THE BABY OR THE BOTTLE
21.12.2002
From the moment they are conceived, some Queensland children don't stand a chance. As Tony Koch reports, alcohol and babies are a tragic mixture
THEY are the children who live with rejection. They are slower to react to everyday occurrences. At school they just don't ``get it''. They are the last to be picked in teams; the first to be laughed at by other kids because they don't comprehend.
The rejection, the continued hurt, the failure to quite grasp what is happening brings on the anger fits, the violent reactions.
They are the ``grog babies'', the children born to mothers addicted to alcohol. Their tiny brains were never given the chance to develop because they were sustained in a womb awash with booze.
Doctors refer to the tragic condition as the most preventable of all mental disabilities: fetal alcohol syndrome, or just plain FAS.
They describe it as the most undiagnosed disorder and unacknowledged disability in society. It is not a subject they are taught about at medical school.
A research paper distributed by Queensland Health says FAS was first defined in 1973. A group of doctors coined the term to describe certain birth defects found in children born to alcoholic women.
``Alcohol passes from the mother's bloodstream to the fetus through the placenta,'' the document says. ``The alcohol runs through the fetus's bloodstream, out into the amniotic fluid that surrounds it, and is taken in a second time.
``A fetus cannot process alcohol. It must depend on the mother to rid the alcohol from its system. As the mother's body does this, alcohol is absorbed by the fetus's tissue that has high water content -- the brain, liver, pancreas, kidney, lungs, thymus and heart.
``Symptoms of FAS can include mental retardation, slowed growth, central nervous system damage, head and facial abnormalities and behavioural abnormalities. The first area is slowed physical growth before and after birth.
``Children with FAS are often smaller than normal when born. They gain weight at about a third of the normal rate.''
The document says mental and behavioural problems affect FAS sufferers all their lives. As young children they have a short attention span, poor short-term memory, take longer to learn to walk and talk, have a low IQ and are often hyperactive.
``Older children have poor social skills, bad judgment, temper tantrums and repeated instances of lying, stealing and disobeying,'' it says. ``Many are unable to think abstractly -- about money and time, for example -- and cannot separate fact from fantasy. They lack problem-solving skills.
``Adults with FAS are often seen as too talkative, impulsive, hungry for attention, are unable to think ahead, can't understand danger and act inappropriately for someone their age in social settings.''
Kowanyama Aboriginal community on western Cape York has all the alcohol-related and violence-related problems common to many remote indigenous communities, and FAS obviously is prevalent.
It is the only indigenous community on Cape York with a full-time resident doctor. Dr Lara Wieland, 30, has spent the past 2 1/2 years at Kowanyama, making her the longest-serving medico to stay at any such place in Queensland.
She has made a particular study of FAS, having had to battle each day with its symptoms in the patients she sees, and those she watches being arrested for criminal offences.
Kowanyama is the first state community to introduce a specific program to counter the problem, and last month clinics were held at the instigation of the Kowanyama Community Council. Workers were given time off to attend and were told bluntly that pregnant women should not drink alcohol.
The community also has refurbished the old hospital building to make it a mothers' and babies' clinic where infants can be taken for regular checks, and those in need can receive care, including food.
Council chief executive officer Bob Sands says a visiting pediatrician told Kowanyama it had several children suffering from FAS.
``There is a problem with the mums getting younger, but we are serious about addressing this issue,'' Sands says. ``It was pointed out that if the mother is drunk and the father is drunk, the baby is halfway to being a drunk fetus. Everybody has to be involved in the program of early intervention and prevention.
``This is all wrapped around trying to come to grips with the problems of alcohol. We had a local referendum where the community decided to sell only low-strength beer and not have `takeaways'. But people then started going to other centres to buy heavy beer, and I was most disappointed by that.''
The Council also has supported determined moves to control alcohol consumption, a recommendation made initially by former justice Tony Fitzgerald who, last year, conducted an inquiry into community alcohol and violence.
He recommended the establishment of community justice groups made up entirely of locals, particularly elders, whose task it was to oversee justice issues at all levels. That included recommending by-laws to control the root cause of much of the trauma: addiction to alcohol.
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Baby or the bottle
From Page 25
The exposures by Fitzgerald echoed similar concerns voiced for several years by Aboriginal leader Noel Pearson, and the result has been enthusiastic support from the Queensland Government for a partnership between government and indigenous people to address the problems seriously.
Last month, the first of the alcohol-control agreements was signed between nearby Cape community Aurukun and the Government. It was formulated by the local justice group after consultation with the Pearson-led partnership team, and demanded such sweeping reforms as banning the serving of alcohol not only to pregnant women, but also to their partners, and thereafter until the child turned five.
In addition, no takeaway alcohol will be available from the canteen, and no one -- indigenous or non-indigenous -- will be allowed to bring alcohol into the community.
The Kowanyama community justice group, headed by elder Priscilla Major, wants the Aurukun agreement duplicated for Kowanyama, but that final acceptance will require consultation within the community and council.
At a meeting last week at Kowanyama, Major was supported unequivocally by other elders who repeatedly said that such issues as FAS could never be addressed without the adoption of appropriate community-wide alcohol control.
``We can see who is going to be a mother, and we just tell them that they should not be drinking,'' Major says.
``Nowadays, many just say that nobody can tell them how to run their lives, but mostly they listen.''
Another elder, Jeremy Jimmy, a quietly spoken former health worker who is highly respected in the community, says the real problem is with the ``first-baby mothers'': ``We tell them, `When you are drunk, your baby is drunk inside you'. ''
The most forceful of all the speakers -- Evelyn Josiah, a non-drinker so strict about young mothers not consuming alcohol she sits inside the canteen and challenges those who should not be there -- agrees that the rules have to apply equally to the husband or the partner.
``Children have two parents, and neither must drink,'' she says. ``Even schoolchildren get involved with alcohol. There must not be `takeaways', and the drinking hours must be shortened.
``If you have `takeaways' the father will take grog home. The woman says to him, `If you don't bring me grog, I don't cook for you'. ''Although Wieland unreservedly supports control on alcohol supply as a first-base cure for FAS, she sounds warnings about problems not quickly obvious to lay people.
``Getting rid of alcohol can solve many problems, but it is only the beginning,'' she says.
``It will take a lot for these people to get back on their feet. The other day the council's chief executive officer, Mr Sands, spoke about the allocation of health services for Cape York people, and said they were `the forgotten people'. That is so true.
``I have just come back from Laos and Cambodia, which is reputedly one of the poorest regions on earth, and the statistics regarding children's health there are little different from those on Cape York indigenous communities.''
WIELAND says stopping the grog on Kowanyama may unmask a lot of problems that alcohol has drowned.
``I knew so little about FAS before I came here, and it was a real shock to me to realise how common it is, and how little people did to address it,'' she says.
``The most vulnerable thing possible is a child in the mother's womb, and it is wrong to have it assaulted in that way -- by alcohol. Adults may drink to excess but they have a choice. The fetus does not get that choice.
``Family Services are now aware of the incidence of FAS, and they counsel the mothers, but that occurs after the baby is born, and by then it is often too late.''
Wieland says the Government should support the alcohol-control reforms.
``Lots of things have been tried before -- various programs -- but none has worked,'' she says.
``The Kowanyama Justice Group is saying what they need, and those ladies are not asking for ridiculous things. The one thing they want is the canteen closed. They have lived with the devastation in the community and in their own families.
``The controls should not be sidetracked by arguments about the rights of people to drink. People promoting those arguments should listen to the people living here and who have never been helped.''
Wieland says special assistance is needed for FAS children, particularly in schools and with occupational therapy. But such services are not available in remote communities.
``People in the wider community have similar disabilities, and I know you can't expect the same remedial services as are available in the cities, but the discrepancies are too huge.
``These FAS children are ill-equipped to deal with life when they have the best possible care, but when they get none at all, it is just so unfair.''
