Africa's unborn alcohol victims

The foetus can be badly affected by alcohol

By Jo Frater in Cape Town

South Africa's Western Cape province has the highest incidence of foetal alcohol syndrome (FAS) in the world.

FAS is caused when a woman drinks alcohol during pregnancy, causing disruption to some form of the foetus's development.

It is no coincidence that the Western Cape is South Africa's grape farming area and FAS was traditionally concentrated amongst coloured workers on wine farms.

This was a legacy of the dop system, whereby farmers would partially remunerate labourers, male and female, in cheap rough wine.

Huge numbers of people in jails have had their mothers consuming enough alcohol for it to affect their development

Dr Colleen Adnams

This way of life has promoted a culture of alcoholism amongst many of the rural communities in the wine land areas.

Margareta Carmel, who lives in the township of Egoli, in Wellington, has three sons, one of whom has FAS.

She said: "I didn't drink in the week but it would start on Friday and I would drink two six-litre bottles of wine."

She is one of 300 mothers in the area that have been visited by Loretta Hendricks as part of an FAS research project in the region.

"A lot of them want to stop drinking, but they don't know how, " Ms Hendricks said.

Through assistance from the project Margareta has now stopped drinking and is caring for her children in her tidy, well-kept one-roomed home.

She has also helped her husband to stop, despite the pressure to drink from neighbours and friends.

Her son is receiving extra help at school, but has a very short-term memory and difficulty concentrating.

He has many of the physical features of FAS - stunted growth, a thick upper lip, squint and difficulty with speech.

The problem is also spreading to cities like Cape Town.

Bitter experience

Frances Fortain runs a home for FAS children, many the offspring of street women who came from rural areas looking for a better life.

Ms Fortain herself used to live on the streets, drank heavily, sold her body and stole.

She gave birth to two children when homeless, and both were removed by the authorities. One has FAS.

She set up the home to try and assuage her guilt once she had managed to give up alcohol.

"In the first place I couldn't forgive myself", she said. "He could have had such a wonderful life. But I had to put the guilt behind me and move on."

Children are affected by FAS to varying degrees.

The damage depends on the amount of alcohol ingested by the mother, and at which stage of the pregnancy it occurred.

I would never say you can have a glass a week or a day, I would say 'Don't drink'

Frances Fortain

If it was throughout pregnancy all major organs can be affected.

The problems do not lessen as the children grow older.

Developmental paediatrician Dr Colleen Adnams believes FAS is so widespread, possibly affecting over 5% of children, that it is affecting South Africa's crime rate.

"One characteristic of older adolescents is poor social control, they are easily manipulated and can end up in crime," she said.

"Huge numbers of people in jails have had their mothers consuming enough alcohol for it to affect their development."

It is impossible to gauge how much alcohol might cause FAS because it is impossible to know what potential a child might have had without maternal drinking.

Frances Fortain has a message for all potential mothers.

"Sometimes you think it only happens in disadvantaged families but it happens all over the world. I would never say you can have a glass a week or a day, I would say 'Don't drink'."