EAJPHR, VOL. 20, No. 2 (December 2014)

414 East African Journal of Peace & Human Rights [Vol 20:2
THE ROLE OF GRANDMOTHERS AS THE PRIMARY
CAREGIVERS IN POOR HOUSEHOLDS AND THEIR
OWN RIGHT TO ADEQUATE FOOD: EXAMINING TWO
COMMUNITIES IN THE BREEDE VALLEY, WESTERN
CAPE PROVINCE, SOUTH AFRICA
K.T. Rendal,*
* W.B.Eide,**
M.L. Marais***
& P. O. Iversen****
ABSTRACT
South Africa’s elderly are experiencing serious challenges affecting
household food security. There are concerns about their use of the older
persons grant regarding their right to adequate food. The aim of this study
was to understand if and how the role of grandmothers as primary caregivers
in poor households living in two communities in the Western Cape Province
of South Africa, affected the realization of their own right to adequate food.
The grandmothers were the primary caregivers in the households and their
grant money could not facilitate them meet their basic needs. Their
realization of the right to adequate food was greatly affected by living with
grandchildren. They reported sacrificing their own basic needs including
food, to feed their grandchildren. Living with grandchildren was the biggest
constraint to their access to adequate food for themselves and was identified
as a major barrier to realizing their right to food and nutrition.
I. INTRODUCTION
According to the World Health Organization (WHO), the global number of people aged
* Master of Science in Nutrition, Institute for Basic Medical Sciences, Department of Nutrition,
University of Oslo, Oslo, Norway. E-mail: <karianne.rendal@gmail.com>.
**. Associate Professor, Institute for Basic Medical Sciences, Department of Nutrition,
University of Oslo, Norway. E-mail: <wbeide@gmail.com>.
***. Senior Lecturer, Division of Human Nutrition, Faculty of Medicine and Health Sciences,
Stellenbosch University, South Africa. E-mail: <mlm@sun.ac.za>.
****. Professor, Institute for Basic Medical Sciences, Department of Nutrition, University of
Oslo, Norway and Division of Human Nutrition, Faculty of Health Sciences, Stellenbosch University,
South Africa. E-mail: <poiversen@hotmail.com>.

2014] Grandmothers and the Right to Food in the Western Cape of S. Africa 415
65 and above increases annually at a rate of 2.7%.1
Most developed world countries
have accepted the chronological age of 65 years as a definition of 'elderly' or older
person, but like many westernized concepts, this does not adapt well to the situation in
Africa.
While the above definition is somewhat arbitrary, it is many times associated
with the age at which one can begin to receive pension benefits. At the moment, there
is no United Nations (UN) standard numerical criterion, but theUN agreed cutoff is 60+
years to refer to the older population. Almost 700 million people in the world today are
aged 60 and above, and it is estimated that there will be more persons at that age than
children in the world by 2050 (more than one in five of the world’s population will be
aged 60 years or older).2
The increase in the number of older people will be the greatest
and the most rapid in the developing world, with Asia as the region with the largest
number of older persons, and Africa facing the largest proportionate growth.3
The Advisory Committee to the UN Human Rights Council has recognized that
problems of the elderly are very important and neglected throughout the world. In its
2009 session, members pointed to millions of elderly people across the world facing
unequal treatment or denial of basic rights, specifically in terms of chronic poverty,
violence and abuse, lack of education, little or no access to the law, and exclusion from
social and political participation. The Committee advised the Council to bring forward
the human rights of elderly people in an integrated manner in the work of the UN
human rights mechanisms and highlighting the issues of responsibility and
accountability were most compellingly needed at the moment.4
A 2011 report of the UN Secretary-General to the UN General Assembly
examinedthehumanrightschallengesandtrendspresentedby populationsageingfaster
than at any other time in history.5
The report stressed that persons aged 60 and above
1. WHO,WorldHealthReport(2013),ExecutiveSummary,at5.HealthoftheElderly, retrieved
from <http://www.who.int/whr/1995/media_centre/executive_summary1/en/index4.html>, (accessed 14
November 2013).
2. UN Secretary-General, Follow-up to the Second World Assembly on Ageing. Report of the
Secretary-General to the General Assembly, 22 July 2011, Paras. 3 and 4. U.N.Doc, A/66/173.
<http://daccess-dds-ny.un.org/doc/UNDOC/GEN/N11/428/83/PDF/N1142883.pdf?OpenElement>
(Accessed 10 June 2014). See also <http://www.who.int/healthinfo/survey/ageingdefnolder/en/>.
3. Report of the Secretary-General to the General Assembly, id., para. 4.
4. Office of the High Commissioner for Human Rights (OHCHR), Human Rights Council
Advisory Committee Adopts its Rules of Procedure and ClosesDebate on the Right to Food. See especially
i n t e r v e n t i o n b y A d v i s o r y C o mmi t t e e E x p e r t M s . C h i n s u n g C h u n g ,
<http://www.ohchr.org/en/NewsEvents/Pages/DisplayNews.aspx?NewsID=8696&LangID=E>,6August
2009 (accessed August 2nd 2012).
5. Report of the Secretary-General to the General Assembly, supra note 2.

face diverse challenges depending on their context, but also that there are a number of
clearly identifiable challenges which require strategies at the national and global levels.
It lists four broad categories: discrimination, violence and abuse, and lack of specific
measures and services. Poverty is the single most pressing challenge to the welfare of
older persons.
Poverty is characterized by homelessness, malnutrition, unattended chronic
diseases, lack of access to safe drinking water and sanitation, unaffordable medicines
and treatments and income insecurity. Despite their own poverty, older persons are
oftenthe main providers for the household and the primary caregivers forgrandchildren
and other family members. The report emphasizes that all of these questions should be
viewed through a human rights prism, in developed and developing countries alike.
While it is encouraging that the suffering of older women receives growing
attention in society, it is also recognized that a lot needs to be done to protect their
rights. This article brings to light the situation of a group of grandmothers in South
Africa and their right to adequate food. Very little research has been done with
emphasis on grandmothers and their rights. There is reason to believe that many of
them are not able to enjoy their own basic needs to food, health and care, due to poverty
and their role as head of the households having to provide for both children and
grandchildren. The study on which the article is based explored the challenges they
face in light of general poverty and the role of social grants in South Africa, aimed at
children and elderly people.
II. ELDERLY WOMEN AND POVERTY IN SOUTH AFRICA
In general, women in peri-urban and rural areas of South Africa are most often the
primary caregivers of the children, and thus prevented from working and earning an
income compared to their male counterparts. In turn, lack of money precludes them
from buying food, and in rural areas they have to produce food for themselves through
subsidized farming. This is challenging, as they cannot afford to pay for land, seeds,
fertilizers or water.6
The women are also more vulnerable than men to interpersonal
and domestic violence, emotional and alcohol abuse, illiteracy, malnutrition and
pesticide exposures, all of which worsen their quality of life.7
Moreover, the discrimination continues as they get older. As the women age,
6. E. Lahiff, Land Rights, in SOCIO-ECONOMIC RIGHTS IN SOUTH AFRICA (S. Khoza ed., 2007),
at 200-201.
7. Y.BOWERS,ET AL.OBSTACLES TO THE RIGHTS OF ACCESS TO HEALTH CARE FOR FARM WORKER
WOMEN IN THE WESTERN CAPE (2009).

they usually outlive the men and are then faced with an even bigger challenge, namely
to provide for their families without the means necessary for doing so due to lack of
necessary skills and opportunities to earnanincome.8
Additionally,researchhas shown
that according to many African cultures, relatives (specifically grandmothers) are
obliged to cope with the care of orphans when parents die at a young age, especially
from HIV/AIDS.9
Families that are affected by this disease are often caretakers for
terminally ill mothers, and their children remain as part of the household after her death.
In large households, grandmothers often look after both their children, grandchildren
and even their own parents, leaving them in great despair.
Since the end of apartheid in 1994, the South African Government has used
differentapproachestoaddresspoverty andinequality includingsocial protection inthe
form of governmental grants, which has proven to reduce the poverty rates and provide
progressive realization of the right to food.10
The social grants are financed through tax
revenue; the Child Support Grant (CSG) and the Old Persons Grant (OPG) are the
largest in scale.11
In 2008 and 2009, the number of beneficiaries of the CSG was 9 million, while
the OPG had 2 million recipients.12
Some households are not benefitting from the CSG
despite eligibility, and the pensions tend to be shared among the members of often large
households where the pensioners are the primary caregivers. Lack of institutional
integration and requirements for identity documents are preventing some groups of the
poor from accessing the grants, rural population being especially vulnerable to this
exclusion.13
The fact that people who are eligible for social grants in practice receive
very little or nothing at all, is of major concern.14
The applicable grants, their amounts
and eligibility criteria are summarized in Table 1 below.
8. Report of the Secretary-General to the General Assembly, supra note 2.
9. B.M. Mayosi, A.J. Flischer, U.G. Lalloo, F. Sitas, S.M. Tollmann & D. Bradshaw, The
burden of non-communicable diseases in South Africa. 374 LANCET (2009), at 9.
10. J. HAGEN-ZANKER & J. MORGAN, SOUTH AFRICA’S CASH SOCIAL SECURITY
GRANTS: PROGRESS IN INCREASING COVERAGE. OVERSEAS DEVELOPMENT INSTITUTE
(ODI); M. LEIBBRANDT, I. WOOLARD, A. FINN & J. ARGENT, TRENDS IN SOUTH AFRICAN INCOME
DISTRIBUTION AND POVERTY SINCE THE FALL OF APARTHEID. OECD SOCIAL, EMPLOYMENT AND
MIGRATIONWORKING PAPERS, NO. 101.
11. M. LEIBBRANDT et al, id.
12. Report of the Secretary-General to the General, supra note 2; South African Social Security
Agency (SASSA). 2008/09 Annual Report, retrieved from <http://www.pmg.org.za/report/20100216-
south-african-social-security-agency-sassa-annual-report-200809> (accessed 14 November 2013).
13. Report of the Secretary-General to the General, supra note 2.
14. Lahiff, supra note 6.

A. Human Rights Focus on the Food Security Situation of Grandmothers
The socioeconomic factors regarding food and nutrition in South Africa appear to be
contradictory.15
While the national food supply is adequate, the country is still faced
with challenges regarding malnutrition, hunger and food insecurity.16
Moreover,
although the per capita income is high compared to other developing countries, the
income is not equally distributed. As a result, the poor are prevented from accessing
the available food.17
The human right to adequate food is recognized in the Universal Declaration
of Human Rights, 1948 (UDHR, Article 25) and further elaborated in the International
Covenant on Economic, Social and Cultural Rights (ICESCR, Article 11.1 and 2). Yet,
the understanding of these and other socio-economic rights is often unclear when it
comes to the corresponding obligations. The broader content of the right to adequate
food was clarified through interdisciplinary conceptualisation and research,18
and civil
society engagement19
basically between the 1980s and 1990s. This prepared the ground
for the standing official interpretation of this right in General Comment No.12 on the
Right to food by the UN Committee on Economic, Social and Cultural Rights (CESCR)
in 1999,20
followed by General Comment No.14 on the right to health in 200021
and
15. E.M. Maunder, S. Khoza, P. Kuzwayo, W.B. Eide, A rights-based approach to community
nutrition in South Africa, in COMMUNITY NUTRITION TEXTBOOK FOR SOUTH AFRICA: A RIGHTS-BASED
APPROACH (N.P. Steyn & N. Temple eds., 2008), at 2, 27.
16. M. de Klerk et al. Food Security in South Africa: key policy issues for the medium term.
Human Sciences Research Council.
17. Id. See also OHCHR, supra note 5.
18. A.EIDE,W.B.EIDE,S.GOONATILAKE &J.GUSSOW OMAWALE (EDS.)FOOD AS A HUMAN RIGHT
(UNITED NATIONS UNIVERSITY PRESS, 1984); K. TOMASEVSKI & P. ALSTON (EDS.) THE RIGHT TO FOOD.
NETHERLANDS INSTITUTE OF HUMAN RIGHTS (SIM), MARTINUS NIJHOFF PUBLISHERS, UTRECHT. 1984; UN
Sub-Commission on the Promotion and Protection of Human Rights. The right to adequate food as a
human right. Final Report by Asbjørn Eide. UN doc. E/CN.4/Sub.2/2987/23 subsequently published in
1989 as UN Human Rights Studiy Series No.1, Geneva and New York. 1989; A. Oshaug, W.B. Eide &
A. Eide, Human Rights: A Normative Basis for Food and Nutrition-Relevant Policies, 19 FOOD POLICY
(1994), 491–516.
19. See for example M. Windfuhr, Experiences from case related right to food work: lessons
learned for implementation, in W.B. Eide & U. Kracht (eds.) Food and human rights in development. Vol.
II Evolving issues and emerging applications. Antwerpen-Oxford, Intersentia. Ch.13, at 351-358. 2007.
20. CESCR (UN Committee on Economic, Social and Cultural Rights). General Comment No.
12: The Right to Adequate Food (Art. 11 of the International Covenant on Economic, Social and Cultural
Rights). May 12, 1999.
21. CESCR, General Comment No. 14: The right to the highest attainable standard of health
(Art. 12 of the International Covenant on Economic, Social and Cultural Rights). August 11, 2000.

No.15 on the right to water in 200322
elaborated within a similar conceptual framework.
While the South African Government has still not ratified the ICESCR, its
commitment to food and nutrition is strongly reflected in the Constitution of South
Africa. Article 27 of the Bill of Rights guarantees the right of all people of South
Africa to health care, food, water and social security.23
In practical terms, it means that
the Government is obligated to ensure that nutrition security (incorporating security of
food, health and care) is respected, protected, promoted and fulfilled as a basic human
right.24
As the Government is also committed to social protection for the needy through
the provision of social grants listed above, it is of interest to see these in relation to the
possible contribution of these grants to the right to food of the recipients. This article
is an input to understanding the links between the two as regards poor grandmothers in
charge of supporting and feeding their grandchildren. It is a qualitative study with a
partial human rights based approach also to its conduct, seeking selected poor
grandmothers’ own perceptions of their situation by having them talk and share
experiences in a participatory manner in focus groups.
III. RESEARCH METHODOLOGY
A. Study Area
Two communities in the Breede Valley, Western Cape were used as research sites:
Zweletemba and Avian Park in the Worcester area, with 35 000 and 10 000 residents,
respectively.25
In Zweletemba, the unemployment rate is approximately 32% and the
majority of the residents have either some primary or secondary schooling. In Avian
Park, the unemployment rate is about 21%, and the majority of residents have some
secondary schooling. Both communities include both formal and informal housing.
Tuberculosis and HIV/AIDS rates are high, as is the prevalence of babies born with low
birth weight.26
22. CESCR, General Comment No.15: The right to water (Arts. 11 and 12 of the International
Covenant on Economic, Social and Cultural Rights). 2002.
23. See http://www.who.int/healthinfo/survey/ageingdefnolder/en/.
24. Report of the Secretary-General to the General, supra note 2 3.
25. Breede Valley Municipality, Integrated Development Plan 2007-2011, retrieved from
<http://www.westerncape.gov.za/text/2008/3/idp_cw_breede_river_winelands_2007.pdf> (accessed 14
November 2013).
26. Id.

B. Study Participants
The participating grandmothers to be recruited had to satisfy the following inclusion
criteria: They were required to be living in Zweletemba or Avian Park for more than 3
days a week in the same household with at least one grandchild, supporting the
grandchildren financially, and who spoke any of the following local languages:
Afrikaans, English or isiXhosa.
Due to the high expenses and limited logistics of the study, the sample size was
limited to 40 grandmothers. Participants were stratified according to age and location
(Zweletemba or Avian Park). The participants were divided into eight groups, with a
total of five persons in each group. The participants were divided equally basing on
age, i.e. either 60 years and above or below. The age of 60 is the cut-off age for the
grandmothers eligible to receive the OPG and for one to qualify for this grant.
Grandmothers were excluded from participating in the study if they were used as key
informants to recruit participants, or having participated in a pilot study during the
pretesting of the various research instruments. The field workers used their social
networks to identify potential candidates.
To develop a deeper understanding of grandmothers’ situation, in-depth
interviews were conducted with ten key informants. Some of these were English-
speaking government staff whose duties were related to the realization of the right to
food, located in the area of Worcester. They were all identified by the researcher and
invited to participate, and these included: two ministers, one from each of the
communities (Zweletemba and Avian Park); a member of a church organization in
Zweletemba; a member of the church/volunteer in the church in Avian Park; a
worker at a health clinic in Zweletemba; a worker at the multipurpose community
center in Zweletemba; a worker at the municipality in Worcester, located in Avian Park;
a worker at social services, family affairs; and two workers at the social services
department of social development.
C. Study Design
The study was conducted in February 2012. A mixed-method approach was followed.
A qualitative study design using focus group discussions was adopted to obtain
information about the personal views, cultural practices, beliefs and experiences of the
grandmothers.27
The focus groups were facilitated by a trained field worker and
27. M. Dalen, Intervju som forskningsmetode: -en kvalitativ tilnærming. Second edition. Oslo:
Universitetsforlaget; 2011.

discussions lasted from two to three hours. Each session was recorded using two digital
recorders, to be sure no material would get lost if one stopped working during or after
the discussions. Field notes on non-verbal communication and group dynamic were
written down by a second field worker who did not facilitate the discussion. The
researcher also took notes on this to supplement the recordings.
Quantitative methods were also applied, and this entailed a questionnaire for
the grandmothers who participated in the study, for information regarding who was
head of the household and the households’ financial situation. Completion of this
questionnaire at their homes was considered the best way to get the participants to
answer all the questions in an open and honest way, with only one of the local field
workers present and no one else listening, as some of the questions were of a sensitive
nature. A questionnaire in form of a hunger scale was added as it provides a proxy for
assessment of food insecurity.28
The questions related to food access and intake that
give indications of food shortage problems and hunger.
A structured interview guide was prepared for the key informants. These
interviews were conducted by the researcher, at venues chosen by the participants and
considered appropriate for interviewing and recording. The interviews were conducted
in English and lasted approximately 30-40 minutes. A local translator assisted the
researcher in translating the focus group discussion guide, the structured interview
guide and the questionnaires from English into two of the local languages Afrikaans
and isiXhosa.
D. Data Analysis
After gathering the data, one local translator from each of the areas helped transcribe
the focus group discussions into English. The data from these and the key-informant
interviews were coded and analysed using the software programme, Atlas TI version.
The questionnaires were analysed by summarizing the responses and converting them
into percentage. When analysing the responses to the Hunger Scale Questionnaire, a
standardized procedure was used as follows29
: A score of five or more, i.e. five
affirmative/positive (Yes) responses out of a maximum possible of eight indicated a
food shortage problem affecting everyone in the household. These families could be
considered as "hungry". A score of one to four indicated that the family was at "risk
28. G. Gericke, D. Labadarios, J.H. Nel, Hunger scale questionnaire: A measure of hunger,
retrieved from <http://www.sahealthinfo.org/nutrition/food8hungerscale.pdf> (accessed 14 November
2013).
29. Id.

of hunger". A negative response (No) was assumed to mean a food secure household.
Further analysis of the data included the frequency of an affirmative or negative (Yes
or No) response for each of the eight questions.
E. Ethical Considerations
Approval for the study was obtained from the Health Research Ethics Committee of the
Faculty of Medicine and Health Sciences, University of Stellenbosch (N11/11/318).
The study was carried out according to the International Conference on Harmonization
of Technical Requirements for Registration of Pharmaceuticals for Human Use and the
Medical Research Council of South Africa guidelines and conducted in full accordance
with the ethical principles of the World Medical Association Declaration of Helsinki.
Written informed consent was obtained from the grandmothers as well as the key
informants willing to participate in the study. They also provided consent to allow
voice recordings of the discussions and interviews. All participants were provided with
information and copies of the consent form. Information and consent forms were
available in the three commonly used languages.
All participants were informed that any participation in the study was
voluntarily, that they were free to withdraw at any stage and that refusal to participate
would not in any way compromise them. Participants were also informed that all data
collected was being handled confidentially to ensure their identities would not be
revealed at any one time.
IV. RESULTS OF THE STUDY
The majority of the households represented in this study consisted of agrandmother and
four other adults. The number of grandchildren living in these households varied from
one to eleven, usually two to four grandchildren. It was observed that many of the
grandmothers were overweight while others were underweight. Several of the focus
group participants reportedly suffered from diabetes and other non-communicable
diseases.
A. Food insecurity
The results from the hunger scale questionnaire strongly indicated that overall, the
households represented in this study were indeed experiencing food insecurity. As
much as 44 out of 45 (98%) households experienced hunger. However, when asked
about the frequency of experienced food insecurity, the percentages declined as could

be expected. For example, as many as 40% of the participants responded “no” to the
question if any of the children or grandchildren ever went to bed hungry due to lack of
money.
B. The grandmothers’ role as primary caregivers in the households
As much as 76% of the grandmothers reported themselves as being the head of the
households. Only 17% dedicated their husbands to this role, and a few (7%) reported
one of their own children being the head of the household. Their grandchildren were
not considered head of the household. Even more (87%) responded that they were also
the one responsible for ensuring the households had enough food. Only 11% of the
grandmothers reported that one of their own children had this responsibility, and 2%
said this was the responsibility of a grandchild. A total of 93% “strongly agreed” when
asked if they felt responsible for feeding the members of their households. Only two
“agreed”, while one “disagreed”.
Thegrandmothersenvisionedthemselvesasbeingtheprimary caregiversinthe
households with many responsibilities, such as getting food and clothes for everyone
in their homes, as well as paying for medication, tuition for the children and
instalments. Their responsibilities also included bathing, feeding and caring for their
grandchildren. The grandmothers reported not only living with their grandchildren, but
some also lived with their own children and even foster care children. They discussed
how living with their grandchildren affected them both economically and emotionally,
and how it impacted their access to food. They reported spending all their money on
the children, which resulted into their failure to meet their needs.
There were also stories told about how they were treated by their children, and
how their daughters forced them to take care of their babies. The grandmothers further
reported struggling and worrying about their grandchildren. Their concerns evolved
around how they would be able to feed the children, and especially the ones that were
HIV positive and needed food to take their medication. One respondent stated that it
is worse when you`re living with sick children, not knowing what you`ll do when it
comes to food.30
C. The grandmothers’ role as financial provider for the households
The majority of the grandmothers (78%) viewed themselves as being the main
30. Interview with a grandmother, aged below 60 in Zweletemba.

providers of the households. Only 11% reported that the husbands were the main
providers, and even fewer (9%) their children. Only 13% of the grandmothers reported
that a salary was the most important source of income.
All grandmothers responded that their households received one or more
government grant. The most important source of incomeinthehouseholds was reported
by 62% of the grandmothers to be the OPG and 20% reported that the CSG was the
most important. A total of 98% of the respondents ranked the income from the grant
to be “very important” for their access to food. Only one of the grandmothers
responded that the grant money was “of little importance”. When asked what the
money in the households was mainly spent on, food clearly stood out as the main item
for expenditure among 98% of the households.
Although several alternative options were given, there seemed to be an
agreement among the grandmothers that there were mainly two constraints to their
ability to provide all the food they needed. Lack of income was reported as the biggest
constraint by the majority (80%) of the grandmothers, while 20% reported the food
prices as their main challenge.
The key informants confirmed that the grandmothers’ economic access to food
within the households was generally limited. There were several reasons for this, such
as grandchildren taking the money from the grandmothers, the grant was too small for
the grandmothers to be able to provide the households with food on only her monthly
salary and costly food. One of the informants described how the grandmothers used
their money on the grandchildren by “getting the children to be comfortable, given that
they might be of schooling age”. Furthermore, one informant explained how some
households spent the grant money on alcohol and drugs.
D. The grandmothers’ reflections regarding the older persons grant
The grandmothers were asked about the OPG and if that money was spent on
themselves as the receivers. The grandmothers seemed to be coherent in their
responses. Their money seemed to mainly be spent on the members of the household,
health care expenses and fixed costs such as electricity. To make ends meet was
challenging “because there is clothes, food, uniform and school stuff with this little
money that we receive.”31
Several of the grandmothers expressed dissatisfaction regarding the amount of
money they received, and some explained that the money was too little to buy food.
31. Interview with a grandmother, aged above 60 in Zweletemba.

Although there was clearly some dissatisfaction with this grant, one of the
grandmothers said that because the money was just given to them, they could not
complain about it. She emphasized the need to be smart with the money and buy food
because: “food is the most important thing that we buy because we stay with
grandchildren, we have to feed them, there always has to be food for them.”32
Their love and commitment for their families were apparent in their responses.
Many reported not being able to passively see that the children or grandchildren did not
have something to eat. They were also concerned with the future of their grandchildren
and put the children`s needs before their own. One grandmother said that it was:
“better than nothing because you know at the end of the month you`ll receive the grant
and be able to buy the necessities of the household”33
E. The grandmothers’ perceptions of reasons for not receiving social grants
Members of one of the focus groups claimed that even though the women aged 60 and
above were applying for the OPG, few in fact received it. The grandmothers mainly
gave three different reasons for not receiving a grant. Some of them discussed the fact
that they had to meet in person to apply for a grant, whereas others did not apply
because they did not want: “to sacrifice their time”.34
Furthermore, doctors could
decide that they were not eligible for applying for a grant. Another main reason for not
receiving a grant despite eligibility was the requirement for identity documents which
many older persons do not have. The grandmothers reported that people were
struggling without proof of identity.
F. The grandmothers’ perceptions regarding who was looking after them
The grandmothers were clear in their answers about who was looking after them. It
seemed that it was either the neighbours or children who looked after them, although
many of the grandmothers did not have any support or assistance as “everyone has their
own problems.”35
One exception was a man from one of the church organizations who
sometimes would give bread to the children if the grandmothers approached him for
help, but this did not seem to happen on a regular basis.
34. View of a grandmother aged less than 60 from Avian Park.
35. View of a grandmother aged below 60 in Zweletemba.

G. Help from the community in the context of food, money or water
The discussion regarding help from the community for food, water or money was
unambiguous. The grandmothers reported not receiving any help from anyone. There
seemed to be lack of knowledge about who to turn to in this context as they did not
know the leaders of their communities.
H. Alternative food sources in times of no money
Thegrandmothersreportedborrowingmoney intimeswhenthey werelackingfoodand
money. They also emphasized the importance of paying back their debts, with interest,
to be able to borrow money again. A grandmother stated how some people were
stealing to feed their children. Several of the grandmothers went to the garbage bins
in desperate need of food when they had no money. Others mentioned people they
turned to in times of need, including family members and neighbours to “ask around
for something to eat, potatoes or flour just so that we can have something to eat”.36
Other options for help were also discussed. However, there was some doubt regarding
where and who they could turn to for help in times of need. Someone mentioned Home
Based Care; others stated how they had received food parcels from the social services
when they needed help to get them through a difficult period.
I. Food production, preservation and alternative source of income
The grandmothers said there were few vegetable gardens in the communities. Reasons
offered for the lack of vegetable gardens were the environment in which they lived, the
poor quality of the soil, the high water bills, theft and water contamination. When
asked about food preservation, only one of the grandmothers reported that she
preserved food by putting the food in plastic bags and freezing it.
J. The grandmothers’ suggestions to improve their situation to achieve their
realization to the right to food.
The grandmothers expressed many thoughts and ideas on how to improve their own
situation, as well as their community in general. Education was especially highlighted,
as most of the grandmothers did not have the opportunity to attend school in their
36. View of a grandmother from Avian Park aged 60 and above.

childhood. The grandmothers further expressed that they wanted the government to
provide them with food parcels, preferably on a regular basis, and to assist them in
buildinghouses in order to improve their livingconditions. Suggestionsweremadethat
the transportation taking the children to school and the crèches ought to be free of
charge, and they also proposed that the government could provide the children with
school clothes.
Another important topic for discussion was that they wanted the government
to create jobs for them, e.g. provide assistance in creating food gardens. The
grandmothers wished that the government could contribute to progress in the
community, as well as take action to protect grandmothers against abuse and make them
feel safe. One of the key informants emphasized the importance of trying to prevent
the young mothers to be able to just leave their babies with the grandmothers, through
legislation. There is a need to create more shelters for foster care as children living on
the streets are getting placed with grandmothers, even though they were not related.
While one key informant felt that the government could increase the grant
money, several of the informants mentioned that they felt the government could have
created jobs for the grandmothers, for example, sewing, gardening, beading, painting
and creating items they could sell. Others emphasized the need for the social workers
to go around looking where the grandmothers were staying and get to know their
situations to possibly be able to help.
Another suggestion was togivethegrandmothersvouchers to thesupermarkets
to get “the food that they know are healthy”.37
This informant thought that in this way
the government would ensure they ate proper food. Another informant suggested that
government should hand out food vouchers according to the number of people living
in that specific household.
Reportedly, feeding schemes providing one meal per day had been in place
earlier but lack of financial support prevented them from maintaining the service. One
informant suggested handing out of food parcels, which was contradicted by another
who emphasized the importance of not just giving the grandmothers food or money as
that might create a bigger dependency on charity. The government should rather aim
at empowering them to produce their own food and livelihoods, and “create some
gardens or things like that, to have a sustainable food supply.”38
37. View of a Priest from Avian Park.
38. View of an employee at a health clinic in Zweletemba.

K. Adequacy of resources according to key informants
According to the key informants, lack of resources and money in addition to the number
of grandchildren residing in the households, affected the food distribution as the focus
was mostly on children and thus the food for grandmothers did not last. There seemed
to be some contradictory opinions held by key informants regarding the dietary
adequacy of the food available for the grandmothers. Some of the key informants who
supported dietary adequacy explained that especially grandmothers with diet-related
health problems, like hypertension, followed the doctor`s instructions on what to eat
and took care of their own health. Others regarded the food as being nutritious and
adequate, “at least if it was bought from the shops”.
Several of the informants doubted the dietary adequacy of the food. The main
reason offered was that access to adequate food was related to the poor economy and
lack of knowledge. One informant was of the opinion that the bread they bought was
so cheap and had a low nutritional value - “to accommodate the poorest of the poor”.
Some also talked about how having little money and many mouths to feed made the
grandmothers buy “something that can feed a lot of people, so it`s not always
adequate”. Racial inequalities were also mentioned: “The white, they are the people
that can buy food that is healthy, but our people in Avian Park, they can`t afford
healthy foods”.
Sadly, one informant mentioned that the diet of the grandmothers ultimately
made them sick. He stated how people (including grandmothers) went to the dumping
site to find food they could both eat themselves as well as bring home to their families,
for example, dead chickens dumped on these sites, by a factory. The hungry people
ignored that they could get sick, not knowing why it was thrown away or how they
were stored.
The majority of the informants reported that the grandmothers did have access
to culturally acceptable food. However, a few informants explained how the
grandmothers sometimes had to eat what was available, not having the chance to take
special considerations. Only few of the key informants believed that the grandmothers
had adequate physical access to food within the households. One explained that it
depended on how the grandchildren were raised, saying that if they did not respect the
grandmother then they would most likely not have easy access to food in the household:
“And when they mistreat you, no, you won`t have access to the food”.
L. The grandmothers’ knowledge of human rights and the right to food and water
The grandmothers were asked about their awareness of human rights, especially in the

context of food and water. The responses to this question were vague. Some said they
did not have any knowledge regarding their rights while others seemed to have more
knowledge on the subject, but without being able to elaborate on the topic.
M. Roles and responsibilities of key informants in relation to the grandmothers’ right
to food
One informant stated that her job going from door to door on a daily basis in an attempt
to try and change the mind-set of people living under poor conditions, also regarding
food and water. Others explained how their role was to refer the grandmothers that
needed assistance, to the Family and Marriage Society of South Africa and the
department of social services. Another said that his role was to educate the people, and
address problems he came across. One informant told how they sometimes gave out
food parcels and clothing to help the people in times of need.
Another informant reported that their role was to compile a database of people
who were in need and to give the information to the South African Social Security
Agency. The informant further explained that they worked with “various stakeholders,
our NGO`s, and the various departments”.
N. Policies and programmes in the context of the right to food.
There seemed to be some inconsistency in the grandmothers’ answers to the question
about existing policies and programmes to promote the right to food. One told that the
ruling party, the African National Congress, and other politicians around election-time
gave the grandmothers some food and blankets, just to get their votes.
In both Avian Park and Zweletemba, people aged 60 and above could go to a
service center and contribute a minimal amount of money. They would then get a plate
of nutritious food: “For every day, every day of the week, 5 days of the week”. Another
informant talked about the Social Relief of Distress programme managed by the
community development section, and that people earning less than R1000 per month
could apply for financial assistance for a period of two months.
The grandmothers reported inaction on part of government in spite of
unsolicited living conditions. None of the grandmothers knew of any existing policies
or programmes in the communities to fulfil their need to food or water. One
grandmother answered: “We only see at other places where people are given food

vouchers, there`s nothing like that here in Worcester.39
All the key informants reported that the water available for the grandmothers
was adequate, safe for consumption and environmentally sustainable. They said the
water was being controlled by the municipality, and if there were any problems, the
municipality would sort it out. There seemed however to be different views on whether
the water was physically accessible for the grandmothers. Some of the informants said
there was no problem with the grandmothers’ access to water, explaining that the taps
was conveniently located to allow access to water for all. Others explained how
walking to fetch water could be a problem for the aged, living in the informal
settlements, where they would have to leave their homes to collect water. One
informant made a suggestion of making water more easily accessible for people without
walking long distances. The suggestion was that the government could have a truck
with water driving around to those who had difficulties getting it themselves, and at the
same time this would create jobs for the locals.
The key informants reported that water was economically accessible for the
grandmothers. They reported that the ones living in brick houses had their own taps in
their yards and were entitled to receive a certain amount of water for free, but that they
paid for additional water consumption. The people living in shacks, however, did not
have to pay for the water as they only had access to community taps placed by the
municipality. Grandmothers who received OPG, made arrangements with the
municipality to pay a reduced amount each month for the water and the municipality
did not terminate the services if they failed to pay their bill.
IV. DISCUSSION
A. Methodological Considerations
Qualitative approaches are considered useful to gain in-depth information about the
participants’ perceptions, thoughts and beliefs, which provide information that cannot
be retrieved when applying quantitative study designs alone. However, there are some
limitations identified with using qualitative approaches. It is both time and resource
consuming, which in turn limits the number of participants, thus couldn’t be regarded
as a representative sample. The analysis of qualitative data is challenging and can lead
to researcher bias due to subjectivity. Researchers must be restrictive in terms of
making generalized conclusions when applying qualitative study methods.
39. View of a grandmother in Zweletemba, aged 60 and above.

All the participants (grandmothers and key informants) in this study were
selected on the grounds that they could contribute valuable information relevant to the
investigation. Furthermore, the key informants were working and living in the area of
Worcester, and thus were knowledgeable of the living conditions and cultural practices
in the relevant communities, as well as relevant policies and programmes pertaining
older persons.
B. Summary of the main findings
In general, it was found that living under the strain of poverty clearly affected the
grandmothers’ access to food, lacking money and having to provide for large
households. Food insecurity appeared to be prevalent in the two communities and
affecting people of all ages. Furthermore, the difference between the grandmothers
eligible for receiving the OPG and the ones who were not was not as evident as might
be expected. There were indications that the grant money received by the grandmothers
did not even enable them fulfil their basic needs. The grandmothers reported their
money being spent by all members of the households with very little, if anything, left
for their own use. However, the grandmothers receiving the OPG stated how they took
comfort in knowing they would receive that money once a month. The grandmothers
aged 60 and below did not have the same privilege. The study did not find any apparent
differences regarding the grandmothers’ role in the household in terms of age (< 60 or
> 60 years) or residence (formal/informal, Zweletemba/Avian Park). The evidence
points towards the grandmothers having the same role as primary caregivers in the
households regardless of these factors.
C. Analyses of the Main Findings
1. The grandmothers’ role as primary caregivers—To appreciate the
grandmothers’ role as primary caregivers, an understanding of the household
composition is important. The majority of the households represented in the study
consisted of a grandmother and four other adults. The number of grandchildren living
in these households was usually two to four grandchildren. A study investigating
household structure and composition in rural parts of South Africa from 1992 to 2003
found that average household size decreased, while the proportion female headed
households increased.40
This is consistent with the finding of the present study.
40. S. Madhaven & E.J. Schatz, Coping with change: Household structure and composition in
rural South Africa, 1992 – 20031.35, SCAND. J. PUBLIC.HEALTH (2007), at 2.

Furthermore, Madhavan and Schatz argued that the reason for this change is not solely
causedby theincreaseofHIV/AIDS.41
They emphasizedthe importanceofconsidering
all the post-apartheid changes, such as democratization, freedom of movement as well
as unemployment as contributors to the changes in South African rural household
composition.
Being a grandmother within the African context is different from their Western
counterparts. They are often younger in age and responsible to on the role as head of
the household. When the daughter in a household becomes a mother herself, the
findings from this study show that her mother is often left with the responsibility of
both her own children and her grandchildren. Some of the adolescent mothers
disappear, often migrating to other places for work or whatever other reason, leaving
their children with the grandmothers. Evidence has shown that also when daughters
marry men other than previous children’s fathers, they often leave their children in their
own mother’s care.42
Grandmothers living in South Africa’s poorer communities
struggle with challenges related to girls getting pregnant at a young age. This is a
phenomenon familiar on the African continent,43
which impacts negatively on the food
security in the household.
According to the United Nations Population Fund (UNFPA), the reasons for
young girls getting pregnant are numerous and they are unable to take care of their
babies both mentally and physically. This, according to UNFPA, results in the young
mothers compromising their future and facing poverty, poor health, and dropping out
of education,44
leaving them ill-equipped to ensure food security for themselves and
their babies. This adds to the grandmothers’ burden of responsibilities. However, the
absence of young parents in the household does not appear to be the only reason for the
grandmother being the primary caregiver of her grandchildren, they sacrifice their own
needs as they become the primary caregiver, encouraging their daughters to complete
their education, caring for her children and grandchildren, providing food and clothing
to all household members, paying school fees and medication, using her older persons
grant. This is consistent with the findings of another study which reported that older
women in fact act like surrogate parents to their grandchildren which is consistent with
41. Id.
42. E.J. Schjatz, Taking care of my own blood: Older women's relationships to their households
in rural South Africa, SCAND J. PUBLIC HEALTH (2007).
43. UNFPA, Giving Girls Today and Tomorrow: Breaking the cycle of adolescent pregnancy,
a v a i l a b l e a t
<http://www.unfpa.org/webdav/site/global/shared/documents/publications/2007/giving_girls.pdf>
(accessed 14 November 2013).
44. Id.

the findings of this study.45
2. The grandmothers’ right to adequate food—The evidence points towards
the grandmothers having very little knowledge on the subject of their right to adequate
food. However, although the participants did not have an in-depth understanding of the
concept of the right to food, they were indirectly talking about their rights during the
focus group discussions as they were in despair talking about their lack of money and
hence food, as they sacrificed their own needs to be able to feed the children in the
households.
It became evident that many of the grandmothers for the most part did not have
access to nutritious food. It is widely reported in the literature that “the double burden
of malnutrition is a paradox caused by poverty, hunger, and food insecurity”.46
Many
of the grandmothers in this study appeared to be overweight while others were
underweight. It is evident that the transgression of the grandmothers’ right of food
impact on the realization of their right as health as well. Several of the participants
suffered from diabetes and other non-communicable diseases associated with
inadequate diets. Women and older persons are not usually economically active thus
it was not surprising that few of the participants reported salary to be the most important
source of income. Furthermore, one quarter of the South African labour force is
unemployed47
andthehistorically disadvantagedgroups,females,uneducatedandyouth
are worse off.48
AlthoughSouthAfricahasexperiencedhigheremploymentratesand increased
economic growth since the end of apartheid in 1993, the country has not kept up with
the increased need for labour force. There were strong indications that the grant money
was very important for the grandmothers’ access to food, which proved to be the
biggest item of expenditure for the study population. This entailed all forms of
government grants. These findings could be expected as food insecurity and hunger
was highly prevalent in the communities. An investigation of the cash transfers to the
elderly in South Africa in 1998 indicated that the OPG proved to benefit all members
45. See http://www.who.int/healthinfo/survey/ageingdefnolder/en/.
46. S.A. Tanumihardjo et al, Poverty, Obesity, and Malnutrition: An International Perspective
Recognizing the Paradox, 107 J. AM. DIET. ASSOC. (2007), at 1966.
47. M. Makiwane & E. Udjo, Is the Child Support Grant associated with an increase in teenage
fertility in South Africa?: Evidence from national surveys and administrative data, available at
<http://www.hsrc.ac.za/en/research-data/ktree-doc/1337> (accessed 14 November 2013).
48. V. Arora, L.A. Ricci, Unemployment and the Labor Market, retrieved from
<http://www.imf.org/external/pubs/nft/2006/soafrica/eng/pasoafr/sach3.pdf> (accessed 14 November
2013).

of the household.49
Furthermore, the OPG has been called “an effective tool of redistribution”,
since it predominantly reaches poor households. Case and Deaton argued that the OPG
is in fact making the older persons the principal earners of the households, and that the
decision-making powers can be directly linked to their earnings.50
Moreover, the OPG
protects the younger members of the households against adverse lab or market
conditions in rural South Africa.51
The results from this study did not show large disparities among those eligible
for the OPG compared to those who were not. Both groups seemed to be lacking
money. However, the women aged above 60 expressed relief of knowing they would
receive grant money at a certain point in time. This was not the case for the
grandmothers aged less than 60 years.
Receiving a social grant requires supporting documentation which has proven
to be a key barrier to social grants access.52
Such documentation may include children’s
birth certificates, official bar-coded identity books for adults, and/or legal orders of
foster guardianship. The data from this study suggested that despite eligibility, not
everyone had access to the social grants. This is something that should be addressed
as a matter of urgency by the Government, as part of the obligation to respect, protect
and fulfil the right to food enshrined in the South African Constitution.
3. Policies and programmes relevant for the right to food of
grandmothers—The grandmothers seemed to be unaware of the various policies and
programmes instituted by the South African government to facilitate their right to
adequate food and to promote food security. It may be due to a lack of understanding
of the right to food as both the grandmothers and key informants related their opinions
in terms of political events rather than empowerment of the community to increase their
49. A. Case & A. Deaton, Large Cash Transfers to the elderly in South Africa, THE ECONOMIC
J O U R N A L ( 1 9 9 7 ) , a v a i l a b l e a t
<http://www.princeton.edu/~accase/downloads/Large_Cash_Transfers_to_the_Elderly_in_South_Afric
a.pdf>.
50. Id.
51. S. Keller, Household formation, Poverty and unemployment – the case of rural households
inSouthAfrica,availableat<http://ideas.repec.org/p/sza/wpaper/wpapers9.html>(accessed14November
2013).
52. M. Samson, K. MacQuene & I. Van Niekerk, Policy brief 1: Inter-Regional Inequality
Facility sharing ideas and policies across Africa, Asia and Latin America. Social grants South Africa,
retrieved from <http://www.odi.org.uk/sites/odi.org.uk/files/odi-assets/publications-opinion-
files/1688.pdf> (accessed 14 November 2013).

resilience in terms of food security.
4. Human rights reflections—In a human rights perspective, all governments
have obligations or duties to respect, protect, fulfil, (facilitate and/or provide) every
human right.53
The government is responsible for ensuring that a right can preferably
be legally established and thus legitimately claimed by all members of society. Firstly,
the grandmothers reported suffering from extreme poverty and severe household food
insecurity. The support from the government was manifested in their access to safe and
clean water in addition to the monthly provision of social grants, which however proved
inadequate to help realize the grandmothers’ right to adequate food when living with
grandchildren, in part due to inaccessibility to the grants.
Secondly, to be able to claim their rights, the right-holders must be aware of
their rights and responsibilities. The participants reported having very little knowledge
of their human rights and how to claim them, including the right to adequate food.
Education about human rights implies that all government officials are aware of their
duty in realising the right to food of vulnerable population groups, such as the
grandmothers, and they should be empowered to support these groups optimally.
The findings revealed that this group of grandmothers perceive a lack of
government commitment towards their human rights obligations concerning the
grandmothers’ realization of the right to adequate food. General Comments 12 (on the
right to food), 14 (on the right to health) and 19 (on the right to social security) were
developed by the UN Committee on Economic, Social and Cultural Rights (ICESCR)
to assist State parties fulfil their reporting obligations on these rights; adequate food,
health and social security.
Even though the International Covenant for Economic, Social and Cultural
Rights is yet to be ratified by the government, these principles were enshrined in the
1996 South African Constitution. Implementation of the relevant policies and
programmes has been slow. Thus, it appears the principles provided in these general
comments do not fully benefit all segments of the population in South Africa. This
group of grandmothers living in two poor peri-urban areas with their grandchildren
seem almost excluded from the rest of society and are neither able to have fulfilled nor
claim their human rights. To address these concerns, the South African National
Development Plan (SANDP) for 2013 proposes several actions to relieve the burden of
the poor and food insecure population groups and is making renewed effort to remove
barriers to the attainment of human rights of the nation.42
53. UNFPA, The human rights-based approach: Advancing human rights, available at
<http://www.unfpa.org/rights/approaches.htm> (accessed 14 November 2013).

The importance of gender equality and women`s empowerment has long been
recognized. The Committee on the Elimination of all Forms of Discrimination against
Women (CEDAW) “establishes an agenda for national action to end
discrimination”.54
These aspects form an integral part of the SANDP and there is
strong emphasis on the women’s role in decision making positions. Thus, the
government of South Africa aspires to implement initiatives to promote the rights of
women, through endingdiscriminationandensuringanequalsociety wherewomen can
be part of political and public life, have good health, be educated and employed.
Empoweringwomen,includingthrougheducation,haveshown to havepositiveimpacts
on the children, which in the long run may strengthen them when they become
grandmothers.
V. CONCLUSION
South Africa is currently experiencing serious challenges affecting household food
security. For grandmothers, the situation is critical. Instead of being looked after by
their children, they are now taking care of their grandchildren. As a result,
grandmothers living in poor rural and peri-urban areas in South Africa suffer both
physically and economically. By empowering this usually neglected group, there is
reason to believe that all members of their households will benefit.
Thefindingsfromthisstudy strongly indicatedaviolationofthegrandmothers’
human right to adequate food. With high prevalence of food insecurity and hunger,
immediate actions should be taken to relief the poverty in the communities. More data
on the situation of grandmothers and their role as primary caregivers when living with
their grandchildren is needed, especially in the context of their right to adequate food.
The overall aim should be to encourage interventions that can help empower the
grandmothers and women as grandmothers-to-be, as well as getting relevant
stakeholders and duty bearers to commit themselves to ease the situation of this
vulnerable group, promote equality, reduce poverty and eradicate hunger.
54. REPUBLIC OF SOUTH AFRICA, NATIONAL PLANNING COMMISSION. NATIONAL DEVELOPMENT
P L A N , V I S I O N F O R 2 0 3 0 ,
<http://www.npconline.co.za/medialib/downloads/home/NPC%20National%20Development%20Plan
%20Vision%202030%20-lo-res.pdf>, (accessed: 6 February 2014).

EAJPHR, VOL. 20, No. 2 (December 2014)

Recommended

Recommended

More Related Content

What's hot

What's hot (18)

Viewers also liked

Viewers also liked (13)

Similar to EAJPHR, VOL. 20, No. 2 (December 2014)

Similar to EAJPHR, VOL. 20, No. 2 (December 2014) (20)

EAJPHR, VOL. 20, No. 2 (December 2014)