Alcohol is one of the oldest substances to be abused by human beings. It pre-dates writing and the wheel (which we see by the fact that preliterate societies without the wheel had ways of brewing alcoholic beverages). The human fascination with alcohol is thousands of years old. It may not be possible to determine exactly how old, but we can safely assume that we're talking about several millennia (this is in no way meant to be disparaging towards those communities who do not consume alcohol at all). This may lead us into thinking that alcohol is a natural companion of people, something inherently concomitant with the human condition, like pregnancy or falling in love.

Pregnancy? Isn't alcohol and pregnancy a strange combination? Well, you'd be forgiven for thinking so. Modern research has revealed that the combination of alcohol and pregnancy is a particularly noxious one. The thought of the unborn baby getting drunk may be entertaining, but the scientific reality is somewhat less so. The recognised condition that arises from foetal alcohol consumption is known as FAS – Foetal Alcohol Syndrome, and, as we'll see as this article progresses, it is far from being a minor inconvenience.

FAS is a threat wherever a community traditionally displays a high consumption pattern of alcohol, any alcohol, it doesn't matter what form it takes. There is no more safety in drinking only beer than in drinking harder liquor like spirits. It's the ethanol/alcohol that causes the damage. The ethanol is able to cross the placental barrier, and enter the body of the foetus, where it does serious damage because the foetus is relatively small and underdeveloped. We know that drugs and alcohol do the most damage to young, developing brains, and no more so than in the case of the developing foetal brain. The foetus is literally poisoned by the alcohol concentration in the blood that it receives from its mother.

The most obvious and lasting consequence of this poisoning is brain damage. This damage will be apparent in the life of the child, and is typically demonstrated by below-average cognitive abilities and impulsive, poorly judged behaviour. The most obvious phenotypical (physical appearance) manifestation of FAS is in the face. The development of the face is closely linked to the development of the brain, and the face of an FAS sufferer betrays their condition. The give-away signs are abnormally widely-spaced eyes, a flat or absent nose bridge, an undifferentiated philtrum, and thin upper lip. But don't believe that everyone who remotely resembles such features is retarded. Only a qualified doctor can safely identify FAS. Rather leave it to the experts. The level of retardation in FAS sufferers is also varied.

The obvious question is – why would a mother do this to her child? The answer is hard to fathom, but probably has something to do with the prevailing attitude towards alcohol in the community of which the mother is a member. Research in South Africa is far from encouraging. In the Karoo town of De Aar, there is approximately a 10% FAS prevalence among first graders (according to a 2001 study). Other towns in the Western Cape had a prevalence ranging from 4% to 7,5%, while in the Gauteng province the rate was 1,9%. These data seem to represent something that we have been aware of for a long time anyway – the relatively high consumption of alcohol in South Africa. It is no surprise that pregnant women also consume alcohol.

This obvious corollary of the data cannot be ignored. It has been estimated that in the USA, the life-time costs in medical care and social welfare of each FAS-affected child amount to $800 000. As it is, South Africa is saddled with an enormous social welfare burden. FAS only adds to that burden. And the damage caused by FAS is supposed to be irreversible. These children will be at a serious disadvantage in their educational and professional career paths. They will also be more likely to become alcoholics themselves.

The damage caused by FAS can only be negated through education. Mothers need to understand the risk they are taking by drinking during pregnancy. This education needs to be backed by political will. We need to get serious about protecting our children from this scourge of our communities. If we are genuinely serious about the society that we are leaving to our children, as politicians seem to enjoy claiming, then maybe the greatest gift of all to our children would be their own health. It is something that we can achieve, in our own lifetime, or we can condemn another generation of innocent kids to reduced educational and career prospects. The choice is ours. The time is now.

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