Narratives on Alcohol Dependence in the Family in Post-Apartheid South Africa

Ubuntu is derived from the above African proverb that refers to a particular philosophy; African humanism, an ethic or world view which reveals how interconnected the family life cycle is in South Africa [1]. This manuscript refers to the concept of Ubuntu as a model of learnt behaviour rooted in an ecological system’s theory which frames this research. Truan [2] explicates this notion of Ubuntu by citing Van den Berg’s [3] opinion that “no one is neurotic unless made neurotic by society”. It should be taken into account that the ecological system’s theory loosely defined means that human being’s thoughts, feelings and experiences are the products of a system of meanings that exist at an environmental rather than an individual level [4]. In other words, depending on where a person grew up, the manner in which someone was socialized culturally and historically would explain their beliefs, attitudes and perceptions of alcohol dependence [5]. This implies that human beings cannot be interpreted out of their lived context, South Africans live out the concept of Ubuntu and this should be kept in mind when seeking to understand the phenomenon of alcohol dependence in the family context in post-apartheid South Africa.


Introduction
Nguni proverb 'umuntu ngumuntu ngabantu': "I am what I am because of who we all are" [1].
Ubuntu is derived from the above African proverb that refers to a particular philosophy; African humanism, an ethic or world view which reveals how interconnected the family life cycle is in South Africa [1]. This manuscript refers to the concept of Ubuntu as a model of learnt behaviour rooted in an ecological system's theory which frames this research. Truan [2] explicates this notion of Ubuntu by citing Van den Berg's [3] opinion that "no one is neurotic unless made neurotic by society". It should be taken into account that the ecological system's theory loosely defined means that human being's thoughts, feelings and experiences are the products of a system of meanings that exist at an environmental rather than an individual level [4]. In other words, depending on where a person grew up, the manner in which someone was socialized culturally and historically would explain their beliefs, attitudes and perceptions of alcohol dependence [5]. This implies that human beings cannot be interpreted out of their lived context, South Africans live out the concept of Ubuntu and this should be kept in mind when seeking to understand the phenomenon of alcohol dependence in the family context in post-apartheid South Africa.
Traumatic events, like Apartheid and its policies [6] such as the Prohibition of Mixed Marriages Act, 1949, the Immorality Amendment Act, 1950, and others had a very destructive consequence to the family structure before the 1994 democratic regime in South Africa. For instance, the Immorality Amendment Act made sure that a mixed-race couple who had children, did not live together. This would result in defragmentation of the family because the child will grow up in a single-parent family. In an ideal world children would be raised by both parents and functionally grow up with minimal exposure to violence, alcohol consumption or any other related trauma such as political violence and injustice. So, because of apartheid policies like the Immortality Amendment Act, families were torn apart because a White a and Black African or Coloured couple, for instance, could not live together. This policy created stressors on the family unit which lead to the abuse of alcohol as a primary substance of choice [7]. Various studies indicate that a single parent family, stressful life events, among others, risk behaviours in single-parent families included use of alcohol [8,9]. Other laws like the Group Areas Act, 1950, and the Pass Law Act, 1952, were the corner stone of apartheid. The Group Areas Act, the Native (Urban Areas) Consolidated Act of 1945, as well as the Native Administration Act, 1927 coerced physical separation of races in South Africa, forcing Black people out of urban areas and creating a racial divide according to clearly demarcated areas. The Group Areas Act (Act No 41 of 1950) implemented the grand design of physical separation of the races (Coloureds, Indians, Africans and Whites). It specified separate residential areas for the different racial groups. As a means of removing black communities living in 'White' areas to their own separate areas, it proved particularly effective. Buffer strips separated the residential areas [10]. For example, before the Group Areas Act, Coloured people experienced a sense of Ubuntu whereby neighbors and friends were like family. A case study on Cape Town's most famous racially integrated suburb in the 1950 -1960s demonstrate the extent to which the idealised apartheid city model was realised such as when the forceful removals from District Six into unknown, undeveloped landscapes came, people were scared. They wondered what will happen to their family life. Where are they going to stay? Coloured, African Black, and Indian people felt shock, anger, and hatred towards the apartheid government. So in a sense the concept of Ubuntu was lost through the legacy of apartheid [11]. The consequence of the Group Areas Act was social decay in the form of total disintegration of the family and hence the community. Before there was social cohesion, after the Group Areas Act was implemented gangsterism, Black-on-Black violence and total social defragmentation continues to be the order of the day in post-apartheid South Africa [12].
The 'Dop' system (tot system) however, had families (mostly Black and Coloured) living in farming communities which institutionalized alcohol consumption as a condition of service. The practice of paying farm workers in the form of receiving wine, often cheap wine, for their labour was and still is rife. The farmer could thus get rid of his lowquality wine, which had little economic value and it resulted in workers becoming addicted to it and workers would not leave the farms. This practice was prone to increase alcohol dependence amongst Black and Coloured people [13]. In present day South Africa, despite being recently made illegal, and after 300 years of implementation in the Western Cape Province, the 'Dop' system has become so ritualized that it is still practiced [14]. The Western Cape Department of Health has institutionalised the Dopstop [15] campaign to readdress the mental anguish caused by the 'Dop' system. The high prevalence rate of Foetal Alcohol Syndrome (FAS) cases in the Western Cape provides evidence that the 'Dop' system continues to affect mothers and children [13]. Female wine farm workers in the Western Cape Province reported struggling with feelings of depression and low self-esteem while being alcohol dependent [14]. Seeing that alcohol consumption is a way of life entrenched in the culture, both at work and at home, it comes as no surprise that almost 50% of pregnant mothers in the Western Cape Province drink alcohol, compared with 34% of pregnant mothers in the metropolitan areas of South Africa [14]. A study also found that mothers of FAS children come from families with a history of alcohol dependence. FAS are now an epidemic in South Africa [14].
Against this backdrop, the South African family system has become ripe for analysis in the post-transition period. This manuscript will illustrate how the life stories of 10 alcohol dependent women, who are in recovery, reflect on their lived-experience with alcohol and the manner in which it affected their family life in post-apartheid South Africa.

History of Alcohol Consumption, Families and Post-Apartheid South Africa
It is useful to further posit the introduction of alcohol within the South African context and explain how this became a problem within the family as a result of racist policies of the apartheid regime. Van Riebeeck built a fort or castle and from within these walls administered the Cape into a settler society and a slave society. Indigenous slaves in the Cape became free citizens in 1658 [15]. Thus for Mcewan and Bek [15] the history of the wine industry is deeply intertwined with the social history of slavery that continued to shape political, economic and cultural power relations from more than 150 years. Therefore an inference is made that the colonizers introduced wine to control the indigenous people of South Africa, especially the labor force [15]. Once they were finished working at the end of the week, they were paid through alcohol which the wine farm workers later became addicted to [14].
At the end of the 20 th century South Africa was entering into a new dispensation, a newly democratic government of national unity was elected and President Nelson Mandela was elected as its first democratically elected president. His task was to begin the long hard job of replacing all apartheid laws and legislations and rewrite these laws, finally providing freedom to masses of people across South Africa. The period between 1994 and 2004 were perhaps the most defining period in post-apartheid South Africa as government ministers were mandated to bring about real change to the lives of South Africans by actively rewriting the law books of South Africa [16].
Van Dongen [16] writes that since the 1994 elections, gradual changes have occurred. In 1996, the Land Reform Act was passed in Parliament protecting the rights of labour tenants and farm workers and it made it possible for individuals to claim land. The new Liquor Act, number 59 of 2003, came into force that totally outlawed the use of the dop system. [17].This law basically replaced the 300-year practice of the 'dop' (tot) system. In post-apartheid South Africa, ownership of wine farms and farms in general are still predominately in the hands of the white elite [14]. Kritzinger and Vorster stated that there have been changes on the farms over the years, whereby farmworkers could organize themselves and have access to social development programs [14]. However, violence plays a big part on the farm, whether it the farmer or amongst workers or husband and wife.
For Kritzinger and Vorster [14] force and alcohol abuse played a significant part in the family life of farms workers. Van der Merwe [18] echoes this by mentioning that in addition to the problem of fetal alcohol syndrome, there is a range of social problems emanating from the misuse of alcohol, such as child abuse, maltreatment of women, and family violence. Alcohol abuse has continued unabatedly in the urban and rural towns of South Africa [19]. Deaths and accidents are as a result of drinking alcohol and drugs use amongst the adult population of South Africa [19]. To address some of these concerns over the last few years (1994 -2009) several new alcohol policies have been adopted to curtail this problem. The policies are: Restrictions on alcohol advertising and counter-advertising, the regulation of retail alcohol sales, control of alcohol packaging, increasing alcohol taxation.
This manuscript problematise that even though the State tries to regulate the liquor industry, there is not enough research into understanding the full burden of alcohol abuse in families in South Africa [20]. Jacobs's [20] research place particular emphasis on the role the parent alcohol dependent plays in the future alcohol abuse of the child. It is herewith that this paper ventures into a discussion on how parenting responsibilities are absconded when alcohol dependence is rife in the family system, next.

Parentification: When the Child becomes the Parent
Children who take care of their parents emotional, physical and even financial needs are defined as Parentified [21]. According to Boszormanyi-Nagy and Spark, temporary Parentification is considered normative yet, Parentification is considered problematic when the parents are excessively and persistently reliant on their children for care giving. Parentified children have maladaptive social and emotional development which has subsequent negative outcomes in adulthood, including depressive symptoms [22], ambivalence about dependency needs [23], characteristics of narcissistic and self-defeating personality disorders [24]. Childhood Parentification is more common in dysfunctional families where one or both parents are alcohol dependents or even workaholics [21].
Parentification is an important concept to grasp theoretically, in relation to this manuscript, because it highlights a particular point that is salient in the South African context, in particular. In the South African context above all, children of alcohol dependent parents socially construct a relationship with alcohol [20]. This is true especially for children who are exposed to alcohol dependence through parents' excessive alcohol consumption that eventually causes dysfunction to family development [25].

Conceptual Framework for the Study
The study is framed within the ecological systems theory which was helpful in understanding how the Apartheid government's policies caused destabilization to the notion of Ubuntu. Bronfenbrenner's ecological systems theory holds that a person's development is influenced by several environmental systems [26]. His theory identifies five environmental systems: Micro system, Meso system, Exo system, Macro system and Chrono system. The Micro system refers to the closest influences in an individual's being-in-the-world such as peers, family, workplace and neighborhood [26]. The person is not merely experiencing these settings as a sedentary recipient of it, but someone who actually helps to construct the social settings. The Meso system refers to the relations between the different micro systems or connections between environments. Like the connections between familial alcohol use and school experiences of children drinking secretly and other experiences with peers who also drink alcohol. The Exo system is concerned with the correlation between a social setting in which the person does not have an active role and the individual's immediate context. For example, a father decides to go drinking at a bar and blacks out. This might cause conflict with his wife which could further affect patterns of interaction with the children. The Macro system describes cultural contexts that could include socioeconomic status, poverty, and ethnicity. The Chrono system refers to the blueprint of ecological events and changes over the life of a person as well as the socio-historical circumstances like divorce. In South Africa, socio-historical circumstances could be the increasing opportunities for women of color to pursue a career.

Goal of the Study
The primary goal of this study was to explore women's alcohol dependence history in order to answer the main research question: How does women's alcohol dependence affect their families?

Methodology
This study was embedded in a qualitative theoretical framework which is focused on Viewing the research from a human science perspective as opposed to natural science. This project utilized the social constructionist approach with an aim to magnify human experience and interpret it, rather than reduce it to a statistical relationship [27].

Participants
Narrative interviewing was used to construct women's perspectives on their alcohol use with dependency. Participants women (n=10, age range =30-65, ethnicity =30% Black and 70% White) were volunteers recruited through collaboration with the Alcoholic Anonymous organization.

Data Collection
Since Alcoholics Anonymous' (AA's) core principle is to protect the identities of alcohol dependents, data collection retained anonymity with regards to AA requirements. Three of the participants were accessed through the Western Cape AA office records and were asked to recommend other women who they may know met the criteria.

Procedure
Permission for the study was granted by Stellenbosch University. Participants individually consented to the study. Strict protocols regarding anonymity and participant rights were adhered to. The interviews were electronically captured by an audiotape and transcribed. The interviews were transcribed taking the following into account: The interpretation or discourse analyses of the participants' interviews used an approach which included both verbal communication and nonverbal exchanges or gestures. The interview consisted of a series of probing questions regarding the life span of the participant's alcohol dependent behaviour. For example, I asked questions ranging from: Explore history of drinking in the family; to what keeps you sober at this stage in your life.

Data analysis
Discourse analysis was used to analyze the interviews, which identified interweaving discursive constructions mentioned in the ensuing paragraphs. When reading these sections the following must be kept in mind: Alcohol is consumed in environments that hone alcohol dependence.

Findings
What stands out in the findings of this study is the quintessential South African discourse on the Apartheid and Post-Apartheid socio-political climate. The overarching themes which encapsulate similarities amongst the participants are the trauma related to post Apartheid socio-political distress like exposure to violence and parentification within the family due to alcohol dependent drinking. Some participants experienced the dop (tot) system where either their parents paid workers with alcohol in lieu of money or they received alcohol, food and accommodation instead of money while working on farms. Subsequent to 1994 when Apartheid was abolished, the legacy of Apartheid policies such as the dop system, inculcate intergenerational alcohol dependence because parents drinking behaviour normalised alcohol use. Other post-Apartheid related trauma such as exposure to violence and poverty has also resulted in alcohol dependence. The following themes explain in further detail.

The Socio-Political Climate and Exposure to Violence
The women in this study presented various reflective accounts in which they are always standing over and against an oppressive and abusive past. One particular example of an oppressive socio-historical experience indicated by a participant who grew up in District Six demonstrates how during Apartheid she was forcefully removed from her home into an unknown, undeveloped landscape. This provides evidence that the concept of Ubuntu was lost through the legacy of Apartheid together with for instance, the disintegration of family life [11]. The effect of the Group Areas Act is apparent in the following excerpt taken from a participant who felt isolated and helpless without the sense of family: The exposure to violence caused by the forceful removal of people living in District six and as a result, in post-Apartheid South Africa, the experience of poverty, loss of community participation and family interconnectedness, explains how Participant 10, a woman of color, resorted to drinking. Participant 10's husband was also alcohol dependent and she suffered frequent beating from him because of their drinking as indicated in this excerpt: The children were small. They used to sit at the back of the car and they used to hide themselves under the seats. Poor mummy got bashed. According to Bronfenbrenner's Exo system there is a correlation between her growing up on a wine farm, not having an active role in how her father treats his employees and the her immediate context which was desensitising her to the abuse of alcohol, by her father and his workers. Her father drank heavily when the harvest was not productive, this impacted on how he treated her mother as explained in this quote:

My father chased my mother out of the house and threatened to kill her. He wanted to burn the house down. When he got drunk he was very violent. (Participant 3 Aged: 60, Marital Status: Married)
In post-Apartheid South Africa, she experienced a different kind of exposure to violence. Because she was desensitised to the dop system and 'did not think anything was wrong with the dop system' she was ironically faced with a similar domestic situation. Her husband took away her allowance and only gave her money to buy food for the household. Instead she used that money to buy alcohol. She felt violated on a psychological level as indicated in this quote: It got so bad that he didn't give me pocket money or food money. I bought food, but I didn't use all the money he gave me for food because I had to buy my booze. I had nothing. So I decided to make sandwiches and sell them. This is how I made money to buy alcohol. He was angry when he found out. (Participant 3 Aged: 60, Marital Status: Married) There are other instances where a participant describes how her alcohol dependent behaviour was shaped by a reaction to environmental conflict as explained in this quote:

...drinking at one o' clock in the morning because a White person insists that the floors be scrubbed till late and that is when the drinking would start. (Participant 2 Aged: 41, Marital Status: Single)
The following excerpt explains how this woman felt while living on a farm and being paid with alcohol instead of money: Perhaps more detail regarding the quote above is needed to understand the mindset of this participant. She ran away from her abusive partner to this farm to work as a laborer and was paid with alcohol in lieu of money. In accordance with Bronfenbrenner's chrono system this woman's abusive relationship drove her to try and find her own independence like finding a job on the farm. Note that the dop system has been abolished but some farmers still illegally enforce this practice. She got paid with alcohol instead of money. It appears as if this woman's socio-historical circumstances played a significant role in her becoming alcohol dependent. The trauma the participant in the above quote experienced related to post Apartheid socio-political distress like exposure to violence, the occurrence of alcohol dependence in the family context and undisclosed alcohol dependent drinking gave perspective to the lived alcohol experience. To further substantiate the participants experience, a study conducted in the Western Cape on exposure to violence led by Bowman, et al. [28] found that exposure to violence led to misusing substances as a means to escape the trauma [22].

Parentification, Poverty and Alcohol Dependence
Participants experienced Parentification which Boszormanyi-Nagy and Spark consider to be problematic when the parents are excessively and persistently reliant on their children for care giving. Childhood Parentification is more common in dysfunctional families where one or both parents are alcohol dependents as depicted in these quotes above [21]. Children from dysfunctional families, according to Bronfenbrenner's ecological systems theory grow up and as adults tend to find themselves in abusive, dysfunctional relationships. Evidence of this is found when participants clarified how as adults they found themselves in dysfunctional relationships and how unbearable it was to live with the violent images and painful memories therefore numbing down with a drink in order to comply with abusive others is learnt coping behavior and normalises the drinking. The following quote explains: Drinking to get drunk serves as a numbing down effect of physical and verbal abuse and functions as an escape and provides a disregard of the pain. In the face of violent others the victim speaks and hurts for making their voice heard. Alcohol is attributed to the same comfort as a baby's bottle and strengthens the participants. Going all the way means drinking to get drunk which accomplishes the disinhibition necessary in order to tell significant others exactly what they think as illustrated in the next quote: The manner in which the participants in the study construct meaning of their lived experience with alcohol contains a dominant discourse of violence accompanied by the women's silence. Demands of silence by oppressive others, as illustrated in the following quote, were made when there is a reliance on the silence of the women. Against the backdrop of an abusive alcohol dependent family system, the person searches to fill the void with alcohol, which serves to numb the pain of the past. This discourse presents two significant findings about women's drinking experience. First, from an observational learning perspective, a parent with alcohol dependence vicariously teaches chemical coping behavior to children. As adults, women who grew up in families with alcohol dependence, replicate that behavior in the selection of spouses, a high tolerance for dysfunctional behavior, and their own use of alcohol and drugs [22]. Second, when it comes to families and alcoholism, there is a concerted silence associated with the dysfunction. Many families, like many of the participants of this study, manage to keep up appearances so that from the outside nothing seems to be amiss. In one house there may perhaps be violent behavior, while a gloomy, glum silence permeates another as indicated in this quote: My parents went to rehab often and my dad told me that he would kill me if I allowed a Social Worker in the house. I was the oldest and I had to look after the others. I had to make sure they went to school, I had to get to school, I had to cook, I had to iron, and I had to do everything. I'm very responsible; I was very responsible until I had a drink. So drinking was an escape for me. (Participant 8 Aged: 41, Marital Status: Divorced) It appears that when it comes to families experiencing alcoholism, there is a code of silence. Families deny that there's a problem by not discussing the alcohol dependent behavior, which makes the problem worse [24].
It could be implied that the experience described by Participant 8 stems from the remnants of Apartheid policies like the Group Areas Act, which forcefully removed people from the comforts of Ubuntu. If in post-Apartheid society human being's thoughts, feelings and experiences are the products of a system of meanings that exist at an environmental rather than an individual level [4] then Participant 8, Pre-Apartheid would not had experienced childhood Parentification. This implies that human beings cannot be interpreted out of their lived context, if South Africans could once again live out the concept of Ubuntu the phenomenon of alcohol dependence in the family context in post-apartheid South Africa could contribute to healing.

Conclusion
Family is the primary society for the individual, and having a father and or mother who drink may send a stronger impression of the social context of acceptable drinking behavior to children. Psycho-education and advocacy is deemed very important for families who are affected by alcohol dependence, which is inline with the Minister of Health's priority to raise awareness of alcohol misuse in the country. This research found a compelling association between exposure to sociopolitical unrest, like Apartheid, which resulted in the disintergration of the family system and alcohol dependence in the post-Apartheid context.