Uganda places fifth on alcohol drinking index

Mafara, once a promising land surveyor, succumbed to the grip of alcoholism after a five-year battle with addiction. Despite medical warnings about alcohol’s toll on his vital organs, Mafara repeatedly fell back into its clutches.

Tragically, even in his final moments, he clung to the vice, sneaking a waragi (local gin) bottle into the hospital he was committed to. Fate played its hand, leading to a sudden collapse that cut his life short a couple of weeks ago.

Mafara’s heartbreaking story is just another statistic that captures the alarming rise of alcoholism in Uganda. The severity of the alcohol problem is evident in rehabilitation centres and mental hospitals.

A visit to Safe Places Uganda, the country’s first private mental hospital, reveals a steady influx of patients battling alcohol addiction. Like most facilities in its trade, Safe Places struggles to provide adequate care and support for patients entrusted to its care.

“Alcohol is the primary struggle for most of our clients. About 65 percent can be attributed to it,” Ms Janet Kantalama, the executive director of the hospital, explains, adding, “Surprisingly, some individuals start with alcohol and then switch to other substances like marijuana.”

Alarming statistics

Recent statistics indicate that about 75 percent of Uganda’s population regularly engages in varying levels of alcohol consumption. The data becomes worrisome when considering breakdowns by age, region, and gender.

Young adults aged 18 to 35 constitute the highest percentage of drinkers, accounting for almost 85 percent. Urban areas register the highest rates due to easy access to bars and nightlife establishments. Men are the primary consumers, making up around 50 percent, compared to 25 percent for women.

On average, Ugandans consume 12.21 litres of pure alcohol annually. Men average 19.93 litres, while women consume 4.88 litres.

Approximately, 50 percent of men aged 15 and above and 25 percent of women in the same age group partake of alcohol. Six out of 10 of them exceed safe limits (i.e. are hazardous drinkers), putting them at risk of alcohol-related health problems per Dr David Kalema, a World Health Organisation (WHO) consultant on alcohol use in Uganda.

Dr Kalema let the Monitor in on the latest but yet-to-be-released WHO statistics to paint a picture of the grave problem.

Uganda ranks significantly high in global alcohol consumption, according to the latest World Alcohol Consumption Report. It boasts a high per capita alcohol intake, topping the list in Africa. Dr Kalema reveals that the country places fifth globally in the upcoming report.

This situation presents the challenge of harmonising lifestyle and cultural practices with responsible alcohol use to address the escalating crisis.

Recommended consumption

According to WHO, moderate alcohol intake for adults translates to one standard drink daily for women, and up to two for men. Health ministry experts also emphasise responsible alcohol use, which includes moderation and occasional abstinence for body recovery.

Uganda’s alcohol market teems with legal and illegal beverages. Legally, licensed outlets offer beers, wines, and spirits. However, unregulated production and consumption of illicit brews such as waragi pose severe health risks, often leading to fatalities.

While traditional brews such as banana beer and local gin are lawful, imported spirits and commercial beers dominate the market. The Uganda Alcohol Report 2022 shows that beers accounted for 11 percent of the alcohol consumed in the country. Spirits (three percent) and wines (three percent) also have a share of the market, with other alcoholic drinks, including illicit brews, accounting for 89 percent.

Illicit brews, which are notorious for sidestepping governmental control mechanisms, easily reach end users in Uganda. This poses substantial health hazards. Elsewhere, binge drinking and consuming much alcohol in a short span are common in Uganda despite being labelled perilous.

The human liver processes about one unit of alcohol per hour. Rapid consumption can disrupt body functions. The liver processes one alcohol unit per hour, roughly equivalent to a bottle of beer, or just two tots of spirits per day.

Dr Kalema underscores that both acute (excessive consumption in a short time) and chronic (long-term intoxication) drinking can be fatal. Acute drinking slows down bodily operations, while chronic drinking can lead to organ failure over time.

For a 24-hour period, Dr Kalema recommends one to two units for women and two to four units for men, considering different alcohol types and their units. He further explains that men genetically bear higher body fluid content. This facilitates efficient absorption and circulation, delaying their intoxication, which is faster with women.

Alcohol intake remains medically associated with potential illnesses. Certain groups should avoid alcohol. These include people on incompatible medications and those diagnosed with Alcohol Use Disorder. Despite the legal age of 18, medically, Dr Kalema suggests waiting until 21 to drink, due to physiological factors.

Extent of problem

In Uganda, there is both anecdotal and empirical evidence to suggest that alcohol consumption has been normalised. Dr Kalema observes that many young people are consuming excessive alcohol, putting them at risk of addiction at an early age. This could lead to a burden on the nation as the young alcoholics may be unable to contribute to the workforce and worse still face health complications.

The Uganda Alcohol Report 2022, published by the Uganda Alcohol Policy Alliance (UAPA), reveals that the industry aggressively markets products, particularly to young people. Surprisingly, 23 percent of advertisements near schools promote alcoholic beverages. Despite the industry’s promotion of responsible drinking, there is no evidence of reduced alcohol-related harm.

“The simple disclaimer that ‘excessive consumption of alcohol is harmful to your health’ and that ‘alcohol is prohibited to persons under the age of 18’ is insufficient,” Dr Kalema opines, adding that these companies should further educate about the real risks of alcoholism.

Tragically, alcohol-related accidents—such as drunk driving and boda boda crashes—claim numerous lives each year. Around 3,900 people die annually due to road traffic injuries caused by alcoholism. Additionally, 1,514 people die annually from alcohol-related cancers like mouth, throat, liver, and breast cancer. On average, alcohol-related diseases and deaths cost Ugandans five years of life per the WHO Report 2018.

Recent findings reveal that 7.1 percent of alcohol consumers, roughly 3.2 million people in Uganda, struggle with Alcohol Use Disorders. Beyond visible addiction consequences, Mr Brian Muhumuza, an addiction counsellor at Safe Places Uganda, says chronic alcohol consumption damages the liver, leading to fatal conditions like early-onset dementia, liver cirrhosis, kidney diseases, and mental health issues like depression and anxiety.

“Alcohol can cause family breakups, financial issues, impact children’s lives, and even lead to criminal acts committed under its influence,” he says, adding, “It affects nearly all organs, rendering the body less able to withstand health complications, ultimately leading to early death.”

 Advisories

The government, through the Ministry of Health, acknowledges the severity of the alcohol problem and has issued advisories, including plans to raise the legal age for alcohol consumption from 18 to 21 years. Dr Hafsa Lukwata, the assistant commissioner in charge of mental health at the Ministry of Health, recently announced this move as part of the government’s strategy to combat the negative effects of alcohol abuse on public health and social welfare.

Although the policy to control alcohol consumption and sale was approved by the Cabinet in November 2019, it is yet to be implemented. Raising the legal drinking age to 21, alongside measures like restricting alcohol sales to licensed establishments and regulating drinking hours, are part of this policy. Health officials believe implementing the policy can guide interventions to ensure safe alcohol production, sale, consumption, and management of related issues.

Dr Lukwata stresses that for the policy to have a lasting impact on the drinking problem, it needs to be supported by legal enforcement and proper financing.

“Right now, we have a policy that we hope can make it to Parliament one day and be passed into law,” she recently said, adding, “However, even then, we shall need to have adequate financing to make sure that what is passed is implemented.”

Breaking free

To address the alcohol issue, Mr Lewis Kibirango, a wellness expert, urges those battling alcoholism to detoxify. This process involves cleansing the body from the toxic effects of excessive drinking and can aid individuals in breaking free from addiction.

Some individuals have successfully overcome alcoholism, often with professional help, family support, and personal determination. Rehabilitative centres and mental hospitals play a crucial role in aiding recovery.

Mr Alex Onen, a recovered alcoholic, fought his demons with professional support. He now advocates for awareness and assistance for others struggling with alcoholism.

Uganda faces a dire impact from alcoholism, demanding comprehensive efforts from individuals, communities, and policymakers. Addressing this crisis requires unity, awareness-raising, regulations, and supportive environments for those seeking recovery. Only then can Uganda aspire to conquer this threat and establish a healthier, alcohol-responsible nation for the future.

A drinking nation

Drinkers in Uganda: 75%

Heaviest drinkers: Young adults aged 18-35

Male drinkers: 50 percent

Female drinkers: 25 percent

Total annual consumption: 12.21 litres

Annual consumption (male): 19.93 litres

Annual consumption (female): 4.88 litres

Exceeding safe limits: Six out of 10 men aged above 15

Per capita alcohol intake in Africa: No.1

Global per capita alcohol intake: No.5

Sources: Multiple