Almost two years later, it’s our children suffering the most collateral damage of the Covid-19 pandemic

by | Covid and Children

It’s 21 months into the Covid-19 pandemic in South Africa, and time for some Christmas soul-searching. Why have children been so absent from our decision-making regarding the management and mitigation of the pandemic, and how has this affected them? Above all, why has no one asked children what they need?

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Children across the globe have been negatively affected by the Covid-19 pandemic. In September 2020, the World Economic Forum indicated that an additional 6.7 million children could suffer from wasting due to the socioeconomic impacts of Covid-19 – 1.5 billion children have been out of school, creating an education crisis; 370 million children have missed out on free school meals and 80 million children under the age of 1 could be at risk of other diseases due to disruption in immunisation programmes.

According to the Organisation for Economic Co-operation and Development (OECD) August 2021 report, “the Covid‑19 pandemic is harming the health, social and material wellbeing of children worldwide, with the poorest children hit hardest. School closures, social distancing and confinement increase the risk of poor nutrition among children, their exposure to domestic violence, increase their anxiety and stress, and reduce access to vital family and care services”.

In her October 2021 report on the pandemic and the impact of lockdown measures, Dr Fouzia Munir analysed children’s experiences of lockdown in the context of the UN Convention on the Rights of the Child. 

Her findings reveal that because of “the mitigating measures implemented to control the spread of Covid-19, many children’s rights are being neglected. The lockdowns and school closures have disproportionately affected children’s wellbeing and have heightened huge disparities that exist between the advantaged and the disadvantaged”.

Munir reports that, globally, children have been affected in three key areas: physically, mentally and in the impact on education.

The physical impact has included poor nutrition, no school meals, physical, sexual and emotional violence, disruption of health services including routine vaccinations, behavioural problems, poor sleeping patterns and inactivity.

Mental impact includes anxiety about the pandemic, the lockdown, school closures, social distancing and loss of learning, grief, fear, stress, depression, loneliness, sadness and anger.

Education has been affected through limitations on learning and teaching time, children struggling with schoolwork, inadequate space and resources to study, and parents battling to fill the gap, especially for children with disabilities.

The author further argues that “there’s a need to understand how children are being impacted by the ongoing restrictions and to safeguard the rights of all children”.

What’s evident is that many countries have made pandemic-related policy decisions without regard for children’s needs. However, the commonness of the problem is probably cold comfort to South Africa’s children.

While other governments have since implemented measures to lessen the effects of the pandemic and lockdown measures on children, the South African government’s response has been largely characterised by the defence of poor policies, slow and reactive changes (often driven by litigation or external pressure from civil society), an inability to move with the science and self-defeating decision-making.

It indicates that authorities are at best out of touch with South Africa’s children, especially the most vulnerable, or at worst, cynically indifferent to their needs.

This is well-illustrated by challenges around nutrition. While governments in 68 countries used advice from the World Food Programme and Unicef to reduce the effect of the loss of children’s daily school meal by “providing take-home rations, vouchers or cash transfers to children – and working on health and nutrition incentives to encourage children to return to school once they reopen”, the Department of Basic Education (DBE) in South Africa went to court to deny that it had a constitutional duty to feed children while they were away from school, and defend its right not to continue the National School Nutrition Programme (NSNP) while schools were closed.

This, despite the government undoubtedly being aware that it was supplementing the nutrition of “half of all children in the country, three quarters of all learners and a fifth of the total population”.

It’s now common knowledge that Judge Sulet Potterill ruled that the department’s failure to feed nine million eligible children was a breach of its constitutional and statutory duties. But, despite this judgment, the matter went back to court in July 2021 to make the DBE’s commitments for the delivery of the NSNP, and reasonable time frames for implementation, an order of the court.

It was all avoidable, though. If the DBE had acknowledged the vulnerability of these children and recognised the risk to them, it could have provided the department of social development with details of eligible children in the NSNP and made them the focus of food parcel or voucher distribution. It was a strategy employed not only by 68 other countries, but also by many local NGOs who ensured targeted provision of sustenance for children in need.

The social development department (DSD), however, seemed no more aware of children’s needs. It failed to recognise the extreme risk to children of loss of food provision in Early Childhood Development centres (ECDs), and the possibility of exacerbated malnutrition and stunting while ECDs were closed (this, in a country where one in four children under five experienced stunting before the pandemic).

Instead, the DSD used the pandemic and the call for ECD centres to reopen, as an opportunity to audit ECD centres, update databases and attempt to force ECD registration.

Again, it took a court case to reopen the ECDs and a second one to get the department to pay subsidies it was withholding in some provinces, either in their entirety or sometimes (ironically) the nutrition portion, despite ECD providers continuing to feed children while they were not in attendance.

Nutrition is not the only area where government’s lack of agility and reluctance to follow science has had a negative impact. Experts, including Spaull and van der Berg, have argued against school closures and the disruption and loss of learning that they bring relative to the impact that Covid-19 has on children’s health.

The 2020 General Household Survey reported that only 6,4% of learners could access remote or homeschool alternatives nationally. Remote learning has also been particularly difficult for children with disabilities.

In addition, the survey showed a large decline in the number of children attending ECD programmes. Compared to 2019, a large percentage of children aged five (37.7% compared to 10,9%) and six (11.8% compared to 3.5%) did not attend an education institution.

This represents a massive setback in early learning, but also contributes to child hunger and child vulnerability, with many of these children left at home alone or in unsafe or abusive environments. Overall, “the percentage of children that attended grade R, pre-school, nursery school, crèche, and educare centres decreased from 36,8% in 2019 to 24,2% in 2020”.

The picture is equally bleak for school children. In its final wave, the NIDS-CRAM survey showed that 750,000 learners aged 7-17 had not returned to school following lockdown, making these children vulnerable to exploitation, including through child labour and forced marriage. The same data indicates that with lockdowns and rotational learning, by March 2021, most learners could have lost up to a year of learning.

Given that as Spaull points out, 78% of Grade 4 children could not read for meaning in any language prior to Covid, the magnitude of this loss is immense.

A further effect is massive anxiety for learners.

Munir cites an international study on the impact of Covid-19 and lockdown on the mental health of children and adolescents, which found “that school closures have adverse educational, psychological and developmental effects on children. Stress, clinginess, disturbed sleep, poor appetite and inattentiveness can also be observed among young children”.

An additional study identified “stress, sadness, boredom, depressive symptoms, sleep disturbance and fear for the situation” as the predominant behavioural and emotional problems in children.

Concerns about children’s mental health were reinforced in an Oxford University survey of 10,000 parents in June 2020. Parents and carers of primary school-aged children reported an increase in their child’s emotional and behavioural challenges, and restlessness or attention difficulties. Researchers suggested that “many younger children have found it increasingly hard to cope as the lockdown period has gone on, which may be because of loneliness, fears about the coronavirus or a loss of the routines and support that come with school”.

Anxiety has not been eradicated with the return to school. In a symposium for children from 11 SADC countries held by the Child Rights Network for South Africa (CRNSA) in August 2021, South African children explained: “When we went back to school, we were months behind schedule. Teachers overloaded us with homework, assignments and exams to catch up, but that has been emotionally draining and many children are struggling with their mental health.”

Significantly, none of the learners at the symposium reported receiving psycho-social support or counselling at their schools.

Rotational learning (where children attend school every second day or every second week, or in some schools as little as one day per week) has been one of the biggest causes of loss of learning and emotional challenges for children.

Disturbingly, although the DBE issued a directive instructing primary schools and schools for children with special educational needs to return to traditional and daily school attendance from 2 August 2021, the caveat is that this is only possible if the risk-adjusted procedures and regulations are adhered to, which currently includes children staying one metre apart.

Given historical problems with overcrowding in schools, this is not an option for many. In the Western Cape alone, 86% of schools have applied for rotational timetabling in 2022.

Even more frustrating, this is a problem of government’s own making. Infrastructural development in schools is an ongoing need. Had it been prioritised, overcrowded classrooms, lack of sanitary facilities and unsafe conditions could have been eliminated as a factor in government decision-making.

But successive budgets have cut the infrastructure budget for education, affecting a total of 1,938 projects. Some provinces have also “reprioritised” their infrastructure budget to provide PPE for schools. In the case of KwaZulu-Natal, reallocated funds in 2020 amounted to what’s estimated to be almost half a billion rand.

Speaking at the CRNSA symposium about her experience of learning in one of the provinces that reprioritised its infrastructure budget, a Limpopo learner – whose school has no water and serious infrastructural problems – explained: “My classroom was filled with cracks. I couldn’t focus because the classroom could have collapsed. We were living in fear. There were no improvements in classes or infrastructure. It led to overcrowding.”

For this child, the pandemic has been a disaster. “There are not enough classrooms for children to socially distance. Children are not safe. Some don’t have classes. In Grade 10, children choose subjects. Children are split and some have to be taught under the trees. They don’t have a table or a desk to write on.”

It is the ultimate own goal by government. Rotational learning cannot end without changes to infrastructure, which cannot occur because of budget cuts.

It has led to educational experts and advocacy groups, including the South African Human Rights Commission (SAHRC), calling for an end to the one-metre distancing rule and a return to full-time schooling for all primary school and special needs learners.

The SAHRC has also called for the decision to exclude high school learners to be reviewed, given the roll-out of vaccines to children from 12-17.

This position is affirmed by the South African Paediatrics Association, which notes that children are less likely than adults to become severely ill from Covid, or transmit it, and that in most settings, schools have contributed minimally to community transmission of the virus.

But some authorities are wary about the full return to school for fear of child infections, particularly among under-12s, the only age group yet to be vaccinated.

The solution may be an agile approach where the department focuses on reopening all learning, with ongoing precautions like ventilation, vaccinations, mask-wearing and, where possible, physical distancing, but also responds quickly to surging numbers in hotspots by closing targeted schools for short periods of time.

Closing some Johannesburg schools could, for example, have minimised the number of children who fell ill as the Omicron variant swept through the city at the end of November.

But the approach requires agility and a real-time response to the science, which the DBE seemingly lacks. It’s evidenced by the ongoing use of school protocols developed 18 months ago despite massive developments in our understanding of the virus, and prevention measures, in the interim.

But while government has a duty to protect children when they are at school, rotational learning also shows a lack of empathy about the lived experience of most South African children. Specifically, has anyone asked how safe are our children when they are not at school?

People who have been in a South African squatter camp or township in the last year will attest that most children on rotation can be found playing on the streets, in overcrowded houses or in informal creches with other children. Not only are many minimally cared for or unsupervised and therefore at risk, but there is no mask-wearing or physical distancing. It’s hard to argue that they are more unsafe at school.

This unresponsiveness is also evidenced elsewhere in government. Scientific research has shown an increase in child abuse, abandonment and the loss of primary caregivers during lockdown.

In August 2020 alone, Childline South Africa reported a more than 36.8% increase in the calls received for help, compared to August 2019.

In addition, poverty and violence have led to more child abandonments, with NGOs detailing a massive spike in numbers since the beginning of the pandemic.

Equally troubling are the findings of the 2021 Lancet study on the deaths of primary caregivers due to Covid. Researchers estimated that globally, 1,134,000 children have experienced the death of primary caregivers between 1 March 2020 and 30 April 2021. 

South Africa was particularly badly affected, with almost 95,000 losses. This amounted to 5.1 per 1,000 children losing their primary caregiver, a ratio only second to Peru of the 21 countries included in the study.

Yet the department of social development, citing stats from the beginning of lockdown, flatly denied that there had been an increase in abandonment during lockdown. It has yet to share any updated statistics. The department also failed to respond to allegations that it was contributing to the problem of care for vulnerable children by failing to provide necessary documentation which would allow children to pass through child and youth care centres into permanent family care – either through reunification or adoption – thus freeing up spaces for those most in need.

Further, when IFP parliamentarian Mkhuleko Hlengwa asked in the National Assembly if government had conducted similar research to the Lancet research and how it was responding to the study, the answer was: “The Department of Social Development has not conducted any study that is specific to orphanhood and therefore does not have the figures of children orphaned due to Covid-19. The causes of orphanhood have not been tracked as yet; services are rendered to all children who are made vulnerable by different circumstances, including those who are orphaned.”

It’s hard not to conclude that children aren’t being prioritised. Nor are we listening to them.

Loss and fear were the main themes when children spoke about Covid at the children’s symposium. They highlighted loss of education, of healthcare, including childhood vaccinations and access to reproductive support, loss of time and loss of family connection.

They spoke about the agony of losing relationships with relatives and friends, or risking making them sick, and their frustration at family members choosing not to be vaccinated when they have the option.

As one child explained: “We have to push for people to be vaccinated. Although government is persuading people to be vaccinated, our parents don’t want to take them because of superstition. Children are getting sick because vaccines are not available to them. We are trying to get adults vaccinated to protect children, but vaccine hesitancy is putting children at risk.”

Ultimately, many children are afraid: “Covid is scary… My whole family has had it. I’m afraid of losing my parents. What will happen to children if their parents die? Will they end up in a child-headed household or in an orphanage?”

The OECD report sums it up best, “Although not medically in the risk group for severe disease, children have been deeply impacted by the pandemic. The strategies to control the spread of Covid-19 have completely changed children’s daily lives and put a whole generation of children in danger. Financial and social challenges resulting from the spread of, and the control of this spread, will significantly impact on children’s right to survive, learn and be protected.”

Munir points out that “the most deprived and marginalised children are being hit the hardest by the pandemic, exacerbating existing inequalities and pushing the most vulnerable even further behind”.

She counsels that her findings should be considered when “devising policy around children, who are unable to make their voices heard, by those whose decisions impact their wellbeing.”

Immediate government measures are necessary to change this bleak picture. But are authorities listening? DM

First published in the Daily Maverick: 15.12.2021

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