LOU-MARIE KRUGER

As jy swaa grootwôd, slaap jy baie soedat daa minner ure innie dag moet wies. My uncle kan heeldag slaap. Toe my ma hom eendag vra hoekom hy soe slaap, antwoord hy: ‘Ek is vrek honge, as ek slaap droem ek van hoe lekke ek iet dan kom maak jy my wakke. Ek was noggie ees klaa geëet’ie . . . Honge ly kannie digter in jou ytbring én’it kan jou mal maak.

Nathan Trantraal^{[1]If you had a difficult childhood, you sleep more so that there are fewer hours in the day. My uncle can sleep the whole day. When my mother asked him once why he sleeps like that, he said: ‘I am damn hungry, if I sleep I dream about how I enjoy eating, then you come and wake me up. I had not even finished eating . . .’. Being hungry brings out the poet in you and it can make you crazy.}

‘What does it mean to be hungry?’ the anthropology student asks her focus group of three women, all of them mothers of infants she met in the line at the local soup kitchen. It is midday, but the sun is feeble and it is still cold outside. The group is sitting in the community hall where the weekly soup kitchen is held. They have finished serving food and, having tidied up, they are having a picnic of sorts. The ensuing conversation is disturbing.

Jessica said that hunger was ‘not having something to eat’. Yes, sometimes, she experienced it. Veronica said she did, too, especially when her father’s construction work had ended without notice. ‘You just go to sleep,’ she said. ‘You just sleep, and you wait.’ Jessica said: ‘One gets headaches from hunger. It’s something everyone in our community has experienced.’

A little later, after the last shreds of cheese had been nibbled and Jessica had cut and shared slices of cake, we began to talk about food diaries. I had planned to request that the women keep food diaries^{[2]See Zimmerman and Wieder 1977.} in order to detail their daily food intake and the sources of food. I handed out the diaries, and began to explain about the columns to fill in daily. The women started trying to recall what they had eaten, wondering out loud. Lydia’s silence rang like a siren. She had been unusually quiet throughout. I asked her if she was ok? She looked at the small book, and the other two women making entries under what they ate yesterday (Tuesday). Lydia? Her voice cracked and with her double stream of tears came the words: ‘Ek het Saterdag laas geëet’ (I last ate on Saturday).

In the fraught pause that followed I calculated how many days that was – three.

We were all in shock. Lydia was sobbing. I moved to comfort her. The others commiserated, expressing their shock and anger at Lydia’s family. The hunger that had been spoken of in past tense and general terms came to the present. It was painful.^{[3]Truyts, 2016: 40–3.} The anthropologist wanted data. She got the soft crying of a hungry woman.

Madness and hunger

‘I am hungry. My child is hungry.’ Dreaded words for a psychologist to hear. But much more dreadful words to speak.

Psychologists do not know what to do with hungry people.

When research is conducted about food, it is clear that at least three issues relating to food and gender are prominent. First, the responsibility of feeding (food provision and preparation) is still relegated to women. Second, men and women eat differently and are entitled to different kinds and amounts of food. Third, women, particularly in Western societies, engage in dieting and disordered eating behaviour.^{[4]Caplan, 1997; Matthee, 2001.}

Social scientists refer to hunger as ‘food insecurity’. In the global mental health literature, the term ‘food insecurity’ is used to refer to hunger, food insecurity being defined as ‘the state of being without reliable access to a sufficient quantity of affordable, nutritious food’, with a substantial literature confirming that food insecurity is one of the factors operative in the association between poverty and mental health, especially in developing countries.^{[5]Maes et al., 2010; Cole and Tembo, 2011.} Several studies specifically link food insecurity with maternal depression.^{[6]Siefert et al., 2007; Maes et al., 2010; Grisaru et al., 2011; Dewing et al., 2013.} The food security literature seems to be far removed from what we experience in the valley.

Hunger ‘was a base and vulgar instinct from which science had averted its gaze’ the anthropologist Nancy Scheper-Hughes writes in her book Death without Weeping.^{[7]Scheper-Hughes, 1992: 130.} She has written extensively about what she calls ‘the madness of hunger’ (delirio dé fome) or ‘hunger neuroses’.^{[8]Scheper-Hughes, 1992: 128; see also Keys, Henschel and Brožek, 1950.} She describes the psychological symptoms accompanying the physical changes associated with hunger:

[Initial] depression followed by faintness, lightheadedness, silliness, giddiness, brilliant flashes of insight, bravado, often accompanied by irritability. These are often followed by uncontrolled weeping; fierce crazy anger; and the lashing out even at those who may be of assistance. Alternating with the rage are passivity and indifference, as if one were absorbed by some distant or interior reality.^{[9]Scheper-Hughes, 1992: 138.}

As David Orr, a social work researcher studying the narratives of carers in southern Peru states: ‘Food . . . is also often central to explanatory models of how the madness arose in the first place.’^{[10]Orr, 2013: 702.}

The word ‘honger’ in Afrikaans, ‘hunger’, evokes powerful reactions in people. When we think of hunger, we might see an open mouth, lips, teeth, tongue. A naked bony body with bones, an anorexic girl, kwashiorkor or an obese man. We associate hunger with discomfort, pain and distress (caused by lack of food or nurturance or love), but always, implicit in hunger is also desire (the desire to eat, to be loved, to be nurtured). In the Oxford Dictionary, the word ‘hungry implies both distress (caused by lack of food) and desire (a desire to eat). The word ‘hunger’ refers to a person’s uncomfortable or painful experience of not having something or an adequate amount of food to eat.^{[11]See also McIntyre et al., 2002; Quandt et al., 2006.}

Over the years we have realised that many of the women we interview or do psychotherapy with are hungry when they speak to us. Often, they have hungry children at home.

In the mental health literature, hunger is regarded as ‘the most potent physical and psychological stressor for women across the globe’. According to Stephen Devereux and Keetie Roelen: ‘In South Africa, where a constitutional right to “sufficient food” exists, 20–25% of children are undernourished. This has been identified as a “national scandal” and a source of shame for the wider society that allows the persistence of “hunger and malnutrition in a food-secure nation”.’^{[12]Devereux and Roelen, 2016: 1.}

Another day in the valley. It is the first day of the third school term. It is cold. My students are running psychotherapy groups with thirteen-year-old boys and girls at the high school. Today’s topic is ‘difficult emotions’. The therapists want the children to think about thoughts, feelings and behaviours that they feel they must keep secret or hidden from others. To facilitate discussion, the children are asked to make masks. The instructions are read:

There are parts of ourselves that we feel more comfortable sharing than others. We all wear a mask sometimes. Take the paper plate, cut out some eyes, like this. Then on the front of your piece of face-plate, draw a picture or write about the face that you show to the world outside. On the back of the face-plate draw a picture or write about the face that you keep hidden from others. Everyone gets a chance to share their mask with the group. You only have to share your hidden face if you feel comfortable doing so.

We do this exercise every year. On this freezing August day, the kids seem impossible and the therapists struggle. ‘My first group was very restless, and I struggled to go through the activities with them. I tried to bring order by reminding them of the values which they chose for our group. This helped a bit, but after a few minutes they were busy with their own things,’ one therapist writes in her journal. She continues:

Some of the boys told me that they are restless because the food scheme at school did not provide food today . . . it seems as if it is a common thing for the food scheme to not provide on the first day of school and also on some other days as well, without warning.

Another therapist is perturbed to see the emotional impact of hunger:

Many of the boys reported feeling ‘sad’, ‘powerless’ and ‘empty’ on the emotion wheel. Upon further inquiry, it emerged that the food scheme was closed on this day, and these emotions were connected to their experience of hunger. Their attention deteriorated towards the end and they told me how difficult it was to focus when hungry.

The therapist is painfully aware of how the children try to alleviate the pain. ‘They seemed to use humour as a defence as they joked about who was the hungriest and what they were going to eat when they got home.’ She is also aware of her own defences. ‘It was difficult to hold this. So foreign. So awful. But it seems being listened to helps – although that’s probably just a fantasy which makes it a bit more bearable (for me).’

Another therapist, who usually has funny stories about his energetic (often quite unruly) boys’ groups, writes a subdued journal:

At school today, things were more out of control than usual. The children were hungry because the food scheme wasn’t open. The discipline in both my groups was poor and at times I felt like a headmaster as I had to command order – especially with the boys. I feel guilty, because I try to create a safe and a free space, but if I don’t intervene things get out of hand.

He clearly struggles to write about his experience: ‘For some reason I struggle to reflect on yesterday – is it because I switched off as a therapist when I went into headmaster mode? Maybe I’m tired – didn’t sleep much.’

After this session, the students cancel their supervision session. Or was it I who cancelled, after reading the reports?

When I eventually see the students they are despondent, almost listless. I know the feeling. We talk about how one cannot think about emotions when you are hungry. How can one think about anything when hungry? Maths, grammar, science? We decide that we have to give the children something to eat when we see them, even if only as a token that we have heard them. One of my long-term private patients, a graduate student in engineering, studies the bruising of apples. This means that he gets apples by the truckload for his experiments. He brings me apples in black bags, which the students take to their next therapy sessions. We carefully take out the bruised ones and eat them ourselves. My engineering student, himself in pain in different ways, is pleased that he can help and that the apples are useful.

The student therapists are surprised by the impact of the apples. ‘My first group was a lot less restless than last week,’ one writes in his journal. He continues:

I do believe that it is because they have had a week to settle in at school, however, I do feel that it is greatly due to them having had the apples to eat. Both groups and other children passing by asked if they could have one more apple and I felt bad in having to say that I have just enough for my two groups. It was very insightful to see how big a change in behaviour there was once they had something to eat.

Another one writes: ‘Yesterday was a better day in Kylemore than last week. The children were not as hungry. The apples really helped.’

I don’t know who the apples are more useful for – the children, the therapists or me.

One of the therapists immediately extended the apple strategy to another patient that he is seeing in the valley, a sad and hungry twenty-year-old man who came back to school to finish matric. Orphaned at a very young age, he is sleeping on the floor of an older brother’s shack. The therapist is clear that his patient benefits from the therapy, but also, definitely from the Monday apple. ‘Of course, I gave him an apple this week . . . he eats once a day . . . there was no doubt that I would offer the apple.’ He adds: ‘But he wants someone with whom he can share stories, and talk to. He also says he is ashamed but grateful for the apple that he received. He is starving.’ Ashamed and grateful.

As long as the woman from Rijksmuseum
in painted silence and concentration
day after day pours milk
from the jug to the bowl,
the World does not deserve
the end of the world.

Wisława Szymbxxorska,
Poems: New and Collected, 1957–1997