Enyobeni tragedy: ‘methanol can be a byproduct when home-made punch ferments’

Methanol can be a byproduct of the fermenting process when people make their own punch or other alcohol, according to a Pretoria doctor.

Dr Jacques Koning, an internist at Pretoria’s Netcare Montana Hospital, was the first doctor to go on record shortly after the Enyobeni Tavern tragedy in the Eastern Cape in which 21 children mysteriously died.

“If it was carbon monoxide the older people, and especially smokers, would have been hurt first. Younger people have a stronger tolerance,” Koning told the Sunday Times in the week after the tragedy.

“The witness accounts are more in line with the intake of methanol, a toxic form of alcohol. It would be significant to know how the survivors were treated. If they were given ethanol and a drip, they were treated for methanol poisoning. If they were given oxygen they were treated for carbon monoxide poisoning.”

On Monday, Eastern Cape health director-general Litha Matiwane said all the children who died at the tavern had methanol in their blood. 

Matiwane made it clear that while methanol was found, they did not know if this was the cause of death. He said they were investigating if the levels of methanol in their blood were toxic.

Tissue and blood samples were sent to the forensic pathology laboratory in Cape Town,  where they also tested for alcohol and carbon monoxide poisoning but found the levels were not high enough to cause death.

“We are looking for other chemicals, formic acid being one. Formic acid is a byproduct of methanol and [if found] can tell us more about the levels of toxicity. We are also processing gastric and bowel tissue to see if there are other activities,” said Matiwane.

He said they also had to determine how the chemical entered the children’s bloodstream. 

“The first way it gets into the body is to ingest it. But it is a byproduct from other chemicals, so it could have been something else. Hence we say we are investigating.”

Koning said since it had been revealed all the children had methanol in their blood, he was even more inclined to believe that was the cause of their deaths.

“Methanol can be a byproduct in the fermenting process when people make their own alcohol. Ironically, and heartbreakingly so in this case, normal alcohol contains ethanol, which is used to treat people with methanol poisoning,” Koning told TimesLive Premium.  

Methanol is a toxic alcohol found in industrial solvents, fuels, fertilisers and many other products. Though a natural alcohol, methanol is not an ingredient in the alcohol people consume. Liquor has ethanol in it. Both liquids are clear and colourless. 

During the June Covid-19 lockdown in 2020, seven people died and 13 others were hospitalised after ingesting methanol used to make a home brew.

Koning said he had a theory about what could have happened at Enyobeni. 

“I suspect what we have here are kids drinking the same batch of home-made alcohol. It can be punch or beer, but something must have gone wrong in the fermenting process and methanol was created.” 

I suspect what we have here are kids drinking the same batch of home-made alcohol. It can be punch or beer, but something must have gone wrong in the fermenting process and methanol was created.

—  Dr Jacques Koning, internist at Pretoria’s Netcare Montana Hospital

When asked if that meant only the children were drinking the fatal brew on the night, Koning said: “Not necessarily. If we go on the assumption that underage kids don’t have money and adults do, it is an easy leap to make to the point where we accept the kids stayed with the free or cheap home-made stuff while the adults had over-the-counter drinks as well. If that is the case, the adults were accidentally treating themselves for methanol poisoning with the ethanol contained in the other drinks.” 

However, a healthcare worker in the area said the children who survived told her they drank ciders that night.

Lindi Mizwana, of Sinako Community Healthcare, who has been closely involved in assisting the community since the tragedy, said: “The children all say they had a brand of cider. All say it tasted funny and believe me, they know what that cider tastes like. I don’t know if there could have been home-made alcohol poured in the cider bottles.”

Mizwana said the children “were treated with oxygen and a drip when they arrived at Frere Hospital”.

Koning said treatment on the day might have been based on witness accounts.

“There were lots of stories doing the rounds about carbon monoxide poisoning. Doctors would have treated for what they were told by survivors and later adjusted.”

Dr. Shani van den Heever, a general practitioner at Tzaneen’s Spies and partners, said methanol and ethanol had no difference in taste.

“You won’t know you are drinking methanol, they both taste and smell the same. These victims had no idea of the damage that was coming,” Van den Heever told TimesLive.

“Methanol is mostly consumed through alcohol. It can be ingested through the skin and through gasses that burn, but that happens very seldom.”

Her gut reaction to the possible cause of death is the same as Koning’s.

“It can’t really be anything else than methanol that killed these children. It was probably the ones with smaller budgets who were unlucky,” Van den Heever said.

She feels as a country we need a new conversation about alcohol.

“We live in South Africa with all its stress. Some exercise too much, others drink too much pills, but alcohol is still the easiest way for many to find relief. Another issue is that teenagers and children do not know enough about the dangers of alcohol. Everybody hears don’t drink and drive, but we don’t hear ‘don’t drink’ or ‘what are you drinking?’ We need to start having that conversation.”

The SA Human Rights Commission’s Eileen Carter said they noted “the feedback from government stakeholders regarding the preliminary findings”.

“We also note the final analysis and cause of death remain outstanding, to the concern of the families. We have made contact with the families of the victims to offer our assistance should they wish to pursue litigation against responsible stakeholders. We are, however, continuing our own investigation and will await the outcomes from the forensic and pathology teams in due course,” said Carter.

On the Monday after the incident police minister Bheki Cele spoke at the Rural Safety Summit in Parys and said the children started dying in the early hours of the morning on June 26.

“Those kids started dying at 2.13am until 4am. They died as they danced. They danced and fell and died, literally. And they were pushed to the side and others kept dancing. Others felt dizzy and fell asleep on the sofa and died.”