Opening remarks by Dr Tshepo Motsepe at the 2019 Child Health Priorities Conference, North West University

Programme Director,
Vice-Chancellor: North-West University (NWU), Professor Dan Kgwadi,
Acting Chief Director: Child, Youth and School Health from the National Department of Health, Dr. Lesley Bamford,
Deputy Director General, Primary Health Care from the National Department of Health, Ms. Jeanette Hunter,
Chief of Health, HIV/Aids and Nutrition at the UN Children’s Fund (UNICEF), Dr Mariame Sylle,
Deputy Vice-Chancellor: Planning, Vaal Triangle Campus Operations, Research and Innovation at North West University, Professor Linda du Plessis,
Deputy Vice-Chancellor: Teaching and Learning at NWU, Professor Robert Balfour,
Executive Director: Student Life at NWU, Dr Sibusiso Chalufu,
Executive Dean: Faculty of Health Sciences at NWU, Professor Awie Kotze,
All other faculty members present,
Distinguished guests,

Ladies and Gentlemen,

Allow me to begin by saying how pleased I am that this year’s Child Health Priorities Conference has made it to my home province.

It was right here in North West, as a young woman aspiring to study medicine, that I first developed what would become an enduring passion for the subject of maternal and child health.

So it really is a poignant moment for me to be addressing this critical conference: in a place where the seeds of my own passion and that of many other medical professionals, first germinated.

The annual Child Health Priorities Conference is now in its tenth year.

This is a sterling achievement, for this conference has come to be recognized as a seminal forum for engagement around the most pressing issues facing the health and well-being of our nation’s children.

And yet it is so much more than a forum for reflection and deliberation. Tt has a clear mandate: that sector stakeholders collaborate and come up with durable solutions to the challenges that continue to impede our progress in fulfilling our domestic and international obligations in terms of children’s rights.

South Africa can be justifiably proud of our consistent and abiding commitment to children’s rights.

The drafters of our Constitution were adamant that the Bill of Rights should include very specific provisions that advance child rights in accordance with international standards.

It should be emphasized that ascribing human rights to children in the supreme law of the land is by no means universal.

There are many countries in the world where children lack even the most basic protection from the law.

And the UN Convention on the Rights of the Child was the very first international treaty ratified by the democratic government in 1995.

Though we are alive to the many challenges we continue to face, this country is recognized by international bodies such as the UN Children’s Fund (UNICEF) and the UN Development Programme (UNDP) for the successful inroads we have made in improving the health, educational, socio-economic and other outcomes of our children since 1994.

Our government recently released the 25 year review that charts our progress as a country in meeting the needs of our citizens, in alleviating poverty and in addressing inequality.

The extensive research undertaken in the compilation of the report bolsters what is not a presupposition but a fact: that the lives of children today are fundamentally better than they were during apartheid.

Through the provision of free primary healthcare; the provision of lifesaving medication including anti-retroviral treatment; through the Primary Schools Nutrition Programme; through the provision of free basic and secondary education; through transformative, progressive and pro-family social welfare policies; and perhaps most of all through the social wage; we have invested – substantially invested in the health, nutrition, well-being, and education of our young people so that they can reach their full developmental potential.

And yet we are not here to be self-congratulatory, or to rest on our laurels.

We are here because we recognize the urgent need to address those who have not been positively impacted by the policies and programmes of this government.

We are here because we have a deep concern for those children without a childhood.

Children for whom mere existence is a struggle, and for whom a plate of nutritious food, or a pair of school shoes, is a luxury. 

We know that the spectre of inequality looms large in this country, and that it fundamentally impacts our progress in improving the health outcomes of the young boys and girls of our nation.

The many social challenges that continue to plague us, of unemployment, of poverty, of violence both inside the home and on the streets – are felt most acutely by our children.

We cannot significantly improve the health of children if their most basic needs: of food, of shelter, of safety, are not in place.

What is taken for granted elsewhere are very real deprivations in our society that is widely regarded as being the most unequal in the world.

Extreme poverty has its most obvious outcomes: but in some cases they are not so manifest.

We are for instance faced with a paradox in this country of rising levels of stunting on one hand, and the rise in childhood obesity on the other.

By some estimates, by 2025, 3,61 million schoolchildren in South Africa will be clinically obese – a daunting prospect by any measure.

Some attribute this to rising income levels in the working class, the adoption of Western-style eating habits and the rapid spread of consumerism. 

On the other hand, we also know that the cheapest food is often the unhealthiest, and with limited disposable income and lack of access to nutritious food, often the easiest.

This contradiction highlights something we all know: that interventions to address child health must be holistic and integrated.

One problem cannot be solved without looking at the attendant issues and circumstances that may or may not be within the health sector.

We cannot meaningfully address the high rate of deaths from intestinal infectious diseases such as diarrhea amongst children under five without collaborating with provincial and national authorities around issues of access to safe and clean drinking water.

Similarly, ameliorating the high numbers of children being disabled and even killed in road traffic accidents cannot be done without collaboration on policy interventions and regulatory reform with the national Department of Transport.

Child health does not stand in isolation, and improving health outcomes necessitates collaboration with multiple stakeholders on platforms such as this one.

Ladies and Gentlemen,

Next year we begin the 10 year countdown to the attainment of the Sustainable Development Goals. We will also enter the final decade towards meeting the aspirations of our National Development Plan (NDP).

The Global Goals are both reflected and reinforced across government’s planning machinery and form the bedrock of the five-year programme of action, the Medium Term Strategic Framework (MTSF) that has been finalized and will soon be released.

In July this year we submitted our voluntary National Review on the SDG’s to the UN Secretariat. The review registers our progress in meeting the SDG’s: of which Goals 1, 3 and 4 are relevant to the purpose of this conference.

The review highlights the challenges we continue to face with underweight children, with stunting, and as I said earlier, with rising childhood obesity.

At the heart of this problem is food security, and the review notes government’s intention to establish a multisectoral Food and Nutrition Security Council to coordinate the implementation of programmes and services that address food and nutrition security.

On Goal 3: Ensuring healthy lives and promoting well-being for all and at all ages the report notes that improved access to healthcare has supported reductions in child and maternal mortality rates – but acknowledges the uphill battle with the availability of medicines and vaccines, the dissemination of  health information, and reducing the rate of communicable diseases, including amongst children.

These are not challenges unique to South Africa as illustrated by this year’s UNICEF report on the State of the World’s Children (SOWC).

For instance, despite global progress in the past two decades, still one third of children under the age of 5 are malnourished.

Many other child health indicators have deteriorated over time.

There are however factors that impact child health in this country that are quite specific, and of which, let it be said, we are deeply ashamed.

A recent report by the South African Medical Research Council found that homicide was the second most common cause of death and it affected children of all ages, with the highest burden (52.8%) in the 15-17-year age group.

Child abuse and neglect accounted for 11.3% of deaths.

The rape and sexual abuse of children has become widespread and disturbingly prevalent across the country.

Not a week goes by without hearing one or another horror story about child abuse and the murder of children.

This is a shocking indictment.

Our society’s most vulnerable are victims of those who are supposed to protect them.

This week, just a day after government launched the annual 16 Days of No Violence against Women and Children another young woman was found dead in Limpopo, killed in the most horrific manner.

If as Tata Nelson Mandela said, ‘the true character of a society is revealed in how it treats its children’ then we have let our children down.'

Over the years various theories have been posited to explain what is unquestioningly a terrible and toxic masculinity being imposed on women and girls by some men in our society.

Some have even gone so far to blame it on the residues of apartheid repression, or even on poverty.

There is one thing of which we are unequivocal and I will say it right here.

Nothing, nothing can ever justify the mistreatment, neglect or abuse of a child.

Nothing can every justify the abuse of women and girls.

Not straightened one's circumstances, not tradition and culture, not having been a victim of abuse oneself.

We will not be a society where a child is treated as a disposable, dispensable and lacking the rights of a full human being.

Nor a society where women’s rights are undermined and violated.

I want to call upon every one of us here today to commit themselves and their organizations to supporting government’s campaign to end genderbased violence and femicide.

I call upon you to be agents of change in your communities, in your places of learning, and inside your very homes.

Taking all these factors taken into account, and the social circumstances under which millions of our people still live, then it becomes clear that there is no panacea for improving child health in this country.

We must forge ahead with holistic interventions that address the root cause – chiefly poverty and inequality.

We must be methodical, and we must be consistent.

I am encouraged to see the many and different organizations engaged and part of the discussions to bring our collective energy and wisdom to bear on the health and development of children in South Africa.

The health of our children is not confined to reducing disease, it is fundamentally about eradicating the factors that deny each and every child the right to have a fair chance at life.

It is about declaring that we leave no child behind.

We all grew up being taught the famous poem ‘Children Learn by what they Live’ at the feet of our grandparents and parents.

We know it by heart. 

That a child who lives with criticism learns to condemn.

That a child who lives with hostility, they learn to fight.

We also know the positive.

That a child who lives with encouragement learns confidence.

And that a child who lives with acceptance and friendship learns to find love in the world.

These wise words find deep resonance in the child health sector, to which we may affix our own words.

If a child receives proper nutrition, appropriate medical care when they are ill, and the necessary and holistic support of their physical and mental health -they have the best start in life.

A start that cannot be denied them because of where they come from, or because their parents are poor.

A hungry child can never be a happy child.

They cannot focus in class, they cannot play on the playground or on the sports-field.

They cannot even get off the starting blocks.

That is why I am immensely encouraged to learn that the Center of Excellence for Nutrition here at the North-West University has a focus on Nutrition in Early Child Development and is working with Grow Great to explore how we can improve children’s nutrition. 

Ladies and Gentlemen,

There is much to say, and there are many many issues upon which we will be deliberating.

On behalf of SACSoWACH, I pledge my unqualified and sustained support to this conference.

In his famous poem “On Children” the poet Khalil Gibran writes:

“Your children are not your children
They are the Sons and Daughters of Life’s longing for itself
They come through you but not from you
And though they are with you
They belong not to you”

Indeed, we hold our children in trust, for they belong to humankind.

They are the inheritors of the South Africa we are building today.

Let us send them forth, as Gibran writes, “as living arrows..upon the path of the infinite.”

A path of safety, of well-being, of security, and above all, of good health.

I thank you.