Babies on alcohol

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GNA Feature by A.B. Kafui Kanyi/ Victus K. Sabutey

Ho, Sept. 23, GNA –
Doreen, 20, sits quietly with tiny beads of sweat quivering near her hairline.
It’s hot in the doctor’s office – she has come to Korle Bu Teaching Hospital in
Accra, to speak with Dr Ebenezer Badoe.

Dr Badoe, a
paediatric neurologist at the Hospital’s Child Health Department, asked: “How
are you, Doreen?” Dr Badoe asked, sitting at his desk across from the teenager.

“I’m doing well.”
She replies, staring off into some unknown space.

Doreen is one of the
many victims of Fetal Alcohol Spectrum Disorder (FASD), a condition found in
children when exposed to alcohol during time in the womb.

FASD is caused by a
woman drinking alcohol during pregnancy. When alcohol is consumed by the foetus
mother, it is broken down in her blood and absorbed into the womb through the
umbilical cord.

The effects of FASD
could be physical, intellective, and behavioral – most affected children
display combinations of all three.

Victims often
struggle with coordination, emotional control, school work, socialisation, and
holding a job, according to the US National Library of Medicine.

The disorder is
known to be among the leading non-genetic causes of neuro-developmental
disability worldwide.

Dr Badoe is Ghana’s
leading researcher on ASD, more commonly known by its more visible
presentation, Fetal Alcohol Syndrome.

From 2008 to 2013,
he documented the first 10 cases in Ghana, a country where alcohol is cheap,
abundant, and readily available, but knowledge on FASD is not.

Although Dr Badoe’s
pioneering medical research is novel here, fetal alcohol syndrome is nothing
new. Ghana, like many other nations – such as the United States and Ukraine has
struggled with this 100 per cent preventable syndrome for years without knowing
of its existence.

A lack of training
and recognition, along with symptoms of FASD like heart disease and mental
disability, has masked the true culprit for decades in the nation’s medical
field.

Dr Badoe’s research
showed that “out of the 10 children documented, 90 per cent presented with
failure to thrive and 80 per cent with heart disease.” Hernias were also
reported.

These grave medical
conditions could easily deter doctors and lead to an overlooked diagnosis
(which has been the sad reality in Ghana for years).

“Apart from South
Africa, there are no publications [on FASD] in Africa. We need to create public
awareness.”

“We can see that her
last finger curves slightly [inwards]. Her fingernails are not well developed,”
Dr Badoe points to Doreen’s hands with a pen.

Her nail beds are
small and uneven, as if she had been biting them. Dr Badoe is identifying only
some of the numerous physical indicators of FASD.

Though the impact on
physical impairment is variable, some symptoms are easy to spot because only
alcohol could create these features.

Dysmorphia of the
face, including a small head, high forehead, squashed nose, and eye
deformations, is a tell-tale sign, according to Dr Julietta Tuakli, the Chief
Medical Officer at “CHILDAccra”.

Dr Badoe explains
that often, the child’s philtrum is missing. “There is no groove above the
upper lip. It’s completely smooth.”

He says, pointing to
a photo of one of his infant patients. “Often the upper lip is much thinner
than the lower one.” He focuses his attention on Doreen. “She has mild
hypoplasia, an undeveloped middle face. Excessive hairiness on her arms, back
and other places are also common signs.”

Regina Amanobea
Dodoo waits outside the doctor’s office. A veteran actress, Queen Mother, and
nurse. Dodoo is the Founder of the Ghana Organisation of Fetal Alcohol
Syndrome, and has been working on the subject of FASD in the United States and
Ghana for over two decades. She also happens to be Doreen’s Aunt.

Dodoo remarked that
there was a problem with Doreen when her sister-in-law sent photos of the
newborn to her while the nurse was still living in the United States. “I saw
lots of drooling [from Doreen].” She says. “I thought it was due to teething.”

But when Dodoo moved
back to Ghana shortly after, her niece’s drooling hadn’t stopped. There were
also other issues. “[Doreen] was unable to hold onto things. [She had] misshapen feet.” Dodoo explained that it was impossible for Doreen to wear flip
flops because she was unable to grasp the shoe thongs with her toes.

Dodoo said Doreen
was not shy, but very sensitive, and making friends was hard. She was unable to
cope in an academic environment. After speaking with Doreen’s mother, Theresa,
Dodoo sent the child to Dr Badoe for a clinical diagnosis.

Many experts
discourage the consumption of alcohol until after the child had been weaned
from breastfeeding.

“There is no known
safe amount of alcohol during pregnancy or when trying to get pregnant. There
is also no safe time to drink during pregnancy” states the Centre for Disease
Control (CDC).

In Ghana, more and
more cases are coming forward. Dr. Badoe believes that the situation is highly
severe in the country due to cultural norms and practices involving alcohol.

Fact is alcoholic
beverages play important roles at funerals, weddings, birthday parties, naming
ceremonies, holidays, social get-togethers in Ghana and at these functions,
women run the services and are directly or indirectly in charge of the drinks.
Better still, have easy access to the drinks. Beer, pito, and akpeteshie are
common favorites.

The drinking rates
differ from one region to another. In the mountains and along the coastal belts
in Ghana, many people are said to use alcohol to keep warm during colder
months. Others drink for ‘darker’ reasons, turning to alcohol as a temporary
problem solver.

According to
Amanobea Dodoo, “[In Ghana], we don’t really see women as drinkers. This was
some years back. Now women drink more than they used to.”

She lists several
reasons, including family and work issues, and frustration. “They want to
forget their sorrows. They don’t realise that the problem is still there once
the buzz leaves.”

A dependency on
alcohol that starts early on creates unhealthy habits and may lead to
alcoholism. Amanobea Dodoo mentions the advertisements for alcohol that are
scattered along highways or on the television channels.

“[There are] mostly
young people in ads,” she says, alluding to the rise of young women drinking.

“The young women
should take care. When pregnant, you don’t know until signs start showing, like
a missed menstrual cycle.”

The consumption of
alcohol by women who are unknowingly pregnant is not only a Ghanaian issue. All
over the world, pregnant women drink, unintentionally putting their children at
risk during the first trimester of pregnancy. However, in Ghana, women who are
conscious that they are pregnant are still downing alcoholic drinks.

This phenomenon is
largely due to a lack of awareness: People simply are uninformed of the effects
of alcohol on their unborn children.

They drink to calm a
baby kicking in the womb, or right before delivery to ease birthing pains. Some
reasons are more spiritual.

Women visit
traditional healers, who prescribe herbs diluted in alcohol for various
reasons. “[There are] many traditional concoctions,” says Dr Badoe, who states
that often, when women are asked if they consume alcohol, they reply “Oh, I
don’t drink, but a [herbalist] gave me herbs laced with alcohol to protect my
baby.”

For Theresa Dodoo,
Doreen’s mother, it was a combination of factors. “When I got pregnant, I went
to see a doctor. He told me I wasn’t [carrying].” Theresa was troubled by the
doctor’s diagnosis, as she had been convinced that she was expecting a baby.
Perturbed and uneasy, she called a friend, who took her out drinking to help
calm her nerves.

Theresa’s edginess
never disappeared, so she continued to drink recreationally to quiet her
worries. After some time, her church pastor told her she was pregnant.

This time, Theresa
decided to tell her mother, who suggested that she should go see a herbalist to
confirm she was pregnant.

The herbalist
prescribed a concoction that he said would help determine her pregnancy,
instructing her to mix the herbal powder in brandy.

Theresa would take a
shot of the herbal mixture every morning for the next six months without
seeking professional medical advice.

She described
feeling weak and unable to perform daily tasks every time she took it. And
while she said she never received confirmation of her pregnancy during her time
taking the medicine, she did report feeling kicking in her stomach every time
she drank it.

At the end of six
months, Theresa returned to the hospital, where she would be officially diagnosed
as pregnant. Only then did she stop taking the herbs, switching to prenatal
treatment and medicine prescribed by the hospital instead.

Many people with
FASD may suffer from learning and remembering, understanding and following
directions, shifting attention, controlling emotions and impulsivity,
communicating and socialising and practicing daily life skills, including
feeding, bathing, counting money, telling time, and minding personal safety,
according to the USA’s National Institute on Alcohol Abuse and Alcoholism.

Doreen switched
schools six times before dropping out completely, facing verbal abuse from
peers and beatings at times from impatient teachers who were unaware of her
condition.

When Dr Badoe asks
her if she had friends, she shakes her head. “They hated me because they said I
don’t know anything…I wasn’t happy.”

Doreen credits her
failure in school to memory loss and an inability to concentrate.

CURE

“There’s no cure, so
we manage.” Dr Badoe says and calls for an increase in training and support for
parents and doctors.

“We need to educate
people. There’s a lot of ignorance.” We must include education on the dangers
of alcohol.” states Dr Tuakli.

Amanobea Dodoo also
calls for advocacy, education, and communication. “The sooner you can
diagnose,” says Dr Tuakli, “the better”.

None of the doctors
think that banning herbs is the answer. “Many [herbal medications] are good…I’m
a firm believer in them,” says Dr Tuakli.

“Women need to ask
questions.” The doctor calls the current situation in Ghana “tragic.” FASD is
“Not a recognised problem. Mothers think they’re doing the right thing by
taking medicines,” she said.

“It’s 100 per cent
preventable…You must know what are in your herbal medications.”

Dr Badoe recommends
occupational therapy to refine motor skills.

“If you can see and
hear well, you can learn.” He tells Doreen.

Dr Tuakli says that
these children are capable of learning, even if it is at a slower pace than
most.

“It’s a question of
practice, teaching them over and over until they get it right.” They could
assimilate peacefully into the society with the right support.

“Loving parents and
astute teachers can do a lot,” she noted.

GNA

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