Justin Summers has a mop of curly brown hair and enjoys playing marbles. Aged seven, he is on the cusp of starting his 12-year journey through South Africa’s education system.

But before he’s even started, the outlook for his education is dire. His ability to learn has been severely compromised because his mother, Agnes, used methamphetamine while pregnant with him. She is now expecting her fifth child, and is still using the narcotic.

Methamphetamine, locally known as tik, is the drug of choice in the Western Cape, and its use has exploded over the past two decades. A slow-moving but devastating health crisis is developing, with the effects of being exposed to the drug in utero becoming clear as many of the children enter the public schooling system.

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

Isaacs had her first child when she was 15. She used the drug daily for the first five months of her second pregnancy. Her son, Alex, is now 11 and has already failed a year of school because he struggles to concentrate.

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

Treatment data from the Medical Research Council suggests that in 2002, less than 1% of patients at the Cape Town drug counselling centre admitted using tik. Just six years later, this figure had increased to 52%.

In expectant mothers, substance abuse has tripled over the past five years, with tik being the predominant drug, according to a recent report by the Mowbray maternity hospital.

In expectant mothers, substance abuse has tripled over the past five years. Photograph: Shaun Swingler/Daily Maverick Chronicle

Bridgette Truter is a grade 3 teacher at Kleinberg primary school who has been teaching for three decades. Some of the 38 children in her class 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.

Stacey, who declined to give her last name, said she started doing tik when she was 20. She had her second child in 2009, and during both her pregnancies she was a heavy user, often smoking three to four times a day. “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.

Dr Kirsten Donald works at the Red Cross children’s hospital in Cape Town and said that the use of tik had 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.

Drug abuse is a normal thing here. It’s something they grew up with and they think it’s OK – that it is the lifestyle Marion Hendricks, school principal

Donald explained that when a mother used tik the development of the foetus was hampered because the drug affected 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.

She said teachers could witness many behavioural problems, “children who are hyperactive, who have very short attention spans, who are more aggressive and impulsive, get into fights more easily”.

Experts believe the drug epidemic is also leading to high dropout rates in schools. In 2005, the education department reported that there were just over 1.23 million pupils enrolled in grade 1 across South Africa.

The 2005 class, now aged about 18, have just received their matriculation results. Out of the 1.23 million who enrolled 12 years ago, only 827,324 registered to take their exam last year, according to department figures.

Marion Hendricks is the principal of the Ocean View care centre where Justin attends pre-school. She knows the difficulties faced by such vulnerable children, including domestic violence and food insecurity, as well as the risk of following their parents’ path. She added: “Drug abuse is a normal thing here. It’s something they grew up with and they think it’s OK – that it is the lifestyle, that it’s my lifestyle,” said Hendricks.



Apart from providing meals and classes, the centre offers occupational therapy to support vulnerable children. Hendricks refers tik-affected children to Jenine Bence for one-on-one sessions. Bence 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 improve their attention span, handwriting and pencil grip skills, as well helping them to better cope with the social and emotional difficulties that often come from growing up in dysfunctional homes.

You can’t cure this, or treat it in the traditional sense. You’re trying to manage it as best you can Dr Kirsten Donald

“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 those with ADHD and dyspraxia.

The Western Cape’s education department is now training teachers to identify and work with children who may require more attention in the classroom due to in utero tik exposure.

“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.

Western Cape’s health minister, Prof Nomafrench Mbombo, said her department was collaborating with the social development and education departments to address these problems with the First 1,000 Days project, aimed at raising awareness about the first 1,000 days of a child’s life.

Though the situation has reached crisis point, Hendricks said she approached each child she taught 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.”

Some names have been changed. A version of this article first appeared on the Daily Maverick Chronicle