Children under siege
Harriet McLea – The Times - Friday May 14 2010
  • Almost 7% of children don’t make fifth birthday

  • SA child mortality on rise, bucking world trend

  • Baby formula should be banned, says minister

  • Rate of immunization ‘extremely low’
The death rate of South African children under the age of five is increasing because of poor healthcare.

At the launch of a report by the Human Sciences Research Council report, which revealed that almost 7% of children did not survive to their fifth birthday, Health Minister Aaron Motsoaledi said South Africa was one of only 10 countries in the world where child mortality was rising.

The rate of child death, often from preventable causes, has risen to 6.7% from 5% 20 years ago.

“The infant mortality rate in our country is very high.  Only 10 countries have seen an increase in the infant mortality rate and South Africa is one of them,” said Motsoaledi at the release of the Health of Our Children report in Cape Town yesterday.

The minister’s spokesman, Fidel Hadebe, said a list of countries where child mortality was increasing had been published in the medical journal, Lancet, last month.  All, with the exception of South Africa, were African countries which had suffered armed conflict.

Motsoaledi said South Africa’s child immunisation rates were “very, very low” - Botswana, Zambia and Namibia’s children were more comprehensively vaccinated.  This, together with the near impossible task faced by women trying to breast-feed their infants while holding down a job, left thousands vulnerable to life-threatening diseases.

“I think that [baby milk formulas] must be banned throughout the world,” he said.

Motsoaledi said it was “criminal” that working mothers did not receive “at least four months” of maternity leave to exclusively breast-feed their babies.

He also admitted that although 97% of mothers received treatment during pregnancy and gave birth in clinics and hospitals, the quality of care was poor, leading to many “unnecessary” deaths of mothers and babies.

The HSRC study, in which 15 000 households around the country were surveyed, also found that:
  • The numbers of orphans rose from 15.6% of the country’s children in 2002 to 19.3% in 2008, meaning more children were susceptible to abuse and exploitation;

  • 10.8% of boys between 12 and 14 were already having sex and were at risk of HIV infection;

  • 26,4% of girls between 12 and 18 had engaged in sex with men five years or older than them, placing them at even greater risk of contracting the disease; and

  • One in 12 school girls reported being harassed by male teachers.

  • Only 35.2% of boys and 50% of girls had been informed about sex by their parents.
On a more positive note, the HIV rate among children under four now stands at 3.3% which Motsoaledi said was a reduction, proving that anti-retrovirals preventing HIV transmission from mothers to their babies are effective.

Dr. Alex Armitage, a senior medical officer in the paediatric department of Ngwelezana Hospital in northern KwaZulu-Natal, said that often children don’t get vaccinated.  He said nurses blame parents for not having their children vaccinated – and parents blame nurses for not informing them of the need for vaccination.

Armitage said that yesterday a three-year-old boy had died in his paediatric unit.

The boy was born with HIV because his mother had never been tested for the disease and had not received anti-retrovirals.

“The mother hadn’t really noticed that the child wasn’t growing enough, and nurses hadn’t really noticed anything – even though the child had been to the clinic,” he said.

When the boy contracted pneumonia, he was admitted to hospital, but “died within 12 hours”.

TRUTH ABOUT BREAST-FEEDING

Only 25.7% of South Africa’s children are exclusively breast-fed for their first six months of life, in accordance with World Health Organisation guidelines.

Of the others, 22.5% are given only infant milk formula and just over half, at 51.3%, are fed both breast and formula milk.

At the launch of a Human Sciences Research Council report on the health of the country’s children, Health Minister Aaron Motsoaledi yesterday called for an international ban on baby milk formula because it does less than breastmilk to prevent children contracting diseases.

Principal HSRC investigator Professor Leickness Simbayi said: “There’s nothing as good as mother’s milk to improve a baby’s chance to survive.”

Simbayi said HIV-positive mothers could under no circumstances both bottle and breast-feed their babies as formula irritates the gut, causing slight tears that makes it easy for the virus in breast milk to enter the baby’s bloodstream.

“She must pick one and stick with it,” he said, adding that mothers on anti-retrovirals had little chance of passing the virus onto the babies they breast-feed.