Food Insecurity and Inequality

Many people have misconceptions about South Africa, thinking it is a developed country without many of the problems the rest of Africa faces-poverty, disease, environmental degradation, food insecurity, corruption, etc….and in some parts of that country, that’s more or less true. You can go to highly developed areas of the country and find every modern convenience, mistaking it for some city in America.

But the reality is that South Africa is plagued by inequality and poverty, leading to widespread food insecurity. It’s estimated that at least 12 million South Africans go to bed hungry each night. In the rural areas, where I’m living, this is pretty evident just looking at the children. Many children show signs of long term malnutrition, through stunting or kwashiorkor. Others show signs of emaciation, indicating short-term or seasonal malnutrition. This affects their development, and impacts their success in school and beyond.

Malnutrition is a problem in South Africa, but it’s often hidden by the modern advances of the First World.

There are a lot of things going on in South Africa that affect food security, and race happens to be one of the factors. During Apartheid, black people were removed from some of the most fertile land in South Africa, freeing it up for white farmers. They were removed to some of the harshest, least productive areas of the country. At the end of Apartheid, much of that farmland was retained by the white farmers. Now, twenty years later, vast inequalities in land ownership exist. 36,000 large-scale farmers control 86 million hectares of land, while 1.4 million black farmers have access to 14 million hectares. (iol.co.za)

Stop and look at that sentence again, and really think about what it means. Out of 100 million hectares of farmland in South Africa, 2.5% of the population of farmers (non-black) control 86% of the land. And 97.5% of the population of farmers (who identify as black) control only 14% of the land.

Imagine how that impacts food insecurity, and which ethnicity is most impacted. Yes, there are white households that are food insecure. But the vast majority of families who face insecurity are either rural black South Africans, or township (think urban slums) black South Africans.

I work in a rural village trying to improve food security through small-scale, intensive food gardening, working with potential young black agriculturists. Many of the children in my village are considered orphans and vulnerable children (OVC) and come from food insecure households. Even if their family has frequent access to food, it might be only during certain times of the month/year (i.e. near payday), it might not be enough food, or it might be food that lacks proper nutrients (i.e. pap, or maize porridge). My goal during my third year is to work with both adults and children to teach sustainable home gardening methods that are high-yielding, low-technology, and which use water responsibly. The idea is that if a family knows more efficient ways of growing food, they can contribute to their own household food security by growing healthy vegetables.

Food insecurity has the potential to cripple this nation, and the problem gets worse as food prices rise. Pensioners in SA receive 1,500 rand/month from the government (about 150USD). For each child in the rural areas (for needy families), the parents receive R250 (about $25) to care for the child. Can you imagine raising a child on $25/month?

Many of the kids at my workplace are one of several, and some belong to households of 8-9 people who rely on 1 or 2 child grants and perhaps a pension from the grandparent. This means that many children either go hungry, or only eat pap. Pap fills the stomach but provides little in terms of nutrition.

But this is why I’m here…in hopes that I can many some small change to increase food security.
-Jen

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What is Hunger?

I will warn you from the start that this post has a good deal of technical language, and wouldn’t necessarily be considered as entertaining as some of my other posts are.  However, because I’ll be talking about the more technical aspects of hunger in the next few posts, I thought it would be nice to lay some groundwork, in case you haven’t studied hunger and food security before.

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I have already indicated that many of the children in my school are hungry and live in food insecure homes.  I’ll come back to what exactly food security is in a bit.  Hunger, as you know, if a feeling people get when they haven’t eaten in awhile.  Pretty simple, right?  Things get a little murkier when you start looking at hunger as it relates to international development. 

What exactly is hunger?

There are a few different types of hunger.  One of them is simply the feeling you get when you haven’t eaten for a few hours.  Everyone has experienced this, and this is NOT what people mean when they talk about hungry children. 

What we mean when we talk about hunger is children who do not get enough food or who do not get enough of the right kinds of food.  Did you know a child can have three full meals everyday, rarely experience the sensation of hunger, yet still be very malnourished?  A child can also be overweight and be malnourished.  How?  Well, malnourishment simply means a condition which is caused by not eating enough healthy foods.  An obese child is every bit as malnourished as an underweight child.

Protein-energy malnutrition (PEM) is the kind of hunger discussed when aid and relief options are put on the table.  These are the “hungry children” I have mentioned in my blog.  PEM happens when a person is not getting enough protein or calories (energy) from the food they eat.  A person could have three meals a day and feel full, but still suffer from PEM.  This frequently happens when a person is eating primarily empty carbohydrates (rice, pap-stiff maize porridge, potatoes, corn tortillas, etc) without any meat or other protein sources. 

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Kwashiorkor causes hair to lose colour.

One form of PEM is Kwashiorkor, which is a severe protein deficiency.  It frequently happens when a child is weaned from breast milk and given food of inferior quality and nutrition.  Kwashiorkor loosely translates into “what happens to the child when another child is born,” referring to the period when a child is weaned.  In severe cases, children will lose hair color, have thinning hair, develop bloated bellies, and/or have swelling in the legs.  Dozens of kids at my school have wispy, blondish hair, indicating cases of severe Kwashiorkor.

Another form of PEM is marasmus, which is severe emaciation.  When you see pictures of a child who is skin and bones-frighteningly thin, you are looking at a child with marasmus.  Marasmus is a condition where there is severe calorie (energy) deficiency, resulting in rapid fat loss.  Some kids and adults in my village show signs of marasmus.

Both conditions are life-threatening if left untreated. 

Milder (though still danger
ous) cases of malnutrition are manifested by children being at a low height-for-age (stunting), low weight-for-age (underweight), or low weight-for-height (wasted).  If a child is below the 5th percentile for weight or height, they are considered moderately to severely malnourished.  What does this mean?  Percentiles are a way to determine how a child is growing/developing compared to their peers (worldwide, children of their age and gender).  If a child is at the 90th percentile for height, 89% of kids their age and gender are shorter than they are.  If a child is at the 25th percentile for weight, 74% of children their age and gender are heavier than they are. 

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Underweight children watching a gardening demonstration.

If a child is at or below the 5th percentile for either height or weight, it indicates either short-term or long-term malnutrition.  An underweight child (at or below the 5th percentile for weight) could be suffering from seasonal or chronic hunger because weight fluctuates frequently.  Low weight is easier to treat and more likely to be “caught up” at a later stage, if a child is given the proper nutrition.  A wasted child (low weight-for-height) is often a child who has suffered from being underweight for a long period of time, and is now wasted.  It is a more serious condition than being underweight.  A stunted child (at or below the 5th percentile for height) indicates long-term malnutrition, resulting in a child whose growth is stunted.  Stunting can be treated, but stunted children rarely “catch up” later on, even if they are given the proper nutrition.  Furthermore, stunted women frequently give birth to underweight babies, meaning they are already malnourished at birth.

Hidden hunger is another form of malnutrition, different from PEM because the body receives enough of both protein and energy (calories), but is still malnourished.  Hidden hunger is a micronutrient deficiency, and can have severe impacts on health.  Deficiencies of vitamins, minerals, and other nutrients can inhibit the body’s ability to develop or function, causing secondary infection and defects.  Hidden hunger is not visible or even noticeable, and therefore is frequently ignored.  Though it is hard to know without proper testing, signs indicate that many of the children at my school suffer from hidden hunger in one form or another.

All of this relates back to food security.  If a household is food insecure, the children are more likely to be impacted and experience hunger.  But what exactly is food security?

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“Food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy lifestyle.” (FAO 2005)

For a household to be considered food secure, they must be able to afford, buy, and prepare enough nutritious and healthy food for everyone in the house, during all seasons of the year.  Food security can be transitory, meaning a household can move from being food secure to being food insecure and back throughout the year, based on employment, growing seasons, etc.

What is food insecurity?  It’s the lack of the above criteria.  Also, “food insecurity exists when people are undernourished as a result of the physical unavailability of food, their lack of social or economic access to adequate food and/or inadequate food utilization.”  Furthermore, a person is considered food insecure when their “food intake falls below their minimum calorie (energy) requirements”. (FAO 2005)

Keep posted for information on how all of this technical information relates to my service and the children at my school.
-Jen

Living in a Food Insecure Household

Prior to moving to Africa, I failed to understand what food security meant on a personal basis.  Though I grew up in a household that didn’t have a lot of money, we always had food.  I never went hungry. 

However, during PST, the first few months of training in South Africa, I lived with a family and ate what they ate.  I didn’t truly realize it at the time, but the family I stayed with was food insecure.

Let me be clear, I never went hungry. But I often wasn’t full.  Our meals were limited in choice and greatly emphasized cheap carbs like pap (stiff maize porridge), rice, and bread.  Though we had protein at almost every meal, the servings were quite small.  I didn’t eat many fruits and vegetables, and sometimes would go days without either.

Peace Corps delivered a food parcel every two weeks.  The first few days after it was delivered were great-we had fresh fruit, green vegetables, and our meals were varied.  The rest of the week, the fruit was gone and the vegetables started to peter out.  The second week meant I was often hungry after lunch, and meals were mostly comprised pap and chicken.  My family almost always had chicken at the evening meal, which was great, but the portions would dwindle during the second week.  Some of the meals I had included penne pasta noodles with ketchup and chicken; lettuce and cheese sandwiches for lunch; pap and baked beans; and eggs, bread, and homemade French fries. Not exactly nutritious or delicious.

I remember times when I would open my lunch at 10am and frown because I was already hungry from breakfast and there wasn’t much for lunch.  There were no snacks.  There was no junk food.  During PST, trainees are given a tiny stipend of about $15usd a week, so I was not able to supplement the family’s food often with my budget.  I would occasionally buy some fruit to share or some chips to eat at lunch, but with such a small stipend, and it didn’t go far.

I lived in a food insecure household for 8 weeks, and that experience will never leave me.  I can’t imagine living that way for the rest of my life, but at least 12 million people in South Africa do.  I have no idea what it would have been like if Peace Corps hadn’t provided food parcels to our host families.  Those food bundles ensured our food security while I was living in the household, and it troubles me that this wasn’t necessarily the case prior to my arrival.

Food insecurity has become an important issue for me since I arrived in Africa.  Food security ought to be a basic human right, but at least 12 million people in South Africa are denied it.  Most of the people in my village live in food insecure household.  I’ve spent most of my service trying to ensure that, in some small way, families in my village can learn to be self-sufficient and ensure their own food security.  Yet climate change and its impact on villages like mine concerns me, and threatens to undo all the work I’ve down over the past few years.  Sadly, there’s no easy answer.

I can’t wave a magic wand and fix these problems.  But I can give people the knowledge to improve their own lives and ensure a better future.  And I’m trying to do that on a very small scale.
-Jen

Surrounded by Hunger, Part 1

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.
-Jen

http://www.westerncape.gov.za/eng/directories/services/11512/6451
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC201028/
http://www.timeslive.co.za/thetimes/2013/01/30/twelve-million-going-to-bed-hungry-in-sa

Hunger in South Africa

Over the weekend, I posted two posts about food security, hunger, and climate change in the North West Province. This week, I am going to be writing about hunger. The hunger I see on a daily basis, and its affect on South Africa. I’m kicking it off with some stats I found this week.

1 in 15 children die before their 5th birthday in South Africa, and SA is one of the few countries where this rate has RISEN since 1990.

15% of babies are born with a low birth weight, meaning they have a much greater risk for dying from infection or lack of feeding.

1/3 of childhood deaths are HIV/AIDS related, and another 1/3 are from infections like pneumonia and diarrhea.
Of all children who die, 1/3 are severely malnourished and 60% are underweight.

A child from a poor family is four times more likely to die than a child from a wealthy family.

2.7 million children (15%) live in households where there is child hunger.

1 in 10 children suffer from severe malnutrition.

12 million people suffer from food insecurity, and 4 million of those are on the brink of starvation.

1 in 5 children are stunted due to chronic malnutrition.

Does this scare you? It scares me. There kids aren’t halfway around the world….they are my neighbors. I teach them, play with them, and learn from them. Their smiles make my day, and their exuberant greetings make me laugh. Yet from birth, they fight hunger. They go to bed hungry, wake up hungry, and try to learn while their stomachs rumble painfully.

It breaks my heart.
-Jen

Sources: http://www.feedthebabiesfund.org.za/News/FactsInfo/ChildPovertyandMalnutrition/tabid/108/Default.aspx
http://www.timeslive.co.za/thetimes/2013/01/30/twelve-million-going-to-bed-hungry-in-sa

Hunger

Grade R learners-notice the hair of the 2 on the left.

Grade R learners-notice the hair of the 2 on the left.

Since arriving in my village, I’ve noticed how thin kids are. Since food is harder to get in my village than others, and since the unemployment rate is higher, almost every single child in my school is thin. Last year, there were 2 kids that would be described as pudgy, and that has more to do with them having poor-fitting uniforms than actually being fat. Few children appear to be at a healthy weight, and the vast majority are bony arms and legs. It’s hard to live in this reality. Adults are typically overweight, but kids are dreadfully skinny. This is due to a diet largely based on pap (cornmeal dish) and for the well-off family, chicken and maybe a veggie.

I had been told that most of the learners didn’t have enough food, and many went to bed hungry or didn’t have breakfast. Each child would get a meal at school, and unlike every other school I’ve visited, only a handful would bring other food with them. The meals are small and basic, just some carbs, veg/fruit, and a protein. At most schools, kids bring a “real” lunch with them, but not at mine. Mma N, my garden counterpart, had said several times that most learners don’t have food at home, and was adamant about giving food boxes from the garden to our OVCs. But I honestly assumed she and other educators were blowing things out of proportion. This is South Africa, kids can’t be starving, right?

Then I started looking and noticing. I saw how few kids brought food from home, how many didn’t buy snacks at school or participate in fundraisers. I noticed brittle, reddish-blond hair, a dead giveaway symptom of Kwashiorkor. I saw how sluggish and out of it kids were in the mornings, before lunch was served. Kids stole our garden veggies. I observed how slowly children developed, and how babies and toddlers didn’t walk or talk. I saw how small the kids really were, and it was heartbreaking.

Hidden hunger, or lack of micronutrients, is a dangerous form of hunger. People don’t necessarily die from it, but it has lifelong effects. Kwashiorkor is a form of malnutrition that comes from not eating enough protein, even though you get enough calories. I had noticed how some kids had reddish or even gold-blonde hair, and found it intriguing. These are black kids, after all, so their hair shouldn’t be red or gold-blonde. I noticed that many kids in Grade R, 1, and 2 had this hair, but only a few older kids did. So when kids start coming to school in Grade R, they are served a complete protein 5 times a week, and it is helping them. The older kids look a little healthier, but the littlest ones are so small, so underdeveloped.

Kwashiorkor and malnutrition stunt children, meaning they do not grow as tall as they should. This typically is lifelong, which may help explain why some people here are so short. With Kwashiorkor, which I think is the prevalent form of malnutrition in my village, children lose muscle mass and do not develop as they should, mentally or physically. They hit milestones late and suffer in school because they are not prepared for the demands of the classroom. Some even get red or gold-blonde hair, which is very brittle. In the worst stages, they will lose their hair and sometimes skin, leaving oozing sores. If a child has Kwashiorkor, it is much more likely that they will suffer from (maybe even die from) another infection, like pneumonia, TB, malaria, or HIV/AIDS.

I’m setting out on a project to weigh and measure the heights of each child in my school. I’m looking for funding through the Department of Agriculture to help the school garden, and I hope this information helps. Since we use the garden to help feed the kids, hopefully they will be more willing to support us if they see the level of malnutrition and stunting. If not, at least I’ll know which kids need the food box the most. I know it will be hard to uncover the extent of the malnutrition in my village, but it needs to be done. Yes, this is South Africa, but people still suffer from malnutrition.
-Jen

Grade R having lunch. Notice the light hair.

Grade R having lunch. Notice the light hair.

Grade R making recycled art!

Grade R making recycled art!

World Food Day

Grade R singing a song about planting.

Grade R singing a song about planting.

October 16th is World Food Day, named to honor the foundation of the UN’s Food and Agriculture Organization.

Food has become a very big issue for me, or rather hunger has. My school has about 2 chubby kids, the rest or skinny or emaciated. And by chubby, I mean they look well-fed and healthy, and would be called normal in the States. I often stand at Assembly, looking at muscle-less legs and knobby knee, hollow cheeks and stick-thin arms. The kids in my village are hungry. Even those from well-off families may be painfully thin, and most are obviously stunted in growth. Kids talk about their “gold” hair, which is nearly as light as mine-on a black child. This is a sign of severe malnutrition.

Living amidst chronic hunger and malnutrition is hard. I can’t relay how torn I feel when I see obviously hungry children in my village. And the reality is that South African kids are better off than most in Sub-Saharan Africa. Every child at my school receives free lunch, every day. The government mandates that it is served by 10am because many kids go without breakfast, and you can’t effectively teach hungry children. So every child gets one meal a day, which consists of a complete protein and sometimes a fruit of vegetable. But for some kids, that is the only meal they get. And on school holidays?

One of the worst moments I had at school was when a gogo brought a child in to the school. The teachers started yelling at him, then he started to cry. Then the teachers calmed down and helped the boy to stop crying. When the boy left for class, I asked what had happened. The teachers showed me a container of grass and explained that the gogo had found the kids eating those grasses in the bushveld. I had no response, and sat there fighting tears until I had to go to class.

Food security is important to me, as I live in such a food insecure village. That is why I focus on the school garden and the development of home gardens. That is why I am working with learners to teach them how to garden. I want to give them a future where they know how to feed themselves, even if they are stuck in the cycle of poverty.

I found out about World Food Day on Sunday, and forgot to mention it to my garden counterpart on Monday. So I went to school today with a plan, and approached her about doing a tree planting demonstration with Grade R. She agreed, and we rounded the Grade R’s up before school let out and taught them about trees and how they can benefit the garden (mainly as shade and a windbreak) and how that means we can grow better food. Then the learners all planted Karee Boom seeds, and now we have about 75 seeds waiting to sprout, in addition to the 30 Moringa seeds we planted last week.

As you read this, consider where your food comes from. Be thankful that you live in a food secure society (if you’re my American friends) and remember that hunger is real, and deadly. It can be hard for those of us from developed societies to understand the importance of food because we typically don’t have to wonder if we are going to eat today. But remember that much of the developing world struggles to feed itself. Today, on World Food Day, more than 7,500 children under the age of 5 will die from hunger (World Vision).

That’s something we can’t ignore.
-Jen

Planting Karee Boom seeds.

Planting Karee Boom seeds.

Say TREES! That's how we get them to smile.

Say TREES! That’s how we get them to smile.

Our newly planted Karee Boom seeds, and Moringa seeds behind.

Our newly planted Karee Boom seeds, and Moringa seeds behind.

The school lunch, and maybe the only meal of the day for some learners. split pea soup and bread.

The school lunch, and maybe the only meal of the day for some learners. split pea soup and bread.