Thabo Mkhize, Sunday Times, 2002/09/15
Nineteen-year-old Khethelwa Msebe had no idea why her eight-month-old daughter, Andisiwe, was suffering from broken skin and an enlarged abdomen when she took her to Mount Ayliff Hospital in the Eastern Cape.
Now she knows. Her daughter is one of more than 700 children in the area who have been admitted to hospital with malnutrition.
Andisiwe is one of the lucky ones. Two weeks ago in nearby Lusikisiki, Honjiswa Mgeduzo lost her 11-month-old son. He died of marasmus - a condition caused by lack of calories and protein.
In the first six months of this year, 166 children - virtually all of them under the age of six - have died of malnutrition in 11 hospitals in the northern reaches of the Eastern Cape.
The horrific figure was calculated by the University of the Western Cape, the Department of Health and the Health Systems Trust.
Experts blamed malnutrition on:
People being unable to get child-support grants because of problems obtaining identity documents;
Extreme poverty and lack of food; and High unemployment.
Commenting on the deaths, Social Development Minister Zola Skweyiya said: I am very embarrassed. That children should die of malnutrition in a democratic South Africa is something that should not happen.
Skweyiya said one of the problems in the Eastern Cape was the need to outsource the distribution of pensions, which had already been done in all the other provinces.
Referring to the northern part of the Eastern Cape, he said: I don't think we have really done enough in terms of making children able to access the child-support grant.
Skweyiya said that on a visit to the area last year, he saw horrifying examples of malnourished children.
We found out that the grave problem there had been the scarcity and unavailability of identity documents, he said.
The chief executive of the SA Congress for Early Childhood Development, Leonard Saul - who conducted a recent study in seven towns in the northern part of the Eastern Cape - said almost 71% of the 1.7 million people living in the region were unemployed.
People don't have access to a well-balanced diet. Malnutrition is a very serious problem, with most families having just one meal a day of pap and potato, he said.
Msebe, who left school in Grade 6, said she could not get the R130 child-support grant because she did not have an identity document.
The unemployed mother from Ntabankulu, near Mount Ayliff, said she depended on her grandmother's old-age pension to support her child.
Many times there is no money to buy milk for my daughter and I am left with no choice but to feed her plain soft porridge made from mealie meal. I know it is not adequate but there is nothing else I can do, she said.
Dr Thandi Puoane, a health scientist based at the University of the Western Cape, said nurses were trained to deal with malnutrition, but the attraction of overseas posts meant many of them left the country - taking their expertise with them.
We trained about 75 nurses in the Eastern Cape to help prevent children who were admitted to hospital with malnutrition from dying. But the problem is that nurses are leaving to find work in the UK, she said.
Puoane said a meeting to improve hospitals' management of malnutrition in the Eastern Cape was being held later this month.
Nzwaki Sogaula, who is involved in community nutrition in the area, said research done in 2000 showed that at least two of 30 children who were monitored at home after being treated for malnutrition had died.
Even if you win the battle against malnutrition in the hospital, the child goes back to the same home environment. There's no food at home; the cupboards are bare.
The province's district health director, Dr Thobekile Mjekevu, admitted this week that malnutrition was a serious problem .
"It is a social problem and mainly serious in the former homeland areas. The problem of malnutrition is made more difficult by other underlying factors such as HIV.
Qaqamba Msweli, director of the Umtata-based Masikhule Project, which provides early childhood development training, said many children were unable to concentrate in class because of hunger.
Most kids in the Eastern Cape do not even attend school because their parents can't afford to send them. They are not being reached and they are dying in silence, she said.
(Thabo Mkhize, Sunday Times, 2002/09/15)