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The South African Human Rights Commission (SAHRC) in the Eastern Cape has given national and provincial government departments three to six months to submit reports outlining their efforts to address child malnutrition in the province.

In findings released in East London on Thursday, the SAHRC concluded that government’s failure to ensure access to adequate food and nutrition directly contributes to preventable loss of life among children in the Eastern Cape. The commission’s inquiry into child health followed media reports highlighting tragic cases of children succumbing to severe acute malnutrition (SAM), a medical term for starvation. In August and September, two Eastern Cape moms killed their children and themselves – poverty the presumed motive.

Presenting the findings, the SAHRC commissioner, Jonas Sibanyoni said, “The prevalence of severe acute malnutrition and malnutrition-related deaths among children in the Eastern Cape, as evidenced by the data on child mortality due to SAM, indicates a violation of the right to life.” The commission also found that there have been violations of the right to food under Section 27(1)(b) of the Constitution at many governmental levels.

“The state’s obligation to take reasonable legislative and other measures, within its available resources, for the progressive realisation of this right has not been met,” said the commissioner.

The report also found that the right to equality on the basis of age has been infringed, children who are below school-going age (0-5 years) and who attend early childhood development (ECD) centres are excluded from vital food programs, resulting in unequal access to nutrition on the prohibited ground of age. It calls on the Eastern Cape Department of Education to make a list of unregistered ECD centres in the designated wards, to provide support for ECD centres and provide a list of actively supported centres per district and detail the forms of support offered to help them meet required norms and standards for registration.

The child support grant was increased to R510 in the current financial year in the budget tabled by Minister of Health Joe Phaahla. The commission found that while the grant is the only income for many households, it falls short of comprehensively addressing the nutritional needs of eligible children. The commission recommends that the Department of Social Development (DSD) collaborate urgently with national treasury to explore the possibility of increasing the grant above the food poverty line, ensuring that it effectively addresses the nutritional needs of children. The commission also recommends that the departments of Social Development and Home Affairs collaborate on a registration campaign to ensure all children’s eligibility for social assistance.

The commission said it has noted with concern under-spending in critical welfare programmes with implications for access to basic nutrition and child welfare. Earlier this year, it was reported that the provincial legislature wants the DSD investigated after forfeiting R67.7 million to treasury a portion of its budget meant for food parcels, thus depriving 85,000 destitute households. In its recommendation, the commission calls on national treasury to come up with human rights baseline assessments before demanding the return of funds, earmarked to address child malnutrition, to the national purse.

Food parcels being distributed at Sassa offices in Khayelitsha, Cape Town, during lockdown in 2020. Archive photo by Lilita Gcwabe

The commission’s manager in the Eastern Cape, Dr. Eileen Carter said that there are currently 39 wards identified in the Eastern Cape that are in crucial need of intervention. “The province has 691 municipal wards, while the inquiry focused on 39 wards, however we are planning to extend whatever efforts that are already on the ground to reach all municipalities because the level of poverty in the province and the stunting level of child poverty, which is 25%, requires us to extend the programmes. The provincial government is already lending a helping hand in these municipalities.”

According to figures provided to the commission by the Department of Health, for the year between April 2021 and March 2022, 1,087 children presented with severe acute malnutrition, and 116 children died because of this condition. “The issue is that malnutrition is under-reported; even though we may have a number of children admitted in hospitals and mortality, we don’t know the number of those who died but were never sent to hospital,” said Dr. Carter.

She said the commission is therefore calling on the department of health to explore the feasibility of establishing nutrition-focused early childhood development clinics in partnership with the DSD, providing regular check-ups, growth monitoring, and nutritional counselling for children under five, particularly in vulnerable communities.