Gregory P Benvenuti,
Process Engineer
Johannesburg, South Africa

 This weekend I had an experience of going to a poor rural area in the Kwa-Zulu Natal province.

I went to stay with some people who are developing healthy feeding and cooking programs in these poor areas. Yesterday I went to a general dealer in the area. What I found in this shop were alcoholic drinks of various descriptions, white bread, soft drinks, some maize meal and sugar. That was it – no other food. Apparently, this is what these people survive on with a little bit of meat thrown in. Little children walk around carrying packets of crisps. There are some vegetable gardens in the area, but according to the NGO I was staying with most families make no effort to cultivate their own fresh fruit or veg. I also spoke to a health activist in the area who has been trying to improve nutritional standards and she confirmed the poor level of nutrient intake in these people. I would not be surprised if these people aren’t suffering from pellagra of some degree.



By far, the staple food is refined maize meal. Very little brown bread is consumed. Very few vegetables are consumed. I saw photographs of a man who was terribly weak, couldn’t lift up his arms, and had this disgusting flaky skin all over his body. Other people are suffering from various fungal infections including cryptomycosis. One woman has had a cryptomycosis infected leg for 40 years. I personally witnessed a young boy having a huge boil on his head lanced and oodles of pus coming out of it. He also had a hugely enlarged gland on the back of his neck. This doesn’t happen to well fed little white boys in South Africa. I wonder if South African doctors are given a course in medical screw ups of the past - like the misdiagnosis of vitamin B3 deficiency as an infectious disease?

I live in South Africa. I don’t actually care what study you care to mention, the sort of stuff that I saw this weekend does not happen to affluent people in this country. This is malnutrition – plain and simple. Rich people (generally white) die of heart attacks and cancer. White people don’t get those type of skin disorders and little boys don’t get disgusting boils on their heads. I’m only telling you what I saw on one weekend, I’ve seen pictures too terrible to even begin to describe. What is the difference between the people in the community and those in my cushy suburb north of Johannesburg? Money and eating habits are two which I think are the most applicable. How promiscuous we are? Rich people are promiscuous too, believe it or not. Do rich people have so much less sex than black people? I don’t buy that argument, sorry.

The area I visited does have access to a reasonable standard of sanitation and there is clean water available. However, the local clinic’s largest problem is uncontrolled diabetes and high blood pressure. Even with medication, the blood pressure and high sugar levels go largely unmonitored and unresolved. This is easily spotted by puffy feet and hands. Some people have been confined to bed for five years in this state due to their chronic diabetes. Is this really a surprise considering that they live on refined maize and sugar? I heard stories of some TB patients taking Bactrim for 6 years! When the man was taken off the Bactrim and put on a high nutrient diet he went from almost being dead to working every day.

People who have changed their diet away from a high sugar, high refined carbohydrate based diet have experienced a huge change in quality of life. The nutrition worker showed me videographic evidence of a woman who had been confined to bed for five years dancing three weeks after her diet change.

If I consider all I have read regarding the effects of vitamin and mineral deficiency and then consider the diet of the population that I witnessed, it’s not a huge leap of the imagination to understand the abysmal health outcomes in the area. This is the sort of stuff that is happening right at ground level in this country. HIV positive sick people are sent home to die from clinics from diseases which on their own are treatable. ARV’s are available in the area and the reason for low ARV subscription at the moment is the people’s distrust of the treatment and the fact that some people who have taken them are reporting feeling worse. This is the word on the ground, given to people who have earned the community’s trust, not intimidating doctors in white coats.

Maybe in the resource rich settings of the northern hemisphere all the unpredictable drug interactions and side effects can be effectively managed but can this be done in a country like South Africa where doctors prescribe a drug like Bactrim for ridiculous periods? Combine the effects of ARV’s on the cells’ essential processes like the well documented effect of AZT on mitochondrial function with an already low level of antioxidants and I think you may possibly have a lethal combination. To add to this you then have to spend money on monitoring things like CD4’s and viral loads. Doctors have to monitor virus mutation and then prescribe different drugs to deal with this. PLUS you’ve got to work out which symptoms are malnutrition related and which are HIV related. Honestly, this does sound like a recipe for disaster to me. Good news for big pharma, good news for pathology companies. Bad news for patients and bad news for South Africa.

At the moment, valuable resources are being diverted to the HIV/AIDS craze when I think it is obvious that we get back to basics and solve the REAL problems – chronic nutrient deficiencies. Then we’ll worry about troublesome retroviruses that kill less than 1% of well fed populations.