Part 8 | Hungry for change: When hunger becomes a health crisis

Part 8 | Hungry for change: When hunger becomes a health crisis

South African health and nutrition experts warn that the crisis of food insecurity in the country can lead to severe health problems even before someone reaches a point where hospital treatment becomes necessary. The urgency of the issue was highlighted when the South African Human Rights Commission launched an inquiry into the country's food systems last year, with estimates suggesting that around 14 million South Africans go to bed hungry each night.

Health-e News documented the struggles of seven households and communities across South Africa in their ongoing series on this issue. In the final installment, nutrition experts shared insights on how the meals these families consume – or lack thereof – can impact their health.

When a toddler named Zinzi* fell ill in March, suffering from severe diarrhoea, vomiting and weakness, she was rushed to Chris Hani Baragwanath Hospital. Her mother was told that her daughter was malnourished. Around 1,000 South African children die each year from preventable acute malnutrition. According to the Human Sciences Research Council (HSRC), nearly 29% of children under five are stunted, indicating chronic undernutrition.

Paediatric clinician and Wits Associate Professor Karl-Günter Technau explained to Health-e News that inadequate nutrition can weaken children's immune systems and hinder their development. He noted that children from homes with general food insecurity struggle more than those whose parents simply lack knowledge about proper nutrition.

Helen Donkin, a nutritionist with the Association for Dietetics in South Africa (ADSA), analyzed seven meals from the communities featured in the series and found that the first 1,000 days – from pregnancy to a child's second birthday – are particularly crucial for proper growth and development. A lack of nutrition during this window can have long-lasting negative effects on a child's health.

School meal programs provide a temporary solution for some families. We Care Daycare Centre in the Free State kept its kitchen open during school holidays to feed more than 200 children, as the feeding scheme alone could not meet their needs. South Africa's National School Nutrition Programme provides meals to over 9 million learners annually.

However, some children rely on these school meals as their primary or only source of food. Paediatric clinician Technau warned that if children are only eating one meal a day, they will struggle with energy levels needed for school and play, as well as issues such as irritability and listlessness.

The issue of food insecurity also affects adults. Research has shown that caregivers sometimes skip meals to ensure their children have enough to eat. This can lead to parents experiencing fatigue, suicidal thoughts, and missed periods. Paediatric clinician Technau added that inadequate nutrition can also impact a mother's physical health and pregnancy. Zinzi* shared that she struggles with fatigue, suicidal thoughts, and missed periods as she tries to provide for her children.

Hunger can also accelerate health decline in older people. Dr Anu Abraham from the South African Geriatrics Society explained that inadequate nutrition can speed up the loss of muscle mass and physiological reserves that come with ageing. A study of over 4,600 South Africans aged 60 and older found that those experiencing food insecurity had nearly twice the odds of developing functional disability compared with food-secure older adults.

Nutritionist Donkin pointed out that an unpredictable food supply can also make it harder for older adults to manage chronic conditions such as diabetes and hypertension.