CNS REGINA LEADER-POSTPublic education campaigns have failed to stem the problem of babies born with fetal alcohol syndrome.A deadly serious but almost invisible problem affects thousands of children in Manitoba and across the country. This problem is entirely preventable; yet we are afraid to take serious action to deal with it. This problem is one we should know more about; yet we are afraid to properly research it.This problem demands a national inquiry. Yet, we would rather not have to think about it.

The problem? Children are born with malformed brains as a result of exposure to alcohol in the womb -- fetal alcohol syndrome, or FAS.FAS symptoms can include both physical and mental problems. In some cases there are serious heart defects, children who cannot walk or talk, or even children who cannot eat and require tube-feeding. Usually, however, children are physically normal, but cognitively impaired. Typically, they lack impulse control and the ability to learn from experience and will be highly susceptible to peer pressure. They often have great difficulties at school. As they grow older they frequently become involved with the law. They are filling our youth detention centres and jails. Some work very hard to succeed, but most live difficult lives that too often end early.How many of these children and adults are there in Manitoba? Of the 10,000 children in care in Manitoba, senior child-welfare officials report about half have "developmental or addiction issues." That is politically correct code for children with FAS. Research on the extent of the problem is surprisingly limited, but some studies on northern Manitoba reserves find that fetal-alcohol problems there appear to be rampant. On one reserve, teachers reported half the children did not seem to be capable of learning. Testing revealed at least one in four children on that reserve was a fetal-alcohol victim. So, we are probably talking about many thousands, or tens of thousands, nationally.To make matters worse, mothers with FAS are now giving birth to babies with FAS. Although there is no genetic link, a pregnant woman with FAS often lacks the ability to refrain from alcohol. So, in some rural communities and depressed urban pockets there are now grandparents, parents, and now children -- all with FAS.Many dedicated people working with fetal-alcohol children and adults

are trying to raise awareness of this issue among young women who are at risk. Poster campaigns and educational programs are offered by medical people, social workers, teachers and volunteers. However, their efforts do not appear to have stemmed the depressingly steady flow of fetal-alcohol births.We need a more aggressive approach in cases where education fails to stop a pregnant woman from endangering her unborn child by reckless drinking and drug consumption. If we saw a parent beating a child to the point of causing brain injury, we would charge, prosecute and jail that person. We would also expect the child-welfare system to step in if those parents had more children.Yet we balk at pursuing aggressively parents drinking to excess, obviously endangering their unborn child.What about authorizing a child-care agency to detain for treatment a pregnant woman who refuses to control her addictions while pregnant? A Manitoba child-care agency tried to do exactly that. The Supreme Court did not allow it and left the woman's future children to their fate in the 1998 case of D.F.G. In dissenting, Justice John Major said if a woman decides to continue a pregnancy, she must take reasonable steps to prevent her child from being born with brain damage. Maybe it is time for another detention-for-treatment test case to see if a majority would agree with his common-sense dissent.Although fetal-alcohol cases are found in all races and population groups, most of the FAS cases we see in Canada are indigenous children and adults. Is it possible there is some genetic predisposition at play? Again, there is very little research on this point, and nothing recent.I suspect researchers are hesitant to deal with an issue that will provoke accusations of "racism" or "eugenics research." But it would be tragic if there were a genetic predisposition and we failed to look for it out of fear of being called names.Some conditions and diseases hit certain groups particularly hard. It is generally accepted that people from a hunter-gatherer background, such as Polynesians or North American indigenous people, are more likely to develop Type 2 diabetes. This finding was made after careful research that aboriginal leaders welcomed. Now we have prevention strategies specific to indigenous people. Maybe the same is true of fetal alcohol syndrome. Maybe not. The point is we should know.And what about an inquiry into this vexing problem? The best minds could be brought in to investigate the extent of the problem and to

devise strategies to deal with it. There is going to be an inquiry into the issue of missing women. The fetal-alcohol issue is every bit as important and the problem is seen across Canada. It is more severe in the far north. Aboriginal leaders, who have been so vocal on the missing-women issue, should be just as vocal on a matter that affects so many indigenous lives. They should demand an FAS inquiry.Every fetal-alcohol birth results in costs of millions of dollars over the course of that child's life. Health care, child welfare, special education and corrections costs are a huge drain on the public purse.More tragically, each fetal-alcohol baby means another child born with a life sentence for a condition that is completely preventable. Brian Giesbrecht was a provincial court judge from 1976 until 2007. He is now retired.Republished from the Winnipeg Free Press print edition December 19, 2015 A15

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One of the reasons "serious action to deal with it” has not occurred is because it [FASD] has been seen as being an aboriginal condition.A myth that Brian Giesbrecht perpetuates.

Two of the offices I worked out of, when in practice, were the Aboriginal Health Centres in Hamilton and Brantford [Ontario]. Generously,I was allowed to see non aboriginal clients. My practice was confined to FASD. Only 44.5% of referrals were aboriginal.

We should not confuse a local high incidence of FASD solely with a genetic susceptibility. There are many reasons for high local incidence, mostly historical and political. 

However, if is to be a focus of research it should be done in tandem with research into why autism is seen so infrequently in aboriginal communities.

Barry Stanley. MB ChB, F.R.C.S.C.[C]