the legacy of the Dop System: Tackling alcohol abuse among South
African farm workers
of Community Health,
University of Cape Town
the payment of alcohol to farm workers as part of their conditions
of service, known as the DOP system, is no longer legal in South
Africa, alcohol abuse remains one of the major challenges facing
the health services in the Western Cape.1,2 Evidence
indicates that although the DOP system no longer operates as
widely or with such intensity as originally introduced under
colonial agriculture,3 a number of farms
in the region continue to provide workers with alcohol as part
of their conditions of service.3-5 For
example, the estimates of the current prevalence of the DOP
system range from less than 2% based on industry estimates6
to 20%.5 Even in the absence of a DOP
system, alcohol dependence among farm workers continues to play
a major role in enmeshing farm workers in a cycle of poverty
and dependence from which escape is extremely difficult.7
health and development impacts of the DOP system and alcohol
abuse are substantial among rural farming communities, where
alcohol-related trauma, exceptionally high rates of TB, child
and adult malnutrition, and foetal alcohol syndrome are common
in the Cape.1 In addition, social problems
associated with alcohol such as child abuse, violence against
women and family disruption are major obstacles to access to
health and social services for farm residents.4
to these kinds of difficulties in delivery of mobile clinic
services in the Stellenbosch rural areas, nursing staff of the
local authority initiated a project aimed at eradicating the
DOP system and reducing alcohol abuse among rural farm residents
in the area. The project began as a loose network of interested
service providers, university public health staff, rural development
non-governmental organisations (NGOs) and interested individuals
in 1995. It has subsequently been formalised as a non-profit
NGO and was officially launched in June 1997 as the DOPSTOP
of DOPSTOP are to end the Dop system, prevent alcohol abuse
and reduce excessive alcohol consumption in farms in the region,
by providing social alternatives and raising awareness of the
hazards associated with alcohol abuse. DOPSTOP plans to implement
a comprehensive programme over a 3- to 5-year period in the
Stellenbosch area which could serve as a model for other areas
in the Province, many of whom face similar, if not worse, alcohol
embraces four broad areas of work, adopting a comprehensive
health promotion approach to the question of alcohol abuse.
and training for farm residents and management with a view
to primary, secondary (early detection) and tertiary (support
groups) prevention, as well as training for health service
providers and other caregivers. Such training aims to learn
from other experiences in alcohol prevention, particularly
with marginalised groups in other countries with similar experiences
to farm workers in South Africa.
provision of clinical and counselling services for alcohol-addicted
individuals, including referrals for detoxification and in-
and out-patient treatment. Preventive work with farm workers
will be severely undermined if clinical services are not able
to support the identification, referral, management and follow
up of individual workers with drinking difficulties.
both quantitative and qualitative (using anthropologic and
ethnographic approaches), to inform interventions and provide
baseline indicators for evaluation. Research, in the form
of a mobile clinic-based survey, was also used to provide
empirical data to back early lobbying and awareness-raising
activities, which was critical for credibility of attempts
to place the issue on agendas of decision makers at the outset
of the project. These data have only subsequently been published
in the scientific literature.4
to promote healthy policies and practices, raise community
awareness and mobilise support. Use of the media has been
relatively successful in raising public awareness and interest.
of activities focuses primarily on developing community-based
interventions working with farm residents and management to
achieve shared goals. Use of peer experience as key vehicles
for behaviour change among both farmers and farm workers, and
of using both group and individual approaches, are critical.
Also important has been the mobilisation of political support
among farmers to ensure that the objective of eradicating DOP
practices is seen as being in the long-term interest of the
entire farming community. With this understanding goes the recognition
that simply stopping the DOP system alone will be insufficient
to achieve real gains for those most in need. In the absence
of alternatives to alcohol, withdrawal of the DOP system may
lead to substitution with other forms of substance abuse or
to farm workers finding other, more expensive (shebeen, or commercial
bottle store) sources of alcohol, placing a further burden on
already marginal household economies.
of the lessons from the projects experience
promotion cannot address the DOP system nor the problem of
alcohol abuse in isolation. A broad developmental approach
placing alcohol in the context of general health and social
needs is required. In light of this, DOPSTOP is presently
completing a large, baseline survey of a wide range of health
and social indicators to provide baseline data on which to
evaluate the impact of the programme over the coming years.
Such data will also assist district health planning for farm
workers, and help shape the interventions developed.
- The understanding
of the nature of drinking in the farm culture is critical
to informing the most effective intervention. Simplistic analyses
of bad farmers and innocent, vulnerable, victim farm workers
are neither correct nor useful for developing coherent strategies
and may serve to further disempower workers in an already
paternalistic environment. The DOP system has served a peculiar
functionality for employers and employees alike, for example,
by providing a unique cultural space for farm
workers in which the consumption of the daily dop "created
a social movement in which farmers could not share".3
This ironic functionality must be explicitly addressed by
carefully constructed anthropologically informed interventions.
- The multidisciplinarity
of the team required for such an intervention needs to mix
a very wide range of skills: legal, clinical, public health,
health educational, advocacy, media, community development
and health promotion.
of all stakeholders has been critical to the progress of the
project, with the commitment of the Stellenbosch Agricultural
Association to the aims of addressing alcohol abuse, and the
support of the provincial and national departments of health
and social services in both financial and organisational terms.
of the DOPSTOP will be greatly advanced by the appointment for
the first time of a full-time co-ordinator in March 1999, a
nurse seconded from the local Winelands District Council health
services in a partnership arrangement. The challenges are substantial
but the groundwork for a comprehensive intervention project
to address a difficult environment has been laid, which will
hopefully provide valuable lessons for novel approaches to substance
abuse in the future for South Africa and other countries.
L, Sanders D, Te Water Naude J. Farm workers in South Africa
the challenge of eradicating alcohol abuse and the
legacy of the "dop" system. (Editorial). SAMJ
1998; 88: 1093-1095.
Administration of the Western Cape. Strategic Management Team
for health. Draft Provincial Health Plan. Cape Town:
Ministry of Health and Social Services, 1995.
P. Liquor and labour in the Western Cape, 1870-1900. In: Crush
J, Ambler C, eds. Liquor and Labour in Southern Africa.
Athens: Ohio University Press, 1992: 56-77.
Water Naude J, London L, Pitt B, Mohamed C. The DOP system
around Stellenbosch results of a farm survey. SAMJ
1998; 88: 1102-1105.
L, Nell V, Thompson ML, Myers JE. Health status among farm
workers in the Western Cape collateral evidence from
a study of occupational hazards. SAMJ 1998, 88:
Jonker, KWV chair, quoted in the KWV Producers Newsletter,
L. The "dop" system, alcohol abuse and social control
amongst farm workers in South Africa: a public health challenge.
Soc Sci Med, (in press).
A, Vorster J. The labour situation in the South African
deciduous fruit export industry. Executive Summary. Sociological
Research Programme. Stellenbosch: University of Stellenbosch,