Justin Summers* (7) is one of 50 Grade R children at the Ocean View Care Centre. He has a mop of curly brown hair and enjoys playing marbles in the open, sandy playground. The impromptu play area is littered with colourful toys and sandwiched between a maze of blue and white shipping containers, which make up the classrooms and offices of the care centre, operational since 2014.

Justin is enrolled at Kleinberg Primary School for Grade 1, where he will start his 12-year journey through the formal education system. But he is likely to struggle at school. His ability to learn has been severely compromised because his mother, Agnes Summers* (24), used methamphetamine (tik) while she was pregnant with him. She is heavily pregnant with her fifth child, and is still using the narcotic.

Watch: Addicts at birth: Ocean View’s ‘tik babies’

Treatment data from the Medical Research Council (MRC) indicates that tik is the primary drug of choice in the Western Cape, when compared to other provinces. In 2002, less than 1% of patients at the Cape Town Drug Counselling Centre admitted to using tik. Just six years later, this figure had increased to 52%. Substance abuse by expectant mothers has tripled over the past five years, with tik being the predominant drug, according to a recent report by the Mowbray Maternity Hospital. However, these stats could be much higher.

Lynne Isaacs* (36), a mother of five in Ocean View, who used tik during three of her pregnancies, said that many women do not seek medical attention “because they’re scared that doctors will pick up that they using while they’re pregnant”.

With short, choppy hair and a husky voice, Lynne had her first child when she was 15. She lives in a backyard Wendy house. A double bed fills the room she shares with one of her children and her boyfriend. Her other four children live with various family members.

Lynne used tik daily for the first five months of her second pregnancy. Her son, Alex, is now 11 years old and in Grade 4. He has already failed a year of school as he has a hard time concentrating in class and is not receiving any kind of additional assistance.

“A normal child will sit in class but he can’t concentrate, he has a temper, he is aggressive,” Lynne said. “But I can’t hit him because it’s my fault that he’s going through that.”

Photos by Shaun Swingler.

Limited funding in public schools means teachers battle with large classes and face high dropout rates.

In 2005, the Department of Education reported that there were 95,090 learners enrolled in Grade 1 in the Western Cape, with the national figure sitting at just over 1.23-million.

The 2005 class have just received their Matric results and, out of the 1.23-million learners who enrolled nationally 12 years ago, only 827,324 learners registered to write their Matric exam last year. This number consists of 677,141 full-time students and 150,183 part-time students.

If you take into consideration only full-time learners who registered to write Matric last year, the dropout rate is as high as 45%. If you include the part-time Matric learners who registered to write, the dropout sits at 33%. Either way, the numbers raise alarms.

“For some of our learners, dropping out is the culmination of years of academic hurdles, missteps, and wrong turns. For others, the decision to drop out is a response to conflicting life pressures, the need to help support their family or the demands of caring for siblings or their own child,” said Western Education Department (WCED) spokesperson Jessica Shelver.

Shelver said that the “Progression Policy”, which sees learners pushed through the schooling system, is a national policy and the WCED is not in favour of schools that “promote learners to the next grade”.

“The progression policy can lead to perverse incentives for learners who fail. It is claimed that many learners who fail a grade do not put in any effort thereafter as they know they cannot be held back in the phase. This aspect is not good for education, the teachers or the learners,” said Shelver.

‘Those kids will drop out’

Bridgette Truter is a Grade 3 teacher at Kleinberg Primary School who has been teaching for three decades. She has a class of 38 learners and some are “clearly affected by tik”.

“They struggle with reading, writing and arithmetic. Some can’t even write their own name. With the parents who do drugs, their kids don’t go to school. Those kids will drop out,” she said.

Photos by Leila Dee Dougan.

Stacey* said she started doing tik when she was 20 years old. She aborted her first child and had her second child in 2009. During both pregnancies she was a heavy tik user, often smoking three to four times a day, depending on how much money she could scrape together.

“Even the day when I was on my way to the hospital in labour I was drugging the previous night and I went high to Groote Schuur hospital,” she said.

Stacey was physically abused by her ex-boyfriend. The violence was often witnessed by her daughter. She would often take her along when buying drugs.

“My child went everywhere with me. Merchants knew her, people loved her, everywhere her mommy went, she went. So she was exposed to [tik]. So if I was coming from the supermarket she would say, ‘mommy, we have to go there to go buy your stuff’ because she knew I needed [tik],” Stacey said.

She would often leave her daughter with sweets and crayons before feeding her habit. “If I was to smoke, I would always open the cupboard door so I would smoke behind the cupboard door, or I would turn my back to her but she knew what I was doing,” Stacey said.

Dr Kirsten Donald works at the Red Cross Children’s Hospital in Cape Town and said that the use of tik has reached “epidemic proportions” in the Western Cape. She released a study in 2013 that looked at the abnormalities in the brains of children whose mothers used tik during pregnancy.

Donald explained that when a mother uses tik the development of the foetus is hampered because the drug affects specific areas of the brain – the deep grey matter. “The chemical crosses over through the placenta, into the baby’s system… it affects similar areas of the brain to actual users,” said Donald.

“In the clinical context, children who have come from heavy [tik] users have significant developmental problems and, as a result, cognitive and academic problems later on as they enter school age,” she said.

Donald said the drug is not used in isolation. “Prenatal exposures including alcohol exposure, tik exposure, other drugs such as cocaine, and other problems such as HIV infection might also cause problems with your executive function, which is your planning and management of your attentional capacities,” she said. “By the time children are identified as being affected, it’s often too late. They drift into the school setting and struggle.

“Teachers may experience problems around behaviour: Children who are hyperactive, who have very short attention spans, who are more aggressive and impulsive, get into fights more easily. But over and above that they may have learning difficulties… compounded by the fact that they frequently come from broken families,” Donald said.

Marion Hendricks is the principal of the Ocean View Care Centre, which forms part of Soteria Ministries. She knows the difficulties that vulnerable children like Justin and Alex face all too well, including drug abuse, physical abuse, domestic violence and food insecurity.

“Drug abuse is a normal thing here. It’s something they grew up with and they think it’s okay – that it is the lifestyle, that it’s my lifestyle,” said Hendricks.

She fills a number of roles at the centre. She and the founder, Johann Kikillus, started off with 15 volunteer teachers and 90 learners, but over the past 24 months all the teachers have left. The centre now operates with overseas volunteers and two women from the community who prepare breakfast and lunch.

“These kids really don’t eat. Their meals are from here. So the school provides breakfast, a snack and lunch,” said Hendricks. Many of the parents she interacts with are unemployed, substance abuse is their norm and their families are “at the hands and the feet of the feeding scheme”.

Apart from providing meals and classes, the centre offers occupational therapy by Jenine Bence, who tries to supply a holistic approach to support vulnerable children. Hendricks refers tik-affected children to Bence for one-on-one sessions. Bence currently sees 13 children at the care centre on a voluntary basis.

She works with each child for an hour once a week and uses techniques to assist learners with their attention span, fine motor handwriting and pencil grip skills, as well as how to better cope with the social and emotional difficulties that often come from growing up in dysfunctional homes.

“The exercises that I’ve been doing with the children mostly here are to help them firstly to be able to regulate themselves, to be contained, or to be able to sit down and be still,” said Bence. The sensory integration therapy she uses is similar to treatments for young children who show signs of developmental delay, as well as children with ADHD and dyspraxia.

Once Bence’s patients move on to Grade 1, as Justin will next year, they will return to the centre for their weekly sessions. At the moment 10 of her patients are at the centre.

“They really need a lot of attention. Some of the children do not listen [in class], they’re not attentive, they cause trouble, they’re often clumsy. With any substance abuse, the brain is affected and, like learning difficulties, the potential of developing cognitive abilities is reduced,” said Bence.

The WCED is training teachers around the province to identify and work with children who may require more attention in the classroom.

“We are rolling out the Screening, Identification, Assessment and Support tool to all our schools. As part of this training, teachers are informed about Foetal Alcohol Syndrome (FAS). [Last] year 10% of all schools were trained,” said Shelver.

Shelver admits that children with FAS are easier to identify than those affected by tik. “In the case of FAS, a medical diagnosis is made which makes it easier to track these learners. This is currently not the case with most of the children affected by maternal use of tik.”

According to Donald, what makes diagnosis more difficult is that the level of care and additional therapies required often differ depending on the length of time they were exposed to the drug in utero.

“Some children are very severely affected and need special schooling, but the vast majority of children in this bracket don’t actually fall into that category. They have relatively minor cognitive problems with difficult behaviour — they don’t have an identifiable medical problem,” Donald said.

“You can’t cure this, or treat it in the traditional sense or meaning of the word. You’re trying to manage it as best you can. You need to provide additional resources to the mainstream system to be able to support the children in the system. Support the teachers who have those children in their classrooms,” Donald said.

Hendricks agrees. “These kids need one on one,” she said, adding that occupational therapy has made a huge difference to the children at the centre who receive it.

“One of the boys who was exposed to tik, he’s been here for two years, he couldn’t read, we struggled with him. He was impossible. But [now] we can see a major change,” Hendricks said.

“I started crying because he came to me the other day and he was so proud. He said to me, ‘I can read the book, teacher.’”

Truter often stays behind to help some of her class who struggle, and said that learners cannot be “pushed through the system”.

“I can’t send kids over to the next grade if they can’t write their name. If you come to me, you can’t write your name, then I ask myself the question, what are you doing in Grade 3? What did your teacher do?” she said.

Western Cape health minister, Dr Nomafrench Mbombo, said her department is collaborating with the Social Development Department (SDD) and WCED to address these issues with the First 1,000 Days project. The project is aimed at raising awareness about the first 1,000 days of a child’s life.

“If a learner falls behind in areas such as reading, writing and calculating, between Grade 1-3, then they will struggle in the later grades, thus increasing the risk to drop out because of poor academic performance and confidence,” said Shelver, and insists that “learner retention” is essential to prevent children slipping through the cracks.

SDD spokeswoman Esther Lewis said her department is addressing the needs of the Ocean View community – “riddled with violence, gangs and substance abuse” – through collaboration with substance abuse organisations to deliver parenting workshops and family strengthening programmes.

“Between April and September 2016, 26 children were removed from their families and placed in foster care due to various reasons… Substance abuse in Ocean View is a contributor to many other social ills including the abuse and neglect of children.”

The situation is dire, but Hendricks approaches each child she teaches with care.

“They are just kids. I don’t treat them differently. They run to school every day because we give them a sense of stability, a sense of pride and belonging.” DM

* Names have been changed to protect the identities of children and mothers

Main photo: Ocean View Care Centre (Leila Dee Dougan)