Calls for government to put children at heart of Covid response plans
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EVEN as most children were spared from severe Covid-infection, and with the fixation of adult Covid-care and prevention, experts agree the needs of children were largely overlooked and they are likely to carry the effects of the pandemic for years to come.
The Children’s Institute, University of Cape Town, in collaboration with the Children’s Hospital Trust and the Michael & Susan Dell Foundation, calls for the South African government to put children at the heart of South Africa’s Covid-19 response and recovery plans.
As South Africa experiences a peak in the third wave, many experts say it is time to stop and count the costs, and to put children first in response and recovery plans. The past year has been met with global efforts to flatten the curve, deepening levels of poverty and hunger, intensifying pressures and the threat of violence within the home, limiting children’s access to schools, healthcare limitations, halting early childhood development and other support services – all of which have caused significant collateral damage.
There is no doubt that Early Childhood Development programmes (ECD) perform an invaluable service to society and have the potential to support young children and their families in times of crisis. This happens by enabling caregivers to seek employment, and ensuring that young children receive safe care, good nutrition, and early learning. Yet, according to Lizette Berry, senior researcher at the Children’s Institute, even prior to Covid-19, the ECD sector in South Africa was fragile and underfunded.
“The mandatory closure of ECD programmes in 2020 intensified existing challenges. Prolonged lockdown, limited state support and the withdrawal of the ECD subsidy in most provinces, led to the permanent closure of many ECD programmes and significant job losses. And this will cause not only immediate but also long-term harm to the health, nutrition and education of young children.”
Education and schools
The opening and closing of schools during the pandemic has been highly contested, as the education department seeks to minimise the disruption to children’s education, while at the same time keeping children, educators and the broader school community as safe as possible.
Less than 1% of learners (1 200) contracted Covid-19 in the Western Cape in 2020, and 3 900 learners required quarantine, mainly from community-acquired infections. Yet, despite these relatively small numbers, widespread fears prevailed about learner and educator safety, resulting in repeated school closures.
Dr Patti Silbert, project manager of the Schools Improvement Initiative in the Schools Development Unit at UCT, says school closures have had a devastating impact on education, with the majority of primary school children losing close to a full-year of learning and an estimated 750 000 learners dropping out of school.
“Closures also prevented children from accessing an important source of nutrition, healthcare and psychosocial support, with more than nine million learners losing out on daily school meals during lockdown.”
Protect children from immediate shock and long-term harm
Lori Lake of the Children’s Institute, University of Cape Town, explains how children are particularly vulnerable to both the immediate shock and enduring impacts of Covid-19.
“This is especially the case during sensitive and rapid periods of development such as the first 1 000 days of life and adolescence when exposure to hunger, violence and adversity gives rise to toxic stress which can cause long-term and irreparable harm to children’s immune systems, their developing brains and education and employment prospects.”
According to Professor Maylene Shung-King of UCT’s School of Public Health, shocks such as climate change and Covid-19 also tend to intensify existing inequalities.
“For a privileged few, the pandemic simply meant a change in lifestyle, but for the majority of South Africans, the pandemic has been catastrophic with families facing unemployment, hunger, violence and an uncertain future.”
According to Professor Chris Scott of the Department of Paediatrics and Child Health, UCT, the initial health systems response to Covid-19 care focused on adults who accounted for over 95% of cases in the Western Cape.
“Children’s needs were side-lined, resources were diverted from paediatrics to adult Covid-19 care, and concerns around infection prompted the separation of infants and children from much needed family support. Yet, over time, child health specialists succeeded in advocating for a more child-centred approach to contact tracing and the care of children in hospital.”
While children accounted for only 4% of cases in the province and 0.5% of the deaths, thousands more children have been affected by the illness and death of family members. Reports indicate that more than one million children around the world are estimated to have lost a primary caregiver from March 2020 to April 2021.