Title: Daily Maverick South Africa | Feature image: The children playing a local game called MOKHUKU.
Carmel Lawry returned to Holy Family Care Centre (HFCC) in Limpopo South Africa at the end of 2020 to offer organisational and administrative support as well as mentoring for the Outreach Program. She has been connected with HFCC since 2011 in various roles including health care mentoring.
Our children at Holy Family Care Centre come to us for various reasons: neglect, abandonment, severe malnourishment, abuse and chronic health conditions such as HIV/Aids. Some have been also deprived of close physical contact in early years or exposed to foetal alcohol spectrum disorder. All of these issues cause them to have some form of physical complication, behavioural issues and learning difficulties.
Food insecurity and malnutrition in South Africa
Some 23.6 per cent of South Africans in 2020 were affected by moderate to severe food insecurity, while some 14.9% experienced severe food insecurity. These statistics would have worsened during the pandemic. All of our children come from impoverished homes and families survive on food that is the cheapest such as maize meal and bread to reduce hunger. Their diets lack the balance of the five main food groups: carbohydrates, fruits and vegetables, protein, dairy and healthy fats.
South Africa has a “double burden of malnutrition”. One in four children — 27% — under the age of five is stunted and, in stark contrast, one in eight is overweight. Severe acute malnutrition is one of the three leading causes of child deaths, and the number of stunted and overweight children is increasing. Children are being deprived of a balanced nutritional diet leading to undernourishment and subsequent low weight or obese through high intake on cheap non-nutritious food.
This is a sign of chronic malnutrition that compromises not only children’s growth but also their cognitive development, concentration levels, ability to learn and employment chances.
It is well recognised that preventing and reducing acute malnutrition or wasting requires that children are born to healthy, well-nourished mothers who receive appropriate antenatal care, access to adequate food and care practices, safe water, sanitation and good hygiene, as well as functional primary health care services.
This is especially critical during the first 1 000 days from when a child is conceived, through to infancy and early childhood, but remains vital throughout the entire life cycle because healthy children grow into healthy adolescents, adults and parents.
Despite the evidence of the importance of breastfeeding, with an exclusive breastfeeding rate at 32%, South Africa still lags the World Health Organization global target of 50% which member states should reach by 2025.
School feeding scheme
South Africa introduced a school feeding scheme in 1994 since the advent of democracy. It has fed millions of students from disadvantaged socio-economic backgrounds aiming to help children concentrate on their education and thrive. For many of the poor this may be the only food a child receives during the day.
With millions of breadwinners losing their livelihoods during the Covid 19 pandemic the situation only got worse. Schools were closed and the feeding scheme was interrupted. Some were able to restructure the program to deliver food parcels but the management and practicalities involved were slow to action.
Helping children to thrive at Holy Family Care Centre
Our children did not rely on the school feeding scheme. Holy Family Care Centre has a dietician approved menu which provides our children with a nutritious balanced diet of meals and snacks. We home-schooled the children for two years during the pandemic and their diet was maintained.
Our children are already part of the poverty cycle and 99% of them are behind in their education levels. It takes many years to build up a severely malnourished child – to gain weight, muscle tone for strength and improved cognition.
Here at Holy Family Care Centre, I have been teaching our nursing staff to understand growth monitoring charts and to interpret where each child lies is on the malnutrition / stunting stage. With this understanding, together we have been are able to design special diets and nutritional daily supplements to promote growth in the children who are compromised. We have the clinic set up so the nurses can cook and prepare special foods ensuring a well-balanced diet. The children are so de-conditioned it can take years for weight and strength to increase. We celebrate every little weight increase!!!!!
Special diets and nutritional supplement regimes have been so important in managing some of our children’s growth. Never underestimate the value of peanut butter, bananas and age-appropriate powder supplements along with specially prepared meals to promote weight gain – slowly but surely. It is also important that the meals are culturally appropriate and to make use of available seasonal foods.
A bright future
Growth-promoting activities need to extend beyond simply weighing a child. We need to ensure that hungry or malnourished children are linked to food provision, growing their own food, community health services and social assistance. Holy Family Care Centre provides these links through our outreach program.
Above all else Holy Family Care Centre through the staff’s care and love can help these sick, malnourished children and see them eventually grow, play and even begin to learn at school.