04/09/2017 06:09 SAST | Updated 04/09/2017 06:10 SAST

Fetal Alcohol Syndrome Is A Real Crisis In South Africa, Deserving Of Urgent Attention

It's a permanently crippling but totally preventable condition.

Andrew Aitchison via Getty Images
A young baby suffering from Fetal Alcohol Syndrome in the arms of a child minder.

The latest global statistics on Fetal Alcohol Spectrum Disorders' (FASD) prevalence in South Africa should be a warning call to local authorities to urgently act on the condition, caution researchers. Out of 187 countries, a study found that South Africa has the highest prevalence rate of FASD, at 111 per 1,000 people.

FASD is an umbrella term used for a group of permanent, life-long and irreversible conditions caused by the effects of alcohol on a foetus. Fetal Alcohol Syndrome (FAS) is the most severe -- with at least two characteristic facial features, growth retardation in terms of height and weight, a smaller head circumference and central nervous system damage with neurodevelopmental delays.


Similar research into FASD by the Foundation of Alcohol-Related Research (FARR) found that at least three million people in the country are affected by FAS, with about six million affected by FASD.

A 2016 study by the foundation assessed grade one learners in 17 towns across three provinces: Gauteng, Western and Northern Cape. The organisation discovered that FAS was prevalent in 29 to 290 per 1,000 live births.

Compared to 10 per 1,000 in Canada, 10 to 15 per 1,000 in the USA, 35 per 1,000 in Italy and 12 per 1,000 in Croatia, FARR believes this is alarming.

The organisation's CEO Leana Olivier is of the opinion that the condition is not being acknowledged as an urgent priority and this needs to change.

Chief research technologist at the South African Medical Research Council Elmarie Nel dismissed the myth that one or two glasses of wine per day are fine during pregnancy. She told HuffPost SA: "It is totally not true. We are of the opinion that no alcohol should be allowed during pregnancy."


Nel also clarified that even if the father-to-be drinks heavily or is an alcoholic, his sperm cannot contribute to FAS in the unborn child. "It can only be from the mother because the alcohol that she drinks is absorbed via the placenta by the baby, which then can cause FASD."

Education, education, education
Children should already be educated in high school on FASD, advises Nel "because this is the one condition that can be totally prevented."

She recommended that there should be life skill programmes, especially in areas where alcohol abuse is rife.

A motivational interviewing intervention was found to be successful in the Western Cape in 2013. At least 165 women aged 18 to 44, who were at the beginning of the controlled trial found at risk of an alcohol exposed pregnancy, were later found to be significantly less at risk.

The researchers recommended that such an intervention be part routine primary care clinic services in similar populations.

Governmental prevention programmes are currently limited to areas identified as high risk: Kimberley, De Aar and Upington in the Northern Cape, and Witzenberg and the West Coast in the Western Cape.

But the awareness should not be one-sided, cautions Nel. She is of the opinion that if expectant mothers and fathers are educated on FASD, this can help reduce the scourge. "When we educate the women, we like to include the spouses so that they are aware of the problems that might occur."

She also advises that women who are planning on getting pregnant not to drink alcohol until they know for sure if they are pregnant or not. This is because, by the time they discover they are pregnant, they might be four to six weeks in and even this early on, alcohol consumption is risky for the growing fetus.

Olivier believes multidisciplinary and intersectoral interventions are urgently needed to raise wide-ranging awareness about the dangers of prenatal alcohol exposure. If not, the condition will continue to cost families, communities and the country at large, owing to FASD's effect on the "psychosocial, vocational and overall wellbeing of the nation."