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FASD Conference 2015

HiSA/Rotary 3rd South African FASD Conference

Overview

The focus for this year's conference was on prevention of FASD. What are the tools and techniques being utilised across the world, with an emphasis on experience and evidence gained in South Africa, to help people understand the dangers of drinking alcohol during pregnancy, and then to abstain for those nine months?
The conference was hosted jointly by the Rotary Club of Kimberley South and Hope in South Africa. It was held in the William Humphreys Art Gallery in Kimberley on Saturday 24th January from 10am to 2pm. 

Programme
Programme Director - Mr Richard Jones
  1. Registration With refreshments (plus time to walk around the gallery) 8.00-10.00am
  2. Welcome - Dr Meldrick Booysen, Rotarian
  3. Overview of FASD in the Northern Cape - Ms Mercia Fani, Programme Manager, Dept. of Social Development
  4. Interactive theatre presentation - “TakeAWAY” Media For Change
  5. Keynote address: Fetal Alcohol Spectrum Disorder: The Reality in the Northern Cape Province - Prof Denis Viljoen, Chairperon of FARR
  6. Literature Review: Psychosocial Risk Factors for Alcohol-Exposed Pregnancies - Ms Bettina Daubermann, Clinical Psychologist and Rotarian
  7. The BOB experiential learning program - Mr Francois Grobbelaar, CEO & Founder of FASfacts
  8. A wide-ranging educational and developmental project in rural Hantam Karoo - Ms Lesley Osler, Hantam Community Education Trust
  9. Educate, Inspire, Mobilise: Stop FASD through the use of sports programmes - Mr Thuso Jones, Grassroot Soccer education specialist
  10. Future plans - Mr Jonathan Warner & Ms Mary Nagle, Rotarians and HiSA
  11. Discussion, Q&A - Facilitated by Ms Mercia Fani 
  12. Vote of thanks - Ms Johanna Snyman, President of the Rotary Club of Kimberley South

Invitees/Participants

130 people registered to attend the conference and more than 100 participants came on the day. This was an unprecedented result after just three years of running this annual conference. 

Participants included Rotarians from the Rotary Club of Kimberley South as well as our sister club, the Rotary Club of Kimberley (including the President and Secretary). There was the President and his wife from the Rotary Club of Beaufort West, Rotarians from the Rotary Club of Colesberg , as well as Rotarians from the Rotary Club of Carroll Creek in Maryland, USA - a very warm welcome to Jonathan Warner and Mary Nagle who are also activists in Hope in South Africa.

In the build up to the conference we have been working closely with a range of professionals from government, including the Departments of Health, Education and Social Development. Participants included managers, nurses, social workers, psychologists, therapists, doctors and others.

From the non-government organisations we have forged strong links, indeed partnerships, with the Foundation for Alcohol Related Research (FARR) and FASfacts, both of who spoke at the conference. The Hantam Community Education Trust and Grassroots Soccer who also both presented. Other participants included representatives of the Helen Bishop Home, the National Council for Persons with Physical Disability, the Association for Persons with disabilities, the Society for Mental Health Care, the Indigo Theatre Company, and lastly, but by no means least, we have community members and business people attending in their personal capacity.

You can download the list of people who registered for the conference (go to the bottom of this report) and use it for FASD networking purposes. Please do not abuse this privilege.

Industrial Theatre Presentation by "TakeAway"

Presented by: Mhimhi Mabona, Andiswa Makai and Joseph Martins. TakeAWAY Thteatre
Abstract
TakeAway Theatre has produced a unique range of theatre-based interventions on Fetal Alcohol Spectrum Disorder since 2004, when they made a short show called The FASSISTS for the Western Cape Department of Health, to educate hospital workers about the condition. The lead singer of Freshlyground, Zolani Mahola, was in the show – one of three hip-hop lovin’ pregnant mums. 

After this, the company investigated the possibility of creating a more in-depth show on FASD that appealed to diverse audiences, and approached NGO’s and community organisations for their input. Amongst these was FARR (the Foundation for Alcohol Related Research.) TakeAway found funding for a pilot project, and visited some at-risk communities, experiencing FASD at close quarters with the guidance of social workers. They learnt more in dedicated workshops from FARR, who continue to provide a mentoring relationship to the company. 

The 35-minute production that resulted, with the continuous input of FARR and others in a work-shopping process, is called Die Liefdeskind/The Love Child. It has been performed since 2006, with almost five hundred shows all over the country – all with the original cast! 

TakeAway Theatre also created an interactive, fully improvised 8-hr long performance on FASD in Cape Town shopping malls for 10 successive days in 2010. They aim to send a theatre van on the road for a year, with social worker – a show a day all over the country, and literally put FASD on the map. 
The Play
Die Liefdeskind is a 40-min production by the industrial theatre group TakeAway. It is a show about a young woman called Jacky, and her roller coaster ride through life. The audiences laughed, screamed, cried and squirmed with her as she dealt with the dangers of alcohol, sex, pregnancy and parties.

The Rotary Club of Kimberley South and the US charity Hope in South Africa (HiSA) sponsored two post-conference presentations of this play in Sol Plaatje municipality on Sunday 25th January. The first was at the Elliot RC Hall in Galeshewe at 1pm, followed by a second performance in the Pescodia High School, Roodepan. More than 120 people attended the first show, with more than 150 at the second show.

Visit takeawaytheatre.com to download video of Die Liefdeskind, Project Reports and more.
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Keynote Address: Fetal Alcohol Spectrum Disorder: The Reality in the Northern Cape Province 

Presented by: Prof Denis Viljoen: Founder and Chairperson of the Foundation for Alcohol Related Research (FARR); Extra-ordinary Professor at WITS and Stellenbosch Universities
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Abstract
Fetal Alcohol Spectrum Disorder (FASD) is caused by alcohol use during pregnancy.  The alcohol consumed by the pregnant woman enters the bloodstream of the unborn baby and can cause permanent, irreversible damage to any of the developing cells of the fetus. The brain starts developing right from conception and is the most vulnerable to the teratogenic (poisonous) effect of alcohol.  Children born with FASD therefore always have brain damage which causes life-long learning and behavioural problems. 

Fetal Alcohol Syndrome (FAS) is the most severe form of FASD.  In South Africa prevalence studies focus on the detection of FAS as some FASD conditions requires extensive testing and diagnostic procedures which is too expensive and intensive to conduct in community prevalence studies.  By doing these scientific studies in large enough samples of the population, the research findings can be extrapolated to provide prevalence rates for the entire communities in the study sites.

Studies in 2001 – 2003 in De Aar and Upington revealed FAS prevalence rates of 122 to 69/1000 in the population (Urban, et al 2008).  At that stage De Aar had the highest FAS prevalence rate in the world. 

By developing and implementing intensive community awareness and focused prevention programmes, FARR has successfully facilitated a 30% decrease in the FAS rate in the De Aar community.  This has led to the development of FARR’s evidence based programme, the ‘Healthy Mother, Healthy Baby Programme©’, which has brought about a further decrease in the FASD rate in De Aar (Chersich, et al 2011). 

Based on the above mentioned successes the Department of Social Development (Northern Cape) funded FARR to conduct a FAS prevalence study in Galeshewe and Roodepan, Kimberley. The study revealed a rate of 60/1000 (6,09%) for the two areas, with a prevalence rate as high as 110/1000 (11%) in some areas within Galeshewe (Urban, et al, article in press).  

The Kimberley rate is alarmingly high given the fact that the FAS prevalence rate reported in a previous study done in a city (Johannesburg, FARR 2002) was 27/1000 (2,7%).  The belief that FASD is a problem in rural communities only is hereby challenged. 

The rate in the USA (1-3%) is the closest to the South African rates. Information obtained in the study furthermore indicates that 83% of the mothers of the children with FASD were still drinking at the time of the study; the drink of choice during pregnancy is commercial beer and then wine.  Of great concern is that 23% of the mothers were already dead by the time their children were in Grade One.

Towards the end of 2012 FARR started with FASD Awareness, Training and Prevention Programmes in Galeshewe and Roodepan. These programmes were funded by Discovery and Distell Foundations and included FARR’s ‘Healthy Mother, Healthy Baby Programme©’, which provides support to pregnant women to have healthier pregnancies and healthier babies. 

With the support of the Department of Health, pregnant women attending antenatal clinics, in the highest risk areas, were invited to register for the ‘Healthy Mother, Healthy Baby Programme©’. Some of the women already gave birth and their babies were examined by Prof Viljoen who detected a marked decrease in the birth of children with FASD.

As part of the follow-up of the research, counselling and support were provided to all the mothers/fathers/caregivers of the children with FASD.  98 Foundation Phase Educators and School Psychologists, 18 Dieticians, 14 Occupational-, Speech and Physiotherapists, 92 Nurses and 74 Social Workers were trained by FARR to enable them to continue with FASD Awareness and Prevention work in Kimberley after the end of the project.  

Since 2012 FARR has involved thousands of community members in Kimberley in FASD Awareness and Programmes such as industrial theatre shows, awareness walks, talks at clinics and presentations to inform people about the dangers of alcohol use during pregnancy. 

The key message remains: If you are of childbearing age, sexually active, using alcohol and are not on a contraceptive method, you are at risk of having a child with Fetal Alcohol Spectrum Disorder! No alcohol is safe during pregnancy.


Presentation: Literature review - psychosocial factors for alcohol-exposed pregnancies

Presented by: Bettina Daubermann, Clinical Psychologist and Rotarian
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Abstract
As research shows that South Africa has the highest reported prevalence of Fetal Alcohol Syndrome (FAS) in the world, a literature review has been conducted to determine whether certain psycho-social factors precipitate and perpetuate this epidemic.

The act of drinking alcohol can be considered both psychological and social where psycho-social factors are an inter-play of being influenced by and influencing the other. A theme of psycho-social risk factors for alcohol exposed pregnancies (AEP) became apparent from a variety of articles published in South African newspapers and the Symposium for the Prevention of FASD held in 2008. Results were shared about FASD research and projects in South Africa by FARR, MRC, UCT and UP, amongst others.

A situational and gap analysis that was presented by key role-players at the Symposium revealed that maternal and community level risk factors for an alcohol exposed pregnancy were complex and that many occurred within a context of poverty.

In reviewing the studies conducted in South Africa and presented at the symposium the following psycho-social risk factors for alcohol exposed pregnancies were found: poor rural populations were most at risk in the Western Cape; very high FASD prevalence was associated with very poor socio-economic circumstances of the communities assessed in the Northern Cape, in which the majority of mothers with maternal profiles for FAS had less than seven years’ schooling, were unemployed, over 80% smoked, over 70% were unmarried, and over 80% had had unplanned pregnancies.

Another study also concluded that there were higher risks for alcohol-exposed pregnancies amongst rural women, who were associated with lower socio-economic status. Furthermore, the associated factors included current smoking, early drinking, a low level of education and schooling. Predictors of risk that were found for urban women, namely current smoking and access to recreational facilities, were attributed to more access to alcohol-exposed facilities and disposable income.

South African research projects have found that women at risk for alcohol exposed pregnancies are responsive to intervention methods, such as education about the risks of alcohol use, simple advice, motivation as well as being provided additional support. A research project that looked at motivational factors for women to change their drinking behaviour based on certain intervention methods revealed positive results.

In reversing the motivational factors that were found, the following de-motivational factors may be considered as psycho-social risks for alcohol exposed pregnancies: lack of social support by a significant other; lack of self-help about alcohol; lack of empowered decision-making; lack of motivation to care for the baby’s health; associating with friends who drink; lack of activities to keep busy; lack of religious affiliation; a partner who drinks; stress and boredom. Furthermore, many women had reported feeling unsupported and alone, and were without stable relationships and moved around.

A study of the barriers in preventing and managing FAS in South Africa found that service-providers also played a role in increasing the risk of AEP, as there were inadequate standardised methods in identifying women at risk for AEP and lack of resources for women to address any alcohol-related problems.

It can be inferred from South African research findings that psycho-social factors play a role in precipitating and perpetuating alcohol exposed pregnancies and as a result, Fetal Alcohol Syndrome Disorder in South Africa. 

Presentation


Presentation: The BOB experiential learning program

Presented by: Francois Grobbelaar, CEO and founder of FASfacts
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Abstract
BOB means “Beste Opgepaste Baba” in Afrikaans (“Best Cared for Baby”) and represents the baby of a mother that abstained from alcohol during her periods of pregnancy and breast-feeding.

FASfacts’ Experiential Learning Program makes use of human senses (hear, touch, see, smell, taste) to convey the FASD message to grades 6 & 7 learners.  The program uses many activities to increase the probability that learners will remember what they have been taught.

Many life-skills are incorporated in the 3 Modules for grade 6 learners and a fourth module for grade 7 learners.  Life-skills which are incorporated into the first module are to respect each other, to be honest with each other and to make a positive difference in other people’s lives.

In Module One the learners are educated in the basic knowledge about FAS/FASD.  Each learner plants a bean which represents an unborn child which he/she takes home to nurture.

In Module Two the girls pledge, “I will not drink any alcohol when I am pregnant with my baby”.  The  boys pledge, “I will help my wife/girlfriend not to drink any alcohol when she is pregnant with our baby”.

Module Three equips each learner to be a change agent in his/her community.  When these grade 6 learners pass on to grade 7 they receive a module on Self-Esteem.  The main theme of this module is “I can” – they are given the tools to make positive life choices.

During the program each learner receives a FASfacts T-shirt which serves as a tool to convey the-message “Say No! Alcohol when pregnant” into communities. To strengthen self-esteem each learner receives a FASfacts cap with the wording “I can”. Thousands of children already went through the BOB-program with excellent feedback.  Our dream is that each grade 6 & 7 learner in South Africa must receive the opportunity to attend the BOB-program.

FASfacts’ programs for other focus groups:
  1. For secondary learners, youth and adults, FASfacts presents its General FAS-Awareness program which also focuses on the prevention of alcohol and drug abuse in general.
  2. FASfacts has a Train-the-Trainer program in which they train program facilitators from other NGOs and role-players to present their General FAS-Awareness program.  This partnership ensures the FAS-message reaches a large number of at-risk communities more rapidly and in a sustainable manner.
  3. Another very effective program is FASfacts’ Pregnant Women Mentoring program where pregnant woman consuming alcohol are motivated, educated and supported by mentors on a voluntary basis to abstain from alcohol and other harmful substances during their periods of pregnancy and breastfeeding. 

The positive effects of FASfacts’ FAS Prevention Campaign in at-risk communities are evident in FASfacts’ Impact Assessment Studies.  Three of the main findings were:
  1. A total number of 82% of respondents indicated that their knowledge of FAS increased since the introduction of FASfacts’ programs.  What was encouraging was the finding that the Experiential Learning methodology applied in all FASfacts’ programs, does make an impact on the adults and learners.
  2. That 70% of respondents indicated that the communities to which they belong are more health conscious after the presentation of FASfacts’ programs than they were before attending the programs.
  3. 59% of respondents indicated that from their perspective, behaviour changes took place after the presentation of FASfacts’ programs, while 25% felt that behaviour change was not affected, and 16% of the respondents were unsure.

Presentation


Presentation: A wide-ranging educational and developmental project in rural Hantam Karoo

Presented by: Lesley Osler, Hantam Community Education Trust, Colesberg
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Abstract
In 1989 the wives of three farmers in this rural area decided to start what was to become the Hantam Education Centre – a small early learning facility for the children of farm labourers in the area. Almost 25 years later, what had initially started out as a relatively simple idea is now a dynamic, award-winning initiative driven by the passion and desire of local people who want to ensure that their children are provided with opportunities. In fact, the local community members were not only instrumental in encouraging Hantam's initial growth beyond a facility exclusively for early learning, but have been ongoing critical and engaged partners, even deciding on the language of instruction at the Centre, for example.  

Hantam Community Education Trust manages programmes for about 200 learners in early childhood development (involving families as well as their children), health (including an on-site pharmacy), youth development, bursaries for continuing education, and the farm school.  

Their overall purpose is to “educate and develop members of the local community within the framework provided by the South African Constitution”. Proof of their success in achieving this is evident throughout the Centre while a clear example is the fact that some of its current teachers were among the Centre's early learners.

Today the Hantam Community Education Trust is a wide-ranging educational and development project. The trust uses advanced educational methods; it also helps learners’ complete further training. The Trust also manages community health and youth development programmes.

In 2010 Hantam Community Trust received an Impumelelo Platinum Award for their work in Education. It has grown a lot since 2010, they have revised their Grade R policy, and children now spend two years in Grade R which they have claimed to be a very successful decision.

Their effective parenting has grown and developed to incorporate active parental involvement with their children. There was also the birth in 2013 of farm worker apprenticeship programme; graduates are placed with farmers for a year to be mentored in all aspects of farming.

The Hantam Community Education Trust is making renewed efforts to address those factors outside its school gates which affect their educational efforts and undermine the potential of their children. Key among these is the disabling home environments of many children in our catchment area.

Like those in rural areas elsewhere, many local households display various levels of poverty and deprivation. Many of their children suffer from FASD or are traumatised by alcohol-induced violence in their homes, resulting in a tragic waste of human potential. The Trust has decided it needs to find new ways of breaking through this self-perpetuating legacy.

As in many other deprived rural areas, many farm workers have low levels of self-esteem. The Trust is engaging with the community to find ways of giving them a new sense of self-worth which will enable them to function as more responsible workers and parents, thus enhancing the educational prospects and therefore the life chances of their children.


Presentation


Presentation: Educate, Inspire, Mobilise: Stop FASD through the use of sports programmes

Presented by: Thuso Jones, Grassroot Soccer RSA
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Abstract
Grassroot Soccer (GRS) realized that the true power of soccer has always been connections that it creates between people. Using footballers as role models, and using the popularity of soccer to engage hard to reach young people, GRS has combined social theory, public health methodologies, rigorous evaluation and a huge dose of passion.

Our curriculum is based on the Social Learning Theory. The program combines three powerful principles of education:
  • Kids learn best from people they respect. Role models have a unique power to influence young minds. Young people listen to and emulate their heroes. GRS uses professional players and other role models as HIV educators and spokespeople.
  • Learning is not a spectator sport. Adolescents retain knowledge best when they are active participants in the learning process, teaching others what they themselves have learned. GRS graduates are trained to become peer educators and advocates in their communities.
  • It takes a village. Role models can change what young people think about, but lifelong learning requires lifelong community support. GRS fosters community involvement through youth outreach, long-term partnerships and special events like graduation ceremonies for graduates.

Initially developed in collaboration with the US Centers for Disease Control and Prevention, the Zimbabwean Ministry of Education, medical professional, and educational and public health experts, the GRS curriculum uses activities and games to provide youth with comprehensive HIV prevention and life skills education. As GRS has grown, several well-respected HIV prevention experts have served in an advisory capacity including Albert Bandura, Martha Brady, Douglas Kirby, Thomas Coates, and Helen Epstein.

The GRS curriculum fits WHO criteria on which school-based interventions should be brought to scale (see WHO Technical Series 938: Preventing HIV/AIDS in Young People), has been approved by a large network of stakeholders, and has been implemented on a wide scale through projects funded by (among others) USAID, AED, UNHCR, the Bill and Melinda Gates Foundation, the W.K Kellogg Foundation, CARE International, and the Abbott Fund in South Africa, Zambia, Zimbabwe, Tanzania, Malawi, Ethiopia, and Namibia (among other countries). Implementing Partners of all sizes (including FHI, JHUCCP, IOM, and Mercy Corps) use GRS methodologies in their own programs across Africa.

Grassroot Soccer has been operating in South Africa since 2006, and set up its African headquarters in Cape Town in 2008.
Following the successful design and implementation of the DeBeers Pilot Project in the Northern Cape in 2006, GRS ushered in 2007 by launching several community-based, football for development programs across South Africa. New sites were created across South Africa, including Port Elizabeth, Cape Town, Gauteng Province, Bloemfontein, the Northern Cape and Limpopo Provinces.

Presentation


Future plans

Presented by: Jonathan Warner and Mary Nagle, both Members of the Rotary Club of Carroll Creek in Maryland, USA and of Hope in South Africa
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Abstract
Sport has incredible power to educate youth and transform communities. This is clearly demonstrated by Grassroot Soccer (GRS)’s successful youth focused HIV prevention program that has been running in the Northern Cape of South Africa since 2007. 

Multiple evaluations from that program clearly indicate positive impact on knowledge, attitudes, stigma, and communication related to HIV. Further, evidence exists that the GRS program contributes to decreased risky behaviours and improved health-seeking behaviours among youth participants and the wider community.

Responding to a direct request from local community members who experience the devastating effects of Fetal Alcohol Spectrum Disorders (FASD), the Rotary Club of Carroll Creek (International club based in USA) and the Rotary Club of Kimberly South (Host club based in South Africa) aim to use lessons learned from the successful GRS program to launch a sports-based life skills program to combat FASD in the Northern Cape of South Africa – where the largest FASD epidemic on the planet exists.

Key objectives of the proposed 2-year project include:
  1. Develop an interactive sports-based FASD prevention curriculum for South African youth aged 10-18.
  2. Identify and train 5 Master Coaches and 45 Coaches from Northern Cape communities of Kimberley, Richmond and Colesberg to deliver effective programs.
  3. Increase knowledge about substance abuse among South African youth and their families by reaching 2,000 youth and 2,000 community members with critical FASD prevention education.
  4. Launch and expand partnerships with key FASD prevention stakeholders including local Rotary Clubs, FARR, FASfacts, and Grassroot Soccer in the Northern Cape Province of South Africa.


Photo gallery


Registration list
You can download the list of people who registered to attend the conference here and use for FASD networking purposes. Please do not abuse this privilege.
fasd_jan2015_conference_invitees.xps
File Size: 298 kb
File Type: xps
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Acknowledgements

The conference organisers wish to acknowledge the following people and organisations:
  • The William Humphreys Art Gallery for allowing us to use their conference facility free of charge.
  • Kia Motor Company (Kimberley) and Mr Drew Spink for sponsoring the refreshments.
  • The Mayor of Sol Plaatje Municipality, Mr KG Molusi and his office staff for helping us secure venues for the post-conference shows on Sunday and the marketing thereof.
  • Thuso Jones, Lebo Ntong and all the young men and women from Grassroot Soccer in Kimberley who assisted us greatly in marketing and organising the post-conference shows on Sunday.
  • To all the presenters and conference organisers listed above.
  • And last, but by no means least, to all the people who gave up their Saturday to participate in this conference - you made it a great success that broke all our expectations.

Post-Conference Rotary Club Fellowship Event

Following the HiSA/Rotary FASD conference on 24th January the Kimberley South Rotary Club hosted a very successful Rotary Fellowship braai and networking event at The Solomon Edwardian Guest House in Kimberley. Rotarians from Kimberley, Beaufort West and Maryland USA swapped jokes and ideas with leaders from government and non-government organisations.

Post-Conference Industrial Theatre Productions in Galeshewe and Roodepan

The Club and the US charity Hope in South Africa (HiSA) sponsored two post-conference industrial theatre production on Sunday 25th January 2014. The first was at the Elliot RC Hall in Galeshewe (attended by over 120 people) and the second was at Pescodia High School (attended by over 150 people). Read more
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