By Nic Spaull and Mark Tomlinson
First published in Daily Maverick
As many as 10 million adults and nearly three million children experienced hunger in the past week in South Africa in 2021, and 2.5 million adults and 600,000 children were experiencing perpetual hunger, hunger every day or almost every day.
When people are asked the question, “What does it mean to live in poverty?” you get a variety of answers. Some people talk about a lack of income to buy what they need, others talk about a lack of shelter or the absence of choices. These are all quite difficult things to nail down.
How much income is “enough”? What is “adequate” when it comes to housing? How do you define “agency”?
However, there is one universally accepted and universally understood measure of extreme poverty, and that is hunger. If you crave food but have no means of getting it (involuntary hunger) you are living in extreme poverty.
Apart from the obvious anguish and discomfort of experiencing hunger, there are many reasons why hunger is bad. Those who are perpetually hungry are more likely to be depressed, to experience anger and be less able to parent well or work effectively.
We also know that the scourge of hunger is detrimental to children, and especially so to infants and pregnant or nursing mothers. Children that experience chronic undernutrition are more likely to be stunted which has profound implications for their being able to cope in school and engage in meaningful employment across the life course.
There is increasing evidence that caregivers who are hungry are more likely to experience mental health difficulties, which in turn may impact on the development of their children. Compared with those who are not hungry, preschool children that are hungry will experience higher levels of chronic illness and are more likely to be shy and withdrawn when interacting with their friends. Sadly, we also know that the parents and caregivers often report feelings of shame about the hunger of their children, further worsening their mental state.
Exactly how bad were hunger and malnutrition before the pandemic?
South Africa is in a fortunate position to have up to date and reliable data on the extent of hunger in the country, both before the pandemic and now.
Before the pandemic, there were numerous household surveys estimating rates of hunger, stunting and malnutrition. The General Household Survey (GHS) administered annually since 2000 shows the percentage of households who report child hunger because there wasn’t enough food in the past 12 months. (Note this is an annual figure). Encouragingly this rate of child hunger has halved in the last two decades. Between 2000 and 2018, the rate of child hunger among households with children in them declined from 35% to 16%, largely attributed to the successful roll-out of the Child Support Grant and improving economic conditions over this period.
However, hunger is only one measure of malnutrition. One might have food to eat, and therefore not be hungry, but the quality of that food may be poor. Meals composed primarily of processed carbohydrates are far less nutritious than those that include protein, vegetables and healthy fats. We know from research that inadequate diets like this lead to stunting as well as poor attention which impacts schooling.
In a paper published this year, Professor Servaas van der Berg and his co-authors show that before the pandemic child hunger had declined significantly but stunting had not. In 1995 approximately 30% of children under five were stunted in South Africa, but by 2017 this figure was still 27%. Unicef estimates that in many other middle-income countries like Brazil, Iran, and China the prevalence of stunting is much lower at 5% or 6%. As van der Berg concludes “It would seem that the improvement in people’s economic circumstances, induced by the Child Support Grant, was not enough to translate into consuming more nutritious food, rather than consuming more food.”
Read the full article in the Daily Maverick here.