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29 November 2024 | Story Prof Mpumelelo Ncube | Photo Supplied
Prof Mpumelelo Ncube
Prof Mpumelelo Ncube is an Associate Professor of Social Work at the University of the Free State.

Opinion article by Prof Mpumelelo Ncube, Head of the Department of Social Work, University of the Free State


As we approach the end of another year, many people take this time to reflect on the successes they have achieved, as well as to appreciate their resilience in overcoming life's challenges. For some, this season of reflection serves as an opportunity to reward themselves for their accomplishments. However, for many others, the festivities become a coping mechanism, masking deeper pain and unresolved trauma.

This year has been marked by several successes, including the simple fact that we are still alive, despite the staggering number of lives lost in the country, but more so, in conflict zones. Countries like Sudan, South Sudan, the Democratic Republic of Congo (DRC), Mozambique, Palestine, and Ukraine have endured severe violence, with countless innocent lives taken. In these instances, the human cost continues to mount, making survival a powerful testament to resilience and divine grace in the face of such overwhelming adversity. Life itself is an accomplishment, but for countless individuals, it also carries untold stories of sorrow, stories not just from this year but from previous years as well. Families continue to grieve the loss of loved ones to the COVID-19 pandemic, and many have lost their livelihoods due to the economic downturn that followed. The situation is further exacerbated by South Africa’s unemployment rate, which exceeds 40% (expanded definition), making it increasingly difficult for many individuals to secure new sources of income.

The violence

In addition, South Africa continues to grapple with violence. Families mourn the loss of loved ones to murder — a pain that never truly heals, though families learn to live with it. The country’s murder rate remains alarmingly high, with slight fluctuations in the past five years looking only at the months of April to June across the years. In 2020, COVID-19 restrictions temporarily reduced murders to 3 466, but once the lockdown lifted, the rate surged to 5 760 in 2021, continuing to rise to 6 424 in 2022. Though slightly declining in 2023 and 2024, the numbers are still far too high. This reflects an ongoing crisis that demands stronger interventions, law enforcement, and efforts to address the socio-economic disparities that fuel crime.

Further compounding the year’s challenges, 2024 saw tragic events such as children dying from poisoned food, mass killings in the Eastern Cape, a rise in extortion, and an alarming increase in teenage pregnancies, especially in underprivileged communities. As we close the year, these issues do not vanish. In fact, they may intensify, often hidden beneath the veneer of holiday festivities.

The impact of alcohol

For many, these festivities are synonymous with alcohol consumption. Despite the economic struggles faced by many, a budget for alcohol remains a priority. This may seem counterintuitive, but it highlights the reality of people using alcohol to escape their suffering. Alcohol, like many other substances, becomes a coping mechanism for the trauma that so many endure.

In its 54th conference, the ANC rightly observed a universal phenomenon of alcohol abuse where socially and economically unequal societies tend to have higher levels of substance abuse, particularly alcohol and drugs. The §National Drug Master Plan 2019/24 identifies alcohol as the primary substance abused across racial and class lines in South Africa, largely due to its easy accessibility, affordability, and cultural associations. South Africa ranks among the high alcohol-consuming countries, with an average of 9.3 litres per capita annually, far surpassing the global average of 6.4 litres.

The consumption of alcohol is particularly concerning among young people, who often gain access to alcohol earlier than legally permitted, especially during the festive season. When young people normalise alcohol consumption, it often leads to lifelong addiction, impaired development, and an inability to fully participate in society. Tragically, in some cases, it results in fatal outcomes.

For the broader population, alcohol is often a catalyst for violence, both in public spaces and within homes. It exacerbates gender-based violence (GBV), fuels broken families, perpetuates cycles of poverty and substance abuse, and undermines social cohesion. These issues have plagued South Africa for years, with little success in addressing them.

The festive season is also associated with a rise in road accidents and fatalities, often linked to alcohol consumption. While this is only the tip of the iceberg, it reflects the broader societal damage caused by alcohol. Yet, alcohol continues to be marketed as a symbol of success, sophistication, and enjoyment. While alcohol-facilitated festivities and social gatherings in general may offer fleeting escapism, they ultimately fail to address the profound psychological and emotional wounds that individuals carry. Beneath the veneer of revelry and glamour, these events often leave participants with unhealed scars, merely postponing the inevitable pursuit of the next escapism opportunity. In truth, the industry exploits vulnerable individuals for profit, often masking the harm it inflicts on communities.

Despite the alcohol industry's substantial contribution to South Africa's GDP, a comprehensive cost-benefit analysis reveals that the industry's socioeconomic costs, encompassing both direct and indirect expenditures, as well as intangible externalities, significantly exceed its economic benefits. In the past, studies have shown that alcohol-related harm costs between 10% and 12% of the country’s GDP, while the benefits, including taxes and employment, account for a less than 10%. This disparity calls for a re-evaluation of the country’s relationship with alcohol. It’s a substance that not only fuels violence and the resulting trauma but also undermines the nation’s aspirations for a more prosperous and equitable future for all. We must question whether alcohol is truly indispensable. Does its social, cultural, or economic significance justify the considerable harm it causes to human life?

16 Days campaign

This truly is the time for the country to reconsider its approach to alcohol regulation. There have been ongoing debates about tightening restrictions on alcohol advertising, with proponents arguing that these measures could mitigate the damage caused by the industry. Some have also called for raising the legal drinking age, suggesting that delaying access to alcohol could benefit both individuals and the economy. Additionally, increasing excise duties could make alcohol less accessible, reducing its harmful impact on society. These steps require leaders who prioritise the lives of the people they serve over the profit margins of corporations. Ultimately, this serves as a clarion call to collective action, urging all stakeholders in society including families, faith-based organisations, community groups, educational institutions, and beyond, to assume a shared responsibility for reversing this destructive trend. By doing so, we can break the cycle of harm, mitigate the pervasive psychological and emotional trauma that permeates our society. Afterall, Life should be treated as sacred and worthy of protection and improvement at every opportunity.

In light of all these issues, we are also reminded of the 16 Days of Activism for No Violence against Women and Children Campaign, a global campaign aimed at raising awareness about violence against women and girls. Let this not be a mere rhetorical exercise, but a call to action, one that demands meaningful decisions and interventions to protect vulnerable individuals and build a society free of violence and harm.

Mpumelelo Ncube is an Associate Professor of Social Work at the University of the Free State. He writes in his personal capacity.

News Archive

Higher than expected prevalence of dementia in South African urban black population
2010-09-22

 Prof. Malan Heyns and Mr Rikus van der Poel

Pilot research done by University of the Free State (UFS) indicates that the prevalence of dementia, of which Alzheimer’s disease is only one of the causes, is considerably higher than initially estimated. Clinical tests are now underway to confirm these preliminary findings.

To date it has been incorrectly assumed that dementia is less prevalent among urban black communities. This assumption is strongly disputed by the findings of the current study, which indicates a preliminary prevalence rate of approximately 6% for adults aged 65 years and older in this population group. Previous estimates for Southern Africa have been set at around 2,1%.

The research by the Unit for Professional Training and Services in the Behavioural Sciences (UNIBS) at the UFS and Alzheimer’s South Africa is part of the International 10/66 Dementia Research Group’s (10/66 DRG) initiative to establish the prevalence of dementia worldwide.

Mr Rikus van der Poel, coordinator of the local study, and Prof. Malan Heyns, Principal Investigator, say worldwide 66% of people with dementia live in low and middle income countries. It is expected that it will rise to more than 70% by 2040, and the socio-economic impact of dementia will increase accordingly within this period. 21 September marks World Alzheimer’s Day, and this year the focus is on the global economic impact of dementia. Currently, the world wide cost of dementia exceeds 1% of the total global GDP. If the global cost associated with dementia care was a company, it would be larger than Exxon-Mobil or Wal-Mart.

The researchers also say that of great concern is the fact that South Africa’s public healthcare system is essentially geared toward addressing primary healthcare needs, such as HIV/Aids and tuberculosis. The adult prevalence rate of HIV was 18,1% in 2007. According to UNAIDS figures more than 5,7 million people in South Africa are living with HIV/Aids, with an estimated annual mortality of 300 000. In many instances the deceased are young parents, with the result that the burden of childcare falls back on the elderly, and in many cases elderly grandparents suffering from dementia are left without children to take care of them. “These are but a few reasons that highlight the need for advocacy and awareness regarding dementia and care giving in a growing and increasingly urbanized population,” they say.

Low and middle income countries often lack epidemiological data to provide representative estimates of the regional prevalence of dementia. In general, epidemiological studies are challenging and expensive, especially in multi-cultural environments where the application of research protocols relies heavily on accurate language translations and successfully negotiated community access. Despite these challenges, the local researchers are keen to support advocacy and have joined the international effort to establish the prevalence of dementia through the 10/66 DRG.

The 10/66 DRG is a collective of researchers carrying out population-based research into dementia, non-communicable diseases and ageing in low and middle income countries. 10/66 refers to the two-thirds (66%) of people with dementia living in low and middle income countries, and the 10% or less of population-based research that has been carried out in those regions.

Since its inception in 1998, the 10/66 DRG has conducted population based surveys in 14 catchment areas in ten low and middle income countries, with a specific focus on the prevalence and impact of dementia. South Africa is one of seven LAMICs (low and medium income countries) where new studies have been conducted recently, the others being Puerto Rico, Peru, Mexico, Argentina, China and India.

Mr Van der Poel says participating researchers endeavour to conduct cross-sectional, comprehensive, one-phase surveys of all residents aged 65 and older within a geographically defined area. All centres share the same core minimum dataset with cross-culturally validated assessments (dementia diagnosis and subtypes, mental disorders, physical health, anthropometry, demographics, extensive non-communicable risk factor questionnaires, disability/functioning, health service utilization and caregiver strain).

The local pilot study, funded by Alzheimer’s South Africa, was rolled out through an existing community partnership, the Mangaung University of the Free State Community Partnership Programme (MUCPP).

According to Mr Van der Poel and Prof. Heyns, valuable insights have been gained into the myriad factors at play in establishing an epidemiological research project. The local community has responded positively and the pilot phase in and of itself has managed to promote awareness of the condition. The study has also managed to identify traditional and culture-specific views of dementia and dementia care. In addition, existing community-based networks are being strengthened, since part of the protocol will include the training and development of family caregivers within the local community in Mangaung.

“Like most developing economies, the South African population will experience continued urbanization during the next two decades, along with increased life expectancy. Community-based and residential care facilities for dementia are few and far between and government spending will in all probability continue to address the high demands associated with primary healthcare needs. These are only some of the reasons why epidemiological and related research is an important tool for assisting lobbyists, advocates and policymakers in promoting better care for those affected by dementia.”

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt@ufs.ac.za  
21 September 2010

 

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