A shocking 122 out of every 1 000 Grade 1 pupils in the Northern Cape town of De Aar have foetal alcohol syndrome - the highest incidence of the syndrome in one population anywhere in the world.
And in the Western Cape, research shows that 88 out of every 1 000 Grade 1 pupils have the syndrome.
In comparison, the US rate of the syndrome is lower than one child in a 1 000.
These statistics were published on the Medical Research Council's (MRC) website among recent research findings.
The research was conducted by Sandra Marais, a senior researcher in the MRC/Unisa Crime, Violence and Injury programme.
It also found that most South African women in urban and rural communities were aware that drinking alcohol while pregnant could damage their unborn babies, but this had little or no effect on the amount of alcohol they drank while pregnant.
"Clearly, interventions will have to go further than raising awareness about the problem and handing out information," the research paper stated.
The frequency of the syndrome has not been measured in all South Africa's provinces, but so far it appears that it is highest in the Northern Cape. In De Aar, 122 children out of every 1 000 pupils starting school were affected, the highest incidence in one population yet reported in the world.
In the Western Cape, the number of affected children had nearly doubled between 1997 and 2001, from 46 to 88 out of every thousand.
The syndrome was not linked to wine-growing areas only, as studies in Gauteng had also shown a high prevalence rate of the syndrome among Grade 1 pupils.
"This underscores the fact that foetal alcohol syndrome is a significant public health problem in South Africa," the report said.
The damage caused to the foetus would stay with the child for life.
"And its consequences are severe: the alcohol a mother consumes during her pregnancy damages the developing brain, resulting in mental retardation. Children with foetal alcohol syndrome struggle to learn and reason. It also causes abnormalities in the nervous system, organs and limbs," the research paper said.
The study recommends that primary health care staff at clinics become involved in routine screening of women at risk of alcohol abuse, and that "motivational talks" designed to reduce their alcohol consumption become routine.
But interviews with staff at clinics showed that, although most were willing to get involved in preventative action, they said their workload made it impossible.
"This poses a challenge to the health services," the research paper said, adding that the department could consider working on this aspect in partnership with NGOs.
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