Category: The Conversation – Africa

Source: The Conversation – Africa (2) – By Simone Papale, Postdoctoral Research Fellow, University of Parma

Over the last decade, there has been growing international focus on the role of food in conflict, particularly in Africa. The continent has seen an increase in jihadist terrorism in several regions.

Violence, like that exercised by terrorist organisations, is linked with food security conditions, causing a vicious circle of hunger and conflict.

Terrorism generates food disruptions. It undermines production systems and supply routes.

At the same time, growing food shortages intensify tensions and competition over essential resources at the margins of vulnerable societies. This increases the risk of mobilisation into violence.

We are researchers in international security and contemporary warfare. In a recent article, we explored the role of food in Africa’s terrorist insurgencies. We focused on Boko Haram in Nigeria and Al-Shabaab in Somalia.

We show how food is not only a driver or victim of violence. It is also central to how terrorist groups fight, govern and survive.

Terrorists use food as a tool to challenge national authorities and increase their followers. In parallel, they exploit food insecurity to control communities and confront counter-terrorism forces, pushing the state out of contested areas.

---

Read more:
How crime is closely linked to Al-Shabaab’s survival strategy

---

This has major implications. The use of food as a weapon worsens humanitarian conditions. It causes the displacement of people in vulnerable settings. As a result, it sets in motion dangerous mechanisms of instability that can even undermine militants themselves, reducing their resources and operational capabilities.

State responses need to address these challenges and promote more comprehensive approaches to counter terrorism.

Weaponising supplies

Since the late 2000s, Boko Haram and Al-Shabaab have engaged African security forces in a strenuous fight. Both groups have sought to overthrow local governments and establish their power.

They have expanded their networks in regions where food security is low. These are Nigeria’s Borno State and southern Somalia.

These areas have witnessed historical frictions between the population and government authorities. Local communities have lamented socioeconomic marginalisation, shortages of essential resources and high levels of unemployment.

Both Boko Haram and Al-Shabaab have sought to capitalise on inequalities to gain appeal among aggrieved populations, seeking to replace the state in the delivery of essential resources.

---

Read more:
Nigeria’s growing security crisis: 6 essential reads

---

Boko Haram militants have reportedly provided supplies, such as biscuits, rice and spaghetti, to marginalised villages. As a Borno State resident put it, the militants have shown “love and concern” while addressing local needs.

Al-Shabaab has resorted to similar practices to win the hearts and minds of southern Somalis and enlarge its pool of recruits. The group has supplied struggling communities with meals and goods, and promoted local agricultural activities.

In parallel to these activities, both terrorist groups have adopted more aggressive measures to counter the advance of anti-terrorism forces. They have used food denial to punish civilian insubordination and cooperation with the state, relying on starvation tactics.

Boko Haram has systematically targeted food infrastructures. The group has burned crops, banned farming and fishing activities, and even poisoned water sources. This has happened particularly in places where militants suspected collusion between communities and national authorities.

Likewise, Al-Shabaab has interrupted trade routes. It has destroyed food imports to isolate southern Somali villages controlled by security forces and deprive them of popular support. During Somalia’s 2011–2012 famine, Al-Shabaab militants blocked humanitarian agencies. This was aimed at preventing the distribution of food aid to curb western influence in territories under their control.

The repercussions

The use of food as a weapon has had major repercussions in Borno State and southern Somalia. It is a primary cause of the deterioration of food security in these regions over the last 15 years.

Attacks on food resources and infrastructure have disrupted supply routes. They have pushed people to abandon their crops and pastures. This has decreased the production and availability of essential goods.

As a result, humanitarian conditions have worsened, local economies have weakened and displacement flows have intensified.

This has had detrimental effects for Boko Haram and Al-Shabaab, depriving militants of key assets to sustain their activities and attract new recruits.

The two terrorist groups have become victims of the emergencies they have helped generate. They have increasingly struggled to supply nourishment for their troops and supporters. Consequently, they have witnessed a growing number of defections motivated by unsustainable conditions.

Reports highlight increasing cases of jihadists surrendering to security forces while requesting food.

To address these challenges, Boko Haram and Al-Shabaab have intensified raids on villages, looting goods and livestock.

---

Read more:
What drives Al-Shabaab in Somalia: foreign forces out, Sharia law in and overthrow the government

---

However, growing frictions with the population have undermined the groups’ operational capabilities, even opening up new fronts of resistance.

Boko Haram has been forced to transfer part of its resources and operations to the Lake Chad area. The group has intensified incursions to capture food in Nigeria’s neighbouring countries.

In Somalia, tensions with farming and pastoralist communities have led to the creation of militias mobilising against Al-Shabaab.

What next

The relocation of Boko Haram’s operations and the mobilisation of communities against Al-Shabaab have not eradicated the terrorist threat. However, these events further highlight food as a crucial factor shaping insurgencies.

African and international authorities need to tackle the dynamics of food weaponisation. They need to refine their approach to enhance local resilience, addressing the inequalities that insurgents exploit.

The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

– ref. Terrorists use food as a weapon: how Boko Haram and Al-Shabaab exploit hunger – https://theconversation.com/terrorists-use-food-as-a-weapon-how-boko-haram-and-al-shabaab-exploit-hunger-256162

Source: The Conversation – Africa (2) – By Peter Kamerman, Professor, University of the Witwatersrand

An estimated 1 in 10 people worldwide have diabetes. Africa is the region with the fastest growth and it’s estimated that the number of people on the continent with diabetes will more than double in the next 20 years, increasing to about 55 million people by 2045.

Having diabetes has serious consequences for health and is associated with increased risk of developing diseases related to damage to the heart (heart attacks), blood vessels (strokes, foot ulcers), kidneys (chronic kidney failure), and the nervous system (blindness, loss of sensation).

When it comes to nerve damage, it typically affects long nerve fibres that supply the feet and can sometimes affect fibres that supply the hands too (a so-called glove and stocking distribution).

It is the nerve fibres that detect sensations such as touch and temperature that are often worst affected, resulting in numbness. The numbness that develops can be a nightmare for people and is often described as their “feet feeling dead”.

A peculiarity of this numbness is that it may be accompanied by intractable pain. This type of pain, resulting from damage to sensory nerve fibres, is called neuropathic pain.

As scientists in the field of pain and pain management we work on neuropathic pain in people living with diabetes and its management. In this article we aim to draw attention to the problem and discuss how it can be managed.

Nerve damage

It has been estimated that up to 50% of people with diabetes will develop damage to peripheral nerves during their lifetime, and up to 50% will experience pain because of that nerve damage.

The predictors of developing nerve damage are well established. Older age, increased duration of diabetes, and poor control of blood glucose concentration are the main culprits. What determines whether the nerve damage is associated with pain is largely unknown.

Neuropathic pain is often described as a “burning” pain, and is frequently
accompanied by other sensations such as “pins and needles”, and pain that feels like stabbing, shooting, electric-like shocks, and deep aching.

In some people there is very little or no numbness. In these people pain can often be triggered by gentle touch and movement across the skin (for example, bed sheets brushing across a foot, putting on socks), and cool and warm temperatures that are not normally felt as painful.

Sometimes my feet will hurt really badly and I can’t get up and can hardly walk. – Anonymous patient

Having such intractable pain has devastating consequences for quality of life.

Pain sufferers have less social interaction with family and friends, and find it much more difficult to enjoy their favourite activities. Sleep is significantly disrupted.

Having neuropathic pain is associated with high rates of anxiety and depression. To make matters worse, the sleep disruption, anxiety and depression may feed back into a vicious cycle to worsen and maintain the pain.

There are days when I’d really like to go somewhere or do something and just
don’t go. I know it will hurt. There’s no point in doing it. – Anonymous patient

Medications to manage the pain

Neuropathic pain is not responsive to the medications used to treat conditions such as headaches and joint pains (for example, paracetamol and ibuprofen).

Instead, neuropathic pain is responsive to medications that in some cases are also used to treat conditions such as depression and epilepsy.

Examples include:

• low doses of tricyclic antidepressants (for example, amitriptyline)

• a class of antidepressants called serotonin and noradrenaline re-uptake inhibitors (for example, duloxetine)

• anti-seizure drugs like gabapentinoids (for example, gabapentin and pregabalin).

However, there is very little information to guide doctors to predict which drug will work best for a patient.

So, often finding the correct treatment is a trial-and-error approach, which can be frustrating for both patients and doctors.

Coping mechanisms

Chronic pain management is also about teaching people to cope with their pain so that they get back to enjoying their lives and are no longer consumed by the pain.

Such interventions include the practice of mindfulness, cognitive behavioural therapy, and other self-management activities specifically designed for people with chronic pain.

With the rapidly growing number of individuals with diabetes, it is more important than ever that we detect and treat the pain caused by nerve fibre damage.

Public education and increased awareness of this painful consequence of diabetes will hopefully encourage affected people to seek early medical attention, thus allowing management of the condition, maintaining well-being and restoring function.

Peter Kamerman receives funding from the National Research Foundation of South Africa. He is the sole proprietor of Blueprint Analytics, and consults for Partners in Research.

Andreas C Themistocleous receives funding from UK Medical Research Council.

– ref. Diabetic foot pain: expert tips on how to cope – https://theconversation.com/diabetic-foot-pain-expert-tips-on-how-to-cope-251937

Source: The Conversation – Africa (2) – By Aduragbemi Banke-Thomas, Associate professor, London School of Hygiene & Tropical Medicine

Nigerian women make up a significant proportion of foreign women giving birth in several countries.

A study done in Calgary in Canada found 24.5% of foreign women identified as having travelled abroad to give birth were from Nigeria.

Research in Chicago in the US found the majority (88%) of those seeking obstetric care in a hospital were Nigerian citizens.

In the UK, the phenomenon is labelled by some as the “Lagos Shuttle”, highlighting the high number of Nigerian women said to be so-called “birth tourists”.

It is estimated that over 23% of pregnant Nigerian women would like to travel abroad to give birth.

Why is this? As medical and legal scholars we asked women who had travelled overseas for the birth of their babies to share their experiences.

Existing research has not done enough to capture their voices, which matter in framing service delivery and immigration policies.

We reported findings from this first-of-its-kind study in PLOS Global Public Health.

As there is no registry of foreign pregnant women who gave birth abroad, it is a challenge to find them. For our study, we used social media platforms to recruit 27 Nigerian women who had given birth to at least one child abroad and conducted in-depth interviews with them to understand their motivations and experiences.

Why women do it

Of all recruited, 23 gave birth to at least one child in the US, and four gave birth to at least one child in the UK. One woman each gave birth in Canada, Ireland and Zambia.

All the women in the study had at least a university degree.

We found that reasons for seeking childbirth abroad varied.

Some women were motivated by both perceived and experienced gains of foreign citizenship, which they believed might give their children a good education, a better living environment, and easier access to jobs and loans.

However, it was not all about citizenship. Another motivation was to benefit from “better healthcare”, especially for those who had either had bad experiences during previous births in Nigeria or were concerned because they were carrying what they called a “precious baby”, for example after years of infertility.

Many women in the study also sought childbirth abroad because it is where they had loved ones to support them through pregnancy, childbirth and having a newborn – a motivation not previously reported.

Indeed, the number of Nigerians living in the US has increased over time and as of 2023, over 760,000 Americans identify as being of Nigerian origin. Essentially, more than one in 10 African immigrants in the US are Nigerians.

Some Nigerian women planned to give birth abroad long before they even got pregnant. Others were encouraged to do so by family, friends or colleagues.

Some decided to seek childbirth abroad after their income increased.

Mostly positive

Childbirth abroad is mostly a positive experience, but some women reported feeling treated badly because they were “self-paying” patients, “black”, or not native to the country.

While travel for many was mostly uneventful, some experienced life-threatening situations en route to their destination or upon arrival.

They found the cost of care to be exorbitant, but many reported that they were able to pay it off in instalments, or negotiated rebates or discounts from hospitals. A separate study showed that four in five foreign pregnant women who gave birth in a Canadian hospital, including some from Nigeria, had no outstanding bill after discharge.

In our study, those who struggled to pay said they incurred unexpected costs due to complications that resulted in caesarean sections or other surgical procedures.

Support during childbirth abroad was considered crucial and included loved ones from Nigeria who would travel with the pregnant woman to their destination.

Push and pull syndrome

With an ongoing exodus of Nigerians out of the country due to push and pull factors, known locally as jàpa, it is more likely that there will be more Nigerian pregnant women who have their support system abroad.

Countries like Nigeria should do more to improve the quality of care obtainable in their health systems.

Clearly motivations vary, and it is not always about birthright citizenship. While most women have mostly positive experiences, some have negative experiences that require attention and safeguards. For example, care guidelines in host countries specifically assuring good quality care for all pregnant women, including women who have crossed the border to seek childbirth.

The return of US president Donald Trump makes the need to install these safeguards particularly urgent. In his first term he ordered the United States Department of State to discontinue the approval of visas for pregnant women.

In his second term he has focused on abolishing birthright citizenship altogether.

The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

– ref. Nigerians having babies abroad: women explain their reasons – https://theconversation.com/nigerians-having-babies-abroad-women-explain-their-reasons-251067

Source: The Conversation – Africa (2) – By Leila Patel, Professor of Social Development Studies, University of Johannesburg

A 2024 Unicef report found that 23% of South African children experience severe food poverty, eating less than two of the recommended five food groups per day. Unemployment, food insecurity, limited access to basic services and a lack of knowledge about nutrition all contribute to this. The lead researcher of this multidisciplinary study, Leila Patel, and collaborating researchers Matshidiso Sello and Sadiyya Haffejee suggest ways to tackle this dire situation.

What’s in place to protect children from poverty?

Since a call for prioritising the needs of children was adopted by the Mandela government in 1994, much progress has been made in expanding access to education, to immunisations, other primary healthcare services and social grants. Just over 13 million children now receive a child support grant. This has reduced child hunger rates from the high levels seen during the apartheid and immediate post-apartheid eras.

But the grant doesn’t get to all the children who qualify for it. Around 17.5% of eligible children still don’t receive it. Reasons include a lack of proper documentation, lack of awareness of eligibility criteria and insufficient outreach by government agencies to reach vulnerable populations.

Also, the grant isn’t close enough to the food poverty line, which is R796 (about US$43) per month per person based on the daily energy intake that a person needs. From 1 April 2025, the child support grant will increase to R560 (about US$30) per month per child.

Secondly, although school feeding schemes are in place, many children fall outside the net. Close to 10 million children in low income communities in South Africa have access to a school lunch via the National School Nutrition Programme. This programme is an excellent intervention which improves the health of children. However, in 2024, about a quarter of the children who are eligible did not receive school meals. Some of the reasons are procurement issues, funding delays, problems with provisioning, and the impact of the COVID-19 pandemic, when school feeding ceased. Uptake has recovered to some extent but there is a need to improve the quality and effectiveness of the school feeding programme to improve nutritional outcomes.

You designed a system to help alleviate child poverty: what did it involve?

The South African Research Chairs Initiative and the Centre for Social Development in Africa at the University of Johannesburg implemented a study to strengthen social and care systems across health, education and social development. The project, which was started in 2020, involved tracking early grade learners and their caregivers in Johannesburg over a three-year period, looking at their health, material circumstances, food security, educational performance and mental health. Our research revealed a concerning picture of child hunger in Johannesburg, Africa’s wealthiest city.

The number of children in our study who went to bed hungry in the past week decreased from 13.7% in 2020 to 4.9% in 2022. Zero hunger was achieved in 2021 but it increased again in 2022 due to broader economic pressures like rising food prices and unemployment. While stunting rates showed a slight downward trend over the three years (from 13.5% in 2020 to 11.1% in 2022), we observed worrying increases in wasting, a severe form of malnutrition (from 5.6% in 2020 to 20.3% in 2022), and underweight (from 5.6% in 2020 to 11.4% in 2022).

Increases in wasting may be due to the COVID-19 pandemic and slow economic recovery. Nevertheless, the fluctuating figures underscore the complex interplay of factors contributing to severe child hunger.

The teams who worked on the project – called the Community of Practice intervention – set about creating a tighter, more supportive net around children experiencing severe and moderate risk. This integrated approach brought together government agencies, NGOs, schools, social workers, families and community leaders, to build sustainable solutions for child wellbeing.

The focus was on strengthening existing systems and fostering collaboration to ensure that children’s needs were identified and addressed effectively. On average, 157 children were reached each year over a three year period.

---

Read more:
COVID-19 has hurt some more than others: South Africa needs policies that reflect this

---

What did you find?

Several promising practices emerged from the collaborations, demonstrating the potential for positive change. These included:

• Strengthening school nutrition programmes by improving the quality and consistency of meals received and providing nutrition education through radio and WhatsApp messaging. More children had access to school meals.

• Tailored interventions: The team conducted screenings to assess the needs of children and their families. Children requiring specific interventions were referred to appropriate services such as child protection services and grants. Caregivers facing mental health challenges were connected to psychosocial support services, and families experiencing hunger were provided with food parcels by NGOs. Providing food top-ups for children resulted in zero hunger in the second year of the pandemic.

The number of children experiencing learning and social and emotional difficulties decreased between 2020 and 2022. Access to food and nutrition improved, higher vaccination rates were achieved and caregivers were more responsive to their health needs.

What does this tell you about what needs to change?

A significant barrier in addressing severe child poverty is the fragmentation of services across the Departments of Health, Basic Education and Social Development. Since the departments run standalone programmes, the synergies between the different social systems are not optimised. Children and their families who need additional support are often referred to the appropriate services, but there is poor follow-up.

The Integrated School Health Policy of 2012 makes provision for better coordination between these departments. But implementation has been uneven and poor in some instances. Improving and strengthening these inter-connected social systems of service provision across government departments is critical to improving child food poverty outcomes.

While managing food inflation, economic growth, job creation, and reduced inequality are important longer-term goals, immediate interventions are essential to address severe child food poverty. Failure to do so will compromise school progression and delay their overall health and social wellbeing. Simply improving economic indicators will not automatically translate to food on the table for every child; targeted interventions are vital.

Ending severe child hunger in South Africa demands a comprehensive and coordinated response, involving government, NGOs, community organisations, schools, and families themselves.

Leila Patel receives funding from the National Research Foundation for the Communities of Practice (CoP) study for social systems strengthening for better child wellbeing outcomes.

Matshidiso Valeria Sello receives funding from the Centre of Excellence in Human Development for a project on Household Economic Shocks.

Sadiyya Haffejee receives funding from the National Research Foundation.

– ref. 23% of South Africa’s children suffer from severe hunger: we tested some solutions – experts – https://theconversation.com/23-of-south-africas-children-suffer-from-severe-hunger-we-tested-some-solutions-experts-252566

Source: The Conversation – Africa (2) – By Tim Baker, Associate Professor, Karolinska Institutet

When someone falls critically ill, hospitals are expected to provide life-saving care. But in many African countries, intensive care units are rare. Critically ill patients are treated in general hospital wards, and the provision of essential emergency and critical care is limited.

Critical illness refers to any life-threatening condition where at least one vital organ – such as the heart, lungs, or brain – is failing. It can arise from any underlying condition including infections, injuries, or non-communicable diseases such as heart attacks and strokes, and can affect anyone of any age.

In high-resourced settings some critically ill patients are treated in intensive care units. They receive continuous monitoring, oxygen support, medication to stabilise their blood pressure, and other life-saving treatments. Until now, most data on critical illness and critical care in Africa has come from small, single-hospital studies. These studies hinted at a serious problem.

For example, a study in Uganda found that 11.7% of inpatients were critically ill, with a 22.6% chance of dying within a week. However, there was no large-scale research showing how widespread this was across the continent.

That is why we, a collaboration of clinical researchers across Africa, conducted the African Critical Illness Outcomes Study, providing the first large-scale look at the state of critical illness care across the continent.

The study builds on a network of clinicians, researchers and policy makers that has been growing for over a decade now, working out how to identify and treat patients who are critically ill.

The findings, published in The Lancet, are striking. One in eight hospital inpatients in Africa is critically ill, over two-thirds of the critically ill are in general wards, and one in five dies within a week.

Most of these patients do not receive the essential emergency and critical care such as oxygen and fluids that could save their lives.

What we found

The African Critical Illness Outcomes Study investigated 20,000 patients at one point in time in 180 hospitals in 22 countries across Africa. Countries throughout the continent were included, from Tunisia in the north to South Africa in the south, from Ghana in the west to Tanzania in the east.

Between September and December 2023, all adult inpatients in each hospital were examined on a single day to collect data about their clinical condition and treatments, and then a week later, their in-hospital outcomes.

The key findings were:

• 12.5% of hospital inpatients were critically ill

• 69% of critically ill patients were treated in general hospital wards, not intensive care units

• more than half of critically ill patients didn’t receive the treatments they needed

• critically ill patients were eight times more likely to die in hospital than other patients.

The study also revealed gaps in the most basic life-saving interventions:

• only 48% of patients with respiratory failure received oxygen therapy

• just 54% of patients with circulatory failure (such as shock) received fluids or medications to stabilise blood pressure

• less than half of patients with a dangerously low level of consciousness received airway protection or were placed in the recovery position.

These findings highlight a clear and urgent problem: many critically ill patients in Africa are not receiving the essential treatments that could keep them alive.

What can be done?

The study suggests that thousands of lives could be saved if hospitals had better access to essential emergency and critical care. This is a set of simple, low-cost interventions that can prevent deaths from critical illness.

The care interventions include:

• ensuring oxygen is available for patients struggling to breathe

• providing fluids or medications to stabilise blood pressure

• training healthcare workers in basic life-support techniques to manage unconscious patients.

Unlike high-tech intensive care unit treatments, essential emergency and critical care can be given in general wards with minimal resources.

Strengthening these systems could dramatically reduce preventable deaths from conditions such as pneumonia, sepsis and trauma.

Urgent action is needed

This study sheds light on a healthcare crisis affecting millions of people, yet one that has remained largely overlooked.

Every critically ill patient, no matter where they are treated, should receive the basic life-saving care they need.

We call for urgent action.

• Governments in Africa should make essential emergency and critical care a core part of universal health coverage. It should be integrated into policies and health benefit packages.

• The World Health Organization should embed essential emergency and critical care measures into its resolutions.

• African health funders should support studies and implementation of essential emergency and critical care.

• Professional medical societies and institutions should include this care in clinical guidelines and training. Frontline healthcare workers must have the tools they need to save lives.

The EECC Network, a global community dedicated to sharing knowledge, research and best practices, has been started to help prevent needless deaths.

* Nick Leech, who works on the promotion of essential emergency and critical care on behalf of EECC Global, contributed to this article.

Tim Baker declares technical consultancies with UNICEF, the World Bank, USAID, and PATH, has received research funding from Wellcome Trust and the National Institute for Health and Care Research and is a board member at the non-profit organisation EECC Global.

Karima Khalid is a board member of EECCGlobal

– ref. Critically ill patients in African hospitals aren’t getting the care they need: new survey – https://theconversation.com/critically-ill-patients-in-african-hospitals-arent-getting-the-care-they-need-new-survey-253355

Source: The Conversation – Africa (2) – By Roxy Davis, Doctor of philosophy, University of Cape Town

Children with disabilities face significant challenges in South Africa. Firstly there are delayed diagnoses which can lead to complications. The high cost of healthcare and little financial support for their families can limit their access to healthcare services altogether.

There is also little access to rehabilitation services. Inadequate facilities and a shortage of trained personnel are just some of the obstacles.

I started thinking about ways to get over these obstacles when I noticed that people with disabilities weren’t well represented in my sport.

As a competitive surfer and instructor, I had always celebrated the ocean’s ability to inspire confidence and resilience.

Every day, the beach was alive with activity – surfers, families and ocean lovers. Yet among them, I rarely saw people with disabilities in the water.

I began to notice that the beachfront itself, the infrastructure, the culture, and even my own surf school, weren’t actively creating space for inclusivity.

This would eventually become the cornerstone of the Roxy Davis Foundation, established in 2019, and later my doctoral research focusing on ocean-based therapy for children with disabilities.

I found surf therapy enhanced the mental, emotional, and physical well-being of these children.

New therapy

Surf therapy teaches people with disabilities to surf to promote psychological, physical and psychosocial well-being.

The first peer reviewed publication on surf therapy appeared in 2010 and focused on Aboriginal children in Australia. It was about mitigating the inter-generational trauma suffered as a result of the government-sanctioned removal of Aboriginal children from their families, a policy that only ended in the 1970s.

In 2020 a review of a 10-year period included 29 studies into war veterans and young adult cancer survivors, among others.

One such study focused on children with autism spectrum disorder. The study took place in the north-west of Ireland. Children said they felt happier and free, while their parents said they were more relaxed and confident.

A South African study with children with autism spectrum disorder explored the feasibility and unique benefits of an existing surf therapy programme and reported largely positive results.

My own research involved an adapted surf therapy programme for children with a range of disabilities.

Five children aged between 12 and 16 were enrolled. Altogether there were 35 participants including parents, counsellors, volunteers, physiotherapists and surf instructors.

Four of the five children were from under-resourced communities in South Africa’s Western Cape province and all had either a physical, sensory, intellectual or cognitive impairment.

None of the children had taken part in ocean sports before.

Getting into the water

For six weeks the children took part in a three-hour surf therapy session on a Friday afternoon.

The first goal was to get the kids in the water. We used mobility mats, surfboards with handles and amphibious beach wheelchairs to help.

Each child was taught now to surf according to their pace of learning and ability.

There was also a “surfers’ circle” with a discussion topic for each session.

After six weeks we conducted follow-up interviews to see what changes the children had experienced, and if these had any influence on their lives outside surfing.

We also asked parents and counsellors to identify the most significant changes in the children.

‘I felt free and confident’

Final interviews were completed one year later.

Charlie, aged 12, with cerebral palsy: “If my brothers want to go surfing I don’t have to stay behind and just watch them, I can go surf with them. It is so cool to surf with my dad and my brothers.”

Charlie’s teacher: “His self-awareness level and how he sees himself in the world has really improved.”

Tala, aged 15, with cerebal palsy: “Once I started surfing, I felt free and confident. Even in other spaces, when I’m not surfing, like, ‘Yeah I can surf, I can do something like surfing that I didn’t know that I could do before.’ ”

Tala’s school psychologist: “She went into this feeling very insecure, nervous and anxious. She said she will always remember who she was and how she felt before she went to the programme and how she came out of it … to be able to use that feeling and apply it to a different situation, that’s huge for her.”

Princess, aged 15, with spina bifida: was determined to “wean” herself off using nappies after gaining confidence through surf therapy.

Princess’s guardian described her experience as similar to “winning a gold medal … She was more confident in herself than ever. She is off that nappy completely now.”

Thabo, aged 14, a leg amputee: “Before session one, I was feeling nervous and excited, but as soon as I got in the sea, the nerves disappeared. You look and realise you can actually do that. I feel like I belong in the ocean.”

After the final session he said: “I can relax, I can be in control of my urges and my temper. I’m now not always thinking about what people think about me. I can be myself in many ways.”

Rowan, aged 15, a quadruple amputee: “Before I started surfing, I was thinking I can’t do it until I tried it and just being there was like beyond being able to speak in my wildest dreams. I couldn’t believe I could surf in the ocean riding some waves.

“On my first session, I was like ‘If I can do it, I can do it for the rest of my life’.”

In his second interview he said: “My goal is to become a national champion and to become a Paralympic champion.”

One year after the surf therapy programme he entered a provincial parasurfing competition, which he won. He was then selected to participate in the South African Para Surfing Championships in 2022, where he came second. Later that year he was selected to represent South Africa at the World Para Surfing Championships in California. Nineteen months after starting surfing, in December, on his 16th birthday, he competed in the World Championships and was placed 17th.

Surf therapy demonstrates what’s possible when we focus on ability rather than limitation.

Roxy Davis is affiliated with the Roxy Davis Foundation.

Angus Hunter, Theresa Lorenzo, and Yumna Albertus do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

– ref. Surf therapy for children with disabilities: how it’s changing lives in South Africa – https://theconversation.com/surf-therapy-for-children-with-disabilities-how-its-changing-lives-in-south-africa-245290