When children start dying of hunger

William Saunderson-Meyer writes on the disturbing number of deaths from malnutrition in SA


It’s one of those grim sets of statistics that this blighted country excels at. In the past three years, 2 818 children under the age of five have died of malnutrition in public hospitals in South Africa.

And this is at the lower end of probability. Factor in rural isolation during the lockdown, hospitals and clinics accepting only Covid patients, and the abandonment of school feeding schemes, and the true figure will be far higher.

As Department of Health (DoH) spokesperson Foster Mohale told MPs this week, “Malnourished children are more likely to die due to infection and infections worsen the severity of the malnutrition. Most deaths from acute malnutrition are linked to infections such as diarrhoea, pneumonia, tuberculosis and HIV/Aids.” 

All of these are conditions that went virtually untreated during the first two years of the pandemic. ___STEADY_PAYWALL___

Aside from the difficulties involved in collecting accurate figures during the past two years of the pandemic, the figures — provided in a response to a parliamentary question by Bridget Masango, the Democratic Alliance’s Shadow Minister of Social Development — also show some signs of being heavily massaged for political reasons. 

It does not seem believable that, as the DoH claims, malnutrition deaths actually dropped in 2020/21 by 25%, to 775, before rising to 1,009 in 2021/22, still below the 2019/20 level of 1,034. And while it is credible that the well organised Western Cape recorded only 38 deaths over those years, it is highly unlikely that the Eastern Cape recorded more than 40% fewer deaths than KwaZulu-Natal (412 to 721). 

There are good reasons for political massaging. The African National Congress is highly sensitive not only to deaths from starvation but any suggestion that it worsened the situation with its pandemic control measures. Ask Glenda Gray.

Two years ago, almost to the day, Prof Glenda Gray, president of the South African Medical Research Council (MRC) and a scientist with a considerable international reputation, was in the crosshairs of a pair of ruthless assassins.

Character assassins. Out to humiliate her, destroy her reputation and strip her of employment — present and future — were the Health Minister, Dr Zweli Mkhize, and his sidekick, the DoH’s then acting Director-General Dr Anban Pillay. 

Gray, who also served on the ministerial advisory committee (MAC) on Covid-19, had incurred the displeasure of the gunslingers over remarks during an interview that were critical of the government’s handling of the pandemic. She had said that one of the consequences of the harsh lockdowns and the closure of school feeding schemes would be an increase in child malnutrition.

This, she said, was already being reflected in the patient intake at Chris Hani Baragwanath Hospital in Gauteng. Gray was right on the first statement but wrong on the specifics of the latter. 

No matter that, at that moment, malnutrition admissions to Baragwanath had not registered an uptick, subsequent developments proved Gray right. Covid and its lockdown effects have exacerbated widespread child starvation and malnutrition in South Africa, and continue to do so.

According to UNICEF, the United Nations Children’s Fund, chronic malnourishment underlies more than half of South Africa’s 43,000 annual deaths of kids under five. Almost one in three of our children is physically stunted from undernourishment. The situation, says UNICEF, has been considerably worsened by the pandemic.

The latest available figures from the University of Cape Town's Children's Institute (CI) indicate that about 4m children in South Africa have stunted growth because of malnutrition, while another 10m went hungry every day. That was according to the CI’s 2020 report and, in the light of rocketing unemployment, unrest, floods and deteriorating service delivery, the situation is now undoubtedly worse.

But the ANC is not interested in reality. It’s interested in managing perceptions.

Gray’s correction of the single erroneous statistic did not appease them. Mkhize — a suave operator with an anatomist’s instinct of the exact spot to best slip a stiletto between the ribs — implied that Gray was driven by politics, not science. He unleashed Pillay, who called Gray a liar and demanded that the MRC — a statutory body over which the DoH holds no executive power — should discipline and fire her for the harm she had caused to the country’s reputation internationally.

The MRC, one hopes to its eternal shame, was quick to say, “Ja, baas!”. In what a SA Medical Journal article described as “a sycophantic manner aimed at political appeasement”, the MRC immediately apologised to Mkhize and forbade Gray to speak to the media. Her ignominious exit at the behest of the ANC seemed assured.

Fortunately, for Gray and South Africa and the tattered integrity of the medical profession, an almighty storm of Biblical plague proportions descended around the heads of Mkhize and Pillay. Hundreds of the world’s top medical scientists sent an open letter to the DoH and MRC; both here and abroad, dozens of medical organisations expressed their displeasure. 

Gray survived at the MRC, which hastily backed down in the face of this global condemnation, but was sacked from the MAC. In one of those rare turns of fate that has one chortling with delight, it is Mkhize and Pillay who have been consigned to the rubbish bin, at least for the moment.

Mkhize had to resign from President Cyril Ramaphosa’s cabinet because of the embarrassment his presence caused. A Hawks’ investigation accused him of wrongdoing in a R127m tender awarded to pals and from which funds ended up — the Mkhizes say they just cannot fathom how — in family bank accounts and funding the acquisition of family vehicles. 

The Hawks’ finding on Pillay — a particularly nasty piece of work in a government where there is stiff competition to be a prick — was similarly damning. They recommended his criminal prosecution for financial misconduct, saying that there was evidence of fraud and that he made “numerous material intentional misrepresentations to the National Treasury”, among others. Pillay is suspended.

Both these men will likely be back. Mkhize has made no secret of his ambition to be selected at the December leadership conference to replace Ramaphosa. The disciplinary hearing against Pillay will conveniently flounder on some technicality and his prosecution, in a country with literally hundreds of bigger fish to fry, it simply won’t happen. 

That’s the ANC way. Relieve the pressure with some obfuscation and then return to the status quo. 

Meanwhile, the children keep dying. But for goodness sake, Prof G, don’t tell the world. 

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