If there is just one outcome from the Covid-19 pandemic in South Africa that could be considered positive, it is this: for perhaps the first time, the reality of household hunger and malnutrition has become visible to policymakers, writes Julie Smith and Tracy Ledger.
To date, food security policies and strategies have displayed a remarkable ignorance of the depth, effect and drivers of household malnutrition. These policies demonstrate little or no knowledge of the daily lived reality of the millions of South African households that struggle to put food on the table. Policies have tended to focus on addressing household food shortages through increasing national food production.
The lockdown has made everyone realise that, in fact, the most important thing is how (and how much) food gets on to the plates in a household, not how much food is being grown on a farm somewhere on the other side of the country.
And the most important factor that determines the quantity and quality of the food on those plates is the cost of the available food relative to the amount of money that the household has to purchase it. In the vast majority of households, all the food that is consumed is purchased. Hunger and malnutrition are an economic problem much more so than an agricultural problem.
The official dearth of interest in what poor households actually eat (or don’t eat) can be seen in the fact that none of the official agencies tasked with the collection of food price data and the publication of food price reports — notably Statistics South Africa (StatsSA) and the National Agricultural Market Council (NAMC) — collects or publishes detailed information on either what households actually eat, or what they should eat to meet minimum nutritional requirements.
Both StatsSA and the NAMC track the prices of what they refer to as a “basic” food basket, but this has not been compiled with reference to the kinds or quantities of food that households actually consume.
Nor does this basket have a nutrition weighting (that is, how nutritionally complete it is) and neither of these organisations track the prices of what would constitute a nutritious basket of food for different household compositions. The latter piece of information is the bare minimum required to begin to understand malnutrition. The StatsSA and NAMC data is thus of practically no value in supporting policymaking that would aim to improve household nutritional outcomes.
Studies have shown that fewer than 20% of South African households spend enough money on food every month to purchase a nutritionally adequate basket of food.
Poor households have other expenses to prioritise alongside food: transport costs are essential — if you don’t have money to get to work you won’t get paid, and then there won’t be any money for food. Energy costs can also not be avoided. Almost all staple foods need to be cooked, using either electricity or paraffin.
After paying for the essentials of transport and energy, households prioritise burial insurance (so that at least in death there is some semblance of dignity) and children’s schooling and transport (so that they can have a better future than their parents and because walking to school is not safe). Lastly, the repayment of debt is prioritised. Money inevitably runs out before the end of the month, and you can’t get more credit if you haven’t been a regular payer.
Food is thus not the first priority expense. Instead, because it is one of the few expenses that women have some level of control over, food is bought only after other non-negotiable expenses have been paid or the money to pay for these items has been put aside.
It means that competition within the household purse for food is vicious, the average food budget is too low, families underspend on nutritious food, and food runs short before the end of the month. A third of South African households have only R120 or less per person per week to spend on food.
The Pietermaritzburg Economic Justice and Dignity Group (PMBEJD) is one of the few organisations that does track what low-income households spend on food, what they actually purchase and how that food is managed by the women who have the primary responsibility for it. Their insights into the reality of the daily struggle for food, a struggle that is normal for households, not something created by the coronavirus lockdown — and the factors that make that struggle even more difficult — should make all of us sit up, take notice and get angry enough to demand something better.
PMBEJD’s work shows that low-income households only have sufficient money for food to buy the most basic items and none of these households can afford anything close to a basic nutritious basket. That would require a household food budget one third greater than it actually is, money that simply isn’t available, even without the lockdown.
In April, the cost of PMBEJD’s (hypothetical) basic nutritional food basket (for a family of four persons) is R2 576.13 — an amount that in a normal working-day month of 22 days is more than 70% of the national minimum wage. No family with one person earning at the national minimum wage of R20.76 an hour (and working for the full month) can afford adequate nutrition.
Women bear the heaviest burden of this daily reality since they have the primary responsibility of feeding the household.
Women use their own bodies as a buffer to absorb economic crises. Women eat last and whatever is left in the pot so that their children and families can eat better. Women forgo all the good nutritious food in the home. This sacrifice has come at a great cost. It is the reason why so many women suffer from non-communicable diseases and why so many women are now dying from diabetes, cerebrovascular and hypertensive diseases. With Covid-19, it is these same women who will care for their sick: women whose bodies are weak.
For most households, a reasonable level of different foods lasts in the house for only two weeks. When the nicer foods (read: nutritionally-rich foods of meat, dairy and vegetables) are finished, they are finished — they don’t get replaced until the next month. In the third week, women’s plates hollow out as they restrict their intake of nutritional foods to extend the period of better nutrition on their children’s plates.
Towards the end of the third week and into the fourth week, and no matter how much women have sacrificed their own bodies, nutritional diversity on everybody’s plates dwindles from almost nothing to nothing. Plates include just a revolving wheel of colourless, pale, insipid, boring starchy foods (maize meal, rice or steamed bread) and very little of anything else (almost no protein, calcium, fibre, vitamins or minerals), maybe some onion, cabbage and cheap cuts of poor-quality meat. The average South African plate of food, for much of the latter part of the month, offers very little resistance to disease.
The results of all this are as we should expect: one in four children under the age of five is so malnourished that they are classified as “stunted”. About 10 children under the age of five die as a direct result of starvation each day in South Africa, and many more succumb to disease because they are nutritionally compromised.
Diet-related, non-communicable diseases place a significant burden on the public health sector and are estimated to have cost the economy $1.88-billion for the 10-year period to 2015. Every day, millions of South Africans are forced to go without food and to put their children to bed hungry. But until the lockdown forced us to think about them, most of these people and their daily struggles for food have been largely invisible.
Low-income households tend to do their bulk shopping once a month at a supermarket, when they receive an income — either a social grant or a salary. The cost of food from that supermarket is critical to households’ ability to feed themselves and determines the extent to which women must sacrifice themselves for their families. In (belated) recognition of the role of food prices, the government announced that it would be taking predatory pricing of essentials seriously, and gazetted price controls on a very limited number (22) of products. Bread, sugar beans, samp and eggs — all basic food items — were omitted from the regulations.
Each month PMBEJD calculates the price of a basket of 38 foods, based on what households tell them they try to purchase every month, and using prices from outlets where women make those purchases (five supermarkets and four butcheries which target the low-income market). The basket is thus an accurate reflection of what low-income households actually purchase every month, and what it costs to do so.
In April 2020, PMBEJD data indicates that the cost of the (actual) basic basket increased by a massive 5.8% (or R187) from the previous month, moving the cost of the basket to R3.408 (the average household they survey contains seven people). Their data also shows very clearly that retail prices of many basic food items jumped very sharply in April from the previous month, as indicated in the table.
These enormous supermarket price increases are devastating to low-income households, already barely managing to survive and who must now also allocate money to additional basic sanitising items such as soap and bleach to try and protect themselves from coronavirus.
Once the lockdown is over, we urgently need the Competition Commission to convene a retail food price enquiry so that we can all see for ourselves how food prices are determined, and who benefits (and loses) from that system.
More important than that, however, is that the daily lived awfulness of hunger in South Africa does not slip away into obscurity again post-lockdown. There is no justification for the daily sacrifices that so many hundreds of thousands of women must make in a country as wealthy as South Africa. There is no excuse for us to continue behaving as if these women are invisible and without value.