Child malnutrition in the Eastern Cape ‘qualifies as a disaster’

Child malnutrition in the Eastern Cape should be declared a disaster in terms of the Disaster Management Act and compel the government to intervene immediately and decisively. This was the finding of the South African Human Rights Commission following its investigation into the state of food security in the province. It found that a substantial percentage of children in the Eastern Cape are suffering from various forms of malnutrition.

Food insecurity in the Eastern Cape should be declared a disaster in terms of the Disaster Management Act, the South African Human Rights Commission ruled on Thursday in a report highlighting the devastating incidence and consequences of hunger in the Eastern Cape.

The SAHRC further pointed out that the government was not responding well to the crisis.

SAHRC commissioner Jonas Sibanyoni said the report was done as a response to waves of desperate calls from communities and heart-wrenching media reports. “We deemed it imperative to investigate,” he said.

As one of their findings they had suggested that the government seriously consider increasing the Child Support Grant (it was R480 at the time and is now R520) and extending the school nutrition programme to early childhood development centres.

The Eastern Cape head of the SAHRC, Dr Eileen Carter, said the data that was provided to them had shown that in 2021 to 2022 more than 1,000 children were diagnosed with severe acute malnutrition in the province and 120 of them had died.

It also showed that 25% of the province’s children are stunted, that is one in four children.

child malnutrition

A 14-year old eats pap with sugared water because that is all that is left in the house in Mthatha West, Eastern Cape. (Photo: Hoseya Jubase)

“But this condition is underreported,” she said. “It is a much bigger issue than what the data is showing,” Carter said.

“The Child Support Grant has never kept up with inflation,” she said, adding that the first calls for an increase in the grant were made in 2016 by the Committee on the Rights of the Child but this has not been actioned by government.”

The report continued: “Despite having multiple programmes and initiatives, the absence of a unified strategy has resulted in a fragmented and less-effective approach to tackling the issue of child malnutrition.

There exists a strong legal foundation for the province to declare a state of disaster and, in alignment with previous successful practices during the Covid-19 pandemic, establish a coordinated war room or command centre within the Office of the Premier.

“In the legal context defined by the Disaster Management Act, it becomes apparent that communities afflicted by the factors causing severe acute malnutrition, notably poverty and food insecurity, lack the inherent capacity to cope with these devastating effects through their own resources. Therefore, there is a compelling basis to argue that the child malnutrition crisis qualifies as a disaster, warranting urgent and comprehensive intervention.”

The Disaster Management Act provides for the classification of a provincial disaster if it affects more than one metropolitan or district municipality in the same province, or if a single metropolitan or district municipality in the province, with or without assistance from local municipalities, cannot effectively manage it.

“This provision is directly applicable, as the deaths and malnutrition cases span across several areas within the Eastern Cape,” the report stated.

The inquiry found that a substantial percentage of children in the Eastern Cape are suffering from various forms of malnutrition.

“Therefore, there exists a strong legal foundation for the province to declare a state of disaster and, in alignment with previous successful practices during the Covid-19 pandemic, establish a coordinated war room or command centre within the Office of the Premier.

“Child malnutrition is not merely a concern for the well-being of the affected children; it is a stark violation of their rights to food and nutrition, dignity, life, equality, social assistance, health and education. Such a situation exposes a range of systemic failures and challenges the effectiveness of the state machinery in safeguarding the welfare of its youngest residents. The consequences of child malnutrition are long-lasting, affecting not just the individuals but the community and the nation at large. It poses severe challenges to the state’s commitments towards eradicating poverty, inequality and other forms of social injustice.”

The report continued: “If thousands of schools in the Eastern Cape suddenly ran out of funding or for any other reason ceased operating at full capacity, thus leading to 27% of children in the province finding themselves without a basic education, [this] would justify the declaration of a state of emergency, both in the best interests of the children and in consideration of the fact that the right to a basic education is, just like the right to basic nutrition, immediately realisable.

State failures are contributing to severe acute malnutrition deaths in the province, violating the right to life.

“The province has a constitutional and moral imperative to act decisively. A declaration of a state of disaster, supported by a coordinated war room, would exemplify the province’s unwavering commitment to addressing this crisis urgently and effectively, and would prove invaluable to ensuring that the nutrition rights of children are immediately realised.”

The inquiry into child malnutrition and the right to food conducted by the Eastern Cape office of the SAHRC was “of utmost urgency and significance”.

child malnutrition

Children line up at the Walmer Angels soup kitchen in Gqeberha, Eastern Cape. (Photo: Deon Ferreira)

The commission had received evidence from NGOs, healthcare professionals and community leaders on the state of hunger in the province.

The findings confirmed hundreds of accounts received by Daily Maverick over the past three years from teachers, doctors and community workers on children’s struggles to access food.

‘Violating children’s basic rights’

Sibanyoni said the national and Eastern Cape governments were violating children’s basic rights to dignity, life and access to food.

“The Child Support Grant fails to provide the basic needs of children,” he said, adding that the state failures are contributing to severe acute malnutrition deaths in the province, violating the right to life.

They had also found that children’s right to food was being violated across levels of government.

“The state failed to take steps to address this violation, as is evident in the enduring severe acute malnutrition crisis.”

This right to basic nutrition was “immediately realisable”.

Despite having multiple programmes and initiatives, the absence of a unified strategy has resulted in a fragmented and less-effective approach to tackling the issue of child malnutrition.

Given that black and coloured communities were unequally affected by severe acute malnutrition, the state’s failure to provide nutritional support also constituted race discrimination, Sibanyoni said.

He stressed that it was of the utmost importance that there is a collaboration in government to increase the Child Support Grant, even, given current fiscal constraints, incrementally to provide for the most vulnerable children.

It was their finding that the government was discriminating against children by age by not extending school nutrition programmes to early childhood development centres.

Most recently, medical personnel recounted how children with high stages of cancer would arrive at hospital and, despite having a terminal illness, pick up 10kg while in hospital because they were fed regularly.

In 2022, community workers rescued a baby who was at death’s door because her mother only had powdered cooldrink to feed her. In August, Taslin Lucas was murdered after she went out after dark to look for food because she was hungry. Social workers have confirmed that in some areas children are eating grass and other plants to stay alive. Several teachers have confirmed that children are so hungry when they return to school on a Monday that they will just sit in the class and cry. In one instance a principal confirmed that they were giving what bread they had left to the poorest of their children, telling them to hide it from their parents since the adults in the household would forcefully take away food that had been sent home with them.

child malnutrition

Bongeka Buso killed herself and her children due to persistent hunger and struggles to obtain food. From left: Iyapha Mntsizela, (14) Inga Mntsizela (8), Ntombizanele Mntsizela (35) and Phila Mntsizela (4). Mntsizela allegedly used rat poison to kill herself and three of her four children. The police said their preliminary investigation found that the family was desperately poor and the mother had become despondent. (Photos: Supplied)

In August 2023, Bongeka Buso, a mom from Butterworth, killed herself and her three children after she broke down over not having enough food for herself and her children. She used the last of her food to mix with poison and fed it to her two youngest children and then stabbed her teenage daughter to death before hanging herself.

The commission’s findings are coupled with devastating new statistics on severe acute malnutrition from the Eastern Cape health department for the year until September showing almost monthly deaths due to severe acute malnutrition in every district of the province, and hundreds of children with symptoms of malnutrition being referred for treatment.

“The submissions painted a grim picture of the situation, revealing alarming rates of malnutrition-related illnesses and even fatalities. Testimonies from parents and guardians highlighted their daily struggles in providing adequate nutrition to their children. Some submissions also pointed out the lack of adequate healthcare facilities and the challenges in accessing existing ones, especially in rural areas,” the report reads.

“This not only impacts their physical and cognitive development but also perpetuates a vicious cycle of poverty and compromised future prospects.”

The report furthermore identifies a significant lack of coordination among various government departments and agencies. Despite having multiple programmes and initiatives, the absence of a unified strategy had resulted in a fragmented and less-effective approach to tackling the issue of child malnutrition.

The inquiry also revealed that there is a considerable lack of awareness among parents, guardians and communities about the nutritional needs of children. This lack of information further exacerbates the malnutrition problem.

Recommendations from the SAHRC to address the crisis include:

  • Increasing the Child Support Grant above the food poverty line;
  • Prioritising children under school-going age for the Child Support Grant increase;
  • Partner with the Department of Home Affairs for a registration campaign targeting unregistered children;
  • Extending the National School Nutrition Programme to early childhood development centres; or
  • Increase the ECD subsidy to an amount that enables ECD centres to feed children nutritious food;
  • Consider providing meals during weekends and school holidays;
  • Promote breastfeeding through supplementary programmes; and
  • Develop a programme for early identification and treatment of malnourished children and make data available to NGOs for targeted interventions.

The commission further suggested that the Department of Rural Development and Agrarian Reform implement community gardens and urban agriculture projects for food security.

It has also recommended that the provincial treasury allocate sufficient budgetary resources for malnutrition interventions and conduct human rights baseline assessments for budget allocations.

The government should also improve its oversight mechanisms for accountability, the report concluded.

Taslin Lucas was murdered in Walmer Township, Gqeberha, when she went out at night to look for food. (Photo: Donna vd Watt)

Government departments were given three months and in some instances six to report back to the SAHRC.

Carter said they had available mechanisms to enforce cooperation but so far they had only received cooperation from all stakeholders.

The commission noted that there were instances of unspent funds meant for nutritional support in the past three years, including a significant R67-million in food aid for the 2021/22 financial year. These unspent funds were due to incomplete procurement processes, delays in distribution, and challenges with service providers.

“Overall, the department worked to address food insecurity and child vulnerability through various programmes and initiatives, but there were challenges and gaps that needed to be addressed to ensure effective implementation and utilisation of resources,” the report added.

This article was written by Estelle Ellis and was first published on the Daily Maverick on 9 November 2023.