Drink fuels nation’s health crisis
Pretoria - As the curtain falls on 2013 not much has changed regarding the health of the citizens. The burdens of disease have not abated, while health departments and other stakeholders have continued to forge ahead with the battle to educate and increase awareness of prevention, rather than cure.
The major burdens on the health-care system – HIV, tuberculosis, maternal and child mortality, non-communicable diseases and violence, injuries and trauma – have continued to haunt the corridors of public and private health institutions.
There has been emphasis on what to do, or rather what not to do, what to eat and what to stay away from, and guidelines on leading healthier lives to improve the population’s health profile.
But while all this has been going on, researchers have been busy trying to identify the causes and effects of young people’s social activities.
One study, in particular, showed that while authorities have emphasised staying away from alcohol and sticking to age restrictions, and even upping them, young people have continued to drink themselves into risky situations.
Youngsters from Mamelodi opened up to a research team recently and said they lost their inhibitions when they were drunk.
They admitted having casual sex after drinking, and said they went on to have multiple partners, usually people they met in drinking spots.
They said they had unprotected sex with these strangers, and some some said the idea of contracting HIV did not cross their intoxicated minds.
Some said they did not think they could contract Aids, while others said the attraction of money and/or other benefits far outweighed the need for protection.
These findings supported other studies about the relationship between drinking and high-risk behaviour, which frequently leads to HIV and Aids.
Other findings have shown that people who drink alcohol generally engage in unprotected sex, multiple partnering and commercial sex more often than non-drinkers, and that drinking venues are fertile ground for young people who want to drink and meet casual partners.
Men and women who meet sex partners in informal bars (shebeens) engage in heavier drinking, have more sex partners and engage in higher rates of unprotected sex.
Young people have also admitted having contracted sexually transmitted infections from random encounters, but this did not put them off unprotected sex.
This has led to another big problem in the social cycle of the country, teenage pregnancy, whose effects on the profile of South Africa have been devastating.
Young mothers are much more likely to die in labour, or to give birth to premature babies, who are at greater risk of dying or being disabled.
Young mothers account for 8 percent of pregnancies countrywide, under-18s making up 36 percent of maternal deaths.
Health experts painted a bleak picture of this phenomenon, and said it made it more difficult for South Africa to meet its commitments in terms of the Millennium Development Goals.
One of the goals is to reduce maternal mortality by 75 percent and increase accessibility to reproductive health by 2015, and early this year Health Minister Dr Aaron Motsoaledi said: “It’s time we stopped moaning about teen pregnancy and did something about it.”
He introduced a package to fight teenage pregnancy, including providing contraception services for pupils between grades 7 and 12.
He promised that the plan would yield results within a year of its introduction, and that it was aimed at ensuring that “girls who were not supposed to fall pregnant did not do so”.
He said offering contraceptives to children in primary school had become important because the age of menstruating had fallen significantly, and some girls began having periods when they were nine.
The socio-economic implications of teenage pregnancy include exclusion from education and a better future, at the same time placing heavy financial burdens on families.
Young girls are often forced to leave schools to care for their infants, sometimes with little, if any, experience, if they, too, are very young. Some stay in school and hide their growing tummies under extra-large clothing, and worry about being caught out and made fun of by others.
Those who are able to go back to school after having babies are sometimes stigmatised and ostracised; educational and child psychologists say this can lead to emotional and psychological problems which are carried into adulthood.
These problems can cause drinking and loose behaviour, leading to further unwanted pregnancies and contracting sexually transmitted infections and HIV.
This is a vicious cycle which places a burden on communities and the economy.
Mental health has also been on the spotlight, and there have been complaints about it being neglected despite its link with other devastating health conditions, and its socio-economic effects.
Cardiovascular diseases, obesity and diabetes, and other non-communicable diseases which are major causes of death, also have links to mental health.
Calls have been made for more be done at health-care facilities to screen and diagnose people with common mental disorders.
Psychological disorders are prevalent in communities, a study by the Human Sciences Research Council revealed. The study also found a lot of people suffering from trauma and stress, which often led to sufferers being unemployable, while costs to families and the state for treatment were high.
There have been calls for mental health care to be extended into the primary health care system, but it was pointed out that to make this work, there would be a need to recruit middle-level mental health professionals, such as psychologists, social workers, heath promoters and community mental-health assistants.
Motsoaledi admitted that this sector had been neglected, and said mental health services continued to be inequitably distributed, fragmented and inadequately resourced.
He said institutions were poorly resourced, and there was an over-reliance on psychiatric hospitals forcare, treatment and rehabilitation.
The World Health Organisation’s slogan, “No health without mental health”, has become a rallying call for stakeholders internationally, and is being brought into the country to try to influence the diagnosis and treatment of mental illness.
The psychiatry department of the University of Cape Town said this could be achieved if parity for mental health services was established. The use of existing resources as efficiently as possible, and the development of additional resources over time, could prove effective, the department’s health practitioners said in a paper on scaling up mental health services.