Under the supervision of Dr Kirsten Bobrow, medical students Nicole Bolton, Mihlali Vezi, Aphiwe Meyiwa, Lwazi Mpuku and Luvo Mbobo have conducted a research study on the nature and burden of food insecurity among attendees of the Vanguard Community Health Centre.
The research was done as part of their public health component in fourth year, which required them to conduct research in various communities around Cape Town. Their study focused on the Vanguard Community Health Centre (CHC), which serves the areas of Bonteheuwel and Langa.
Xola Nofemele, a member of the Langa community who acted as liaison with the communities of Bonteheuwel and Langa, as well as with health workers at the CHC, worked as the group's facilitator.
“There are so many complex socio-economic burdens facing the people of Bonteheuwel and Langa, yet there are few studies available to quantify the prevalence of food insecurity – even less focused on a clinic population of sick and vulnerable individuals,” explains Bolton.
Both areas are known to have a significant problem with food accessibility. Many residents report going without food for multiple days on end, and this has significant complications for their ongoing health.
The Food and Agricultural Association of the United Nations defines food security as all people, at all times, having physical and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life.
It is determined by four measurements: food availability, food accessibility, utilisation of food by the body and stability of the utilised food. Food insecurity occurs when there's instability in any of the four measurements.
“The study was conducted to find out the proportion of people, in a sample of adults from Vanguard CHC, who are experiencing food insecurity. It also aimed to identify the social and demographic factors associated with this,” says Bolton.
Findings are of concern
Of the 121 attendees that were surveyed, 81.82% were found to be food insecure to some extent. A further 53.71% were found to be severely food insecure, meaning that the individual goes a whole day and night without food due to a lack of resources. In some cases, participants indicated that this happened more than 10 times in one month.
“This is particularly concerning considering the close relationship between food insecurity and health. Poor nutrition has long been linked to a variety of health conditions,” says Bolton.
There were also important associations found between severe food insecurity and those who were older than 45.
“With increasing age there is increased exposure to chronic diseases which make work difficult. This inability to work may result in financial instability, leading to food insecurity,” explains Bolton.
A number of initiatives already exist in the communities of Bonteheuwel and Langa. These include the Labon Foundation, which provides one meal a day to around 250 people. Unfortunately, this does not meet the full needs of the community.
“Many people cannot get to Labon in time for a meal or cannot leave their homes to go get a meal at Labon due to illness, travel restraints or problems with gang violence making it unsafe,” says Bolton. “There is also evidence of desperation among some individuals in the community; there have been some cases where people have been robbed for their food after leaving Labon.”
She adds, “What many do not realise is that food insecurity can be present with obesity. This happens when food is scarce and individuals are uncertain as to where their next meal may come from. They tend to eat calorie-dense, high-carbohydrate foods when available. Over time, this presents as obesity, even though the individual is chronically malnourished.”
These complex issues were motivation for the group to try and better understand these communities.
Learning from one another
Seated: Nicole Bolton, Xola Nofemele (site facilitator) and Mihlali Vezi. Standing: Luvo Mbobo, Aphiwe Meyiwa and Lwazi Mpuku.
“We each come from unique and different circumstances and were able to use this to consider different cultural and psychosocial aspects of this project,” says Bolton.
Working together, the group soon realised how quickly their project became less of a project and more of a real problem that they wanted to address.
“In getting responses for our data, we heard the stories and challenges of many desperate people struggling to feed their families. This was a hard lesson to learn as we tried to find the balance between clinical data and the emotional truths,” says Bolton.
She believes that medicine is a multidisciplinary field which has the ability to really test and challenge you.
“I like that idea of striving to be better and do better for others,” she says. “I love that UCT continues to serve the communities around us. We are given opportunities, through SHAWCO and research projects like ours, to try and make a tangible difference.”
Mihlali Vezi, concurs, “It is through experiences and relationships made at UCT that I have come to have a better understanding of our society, and even entertain the possibility of affecting changes that probably would have never seemed possible had I not been exposed to so many socioeconomic disparities in the communities that we serve.”
The group hopes that the findings of their study will also provide justification for resource allocation to these communities from corporates or other organisations to assist with long-term solutions.
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