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Why the Covid-19 coroavirus has a seemingly milder clinical course in children than in adults is one of the many unknowns. Picture: iStock/ Coscaron

Fear, sadness and anger: The hidden impact of lockdown on children

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The Covid-19 coronavirus pandemic and measures to prevent its spread have impacted children in some predictable and some less predictable ways.

Kathryn Cleary spoke to experts and children to get a deeper understanding.

After two months in lockdown, issues such as food insecurity and economic hardship have become overtly obvious, but underneath these realities of Covid-19’s effect on South Africa lies the fears and anxieties of some younger voices in society.

Spotlight spoke to experts in child health and child rights about the lockdown’s effects on children, and highlights some testimonies of at-risk children and their parents.

Children still being abused

In Cape Town, the Red Cross War Memorial Children’s Hospital continues to see similar numbers of child abuse cases during the lockdown compared to before.

Although the hospital has seen a decrease in motor vehicle-related accidents, preventable injuries and intentional violence towards children have continued.

Manager of social services for the hospital Carla Brown is concerned that the lockdown may hide the realities of child violence.

“If everybody is home, then there’s vigilance and supervision for children, so on the one hand I hope that children are correctly supervised.

"But we are still seeing the same numbers that we saw before, which means that children are still being raped, beaten, abused, neglected [and] emotionally abused,” she says.

According to Brown, the hospital sees between 45 and 60 child abuse cases a month.

“[Red Cross] sees the worst [abuse] cases from our drainage areas – rapes where children need to go to theatre for [reparative surgery], head injuries where neurosurgeons need to be involved, children who come in with multiple fractures and the very young children who [other hospitals] can’t deal with,” she says.

Since the lockdown started, Brown says there’s been a correlation between gender-based violence and child abuse.

“When we do our investigations, we find that gender-based violence issues exist in these cases as well. There’s been violent acts against the caretaker, the mother, and the child has gotten injured in that domestic violence,” she says.

Brown adds that drug-related abuse is another common thread in children’s injuries during the lockdown.

If everybody is home, then there’s vigilance and supervision for children, so on the one hand I hope that children are correctly supervisedCarla Brown, Manager of social services for the Red Cross War Memorial Children’s Hospital

“The fact that we went through this rapid change, we’ve underestimated how much children have been affected by that,” she says.

“I don’t know what the cloak of lockdown has hidden, and I hope in my heart that children who have needed help [after being] exposed to violence have been able to receive the help that they need, and [that] as we change from one [lockdown level] to the next we’re going to find a lot of children presenting at schools, hospitals and clinics having been injured and abused while this lockdown was happening.”

Acting chief director of child, youth and school health at the national health department Dr Lesley Bamford tells Spotlight that the department is concerned by the potential for an increase in household violence, particularly violence against women and children.

“Currently, we do not have any evidence as to whether or not this occurred, and whether banning alcohol mitigated this risk in any way,” she says.

Are children being isolated?

At Red Cross, Brown says the hospital has managed cases of children and families with Covid-19.

“As a social work department, we immediately provide daily support to such a child and family.”

This includes daily phone calls to check in with the family, intensive counselling to adults and assisting families to link to resources through the social development department, as well as through community action networks and faith-based groups.

“As far as I know, children don’t isolate from their families,” says Brown.

Bamford confirms this, adding that if a child does not need to be isolated, then where possible they would be cared for by another household member, family or friend.

In Cape Town, the Red Cross War Memorial Children’s Hospital continues to see similar numbers of child abuse cases during the lockdown compared to beforeKathryn Cleary

If this is not possible, Bamford says the social development department would need to provide temporary accommodation and care for the child.

“Generally, if a child [tests positive], the adult is likely to have it too,” says Brown.

“All of the cases which I speak of have always been where both the child and the caretaker have had [Covid-19].”

In isolation facilities, Bamford says that families are kept together and no children are admitted unaccompanied. Should a child be alone, they should be admitted to a hospital ward where staff can look after them, she says.

She adds that some isolation facilities are not as child-friendly as they should be, but guidelines are currently under revision to ensure that this changes.

Children’s feelings towards the lockdown

A recent study conducted by the National Planning Commission (NPC) looked at how children were affected by the lockdown.

Child’s rights specialist at the NPC and incoming children’s commissioner for the Western Cape Christina Nomdo spoke to Spotlight about the results of the study, as well as about her plans to incorporate children’s voices in her future role.

She says the study was a third iteration of the NPC’s children’s national development plan programme, which focuses on children’s participation in governance.

“I thought the project was finished until we had [this] pandemic and then we decided to do a special edition about reaching out to children during lockdown,” she says.

Nomdo explains that the NPC works with different organisations across the country to connect with parents and their children.

She says the study asked children about their feelings and understanding of the pandemic and the lockdown.

“Children mull over the same kinds of concerns that adults mull over,” she says.

She categorised the main feelings expressed by children in the study as fear, anxiety, sadness and anger.

“Fear or anxiety of losing someone you love,” she says.

“Sadness – I’m sad because it’s a difficult time for me [and] I’m separated from my friends.

Children from more vulnerable and marginalised communities could not be reachedChild’s rights specialist at the NPC and incoming children’s commissioner for the Western Cape Christina Nomdo

“Anger – Almost like a sense of hopelessness about the effects of an external hazard that nobody has any control over. [The children] understood [this] and felt a bit powerless in the face of this hazard,” says Nomdo.

One limitation of the study, however, was that the children and families involved were often well-supported and stable, perhaps because of their relationship with an organisation.

Children from more vulnerable and marginalised communities could not be reached, says Nomdo.

“We will only hear about the children bearing the brunt of this pandemic from them when they reconnect with other members of care and their care network in society.

"We will only hear the realities of [what] children experienced at that time, and that’s worrisome to professionals in the children’s rights network.”

The children are listening, Mr President

While adults might be the usual suspects eagerly listening to each of President Cyril Ramaphosa’s lockdown addresses, Nomdo says that children have also been watching.

“This is interesting because [Ramaphosa] has a lot of trust in them,” she says.

“Children trust that he’s made the right decision for the sake of their safety and he’s somebody that they’re willing to listen to.”

She adds that it would be useful for the president to host information sessions that are directly aimed at children, “but we are not at that level of maturity in our governance”.

“Part of the motivation for our study is to bring this insight that children should be involved in governance, and they have a valuable role to play.”

Nomdo officially takes office on June 1.

In a box

Tuning in to children on RX Radio

What do the children say? Spotlight tuned in.

“My listeners, apologies for the background noise,” says 18-year-old Luzuko Sonkapu as he speaks into his phone at his home in rural Komani (Queenstown), Eastern Cape.

“I’m at home and I can’t find a quiet place because I can’t go outside.”

Sonkapu is a reporter for Red Cross War Memorial Children’s Hospital Radio, otherwise known as RX Radio, a station “by and for children”.

Listen: Luzuko’s experience during Covid-19 pandemic

Sonkapu is also a patient at the hospital, with a chronic illness called spinal muscular atrophy.

Since the beginning of the lockdown, RX Radio has featured the voices of young reporters from across the country and within the hospital, describing their experiences of the lockdown and their thoughts on the pandemic.

Through the muffled background noise, Sonkapu says “it’s getting loud, it’s getting loud”, describing his family’s discussions about Covid-19.

On a positive note, the teenager says he’s been able to stay inside and spend time with his family.

“The negative side is that everything that I’ve planned to do is now on hold.”

For 2020, between finishing matric and writing songs for the school choir, Sonkapu was planning to do bigger things on RX Radio and release more of his own music.

He says the lockdown is affecting him mentally, socially and physically, and fears human interaction because his illness makes him immunocompromised.

“Coronavirus and my illness; if they click together they can kill me,” he says.

“I have a fear of that and I’m scared. I’m feeling a bit shaky because it can affect my lungs and affect my breathing.”

Sonkapu says that as soon as he heard about Covid-19 he moved out of the city and back to the village.

“In the city, it’s more dangerous than a rural area,” he asserts, even though there may not always be fresh water.

Before signing off, Sonkapu calls for people to follow the infection control measures put in place by the health department.

“Stay safe, be humble, be patient and pray to God that everything will be fine,” he says.

Concerns for chronically ill children

In Khayelitsha, Babalwa Dlakavu, the mother of one of RX Radio’s reporters, shared her insights earlier this month. Like Sonkapu, her fears included serious concerns for her child’s health.

Dlakavu told listeners that she was unemployed and that it was difficult care for a chronically ill child during this time.

Listen: Babalwa’s experience during Covid-19 pandemic

Her daughter, Lindokuhle, has a lung condition called bronchiolitis and pneumonia. She has only one functioning lung and depends on oxygen.

“The challenge is that my street is busy,” she says in isiXhosa.

“People are going up and down; they are not taking the lockdown seriously. Even the kids are playing outside.”

She says it’s stressful for her daughter, watching the other children play, knowing she can’t join them.

Dlakavu says she wishes the government could help her family by delivering Lindokuhle’s medicines. Because of the lockdown, Lindokuhle’s treatment has to be collected from the closest hospital to her home instead of Red Cross.

“It takes a long time to fall asleep at night because you are thinking about this virus that does not yet have a vaccine,” says Dlakavu.

“We are really scared,” she says.

“We [have] come a long way with our chronically ill children and it’s hard.”

This article was produced by Spotlight – health journalism in the public interest