GROWTH FORECAST
Novelist on a mission to end stunting
Here’s the thing about motherhood. Not only does it lead to intricate involvement in the wellbeing of your own children, it also extends that to the children around you. This is evident in the work of Dr Kopano Matlwa Mabaso, who heads the Grow Great Campaign, which aims to bring SA closer to achieving zero stunting in children by 2030.
“Mothering has been such a joy. Motherhood is a universal truth. It unites women in a special experience. I find it a means of feminism, to let women care for each other,” she said in an interview.
It has brought societal issues such as breastfeeding, maternal mental health and childhood nutrition into her life mission.
“In SA, we have focused our care on children surviving, but not on children thriving. Stunting is a silent epidemic. By not addressing it, we are robbing ourselves and our children of a future where all South Africans have a fair chance to achieve their full potential,” said Matlwa Mabaso.
One in four South African children is stunted, a result of prolonged poor nutrition from pregnancy to early childhood. The results are lower physical and intellectual growth.
“Economically, stunting is a tsunami waiting to happen. It results in a generation of poorly educated, unemployed, very ill people who will increase the burden on health care,” she said.
“Children who are stunted are less likely to finish school and work as an adult, so they are trapped in intergenerational cycles of poverty. It will cripple our country.”
A decade ago, the 33-year-old Kopano Matlwa was a student and author of Coconut, which examines race, class and colonisation, that she wrote while completing her medical degree at the University of Cape Town. She completed a master’s in global health science and a doctorate in population health at Oxford University. She also wrote two more novels.
She came back to SA with big-world solutions on her mind.
“I have always loved patient contact, being at bedsides, feeling pulses and listening to stories. But you realise as a doctor that you are doing so much damage control. We shouldn’t have these health outcomes for our country … We have to ask: ‘Why are we in this state?’”
Soon after it launched, the Grow Great campaign was invited to be part of the Global Poverty Project, which, through its Global Citizen movement, engages with pop stars to create huge music festivals and campaigns that aim to convince global leaders to change policies and pledge funding.
“This is a great opportunity to leverage the incredible platform and following that they have, to align what we are doing and get young people interested,” said Matlwa Mabaso.
“It is true that we are the generation that can make change. As Grow Great, we want to see stunting gone by 2030.”
The global campaign involves young people taking “actions” through social media, which include bombarding their governments with tweets. The campaign keeps tabs on countries’ funding commitments and people do volunteer work to earn rewards such as festival tickets.
It might seem a tenuous connection, but billions of dollars have been put to use around the world for vaccines, access to water, anti-poverty and zerohunger initiatives.
Grow Great’s focus on breastfeeding, for example, will spark Global Citizen tweets to the labour ministry to get it to highlight an existing law that allows new mothers two 30-minute breaks a day to pump milk or feed their babies.
Matlwa Mabaso said that whatever the status quo, it was not working.
“Even in the top wealth quintile, 12% of children are stunted. We don’t know why exactly, but stunting is multi-factoral. Maternal mental health is an aspect, both ante- and post-natal. Depression has an effect on the growth of the child.
“Another factor is the unhealthy gut, which may be linked to unclean water and poor sanitation in many of our communities. There is also social aspiration to formula feeding. For middle-class black women, society will say that you can afford the most expensive gold tin, so why must you breastfeed?
There are all sorts of devices on the market to help women pack, prepare and serve formula in public spaces like restaurants, but not enough places are breastfeeding friendly. Breastfeeding is seen as a backward process.”
Her team often hears stories of mothers in poor communities having to mix formula with flour to make it stretch, reduce the number of feeds and on the other end of the spectrum, avoiding “superfoods” such as eggs in children’s diets because of myths that these lead to the early onset of adolescence, and to promiscuity.
“The World Health Organisation and the department of health, everyone who has been promoting breastfeeding for decades, spent their time talking to the mother. It still isn’t happening. What are the barriers? Research is suggesting that we don’t have enabling workplaces, even with the breastfeeding code in place for almost two decades. Few employers are aware of it. Even I didn’t know and I was surprised to find out when I went back to work. I don’t think employers are not wanting to support workers; there is ignorance of the law.
“Those messages about how breastfeeding is great for kids, mums and our economy because parents are less likely to take sick leave and are more loyal employees, that kids will have higher IQs and be healthier, are known. Now we want young people tweeting ... talking to the minister to highlight it.
“Breastfeeding is a big part of our work, but it isn’t forcing people to breastfeed. Adults must make the best choice for their family, and I know it is difficult, I struggled too.
“But we work around dispelling myths like you can’t have sex while breastfeeding, and teaching how to hand-express milk so you don’t need expensive equipment. Women want the best for their children so it is about enabling and informing them. Children are most vulnerable to stunting in the first 1,000 days, so you need to be in the home if you want to influence that critical period in which 80% of the brain is developed.”
Part of the programme is supporting non-professional health-care workers, or ward-based community workers who are an unrecognised workforce, said Matlwa Mabaso. “They are the workers who reach the most vulnerable … We support these community workers with training, resources, equipment and affirmation of the critical role they play in the health system. They have clubs where we champion their work, celebrating them so they feel valued. Because they are not formally trained as traditional health professionals, sometimes they can’t even use a staff toilet at a local clinic,” she said.
Matlwa Mabaso packs a punch when she talks policy: “Right now there is a feeling of disappointment. Many of our leaders have let us down but I am excited by the sense of civil society, the gathering and marches. We are demanding to be heard. This country doesn’t belong to the rotten leaders, it belongs to us. That is the SA I know and believe in, and feel proud of.”
Her best friend
A homebody, she said her downtime was spent staying in with her four-yearold daughter, 18-month-old son and engineer husband, whom she calls “her best friend”.
“My parents have always reminded us that we grew up with more privilege than others. My dad is a chartered accountant but he did a number of part-time jobs to get through his studies, so we wouldn’t have to,” she said.
Having a psychologist as a mother was a boon, too, as was her parents’ encouragement to read widely, which helped her “navigate the world”.
“I grew up reading everything from Toni Morrison to Animal Farm.” She is “doodling” with writing at the moment, but does not have book four in mind just yet.
A fan of national health insurance, Matlwa Mabaso is uncompromising about “good health care being a human right”.
“There are technical issues about how to roll out NHI and build on the good, efficiently. Countries that are poorer than us have done it … we cannot as a country continue as unequally as this.”
✼ Visit globalcitizen.org/za or dgmt.co.za/zero-stunting/
Stunting is irreversible and it will cripple our country