Foetal Alcohol Syndrome (FASD or FAS) is a serious health problem that tragically affects its victims and their families, but that is completely preventable condition. FASD came to public attention in the early 1970s and is now recognised as a major health problem. FASD is a problem that reaches all corners of the Earth – where there is a love affair with alcohol, there is FASD. Unfortunately, it is also a problem that is misunderstood, and often perpetuated by ignorance and denial.
Africa has the world’s highest proportion of binge drinkers. Africa has become a boom market for international brewers and distillers whose sales are often flagging in the wealthy world. Drinks companies want to keep up the momentum. SABMiller is investing up to $2.5-billion (U.S.) over the next five years to build and renovate breweries on the continent. Rival Diageo’s African sales have risen by an average 15 per cent in each of the last five years, and now account for 14 per cent of the group’s total.
For years, poor Africans were limited to home-brew sorghum or maize beer, sometimes made with dangerous ingredients such as battery acid to increase the potency. Commercial alcohol is now widely available in most African states and premium brands such as Johnny Walker whisky or Heineken beer are increasingly in reach of the average drinker.
Many South Africans are binge drinkers. South Africa has one of the biggest alcohol consumption rates in the world. South Africa’s Western Cape province, has the highest reported rate in the world. Foetal Alcohol Syndrome is very prevalent issue throughout South Africa wine-regions- the Western Cape where farm labourers were once paid in alcohol. 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.
Cheap alcohol is common in South Africa, and the shebeen system doesn’t help. Also, poverty is at the root of the problem. The shebeen system is one of informal taverns dispensing alcohol because there’s lack of employment opportunities. So people open up shebeens trying to make a living. De Aar is a town in the Northern Cape Province has 95 shebeens in a population of 28,000. Alcohol abuse leads to unsafe sex and “many, many unplanned for and unwanted children,” and “no doubt” contributes to rising rates of fetal alcohol syndrome and HIV infection according to experts.
Denis Viljoen, a founder of the non-governmental organisation the Foundation for Alcohol Related Research (FARR), states, “Fetal alcohol spectrum disorder is the most common birth defect in South Africa, by far more common than Down syndrome and neural-tube defects combined.”The move is designed to cut one of the world’s highest rates of Fetal Alcohol Syndrome.
FASD is a term that describes a range of disabilities (physical, social, mental/emotional) that may affect people whose birth mothers drank alcohol while they were pregnant. Alcohol use appears to be the most harmful during the first 3 months of pregnancy; however, drinking alcohol any time during pregnancy can be harmful. As mentioned, alcohol can damage a growing baby’s brain, organs and body. This damage can affect how the baby thinks, acts, looks and learns as a child and as an adult. Alcohol damage doesn’t always show up before the child goes to school. And every pregnancy and every baby is different.
There is no cure for FASD and its effects last a lifetime. The World Health Organization recommends that pregnant women should avoid alcohol. The World Health Organization, for instance, says alcohol-related injuries such as road traffic accidents, burns, poisonings, falls and drownings making up more than a third of the burden of disease, all because of drinking. South Africa is considering introducing a law that bans retailers from selling alcohol to pregnant women. A large number of South Africans are misinformed about FASD and when we tell people that drinking just one or two glasses can harm their baby, they don’t believe me.
Causes
Alcohol is readily absorbed from the gastrointestinal tract into a pregnant woman’s bloodstream and circulates to the foetus by crossing the placenta. Here it interferes with the ability of the fetus to receive sufficient oxygen and nourishment for normal cell development in the brain and other organs. The consumption of alcohol directly contributes to malnutrition because it contains no vitamins or minerals, and it uses up what the woman has for metabolism. The foetus is most vulnerable to various types of injuries depending on the stage of development in which alcohol is encountered. During the first eight weeks of pregnancy, organogenesis (the formation of organs) is taking place, which places the embryo at a higher risk of deformities when exposed to teratogens.
Symptoms
A baby with fetal alcohol syndrome may have the following symptoms:
- Poor growth while the baby is in the womb and after birth
- Decreased muscle tone and poor coordination
- Delayed development and problems in three or more major areas: thinking, speech, movement, or social skills.
- Heart defects such as ventricular septal defect (VSD) or atrial septal defect (ASD).
- Problems with the face, including narrow, small eyes with large epicanthal folds
- Small head
- Small upper jaw
- Smooth groove in upper lip
- Smooth and thin upper lip
What happens to children born with Fetal Alcohol Syndrome?
- Their brain is permanently damaged, so they have trouble following simple instructions or remembering things.
- They’re small and don’t grow normally.
- Their faces may look different, such as small eyes and thin lips.
- They’re often colicky babies and hyperactive children.
- They might have trouble seeing, hearing or speaking.
- They might have heart or kidney trouble
The advice of midwives and nurses is likely to have the most powerful impact on pregnant women and help them to avoid the risks. It is essential that the advice given is up to date, consistent and evidence-based, alongside advice provided on other lifestyle choices such as drugs, smoking and nutrition. All health care providers at all levels should be trained to screen for, diagnose, prevent, and treat an alcohol-exposed pregnancy. Curriculum programs and materials tailored to meet the learning needs of these professionals should be developed and used. We need to better understand the many social and psychological processes that contribute to risky drinking and sexual activities in the environments in which these women live, and we must seek to delineate personal and societal interventions that are both acceptable and realizable.
TakeAway Theatre has been creating groundbreaking community theatre with South Africa’s leading Fetal Alcohol Syndrome (FAS)-related research and training organisation, the Foundation for Alcohol-Related Research (FARR), for the past four years. Another non-profit organization works in communities in the North and Western Cape of South Africa and they partnered with SAB Ltd to address the issue of Foetal Alcohol Syndrome. Young girls and adult women are taught the risks of drinking alcohol when pregnant, while young boys and adult men are encouraged to support their future girlfriends/wives not to drink during pregnancy. An independent impact assessment found that 82% of those involved said that their knowledge of FAS and the dangers of alcohol abuse had increased. Let me end with this phrase:
“The future of our country…
Does not only lie within our mothers’ wombs…
But also in the supporting hands of many…
Mothers, Fathers, Families, Community Leaders…
And yours…because in the end it takes a village to raise a child”
African Proverb
Sources
National Council on Alcoholism and Drug Dependency — www.ncadd.org
Fetal Alcohol Syndrome Family Resource Institute. www.fetalalcoholsyndrome.org
World Health Organization: http://www.who.int/bulletin/volumes/89/6/11-020611/en/