SA has a serious gender violence problem, and alcohol is the main culprit

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  • The abuse of alcohol in South Africa is ranked among the highest in Africa, while the country also has the highest incidences of domestic violence in the world.
  • This according to the Commission for Gender Equality, which hosted a webinar titled Alcohol Abuse as a causal factor in Gender-based Violence on Thursday. 
  • Various speakers discussed the causes, effects and possible solutions to this problem.

The abuse of alcohol in South Africa is ranked among the highest in Africa, while the country also has the highest incidences of domestic violence in the world.

READ | 30 hotspots identified around SA where of gender-based violence and femicide are most rife

This according to the Commission for Gender Equality, which hosted a webinar titled Alcohol Abuse as a causal factor in Gender-based Violence on Thursday. 

"South Africa, like the rest of the global community, was hit by the Covid-19 pandemic, which led to the imposition of lockdowns and curfews to restrict movement of people in order to control the spread and rate of Covid-19 infections in the country.

"As one of the control measures on the spread of Covid-19 infections, government placed restrictions on the sale and availability of alcohol during the lockdown period on the understanding that alcohol contributes to fatalities, including gender-based violence [GBV], that in turn, would have exacerbated the already high rates of GBV during the lockdown period," the commission said. 

"The effect of alcohol on the cognitive capabilities of individuals lowers inhibitions and heightens patriarchal ideologies, thus arousing dominant toxic masculinities that often lead to violence by men towards women."

READ | 'Surge' in gender-based violence during lockdown Level 3, says Ramaphosa

The commission added during the Covid-19 pandemic, alcohol became a key feature, with the government banning it during the more restrictive lockdown levels.

"This was mainly due to heightened concerns regarding alcohol-related road accidents, injuries, violence and even fatalities caused by the abuse of alcohol during the lockdown periods.

"During the more restrictive phases of the Covid-19 pandemic, concerns about alcohol abuse and the harmful consequences were therefore cause for grave concern, especially with regard to the capacity of health facilities to handle the numbers of victims, including victims of GBV, to be treated during the pandemic."

Substance abuse has a mammoth societal effect

The first speaker at the webinar, Reverend Bafana Khumalo, the co-executive director of Sonke Gender Justice, said substance abuse had a mammoth impact on users, their families and communities, resulting in a number of social, psychological and economic ills.

"These ills have a bearing on the family unit, health system, education, and community relations. Moreover, substance abuse places an increased financial burden on the individual and the family; the destabilisation of the family unit - permeating every area of life; and affecting the very social fabric of society."

He added studies linking alcohol consumption and intimate-partner violence (IPV) have found that 45% of men and 20% of women were drinking during episodes of IPV.

"Alcohol abuse among men, as well as intimate-partner violence, is often a manifestation of an underlying need for power and control related to gender-based inequalities and insecurities."

He added there were multiple and complex links between alcohol, masculinities and GBV.

"Dominant masculine gender norms and behaviours largely revolve around notions of aggression and risk-taking and are pursued through male involvement in activities such as violence, high-risk sexual activity and the use of alcohol and other drugs. 

"Heavy alcohol consumption is often associated with masculinity and male camaraderie, where men are encouraged - even expected - to drink excessively in order to satisfy male-gendered expectations. When men partake in typically masculine behaviours such as heavy drinking or risky sex, this can often lead to violence against their partners and families - disproportionately impacting on women and girls," Khumalo said. 

Coping with unemployment

"Due to widespread unemployment, men have had to withdraw from their traditional roles as breadwinner and provider, while women have often created a new socioeconomic role for themselves that challenges men's position as head of the household.

"This shift in gender roles for women and the rise of women's rights, without a similar proactive shift in gender norms for men, directly exacerbates gender-based violence in the African region.

"In the absence of traditional pathways to masculinity [eg breadwinner expectations], men may turn to violence, sexual activity and alcohol consumption as a way of demonstrating their manhood. 

"High levels of GBV are not caused by poverty itself, but rather from an inability of men to cope with feelings of male vulnerability and powerlessness - for which they become reliant upon heavy alcohol and drug use as a coping mechanism."

Khumalo said men who used high levels of alcohol were more likely to engage in risky sexual behaviour, for instance: multiple sexual partners; inconsistent condom use; coercive sex or rape; and transactional sex. 

He added the reluctance of men to seek help with, or express, their mental health issues led many to turn to alcohol and drug use to cope psychologically with trauma or hardship in their lives. In particular, childhood sexual abuse experienced by men can often lead to depression and alcohol problems later in life.

Reluctant to seek treatment

"Men and boys are particularly reluctant to seek treatment for physical and mental ill health and can turn to alcohol and substance abuse as an almost medicinal solution.

"This reluctance stems from previously discussed traditional gender norms and conceptions of masculinity, but also are a result of specific structural barriers that are in place to prevent men from accessing health services.

"In relation to gangsterism, alcohol and substance use is also encouraged among combatants to boost their courage and minimise their moral judgement or inhibitions with regards to committing acts of violence. The severe trauma of conflict and the normalisation of sexualised violence lead both to increased alcohol and to increased levels of sexual GBV.

"Men's reliance upon alcohol to cope with post-traumatic stress disorder when no other services are available leads to continued and normalised sexual and physical violence against women," Khumalo said.

He added childhood experiences with predominately male-perpetrated sexual and physical abuse led to greater reliance on alcohol and the perpetration of gender-based violence in adult life - both of which were often framed as expressions of men's required behaviour.

"Men who witness their fathers being violent towards their mothers are more likely to normalise violence as part of masculine gender norms, and replicate intimate-partner violence in their adult lives.

"The cycle between alcohol dependency and adulthood violence should therefore include child abuse prevention in order to prevent inter-generational cycles of sexual risk, HIV prevalence, alcohol abuse and gender-based violence. Common association between alcohol and masculinity can create the assumption that women do not, or should not, drink heavily.

"Women who experience intimate-partner violence are more likely to abuse alcohol, and are also more likely to be violent towards, or neglectful of, their children. Children who experience such violence may go on to perpetrate violence as adults.

"In these instances, the role that alcohol plays in fuelling a cycle of violence must be examined in relation to motherhood and the impact of mother's alcoholism and violence towards young people. 

"We urgently need a serious review of the laws related to alcohol access and use taking into account the related social ills related to this," Khumalo said. "More educational programmes are needed to ensure that particularly young people have a greater appreciation of the ills related to abuse of alcohol and substances."

Where to from here?

He added laws in local municipalities should be strictly applied and adhered to and alternative forms of socialising should be explored to ensure that vulnerable communities did not see alcohol as the only source of recreation.

"We must debunk the notion that parades alcohol use as enhancing masculinities." 

Clear link between alcohol and gender violence globally

Dr Leane Ramsoomar, a public health researcher and research uptake specialist at the Gender and Health Research Unit at the South African Medical Research Council, said it was globally recognised there was a clear link between alcohol use and IPV perpetration by men and experienced by women.

"Violence against women and girls and alcohol use are intersecting problems facing South Africa. One in three women report having ever experienced physical and/or sexual IPV in their lifetime, but these numbers may be masked by variations in sub-groups. Increasing alcohol use is associated with increasing frequency in IPV." 

The scale of the problem was huge, she said. 

Compared to other countries, South Africa had a significantly higher rate of women experiencing physical or sexual violence. In addition, 59% of South Africans identified as heavy drinkers, ie having had more than five drinks in a single occasion in the past 30 days. Of these, 70.8% are men.

Previous research has established that among men:
  • IPV is often preceded by drinking;
  • A significant number of people who perpetrate IPV also misuse alcohol;
  • The patterns (heavy episodic drinking) and overall volume of alcohol have differential implications for IPV;
  • Harmful (binge drinking) is associated with severity of partner violence, including femicide;
  • Alcohol's disinhibitory effect can escalate quarrelling into violence - especially important when couples drink at harmful levels together;
  • Infidelity when drinking and spending resources on alcohol and not household essentials may also trigger for conflict; and
  • There's a body of evidence on interventions to reduce harmful alcohol use, but we are still learning about how these impact on VAWG outcomes. 

Systematic reviews and meta-analyses established that, among women:
  • A clear positive association exists between alcohol use and IPV physical/sexual violence victimisation;
  • Alcohol consumption and, in particular, binge drinking increases the risk of being a victim of violence, usually through compromised decision-making ability and decreased physical capacity;
  • Femicide research shows that a high proportion of victims have high levels of blood alcohol levels (BAC) when killed;
  • Women who experience IPV are more likely to have poor mental health and problems with alcohol and substance use;
  • Poor mental health and problems with alcohol and substance use increase women's risk of subsequent IPV experience; and
  • In South African informal settlements, experience of IPV and NSPV show a dose response.

The link between GBV and alcohol.
The link between GBV and alcohol.

Ramsoomar said problems associated with harmful drinking were inseparably linked to other key drivers of GBV.

"Alcohol use and IPV exist within the context of gender inequitable masculinities, gender inequitable masculinity, poverty, depression and childhood trauma. Violence and heavy alcohol use can concurrently embody an image of 'what it means to be a man'.

"Alcohol-related violence perpetrated by men may help to establish and maintain a gendered identity. Men who embrace gender inequitable masculinities often report harmful alcohol use. Men who perpetrate IPV and rape are more likely to drink heavily, engage in transactional sex, and have large numbers of partners," she added. 

Interventions work

According to Ramsoomar, interventions by the What Works to Prevent Violence against Women and Girls Global Programme had led to a reduction in substance abuse, depression and trauma in both men and women. It has also had an impact on violence against women and girls and harmful alcohol use. 

She said a range of interventions existed which have been shown to have promise at different levels.

These include:

Structural measures

  • Policy and fiscal interventions, for example, alcohol taxation, price increases, restricting the availability of alcohol; partial and total bans on alcohol advertising.

Evidence-based treatments

  • Brief interventions - detect problems early on.
  • Motivational interviewing.
  • Pharmacological treatments.
  • Treatment - CETA is an example of an integrated treatment model.
  • Community interventions

    • Altering the drinking environment, public education campaigns, schools-based work.

    Gender-transformative programmes

    • These provide men with opportunities to reflect on, and reframe their lives as men, change their relationships, and reduce their use of violence and other harmful practices, including heavy drinking. 

    "Group-based gender transformative programmes, such as Stepping Stones, tackle the nexus of gender inequitable masculinities and men's mental health issues and are shown to reduce IPV perpetration and reduce men's harmful use of alcohol," Ramsoomar said. 

    "Interventions that address harmful alcohol of this nature are more effective than measures that do not address the social and psychological context of men's drinking. [These include] individual psychotherapeutic programming that tackles men's mental health and alcohol use [such as the CETA intervention used in Zambia].

    "Screening IPV clients and mental health/substance disorder patients for the converse problems may have important implications for intervention planning. Measures to restrict access to alcohol and the volume consumed are likely to have some impact on GBV."

    Stronger enforcement of existing legislation for both GBV and harmful alcohol use would also have a positive effect, she added. 

    GBV is a global problem, SA not immune

    Octavia Lindiwe Ntuli-Tloubatla, a commissioner at the Commission for Gender Equality (CGE), said GBV was a global problem.

    "South Africa is not immune to this pervasive problem. The drivers of substance abuse are, among others, urban violence, crime and gender-based violence. The CGE has also established a link between drug abuse and gender-based violence, and women are at the centre."

    She added the levels of abuse in South Africa ranked among the highest in Africa.

    "We have very high incidents of GBV and that is a serious challenge." 

    Ntuli-Tloubatla said liquor stores situated close to schools in informal settlements have embedded a culture of alcohol use. 

    In urban areas, it is the opposite, where gyms and recreational facilities are instead found in close proximity to schools. 

    "Alcohol contributes to people acting irresponsibly, and not being able to make sound and clear decisions. 

    "Research has shown that some women who experience IPV are most likely abusing drugs or alcohol themselves. At times, we find the situation leads to [women] neglecting themselves and their families, children in particular." 

    Children exposed to substance abuse or GBV then grew up to replicate the same behaviours, Ntuli-Tloubatla said. 

    Alcohol was fuelling a cycle of violence, she added, and this could not be ignored, saying intervention strategies were urgently needed. 

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