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Report Spells Out Tragedy of Fetal Alcohol Syndrome

Medical workers are getting better at recognizing FAS, but treatment funds are scarce.

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The most innocent victims of all.
Photo via thinkstockphotos

By Dirk Hanson

06/10/11

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Fetal Alcohol Syndrome, also known as Fetal Alcohol Spectrum Disorder, has been a recognized complication of heavy drinking for more than 40 years. Caused by damage in the womb due to excessive maternal drinking, it results in abnormal facial features, small head size, and difficulties with memory, learning, coordination, and control. The Bulletin of the World Health Organization recently reported on the Western Cape area of South Africa, famous for wine growing, and also for the highest reported rate of Fetal Alcohol Syndrome in the world. Marion Williams, a 45-year old mother in the region, whose third child was “born slow,” says she blames herself for her son's disabilities. Heavy drinking in Western Cape farming communities goes back 400 years, connected with traditions of giving slaves free alcohol as payment and as an addictive tool of control. There is also a long tradition of illegal bars, called shebeens. “He can work with his hands and build cupboards but not a thinking and writing job,” Williams said of her son. “He asks me why I drank so much. I don’t really have answers for him.”

Denis Viljoen, a geneticist in Cape Town, called fetal alcohol disorder “the most common birth defect in South Africa, by far more common than Down Syndrome and neural-tube defects combined.” The Bulletin reports his shocking and much-disputed conclusion: One out of every 10 children seen at his clinic in Cape Town is suffering from a version of Fetal Alcohol Syndrome. And he insists the problem is not limited to the rural poor. “We see an increasing number of children with fetal alcohol spectrum disorders from middle and higher socio-economic groups,” he told the Bulletin.

Is there an epidemic of fetal alcohol syndrome, or are researchers simply getting better and looking for and diagnosing the problem? Viljoen thinks it’s the latter, and thinks it’s true throughout the developed world: Not more cases, but the discovery of more existing cases. As late as 2007, the British Medical Association called on member health professionals to make greater efforts to detect and prevent FAS. In Russia, a program funded by the University of Oklahoma and U.S. Centers for Disease Control (C.D.C.) is just now attempting to prevent Russian women from drinking during pregnancy. “Our country has one of the highest levels of alcohol consumption with drinking among women on the rise,” said a scientist at Moscow’s Federal Research Institute for Health Care, “and recent studies found high rates of fetal alcohol syndrome in Russian orphanages. Now it is time to act.”

There are no reliable global figures on fetal alcohol syndrome, but a 2005 U.S. study estimated a global rate of about 1 per 1000 live births.  And there is not much in the way reliable NGO activity, either. Which doesn’t make much economic sense. An American study, published in the American Medical Journal, did its best to estimate the total U.S. social costs—loss of productivity, lifelong medical care, rehabilitation expenses—and came up with the staggering figure of $4 billion—in 1998 dollars. And there is no cure.

By the way, Marion Williams gave up alcohol completely when she found herself pregnant again. According to to W.H.O. report, the child “came out fine,” and today is a healthy 12-year old girl hoping to become a teacher.

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