The Western Cape’s Boland district, renowned for its world class wines, also have one of the highest reported levels of foetal alcohol syndrome (FAS) in the world.

Earlier this year, Sanna*, a 21-year-old farm worker in the Rawsonville area tried to take her own life. Sanna, along with thousands of other farm labourers in the district, lost her job after the minimum wage rose from R69 per day to R105 per day following a crippling strike in this sector last year – forcing farmers to cut down their work force.

“There is a deepening of the feminisation of poverty on farms with the wage increase, and this has lead to very particular kinds of health trauma – she tried to take her own life,” said Dr Susan Levine, a medical anthropologist with the University of Cape Town at a session of the Rural Health Conference currently underway in Worcester.

“Her father worked on the same farm for 40 years and her grandfather before that,” Levine told Health-e News. “A genealogy goes back several generations on this particular farm nearly ended in her dying of hunger with no land, no house, no savings and two children who are malnourished.”

Sanna and her young children are one of many labourer families in the picturesque Western Cape Winelands with intimate knowledge of hunger, depression and an array of other health ills plaguing the community.

And with historical, cultural and environmental factors stacked against them, the situation is unlikely to change in the near future, says Levine.

World-class wines, world-class problem

[quote float=”right”]”There is a deepening of the feminisation of poverty on farms with the wage increase, and this has lead to very particular kinds of health trauma”

The Western Cape’s Boland district, renowned for its world class wines, also have one of the highest reported levels of foetal alcohol syndrome (FAS) in the world. FAS is caused when a foetus is exposed to alcohol in the womb, leading to low birth weight, physical deformities, and mental and developmental difficulties.

In the United States, it is estimated that fewer than two out of every 1000 children have FAS, but in the Western Cape around 43 out of every 1000 children are afflicted to some degree, with levels of up to 300 per 1000 children in some Boland regions.

Research by Levine and others have found that the drinking patterns in these communities responsible for the high levels of FAS, is a product of the former “dop” system whereby farm labourers received liquor as part of their wage. The first evidence of a type of “dop” system being introduced in the region was recorded in 1658 by the Dutch settler Jan van Riebeeck who described how they gave liquor and tobacco to slave children to coax them into submission. Although it was formally banned in the 1960s the practice continued until well after the end of apartheid.

After 300 years of practice the culture of drinking is firmly embedded, evident from the high levels of alcoholism in the labour communities. The only change after the abolishment of the dop system, says Levine, is that instead of receiving liquor as part of the wage, labourers are now spending a considerable percentage of their household income buying liquor.

“Drinking is part of labourer’s experience of the farm, and without measures in place to combat alcohol dependency, the admission of the dop system has resulted in a terrible, yet predictable social crisis,” said Levine.

The health ails of these farm workers are not limited to alcoholism and FAS, and they are also particularly vulnerable to tuberculosis (TB), and chronically suffer the effects of pesticide poisoning, which ranges from mild symptoms like skin irritation and in more severe cases may cause neurological damage.

With their close proximity to the ground, children are especially vulnerable to the effects of pesticides.

“Multiple concurrent exposures to alcohol, pesticide and malnutrition – in utero and during the life cycle – means that it is not possible to isolate FAS as that only cause of childhood stunting here in the Western Cape, where the rates among farming communities are twice as high as national averages for urban children,” said Levine.

* Full name withheld to protect the individual.