‘It Destroys Families and Communities’: Alcohol and Drug Abuse in Rural South Africa

We present participatory action research (PAR) inclusive of Photovoice from rural South Africa as part of a broader programme of health policy and systems research entitled ‘Verbal Autopsy with Participatory Action Research (VAPAR).

We re-engaged 16 participants representing community actors, service users and providers across two villages from earlier work in 2013 and 2015. Alcohol and other drug abuse was an issue that participants considered important and relevant, and a further 16 young people were recruited by the original participants to explore the topic as a collective. We then held a series of village-based workshops employing deliberative techniques to understand the problem and its causes, identify relevant actors, and develop action plans. Participants also used photography to document local issues around AOD abuse.

The combined effects of AOD abuse on families, communities, society and the economy were evident. Participants developed integrated community health action plans inclusive of multi-sectoral partnerships and monitoring mechanisms. PAR inclusive of Photovoice developed compelling evidence on the lived experience of AOD abuse in rural communities. The next step is to engage stakeholders to encourage visibility and action in health systems.


Submitted by:
Denny Mabetha

Alcohol and drugs - the stress relievers

Men dancing and singing after drinking alcohol and smoking. Alcohol and drugs were described as stress relievers for people living in hardship. According to participants, alcohol makes them forget their problems and helps them through to the next day.

Photographer: Delight Zitha / VAPAR learning platform

Alcohol abuse in older people

An elderly woman lies down after drinking a number of bottles of beer. The photo was taken in the early hours of the day to show how widely alcohol use and abuse is accepted in the community: it is normal for anyone to drink alcohol at any time of day.

Photographer: Ennie Khoza / VAPAR learning platform

Drugs at home

Remnants of drugs smoked by one person. The high levels of addiction to marijuana and Nyaope (antiretrovirals that are mixed and smoked) is of great concern in the community because of the linkages to crime and abuse.

Photographer: Florah Mafuyeka / VAPAR learning platform

Youth drinking and driving

A young man at the wheel of a car at night with an alcoholic drink in one hand and a cell phone in the other. Villagers considered such practices as contributing to the high levels of death and disability owing to road traffic accidents in the village

Photographer: Cornright Zitha / VAPAR learning platform

Traditional beer for unemployed youth

Young men drinking traditional beer during working/school hours. The situation is caused by high levels of unemployment: many people have nothing to do to keep busy which can lead to drug use, addiction and crime to support addiction.
Photographer: Florah Mafuyeka / VAPAR learning platform