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SAMJ: South African Medical Journal

versão On-line ISSN 2078-5135
versão impressa ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.103 no.10 Cape Town Jan. 2013




South Africa's hungry cities - the 'canary down the mine'[1]



Janet Seggie




World Food Day (WFD) will be 'celebrated' on October 16 in honour of the founding of the United Nations (UN) Food and Agriculture Organization (FAO) in 1945. This year's theme is 'Sustainable Food Systems for Food Security and Nutrition'.

There is little to celebrate - our news bulletins inform us that one in two South African families are struggling to put food on the table.

This stark reality is outlined in Leonie Joubert's book The Hungry Season: Feeding Southern Africa's Cities[2] that came into my hands a few months ago. Written in accessible style, and using the device of tracing, chapter by chapter, a typical meal for a series of 'families', the author portrays the food insecurity faced by South Africa's (SA's) town and city dwellers. 'Family' ranges from children being raised in an impoverished township of De Aar, but rounded up daily by a kind mother figure for a bath, a change of clothes and the single meal they are likely to have that day, to a plakkerskamp 'family' of poor, jobless whites reliant on food donations, to Karoo citizens dependent for their monthly food on hampers sold to them on 'grant payout day', to an Indian family in Natal, whose plump figures hint at their higher risk of type 2 diabetes and other non-communicable diseases.[1]

In producing what really is a treatise, Joubert collaborated with academic colleagues with expertise in diverse fields. Among them was Jane Battersby, an urban, social and cultural geographer and member of the African Food Security Urban Network (AFSUN), who along with Milla McLachlan offers an Editorial in this issue of the SAMJ which is aimed at healthcare personnel.[1]

Two-thirds of SA's populace has become urbanised, following an rural-urban shift, which is set to continue at its present rate of 2% per annum.[3] People have moved principally to 'enjoy' the advantages of city life: education for their children, access to clinics and hospitals and the chance of economic security through employment. But, these latter expectations have, all too frequently, not been realised. Over 40% of the population is jobless and many citizens find themselves living in shacks in 'informal settlements' on the peripheries of towns,[4] and struggling to survive on ~R500 per month.[5]

The situation would be much worse were it not for our country's well-developed system of social grants in the form of old age pensions, disability grants (that go also to those with HIV/AIDS) and child support grants.[6] The hope must be that 5 million taxpayers will sustain payment of these grants to the 18 million citizens who presently receive them!

In leaving their rural homes, people lose the prospect of providing food for themselves through subsistence farming. As Joubert's treatise confirms, and as surveys show,[7] a third of households in Cape Town, Ekurhuleni and Johannesburg experience serious hunger. The problem, as Battersby and McLachlan[1] point out, is not that food is unavailable but rather that people are too poor to afford food and, living in peripheral 'shacklands', are unable to shop at supermarkets.

It is informative to trace the evolution of the definitions of food security on the part of agencies such as the FAO.[8]

In 1996, food security was defined 'as existing when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet dietary needs for a productive and healthy life'.

By 2012, the stress (reminiscent of this year's WFD) was on 'food and nutrition security' which 'exists when people at all times consume food of sufficient quantity and quality in terms of variety, diversity, nutrient content and safety to meet their dietary needs and food preferences for an active and healthy life ... coupled with a sanitary environment, adequate health, education and care'.

How far beyond reach must this sophisticated definition seem for SA, with her population of some 52 million? A population, moreover, that has grown, by 7 million - including 3 million immigrants from the rest of Africa - over the last decade.[4]

The old 'poster' depicting poverty and hunger - that of a stick-limbed, pot-bellied, fretful child in a rural village - no longer holds true. Instead, it is children living in our cities' informal settlements who are the most disadvantaged and vulnerable[9] viz. Joubert's De Aar 'family', dependent on charity for their single, nutritious daily meal. SA has entered a phase of so-called nutritional transition, wherein underweight and stunting of growth in our school-going children occurs side-by-side with overweight and obesity.[10]

In SA, large-scale commercial farming, contributing most to food security, operates alongside small-scale and traditional farming in communal areas to provide urban households with food via complex food supply and distribution systems that begin with food production.[11]

Whereas there were 120 000 commercial farms in 1980, this number has declined to 40 000 and may drop to 15 000.[12] While the importance of small-scale farming is recognised, at the hands of 1 - 2 million communal farmers it is at a disadvantage: poor infrastructure; lack of finance for fertilisers, machinery and seeds; dwindling water supplies for irrigation and the depredations of climate change; and inadequate transport systems to the market. Yet, arguably, food produced on small farms would be nutritious and 'organic' (i.e. chemical-free).

Access to sufficient food is enshrined in sections 26 and 27 of the SA constitution.[13] Government is thoroughly alive to the looming food security crisis: the 2030 National Development Plan identifies food security as a priority issue.[14]

Joubert comprehensively deals with possible strategies that will assure the food security of city dwellers in the concluding chapter of her book.[2] The state would take responsibility for micronutrient (vitamin and mineral) fortification of the staple foods (already introduced in 2003 to good effect), and would regulate food companies so that they offer good food choices. The municipalities would provide healthier and safer city environments, encourage the adoption of healthy lifestyles and foster urban agriculture, and ensure food banking of leftover food from retailers. Apropos, SA wastes just over 9 million tonnes of food a year.[15] Fortunately, organisations such as Foodbank SA[16] exist to distribute about 6 000 tonnes of this 'waste' as 20 million meals to the hungry every year.

Freedom from hunger and the provision of nutritious, as opposed to malnutritious, food will not be easily achieved. Food insecurity is slowing (South) Africa's progress in attaining, by 2015, the Millennium Development Goals (MDGs) of eradication of extreme poverty and hunger, reduction in child mortality, improvement in maternal health, and assurance of environmental sustainability. Significantly, the African Union, which celebrated 50 years of existence recently, subtitled its annual MDG report 'Food Security in Africa.'[17]

SA will host the Third Global Conference on Agriculture, Food Security and Climate Change in December. On October 16, the international community will mark WFD to heighten public awareness about food security.[13]



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