GOVERNMENT MUST WORK TOGETHER TO DISRUPT THE FASD CRISIS

08 September 2020

The complex social, cultural and political history of South Africa as well as the enforcement of apartheid government policies prior to the attainment of democracy has moulded South Africa’s alcohol consumption.

In coloured communities, the impact of the dop system saw farm workers being paid part of their wage in the form of alcohol. In black townships, there was a proliferation of illegal small scale alcohol outlets due to restriction of access to alcohol by black communities.

In 2016, the national prevalence of Foetal Alcohol Spectrum Disorder (FASD) was reported to have ranged from 29 to 290 per 1000 live births. At that stage, already representing the highest rate of FASD globally.

In 2007, the prevalence of FASD in grade one learners was estimated at 89,2 per 1000 in the WC. In 2013, the prevalence was reported to have doubled to 135,1 to 207,5 per 1000 grade one learners and having further increased to 170 to 233 per 1000 grade one learners by 2016. More recently, the prevalence of FASD in the WC was estimated to be between 196 to 276 children per 1000 representing the highest prevalence in South African provinces.

This is especially among the low-income areas in which binge drinking is common and the sale of alcohol poorly regulated.

Risk factors which entrench high risk drinking are described in varying detail. These include, but are not limited to, low socio-economic status, low educational achievement, an alcohol problem in one or more family members, regular binge drinking, insufficient nutrition as well as high gravidity and parity.

Some studies have shown that mothers of children with FASD report drinking an average of 13 drinks per week and that in most cases, this is done in all three trimesters with less than half of pregnant women quitting in the second or third trimester.

More surprisingly, the literature shows that a large percentage of heavy drinkers are aware of the impact of alcohol on the developing foetus; however, this does little to discourage the mother from high-risk drinking.

Also, individuals with family members with an alcohol problem may well result in a pregnant woman developing high risk behaviour long before becoming pregnant.

The high prevalence rates of FASD must be ascribed to the lack of a comprehensive and multi-sectoral policy. In South Africa, the approach to addressing FASD at all levels of government remains non-specific as demonstrated by the presence of generic and poorly implemented policies.

Appropriate prevention and management efforts continue to pose a challenge for policymakers and service providers. A sustained call for a co-ordinated effort for the prevention and management of FASD has been made by stakeholders.

The literature supports the importance of a co-ordinated whole-of-society policy development approach for the prevention and management of FASD, but it will require commitment from all spheres of government.

During the past financial year, the City's Social Development and Early Childhood Development (SDECD) Department has run 34 citywide foetal alcohol syndrome simulator programmes, reaching up to 1 020 learners aged 16 – 18 years old. The simulators are able to illustrate quite vividly the impact of substance abuse during pregnancy and the programme encourages responsible lifestyle choices, while raising awareness of FAS and the effect of alcohol on unborn babies.

City Health has Basic Antenatal Care programme where they create awareness and reinforce messages of alcohol or harmful substances during pregnancy.

The reality is that no amount of alcohol is safe during pregnancy and it's never too late to stop drinking.
The City has various programmes in place designed to address substance abuse, focusing on intervention through treatment by City Health, and prevention which is the ambit of the Social Development and Early Childhood Development Department.

Also, the City offers treatment for addiction via the eight clinics that offer the Matrix Model of Treatment.

I call upon the political principals at National and Provincial governments to renew their commitment to making use of evidence-based practises to guide co-ordinated policy development within their ambits. The City of Cape Town remains committed to play its role in developing policy and programmes to tackle FASD across all of our communities.

Councillor Zahid Badroodien, Mayoral Committee Member for Community Services and Health, City of Cape Town

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Published by:
City of Cape Town, Media Office