweight. 28 of the learners have a Body Mass Index (BMI) below the 5th percentile. Body Mass Index is a calculation that uses weight and height to determine the amount of fat a person has. Only 1 child has a BMI at the 50th percentile, the rest were below, mostly far below. The 50th BMI percentile mark for a 5 year old girl is 15.1 and for a boy is 15.5.
One of the learners only weighed 11.5kg, or 25.3lb, which is considered underweight for a two year old, and she is 5.
How do we fix this? How do we feed these children? How do we improve this situation?
Stunting has lifelong impacts on a child, even if they receive better nutrition later on in childhood. They rarely catch up with their well-nourished peers. Stunted women often give birth to children with low birth weight, and the cycle begins again. When children have HIV, TB, malaria, or other opportunistic infections, they often do not have the ability to fight the disease, leading to death when it could have been averted. Hidden hunger and parasitic infections exacerbate all of this.
According to the Global Competitiveness Report in 2012, South Africa ranked 107 out of 144 in the world for infant mortality deaths, and 133 out of 144 for life expectancy. In a country that is the economic leader in Africa, a relatively stable economy, and rich in resources, this is a tragedy. In 2011, the GINI coefficient labeled South Africa as the most unequal nation in the world, surpassing Brazil. In a country where wealthy children receive a world class private education and feast on well-rounded, nutrition meals three times a day, rural children are slowly fading away, with empty bellies and immune systems that are unable to cope with the onslaught of physical, psychological, and social maladies. A child raised in poverty in South Africa is four times more likely to die before reaching their fifth birthday than a child raised in a wealthy family.
It is estimated that 30% of children in South Africa are stunted, and 12 million of 52 million people in the country regularly go to bed hungry. In Limpopo, 48% of children were considered stunted in 2005. In 2004, over 800 children died from kwashiorkor, which is an acute form of protein-energy deficiency. Kwashiorkor is commonly seen in places such as war zones, famine relief programmes, and refugee camps. There is no reason it should be seen in a country that has enough food to feed everyone. Kwashiorkor often causes children to have bloated, distended stomachs, and their hair will begin to turn reddish, orange, or gold in severe cases. It is obvious to me that some of the learners I interact with on a daily basis are suffering from kwashiorkor.
What can we do? We can give them seeds and teach them to plant. We can put the power in their hands and help them to ensure their homes are food secure. But I live in the desert. Is it enough?
I’ll write more about ways the government in trying to intervene, and ways in which they should intervene. This country is in a crisis. Food insecurity is a far-reaching problem, which has direct impacts on health and education, and is extremely difficult to overcome. But we must have hope that something can be done.
Otherwise, I’m looking at children who are doomed to be sick and hungry for the rest of their lives, who will raise hungry children, and who will ultimately die prematurely. I am very afraid that this could very well be the reality, unless something changes.