The hidden starvation

Starvation among blacks was rife in South Africa in the early 1960s. But it was hidden. Apartheid’s victims had no power. They suffered and died, out of sight in city hospital wards and in rural areas.

Two years of devastating drought in the north-east of the country helped to bring the issue into the open. Attention was first focused on the plight of (white) farmers. Then came a new private organisation, Kupugani, the Nutrition Corporation, created to provide high-protein soup powder on a mass scale to the poor. It wanted publicity and the Rand Daily Mail was willing to help. Stirred by Kupugani’s information about the extent of starvation, editor Laurence Gandar agreed to embark on a major exposé.

Gandar was already famed for his probing, relentless analyses of the evils of apartheid. He also had a newsroom which had become skilled in aggressive chasing after news, and sub-editors with a flair for eye-catching design and headlines. The Mail now entered a new phase, the first South African newspaper to put together a dedicated investigative team.

‘Starvation: A national scandal’, the front page announced on Monday, 1 October 1962.

The campaign began with reports from the drought areas by Keith Abendroth of the Mail’s Pretoria Bureau: ‘Pellagra and kwashiorkor – the dreaded, deadly malnutrition and starvation diseases – are the constant companions of thousands of African children in Shilwane, in the remote north-eastern Transvaal.

‘In kraals in the sun-scorched Drakensberg mountains and in the normally lush Thabina, Letsitele and Letaba valleys the infant mortality rate among Africans is climbing and the incidence of pellagra particularly is 10 times higher than it was three years ago …’

By then I had spent weeks investigating and researching. I learnt that the Infant Mortality Rate – the number of deaths before the age of one – revealed the grim story: for whites, it was 27 per 1000; for blacks, anything up to 400. A prime source was Kupugani’s national organiser, Neil Alcock, a farmer with immense understanding of agriculture and driven to ensure food security for all. My secret source was Dr Sam Wayburne, chief paediatrician at Baragwanath Hospital: he risked his job by taking me through his wards to see starvation victims – shrunken babies, two to a cot. It was horrific.

I also tapped into a resource which no one ever bothered to look at: the annual reports of city medical officers of health. Dry as dust, difficult to get hold of, they yielded damning statistics and comments about baby deaths.
So by Day 3, when my reports began, we were well prepared: in a succession of reports we presented emotional words about dying babies and starving people, and published difficult-to-look-at photograph of kwashiorkor babies. Underlying everything, we reported fact after fact.

The results were immediate. The Nationalist government condemned us: our picture of the drought areas was ‘unfavourable and distorted’. As our reporting continued the attacks rose. I was called a liar in Parliament. The then Transvaler newspaper, the National Party’s organ, sneered at us as ‘die hongersnood koerant’ (the malnutrition newspaper) and said our pictures of starving babies were fakes. Dr Wayburne told me that a Transvaler reporter had arrived and said he had the job of checking everything I was writing. He demanded a tour of the kwashiorkor wards: ‘After walking through the first ward he was green in the face,’ said Wayburne. ‘He declined my offer to look at the next ward.’ The Transvaler went on abusing us.

Meanwhile, however, our Pretoria Bureau was conveying a different message to me from senior officials: Keep going, we need to pressure the politicians. The public response was staggering. Outrage and anger erupted about the extent of starvation; money poured in for Kupugani.
After 10 days of non-stop exposés, Gandar wrote a front-page editorial, ‘END THIS SCANDAL!’ with the message: ‘Prevention, prevention, prevention’. I followed up with a week-long swing deep into rural KwaZulu with Alcock, from one church mission hospital to another, checking levels of starvation and what food was needed. That led to renewed campaigning late in November, with another article titled, ‘The price of hunger’.

‘Detailed statistics of the extent of kwashiorkor and malnutrition in the rural areas do not exist,’ I reported. ‘When babies die they are buried without ceremony. African parents see no point in walking miles to the nearest Government office to notify the death.
‘But every authoritative statement by doctors and nutritionists
makes clear the gravity of the situation.’

We went into a new dimension, to give readers broader perspective about the causes of malnutrition. ‘The death toll and misery caused by kwashiorkor can be ended by emergency measures to ensure that every baby has one pint of milk a day,’ I reported. But malnutrition needed prolonged effort to deal with complex factors: poverty, which prevented people from buying enough of the right foods; ignorance, which resulted in mothers giving babies the wrong foods and failing to observe elementary rules of hygiene; migratory labour, which broke up family life, causing instability and illegitimacy; detribalisation had good and bad results, including the lowering of moral standards; rural reserves were overcrowded and eroded. ‘The land cannot support the people who live on it. Disease is inevitable,’ I wrote. ‘None of these causes can be viewed in isolation. They hang together, and must be fought as one.’

Grim hunt in the bush for their food

Benjamin Pogrund, Rand Daily Mail, 3 October 1962

Mass starvation has driven Africans in part of the Eastern Transvaal back to Stone Age conditions. They are living on wild fruit picked from bushes. In other parts of the Eastern and Northern Transvaal: • Children sometimes go without food for two or three days. • Many adults eat mealie meal – and nothing else – only every second day. • Hospitals are overcrowded with malnutrition cases. • In one area Africans believe that an epidemic has broken out. They have no name for it. The ‘epidemic’ is pellagra, due to malnutrition …

These are the findings of two nutrition experts, both members of the Nutrition Corporation (Kupugani) – Mr Neil Alcock, the national organiser, and Mr Carl Keyter – after a tour of thedrought-stricken areas.

Mr Alcock and Mr Keyter say that in Potgietersrus, the one district where famine conditions have received wide publicity – money is being used by a relief committee and the government to feed about 6000 Africans, mainly children, out of a total population of 108,000. ‘Only an insignificant proportion are being fed. The surface has only been scratched.’

Most government officials are aware of the serious situation in their areas and would like to help. But they want official approval from a higher authority … Although drought conditions have aggravated the situation ‘we were very much aware that malnutrition was a permanent condition of the people and existed long before the drought’. They found that an estimated 20 percent of the people of Sekukuniland suffer from advanced malnutrition diseases such as pellagra, kwashiorkor and scurvy. In the Maandagshoek-Steelpoort area ‘we found a rural community who had reverted to Stone Age conditions.

‘They had no mealie meal, and lived solely on the wild mapoeshan, a yellow date-like fruit which they picked from bushes and soaked overnight in water to make them more palatable.’ The basic diet of Africans in the reserves is mealie meal every day – or every two days; meat once a week – or once a fortnight. Yet in some areas farmers periodically destroy their surplus crops. The Africans do not have milk, vegetables, merogo or other supplementary foods.

Near Nelspruit, Trichardtsdal, Bushbuckridge, Tzaneen and Warmbaths areas, periodic surpluses arise and are destroyed by farmers. The surpluses cover all types of food: dairy, oranges, vegetables, pineapples and bananas. In Sekukuniland, 12 miles from large citrus-growing lands, there is widespread scurvy – caused by lack of vitamin C found in oranges. The symptoms of scurvy are bleeding gums and fissured lips.

In Trichardtsdal, farmers leave chopped bananas to rot on the ground to fertilise the soil.

Hunger: The facts are in sick beds

Benjamin Pogrund, Rand Daily Mail, 4 October 1962

Ulcers on the eye-balls and on the mouth, swollen bellies, deep open cracks behind the elbows and knees, wasted bodies, sparse and feathery hair, blisters, a scaly rash, listlessness and misery – these are the visible, obvious signs of starvation and malnutrition. They are found in kwashiorkor and pellagra cases. Left unchecked, they lead to death. Cured, permanent liver damage remains. There is no shortage of calories or protein in South Africa as a whole. Yet the facts are that thousands die each year from either direct malnutrition – kwashiorkor and pellagra – or from allied diseases.

The death toll statistics have reached proportions where they no longer have meaning in human terms!  10,000 non-White deaths a year from gastro-enteritis in the urban areas alone. 10,000 African deaths a year from tuberculosis.  Up to 800 children a year admitted to Johannesburg’s Baragwanath Hospital with kwashiorkor. One in five of them die.  Another 3000 a year treated as out-patients for the same disease.  And no one has any idea of the exact situation in the rural areas. Putting it at its best, nutrition experts say it is as bad as in the cities.

The only clues come from reports that the majority of cases admitted to a hospital in a Northern Transvaal African reserve suffer from malnutrition, that children with kwashiorkor pour into Durban hospitals from the surrounding rural areas; and that many of Baragwanath’s cases are also from the rural areas.

However staggering the available statistics, they are still only part of the total picture … the greater mass – of chronic malnutrition – is hidden. The implications for South Africa and for the affected individuals are far-reaching and devastating: • Growth is stunted. The adult in his mid-twenties is physically weak, easily susceptible to a host of diseases. • Workers, one step away from starvation, cannot do their jobs properly. Their employers call them ‘lazy’ and ‘stupid’ – and the loss of productivity and the effects of absenteeism are incalculable. • Women start off malnourished and become worse with each pregnancy. They cannot give their babies a fair start in life. Left to itself, malnutrition can only continue to grow with each succeeding generation. Not only ethical principles, but also sound economic facts call for South Africa to end a scourge that need not exist in our land of riches.

The children suffer more than any

Benjamin Pogrund, Rand Daily Mail, 5 October 1962

‘Because of the serious drought in parts of the country and in view of the potato surplus, the Potato Board has decided to make potatoes available to farmers for cattle feed at a nominal price.’ – Announced in Pretoria yesterday. The children suffer most. Underfed, wrongly fed, their bodies offer no resistance when illness comes. The result is a rate of death among African infants which is as high as, if not higher than, the world’s most backward areas. Two years ago, Durban reported that of every 1000 African babies, 246 died within their first year. This has dropped by 30 per cent, since the start of a feeding scheme. In 1960, Johannesburg’s African infant mortality rate was 122 per 1000; last year it was 92. Cape Town’s figure is 144 and Kimberley’s is 89. The Director of the National Nutrition Research Institute, Dr F.W. Quass, has said that estimates of African infantdeaths throughout South Africa range from 100 to 400.

In contrast: India 185 per 1000; Egypt: 141; Ghana: 90; Nigeria: 76. South Africa’s national average for Whites is 27 per 1000. This compares favourably with Britain, the United States and Australia. A major cause of the big killers among African and Coloured children – gastro-enteritis and bronchopneumonia – is malnutrition. Gastro-enteritis accounts for one-third of African children’s deaths – 10,000 a year in the urban areas. A survey among doctors by the National Nutrition Research Institute indicated that, of 200,000 child patients, 22 per cent suffered from deficiencies linked to malnutrition. A senior doctor at Johannesburg’s Baragwanath Hospital states that, apart from the 3800 direct cases of kwashiorkor each year, ‘tens of thousands of other children who came for treatment have a background of malnutrition’. Cape Town’s medical officer has reported that the percentage of non-White deaths is seven times greater than that for Whites. Among Whites, nearly five per cent of all deaths are under five years of age. Among Africans, 57 per cent. A survey at the Red Cross Children’s Hospital in Cape Town showed that half the children who came as out-patients were underweight; of all the children at the hospital, 16 per cent suffered the ‘grossest degree’ from diseases caused by malnutrition. Malnutrition is also believed to affect mental development. That is what the available evidence indicates. One study carried out in the Valley of a Thousand Hills, Natal, was on a group of African children a year after they had recovered from kwashiorkor. The children were found to be apathetic, lacking in intelligence and initiative, acting only when given orders. ‘They were like zombies in horror films, automatons,’ said the report. South Africa’s other great scourge, tuberculosis, is linked with malnutrition on the simple basis that an underfed body falls easy prey to infection. The country has an estimated 150,000–200,000 tuberculosis victims. At least half of them are walking around undetected, in many cases spreading the disease still further. In 1948, the state spent R500,000 to combat tuberculosis. Now the figure has grown to R13m. Yet the number of new cases reported by SANTA – 160 a day, nearly all non-Whites – has shown little sign of decreasing. For those who still do not believe the gravity and extent of malnutrition in South Africa, here are the views of some of the men who know the situation: ‘It is evident that malnutrition and its associated deficiency diseases exist to a far greater extent than even the most pessimistic nutritionist expected.’ – Dr F.W. Quass, director of the National Nutrition Research Institute, September 20, 1961. ‘There is little doubt that serious malnutrition occurs among the lower sections of our population, and until this is seriously and whole-heartedly tackled by all authorities, no improvement in the incidence of gastro-enteritis, kwashiorkor, bronchopneumonia and tuberculosis can be expected.’ – Dr E.D. Cooper, Cape Town’s Medical Officer of Health, 1960 Annual Report.