Watching her five-year-old daughter at play fills Katrina Wilson with guilt instead of motherly pride -- the slight frame a daily reminder of her heavy drinking while pregnant.

And if life was not hard enough in the poverty-stricken South African town of De Aar, Wilson has to battle with the knowledge that she condemned her own flesh and blood to brain damage and an uncertain future.

The girl is one of hundreds diagnosed with Foetal Alcohol Syndrome (FAS) in the dustbowl town with its 30,000-odd residents and the unenviable distinction of the world's highest reported incidence of the condition.

"It was a shock when the doctors told me I had caused my baby harm. I felt terrible," Wilson reflected at her bare home in the semi-arid, mostly rural Northern Cape province -- where alcohol abuse is a way of life, a means of escaping the daily reality of poverty and misery.

The now defunct "dop system" whereby farmworkers were paid part of their wages in alcohol has left many dependent on drink. Though "dop" payments were banned in the 1920s, the system carried on in many rural zones until apartheid ended in 1994.

The erstwhile phenomenon of males-only mining hostels also contributed to a boozing culture in the province.

De Aar resident Valerie Farland, herself a former heavy drinker, believes alcohol's grip on the community will be hard to loosen.

"There are more drinking holes in De Aar than food shops," she says.