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Cape Town -

A disproportionate incidence of foetal alcohol syndrome (FAS) in the Western Cape indicated this week that the legacy of one of the province’s most shameful practices continues ravaging communities.

Cape Town City councillor Barbara Ras said this week the legacy of the notorious “dop system” – which is illegal – is directly linked to FAS.

More than 50 years after this practice was prohibited in law in 1960, according to Ras a distressing pattern of FAS-related disabilities continues to manifest in the West Coast dormitory township Atlantis and surrounding areas.

The Western Cape has emerged as the area with the highest incidence globally, according to a recent UCT study. The province has an incidence of between 40.5 to 46.4 cases per 1 000 children aged 5 to 9. The incidence worldwide is 0.5 to 2 cases per 1 000 in developed countries for the same age group.

Ras, a city council member for ward 32, said there was an urgent need for an incisive and detailed study “on the devastating effects of alcohol abuse on the children of Atlantis and surrounding areas”.

Atlantis, about 40km from the Cape Town CBD, and not a reservoir for labour on the winelands, has been particularly hard hit over the last two decades with unemployment and crisis levels of alcohol and drug abuse.

The latter especially takes the form of binge drinking and the consumption of cheap fortified alcohol, often fermented using dangerous accelerants.

FAS is associated with excessive alcohol consumption – classically binge-drinking – by mothers during pregnancy, and apart from the retardation of physical growth is also associated with developmental disorders and the retardation of cognitive development.

More broadly, it has been linked to behavioural problems like impulsiveness and inability to concentrate – features of what is known as the FAS spectrum of disorders.

Ras told Weekend Argus a preliminary investigation into alcohol- related problems had revealed an alarming trend of developmental disabilities affecting young children in Atlantis.

“Our work at this stage has been limited to social workers and abuse counsellors who have collated anecdotal data that points to a deeper, much more serious problem, for which we now need urgent intervention of medical professionals who can assess the problem and produce guidelines for effective and sustainable interventions that can address the problem and arrest the trend.”

Specific studies needed to be conducted, she said, “as a matter of urgency” at local maternal clinics and at schools to ensure that the full scope of FAS is assessed.

“With a detailed study of this nature, we would be able to be effectively plan interventions,” said Ras.

The city councillor said she had “first hand knowledge of the effects of FAS” because it had affected some of her family members and people she knew personally.

Ras said Atlantis is “only the tip of the iceberg” of the problem, because indications were that there were “more communities, already reeling from the effects of drug abuse and other social ills, where the problem had manifested in the greater Cape Town”.

“This problem is compounded because we are trying to deal with a tik (methamphetamine) problem that is spinning out of control, and resources which should have gone into taking on problems associated with alcohol abuse have been diverted to confronting the drug scourge.”

A study completed two years ago in the West Coast town of Aurora revealed that out of 160 children tested, 78 (49%) screened positive for FAS.

It concluded: “FAS may be very high in isolated communities or in particular hot spots. It adds to growing evidence that FAS is a significant, and underestimated health problem in South Africa.”

Ras said the problem had been brought before the city council’s portfolio committee on social development which had launched a public awareness campaign, but that this was just not enough to tackle the collateral damage on children.

“What we need now is a concerted effort that brings together all relevant sectors including medical professionals, research institutions, educators, the private sector and government,” said Ras.

University of the Western Cape historian and sociologist Dr Yvette Abrahams, also a gender studies specialist, supported the call made by Ras.

Abrahams believes “now is the time for a comprehensive multi-sectoral study, because there has been far too little money spent on the problem”.

She believes the problem is pervasive and so serious that “we have to take responsibility in this generation”.

She said: “Survivors of genocide, slavery, land dispossession who suffer from post-traumatic stress disorder grow up thinking excessive drinking is normal, because they’ve observed it and emulated it over generations.”

Several intensive studies over the past few years have said that the Western Cape tops the list of problem areas worldwide with the number of people affected by FAS.

One study, conducted in Aurora by the Foundation for Alcohol Related Research revealed alarming statistics of 49% of the children studied showed signs of the disease.

This study was prompted by retired psychologist Pam Tilley.

The former Aurora resident said she noticed “unemployment and a ready supply of alcohol from shebeens and the local bottle store made drinking a daily thing, where people were seldom sober”.

After attempts to address the problem, she enlisted the support of Liana Olivier, who was able to gain the support of the community and the consent of the parents for a study to be conducted.

The report, “Burden of foetal alcohol syndrome in a rural West Coast Town of South Africa” (October 2012), conducted under the auspices of the Foundation for Alcohol Related Research, noted “of 160 learners screened, 78 (49%) were screen positive (showed signs of FAS), of which 63 (81%) were clinically assessed for FAS”.

This report, published in the South African Medical Journal notes that FAS is endemic to impoverished communities of the Western Cape and Northern Cape, with an alarming prevalence ratio in one area of 135.1 to 207.5 per 1 000 in one area.

Symptoms associated with FAS include distinctive facial features, such as head and jaw size, compromised nervous systems, and developmental and cognitive disabilities.

Sunday Argus