Risks to SA's malnourished, 'home alone' children means schools must reopen: Study
After nearly 11 weeks, 90% of children are still not allowed to go to school or see their friends and family outside their homes as a result of the Covid-19 lockdown — compromising their education, welfare and mental health.
The ongoing school closures are not in the best interests of children, say researchers at the Stellenbosch University department of economics, Prof Servaas van der Berg and Dr Nic Spaull.
Based on the government’s current plans, by the end of term 2 (August 7), grade 7 and 12 children will miss only 25% of normal school days, but their grade 4, 5, 8 and 9 peers will miss 57% of scheduled school days up to that date.
“By August 7 2020, at least four million children will have missed more than half (57%) of the number of school days that are normally scheduled up to this point. Teachers will not be able to complete the entire remaining curriculum in the limited time available. Inequality is likely to increase since poorer learners and schools are least able to catch up. International research on the cumulative effects of learning losses and subsequent income losses indicate that many of the losses in both learning and income are long term in nature and can be measured five years after the event.”
Calculating the risk of death from Covid-19 ranges from a 1-in-76,878 chance (0.001%) for those aged 0-19 years, the researchers argue that “the relatively low mortality risk from the virus needs to be contrasted to the significant additional mortality risk from acute malnutrition and associated mortality in children (especially pneumonia, diarrhoea and HIV/Aids) arising from the lockdown”.
Even before the lockdown began, they said the official General Household Survey data showed that at least 2.5 million children experienced hunger and lived below the food poverty line.
“Approximately one million children under the age of five are stunted. Hunger and acute malnutrition are likely to have been severely aggravated by the lockdown and school closures since hundreds of thousands of informal workers lost all income and children no longer received free-school meals.
“Even though malnutrition is not often stated as the cause of death in SA, it often remains an important contributor. Child mortality audits show that almost a third of children who die are severely malnourished.”
The researchers said emerging evidence from rapid surveys from both Stats SA and the HSRC have shown clear increases in rates of hunger among children and adults. Increases in acute malnutrition significantly raise the risk of children dying from pneumonia, diarrhoea and HIV/Aids. These avoidable deaths need to be considered when deciding whether and how to lockdown SA, and whether schools should be closed again in future.
Young children being left home alone was a concern for Spaull and Van der Berg.
“One of the least appreciated costs of reopening the economy while keeping schools closed for 90% of learners (as is currently the case in SA) is that children are at higher risk of being left home alone. Our analysis of the Quarterly Labour Force Survey (QLFS) data of 2019 shows that if all employed workers return to work, there would be more than two million children aged 0-15 years without an older sibling (15 years+) or an adult caregiver to look after them,” they say.
“Of highest concern are the almost one million children (974,000) below the age of six who have no other adult caregiver in the household except a working parent. It is highly plausible that hundreds of thousands of these children would be left home alone in households without an adult caretaker if their employed caregiver was forced to return to work to earn an income and sustain her family. Even though most sectors of the economy have reopened, Early Childhood Development centres or crèches remain closed.”
Mental health was also flagged as an issue of concern by Spaull and Van der Berg.
“School closures, lockdowns and increased financial stress are likely to have increased the risk of child abuse, mental health breakdowns and the emotional exhaustion of caregivers together with rising rates of depression and anxiety,” they said.
Citing recent surveys of children in Nicaragua, Indonesia and a number of other countries, they said children are at higher risk of lasting psychological distress, including depression. After one month school closures in Hubei, nearly a quarter (23%) of children in grades 2-6 reported symptoms of depression. Recent reviews of lockdowns, school closures and natural disasters show increases in rates of substance abuse, depression, fear, loneliness, domestic violence and child abuse.
In addition, children’s routine immunisations, testing for HIV and TB, and health seeking behaviour when children seem sick are all likely to have decreased as a result of the lockdown and school closures, they say. “Any delays in the diagnosis and treatment of HIV in either pregnant mothers or newborn children is likely to have long term consequences.”
They commented: “When the new coronavirus rapidly spread across the globe, the impact of the virus on children was still unclear, and closing schools from an abundance of caution seemed the responsible thing to do. But much has been learnt since about both Covid-19 and about the effects of lockdown and school closures, both in SA and internationally ... Given what is now known about the mortality rates of Covid-19, we believe that the ongoing disruptions to children’s care, education and health are no longer justified.
“It is our view that keeping children out of school is not in the best interests of the child ... All children should return to schools, crèches and ECD centres without any further delay. The profound costs borne by small children and families as a result of the ongoing nationwide lockdown and school closures will be felt for at least the next 10 years.”