Perceptions of community members towards youth abusing alcohol in the Capricorn District of the Limpopo Province, South Africa

Curationis 32 (4): 48-54 Alcohol abuse is a problem in South Africa and it has negative effects on the well­ being o f individuals, families, friends, work associates and neighbors. Alcohol pro­ duces both psychological and physical dependence. Gillies (1999:112) indicated that alcoholism usually interferes with the ability to socialize, work and may lead to much other destructive behaviour. It was further stated that people who are addicted to alcohol often have a low self-esteem, immaturity, are easily frustrated, and have difficulty in solving personal problems. This study investigated the perceptions of community members towards youth abusing alcohol and identified, among others, anti-social behavior, poor interpersonal relationships, family disorganization, poor integration with family members and physical damage as the major concerns. An attempt was also made to develop strategies that can be used to overcome the problems of alcohol abuse by youth. Design and Method: A qualitative, exploratory, descriptive and contextual research design was followed in this study for the participants to describe their perceptions regarding the phenomenon in question (Brink, 2006:113). Data were collected through individual unstructured interviews in one village o f the Capricorn District of the Limpopo Province. The researchers employed the principles of Guba and Lincoln (1993) cited in De Vos (1998:331) relating to trustworthiness and adhered to the ethical standards as set by the Democratic Nurses Association of South Africa (DENOSA, 1998:2.3.2). Findings: Five themes and seven categories emerged from the data analysis, using Tech’s open coding approach (1990), as outlined in De Vos (1998:343), namely, anti­ social behaviour, poor interpersonal behaviour, physical damage, poor progress in life processes and effects o f alcohol on the body. To address the problem of alcohol abuse by youth in one village (the study area) of the Capricorn District in the Limpopo Province and other villages the study recommends that educational and recreational facilities and the formation o f youth structures should be established. Correspondence address University of Limpopo, Turfloop Cam­ pus mariatm@ul.ac.za Kev words Perception; Alcohol abuse; Youth; Community; Behaviour 48 Curationis December 2009


Introduction and background
Alcohol abuse is a phenomenon that results in major social, economic and health problems for those individuals afflicted, their families, friends, neigh bours, work associates and society.Several factors, including constitu tional and environmental, can lead to alcohol abuse (Paton, 1996:5).The con sumption of alcoholic beverages in South Africa has a long history and it is outlined that during pre-colonial times, alcohol drinking was mainly pre served for elders, senior members of society and traditional healers, but it was uncommon among youth of child bearing age (Miller, 2001:247).On con trary research in South Africa has shown that, since 1994, more and younger people in rural communities are abusing alcohol, claiming that it is their right to consume alcohol (Smith, 1997:261).The study conducted by Latimer, Rojas and Mancha (2008:325) indicated that alcohol use amongst youth is prevalent worldwide and the researchers reported problematic use in Russia, South Africa, United States and Puerto Rico.According to Paton (1996:1), alcohol produces both psychological and physical dependence because people who are drunk usually have low self esteem and are violent -sometimes fa tal -tendencies.Alcoholism usually interferes with an individual's ability to reason, socialize, and work which also lead to other forms of destructive be haviour.People who are addicted to alcohol are often immature, become easily frustrated and have difficulty in solving personal problems and in re lating to people of the opposite sex.Alcohol abuse affects the youth's well being and social relationship with com munity members (Smith, 1997:261).The youth of today frequently manifest outward signs of disrespect and inter act poorly with community members.The approval or acceptance of alcohol abuse by family members, friends or society as normal may encourage an addicted person to continue unabated.Moreover, it has been reported that children of alcohol abusers are more problematic and disobedient (Baker, 1999:178).The recommendations of this study should be included in health education programmes to encourage the youth and community members to realize the damaging effects of alcohol abuse on personal well-being and social relation ships.

Problem statement
Alcohol abuse amongst the youth in one community in the Capricorn Dis trict of the Limpopo Province seems to cause problems for example leaving school by youth, teenage pregnancy, physical fights and poor interpersonal relationships between the youth and other community members.These prob lems, as perceived by community mem bers, arise because the youth are in creasingly displaying anti-social be haviour, such as hostility, attacking, fighting and hurting people with knives and other dangerous objects.People who are abusing alcohol escape from reality and have been described as fear ful, withdrawn and depressed.Some abusers have a history of frequent sui cidal attempts or self-inflicted injuries while others display dependency per sonalities in that they experience diffi culties in taking care of themselves (Smith, 1997:261).The health education program for prevention of alcohol abuse among the youth in schools and health care facilities seem not to be available in the healthcare facilities and community centers.

Purpose of the study
The purpose of this study was to ex plore and describe the perceptions of community members towards the youth who abuse alcohol at a village of the Capricorn District in the Limpopo Province of South Africa to develop health education program with guide lines which will assist youth to stop abusing alcohol.

Abuse
Abuse is anything that is harmful, in jurious or offensive, and it includes excessive and wrongful misuse of any thing (Behrman, 2000:57).In this study, abuse is defined as the misuse and ex cessive drinking of alcohol which re sults in addiction and negative inter personal relationships amongst com munity members.

Alcohol
Alcohol is defined as a depressant drug that is produced by fermentation of sugar and is the psychoactive con stituent intoxicating beverage (Smith, 1997:251).In this study, alcohol is any liquor or brew containing alcohol as the active agent that people, including youth, consume.

Youth
The United Nations (UN) defines young people as individuals who are female or male aged between 15 and 24 years (O'Higgins, 1997:1).In South Africa, young people are considered to be females or males aged from 14 to 35 years old (National Youth Commis sion, 1997:5;Kenniston, 1997:5).In this study, youth refers to both females and males from 15 to 25 years of age.

Perception
Perception is defined as an attitude or understanding based on what is ob served or thought (Henry, 2003: on line).In this study, perception means the views of the community members based on their observation and experi ences regarding the youth who are abusing alcohol.

Community member
Community member is defined as a per son who lives within the community, interact, react, expect other members to act and interact with him/her within the given geographical area (B artle, 2007:3).In this study community mem ber is a person who lives within the community and interact with youth who abuse alcohol in a given geo graphical area.

Behaviour
It is defined as the manner of behaving or conducting oneself (South African Oxford School Dictionary, 2007:40).In this study behaviour means the man ner in which youth behave or conduct themselves after alcohol consumption.

Ethical considerations
Ethical standards, as outlined by DENOSA position statem ents (1998:2.3.2), were used in this study.All participants signed an informed con sent form before they could participate in the study.The purpose of the study was explained to each participant be fore commencing with the in-depth oneon-one unstructured interview ses sions.Permission to conduct the in terviews was obtained from the clinic manager of the village's healthcare fa cility in the Capricorn District of the Limpopo Province.The participants were made aware that they were not forced to answer any questions if they felt the questions violated their rights of confidentiality.The participants were informed that field notes would be writ ten and that a tape recorder would be used during interviews to capture the proceedings of interview sessions and the tapes will be destroyed after two years.Participants were allocated num bers and their real names were not used to ensure confidentiality and anonym ity in the entire research project.

Research methodology
In this study, a qualitative, explorative, descriptive and contextual research design assisted the researcher to ob tain complete and accurate information about the perceptions of the commu nity members towards youth who are abusing alcohol in one village of the Capricorn District in the Limpopo Prov ince of the Republic of South Africa (Denzin & Lincoln, 2000:489).The par ticipants were given an opportunity to describe their perceptions towards youth who are abusing alcohol during one-on-one in-depth unstructured in terview sessions.The exploratory de sign enabled the researcher to ask prob ing questions from participants to ob tain extensive data with regard to the phenomenon under study.The con textual interest by the researcher was aimed at understanding events of the phenomenon studied within the con crete, natural context in which they occur in one village in the Capricorn District of the Limpopo Province (Babbie & Mouton, 2001:272;Brink, 2006:113).

Research design
A qualitative phenomenological re search method was used for this study, because it was aimed at exploring, de scribing and promoting understanding of how participants perceived alcohol abuse by youth in their village.The method further allowed the researcher to gain a full view of the study area.
The participants were given an oppor tunity to describe their perceptions re garding the phenomenon under study during one-on-one in-depth unstruc tured interviews.Qualitative research is contextual because the participants were given a chance to relate their own perceptions towards youth abusing alcohol in their village (Brink, 2006:113;Denzin & Lincoln, 2000:489).The find ings of the research after data analysis reflected the essence of the partici pant's perception regarding the phe nom enon under study (De Vos, Strydom, Fouche & Delport, 2006:271).

Inclusion criteria
The following inclusion criteria deter mined who participated in the study: The participants were members of the community who attended or accompa nied patients at the village's health care facility in the Capricorn district of the Limpopo Province of South Africa.Participants were community members who were able to understand instruc tions and be able to communicate.
Participants gave informed consent be fore they were included in the study.

Study population
A study population is the entire group of participants who are of interest to the research in order to meet the crite ria that the researcher set (Brink, 1999:121).
The accessible study population com prised of community members who at tended or accompanied patients to a healthcare facility in one village of Cap ricorn District in the Limpopo Province of the Republic of South Africa.

Sampling
A non-probability purposive sampling m ethod was used in this study.
Purposive sampling entails judgmen tal sampling that involves the con scious selection by the researcher of certain participants or elements to be included in the study (Bums & Grove, 2005:475).In this study a community members who attended or accompanied patients to a health care facility in the Capricorn District of the Limpopo Prov ince of South Africa were selected.A total number of twenty (20) participants were interviewed over a period of four weeks till data saturation was reached.

Data collection
Unstructured one-on-one in-depth in terviews were conducted during the research study.The purpose of this interview method was to understand the perceptions of the participants as they were given an opportunity to de scribe their experiences with regard to youth abusing alcohol.Different data collecting methods (triangulation) were used in this study to complement each other in order to maximize the trustwor thiness of collected data and to reduce the chance of bias by the researcher (Babbie & Mouton, 2001:274).The methods included: • Unstructured one-on-one in--depth interviews.

•
Field notes of unstructured one--on-one in-depth interview ses sions were recorded verbatim.The central question was asked to all participants the same was during the interview sessions followed by prob ing questions because the researcher wanted to understand more about the perception of the community members towards youth who are abusing alco hol.The central question was "De scribe how you perceive youth abus ing alcohol in this village?"

Data analysis
The Tesch's open coding approach of data analysis (1990) as outlined in De Vos (1998:343) was used: All tape re cordings were listened to and tran scribed verbatim.Field notes taken during unstructured in-depth one-onone interviews sessions were given meaning.The ideas that came out of the unstructured in-depth one-on-one interview sessions were consolidated.A list of all probing questions and their responses were drawn up and similar topics that emanated from the re sponses were grouped in columns.The topics were arranged into five themes and four categories.The lists of all topics were compared with the original data.Codes were allocated to data ac cording to identified topics.Data be longing to each category were grouped and analyzed and then final remarks on the data analysis written (De Vos, 1998:345).Raw data were forwarded to an independent coder with no catego ries.The independent coder then allo cated the codes from the original raw data given by the researcher.Thereaf ter, a meeting was scheduled to discuss and to reach consensus on the catego ries reached independently (Brink, 2006:185).The literature control was presented after data were collected and analyzed as it formed a basis for com paring and contrasting the findings of the qualitative nature of this study (Creswell, 1994:23).

Credibility
Credibility was ensured through pro longed engagement in the health care facility of a village in the Capricorn Dis trict of the Limpopo Province until data saturation was reached.Participants who were interview ed were purposively selected and satisfied the research study inclusion criteria (De Vos etal, 2006:346).

Transferability
The thick description of research meth odology was outlined in this study and the research context was explained (Babbie & Mouton, 2001: 276).The participants were given an opportunity to describe their perceptions towards the youth who abuse alcohol (Univer sity of Johannesburg Postgraduate Research Reader for Health Sciences, 2007:166).The study findings are not generalized to all villages in the Capri corn District in the Limpopo Province, but are limited to one village only (De Vos et al, 2006:346).Triangulation of data collection methods were used in the verification of the truth of data col lected from the participants themselves and not from the researchers.

Confirmability
The findings of this research are the products of the research inquiry and not from the researcher's bias.In this study, conformability was ensured by the involvement of the independent coder.Raw data were forwarded to an independent coder with no categories.The independent coder then allocated the codes from the original raw data given by the researcher.Thereafter, a meeting was scheduled to discuss and to reach consensus on the categories reached independently (De Vos, 1998:351;Babbie & Mouton, 2001:278;Brink, 2006:185).

Limitations of the study
The study was limited to one village in the Capricorn District of the Limpopo Province and thus the findings of the study are not generalisable to all the villages in the Limpopo Province.

Discussion of the results
A total number of twenty participants were interviewed over a period of four weeks.Participants were community members who attended or accompanied patients to one village's health care fa cility in the Capricorn district of the Limpopo Province of South Africa.Table 1 indicates themes and catego ries emerged from data analysis regard ing the phenomenon under study.

Theme 1: Anti-Social Behaviour
Participants indicated that the youth who abuse alcohol fight with each other and other community members which result to injuries or death.One participant reported that " When peo ple are drunk they start fighting with everything they have, fo r example, knives and broken bottles Hannigan, Spear and Norman (1999:34) supported this statement noting that drinking pat terns are a common form of abuse in humans, and that they appear to pro duce more injuries.Participants per ceived alcohol abuse by youth as one of the contributing factors to rape inci dents in their community.Another re spondent stated that: "When young people are drunk, they rape others in cluding their parents".According to Graves (2000:35), alcohol reduces self control and increases aggressiveness which may result in the alcohol abuser being abusive, raping women and dis playing violent behaviour.Neubeck and Neubeck (1997:605) found that half of all murders and a third of all suicides involve drinking, and many people die annually in the United States.It was further stated that physical assaults, child abuse, rape and other sex crimes are thought to be associated with alco hol use.Some of the participants perceived al cohol abuse as one of the causes of family disorganization and eventually family breakups.They stated that "Al cohol brings problems in the families and divorce is one o f the results ".This statement agrees with reports that di vorce was common amongst young al cohol abusers (B uttler & Hope, 1997:326), and that disruption of family life due to alcohol often end up cost ing the taxpayer money because there will be unhappy families who will need professional counseling, broken homes which will need repairs, and displaced or deprived children who will need gov ernmental assistance (Neubeck and Neubeck, 1997:601).

Family Members
Participants indicated that youth who are abusing alcohol develop poor in terpersonal interactions with others, including their families.They stated that "When young people are drunk they become arrogant and insult oth ers, including their parents ". Miller (2001:134) supports this notion and re ports that young people are at high risk of alcohol abuse that predisposes them to poor interpersonal relationships with their family members.Neubeck and Neubeck (1997:601) asserted that the impact of alcoholism often dramatically affects the alcoholic's relationships with other people, especially family members.

Theme 3: Physical Damage
The results indicated that when young people are drunk, they sustain physi cal injuries through burns or falls.(1994:116) that alcohol abuse demon strated increased incidence of people who burn themselves accidentally when they are under the influence of alcohol.Some participants stated that: " Many young people when drunk sus tain injuries due to falls Hannigan, Spear and Norman (1999:34) also sup ports this statement by observation that drinking patterns are a common form of abuse in humans, and they ap pear to produce more injuries.The study revealed two categories un der theme 5 which is Physiological ef fects and Physical effects of alcohol on the body.

Category 5.1: Physiological Effects
Participants explained that it is not good for the youth to abuse alcohol because it also results in brain damage.They stated that: "Alcohol distorts brain functioning".Graves (2000:8) sup ports the notion that alcohol may de stroy the brain and liver cells and, over time, excessive alcohol consumption maybe fatal.

Category 5.2: Physical Effects
The participants indicated that youth who are abusing alcohol looks older than their age with wrinkles on their faces, skin seem to be worn-out and they walk like older people.One par ticipant stated that "You know madam youth in our place they look like their grandfathers sometimes I will say their grannies are better, their skin are not well nourished they look as is they are old I must tell you and they are always sick". Brown (1993: 667) pointed out that heavy alcohol consumption results in the excess morbidity experienced by blacks compared with whites.

Recommendations
The following strategies can be used to overcome the problem of alcohol abuse by the youth.

Educational Program
• The youth must be educated about the after effects of alco-hoi abuse, such as poor educa tional progress, and unemploy ment and violence, so that they may be able to understand the importance of stopping alcohol consumption and addiction (Howe, 2001:44) (Gordon, 1999:218).
Recreational Facilities

•
The youth must be encouraged to participate in community projects which will keep them busy and stop them from drink ing alcohol (Parry, 1998:175).
Youth should be involved in youth recreational activities for example sports, poetry, drama and educating one another as peers about positive aspects of life.• Support groups must be initi ated in rehabilitation centers where most young people will be encouraged and assisted to stop drinking, and to express their feelings about drinking (Parry, 1998:173).Youth should be engaged in group discus sions and brainstorm possibili ties that can assist them to stop abusing alcohol.

Educational Facilities
• Mobile and community libraries should be provided in the com munity.

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Expansion of community re sources such as community coalitions to prevent alcohol and substance use (Rhodes & Leonard, 1998:45).
Youth Structures

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The youth must be given infor mation about the availability of government youth structures such as the Umsobomvu Youth Fund, that can assist them to start their own businesses, es pecially those who are unem ployed (Gullotta & Adams, 1999:183).

Community Leaders
• Community leaders such as a chief in the community need to be encouraged to implement the rules that force bottle store owners in the community not to sell alcohol to the youth (Gordon, 1999:217).

•
The chiefs must encourage the formation of community police forums to trace people who are selling alcohol without a li cense.

Rehabilitation Centers
• Community members must be informed about the availability of alcohol rehabilitation centers that can be utilized by the youth (Party, 1998:173-175).

Conclusion
The findings of this study revealed that there are problems associated with youth who abuse alcohol such as fam ily disorganization, poor interaction with family members, unemployment and poverty, poor education progress, school dropout, physiological effects and lastly psychological aspects.The preventive programs could be imple mented to assist youth to stop abus ing alcohol.The recommendations of the study indicated strategies that can be included in the preventive program for youth who abuse alcohol.

Theme 4: Poor Progress in Life Processes Category 4.1: Unemployment and Poverty
Theme 5: