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‘Mandela's Children’ 32 years later

- Wits University

The stories, people and science behind Africa's largest longitudinal study have been captured in a book by Wits Distinguished Professor Linda Richter.

Almost 36 years ago, at the end of 1986, a dream germinated to track the health and development of South Africa’s children born just as apartheid was being dismantled.

At that time, Professor Noel Cameron and Dr Derek Yach sought to study those born in Soweto specifically – a township reflecting much of apartheid’s disastrous legacy, but also a rapidly transforming society.  

By 1990, the study would have more than 3000 participants, the first of whom was born just after Nelson Mandela's release from Victor Verster Prison on 11 February 1990.

The participants, affectionately known as ‘Mandela's Children’, have, through their participation over three decades, contributed significantly to evidence-led policy in Africa's largest and longest birth cohort study.

Documenting a 32-year study

Prof Linda Richter signs copies of her book for 3 generations of Birth to 30 study participants at Jabulani Soweto

What started as the Birth-to-Ten cohort study, now in 2022 celebrates its 32nd anniversary, marked by the launch of the book by Wits Distinguished Professor Linda Richter, titled Birth to Thirty: A study as ambitious as the country we wanted to create, at the Origins Centre, Wits University, on 19 August.

Richter is the only remaining part of the original study team.

A second launch was held for participants in the study at the Jabulani Community Centre in Soweto on 20 August. Each participant received a copy of the book.

More than 20 million data points

Using the rich data gleaned from the study – more than 20 million data points – 270 papers have been published. Sixty-two postgraduate students have based their work on Birth-to-Thirty, and a building at Chris Hani Baragwanath Academic Teaching Hospital has been co-opted, renovated and outfitted with an internationally-accredited laboratory.

In addition to the study's global significance, it is part of a unique collaboration of five other cohort studies in low-to-middle income countries.

At the book launch, the Deputy Vice-Chancellor: Research and Innovation, Professor Lynn Morris said that the book coincides with Richter’s National Research Foundation Lifetime Achievement Award and the celebration of Wits’ centenary.

LtoR Wits Profs Shane Norris Linda Richter and Lynn Morris at the academic launch of the Birth to 30 book by Prof. Richter at Origins Centre

“The study is an incredible source of scientific data. It is the only longitudinal study in a developing country with several closely-spaced measures for cognition, growth, and personality, from early childhood through adulthood,” said Morris.

Early childhood impacts health and human capital

Morris added that the study’s major contribution is to show how experiences and exposures during early childhood “create avenues to adult health and human capital”.  But it also shows how these effects are not fixed and that there is substantial room for a person's trajectory to change. “We should therefore do everything we can for children – health interventions make a huge difference,” she said.

Richter spoke about the study’s origins: “I have to say that nothing went to plan. We muddled through with short-term funding and grants. But with the ingenuity of my colleagues, we collected five years’ worth of good data.”

Crisscrossing stories from birth to 10, 20, 30

Study participants received a copy of the Birth to Thirty book that documents Africa's largest longitudinal study

When Cameron and Yach left South Africa in 1996, the study began to flounder. However, Professor Shane Norris, then a research assistant, with Professor John Pettifor and Richter, rekindled the study through Wellcome Trust grants and updated the study’s name to Birth-to-Twenty. At the book launch, Richter applauded Norris’s continued and dedicated leadership on the project.

“The book is filled with crisscrossing stories,” said Richter. “Stories about the political struggle at the time; stories about linguistic and language diversity in Soweto; stories about the immense technological changes…Importantly, the book is about people and their relationships.”

The study highlights the many challenges young people face in post-apartheid South Africa. “Violence, in particular, begins early for children in South Africa. By 18, only one percent of children have not witnessed or experienced violence. It is truly an epidemic in this country and is pervasive and structural,” said Richter.

Intergenerational pros and cons

Among the most salient findings of the study include the intergenerational nature of health and disease. “Physical growth, cognition and mental health show intergenerational links,” said Richter. “But this can also be improved upon through access to quality services, education, better socio-economic circumstances and the dedication of families.”

Examples of change include that the women in the Birth-to-Thirty cohort are on average 1cm taller than their mothers, more than half have passed matric, and more than half live in households with several consumer goods.

On the downside, more Birth-to-Thirty women had their first pregnancy before the age of 18 and are overwhelmed by debt. Many of them report experiences of interpersonal violence and depression. These experiences all affect later health.

“While South Africa has changed, it has not changed enough or enough in the right direction to ensure that all children reach their full potential,” said Richter.

She concluded that Birth-to-Thirty was always more than a study; it was where true and lifelong connections were forged. She thanked the research participants, some of whom were present at the launch.

As a treat, mountaineer Sibusiso Vilane spoke at the book launch. The first black African to summit Mount Everest in 2003, Vilane also raised funds for Birth-to-Thirty, noting his affinity and admiration for the research work.