Many Eastern Cape women start to drink alcohol at ages as young as ten years old and the area now has the highest reported rate of fetal alcohol spectrum disorder (FASD) in the world, according to research released by the Foundation for Alcohol Related Research (FARR).

Thirteen percent of Grade One learners in the Nelson Mandela Bay
areas of Bethelsdorp and Helenvale have been diagnosed with FASD. 

“In many cases the day on which the women we interviewed were
introduced to alcohol, was also the day on which they began drinking regularly.
It shows that there is a high level of acceptance of alcohol in the community
and that it is not frowned upon,” says FARR’s head, Leana Olivier.

Research has shown that up to three quarters of pregnancies in
South Africa are unplanned or confirmed late which can result in women drinking
alcohol without knowing that they’re pregnant. 

Previously, De Aar in the Northern Cape was thought to have the
highest rates of FASD with a prevalence rate of 12.2%, based on studies conducted
in 2002. 

According to the United States’ Centre for Disease Control FASD
“are a group of conditions that can occur in a person whose mother drank
alcohol during pregnancy” resulting in mild to severe consequences such as
stunted growth, intellectual disabilities, abnormal facial features, vision and
hearing problems as well as problems with the heart, kidneys or bones.

“What this research also proves is that high rates of FASD are not
only found in rural areas, impoverished communities and amongst older mothers
as previously thought,” says Olivier. “We found extremely high rates in urban
areas, among young mothers and not limited to any specific socio-economic

Olivier says the “dilemma” is worsened by the fact that many of
the women involved in the research were not aware of the risks posed to their
babies from drinking alcohol while pregnant.

“There were moms who had never even heard about these dangers and
were absolutely devastated to find out the consequences of their alcohol use on
their children,” she says.

Alcohol an only resort for some
Some women however were aware of the “possible risks”, but she
says, “their living circumstances are sometimes so terrible they see alcohol as
the only way to survive – they use it to self-medicate and to escape their
desperate conditions”.

According to FARR the research only identifies the problem and further “inter-departmental action” is required to support children affected by
FASD who have specialised health, social and education needs which are often

The FARR study was commissioned by the Eastern Cape Liquor Board
in 2013, funded by the South African Breweries, and will continue to

The organisation has trained 182 foundation phase educators in the
area on how to manage the particular needs of children with FASD in the
classroom and provided 70 local social workers with “awareness and prevention
training, equipping them with the necessary skills and knowledge to incorporate
into their day-to-day service delivery”.

South Africa has been at the “forefront” of FASD research on the
continent, even though studies have largely only been conducted in the Western,
Northern and Eastern Cape provinces, but FARR has plans to extend their
research to the rest of the country starting with the Free State towards the
end of this year. 

“As for the rest of the continent,” Olivier says there is “almost
nothing” with regards to FASD research. 

“All the figures quoted for the region rely on research done in
South Africa, particularly in the Cape, so there is an urgent need to assess
the problem in other countries on the continent.”

The available research on the extent of FASD is mostly from
developed countries with much lower rates. For example, in Canada, there is an
average prevalence of 1%, according to the World Health Organisation. 

But Olivier says that the situation for developing countries is
confounded by a lack of specialised services for children affected by FASD and
a “culture of drinking” coupled with “a lack of education about the

“In many communities excessive alcohol consumption is so
normalised that it’s extremely difficult to break these barriers – to say that
absolutely any drinking during pregnancy is not okay. This can be a hard message
for some to take on.”

Fetal Alcohol Spectrum DisordersEastern Capebinge drinking