Corking the bottle?

The stories may have different characters but the plots remain the same: a man, a woman or a child is the victim of a senseless act of violence, the result of someone who has had too much to drink.

Last month, Keron Caldeira, 18, joined an expanding cast when he was fatally stabbed at Line Path, Skeldon. His attacker was a 15-year-old with whom he was drinking. Then last week, Edwin Motoweren, 32, died from wounds he sustained when he was stabbed by workmate with a putty-knife at a construction site at Parafield, West Coast Demerara. Before he died, Motoweren recalled the image of his attacker, sitting and drinking rum while he was lying on the ground bleeding.

Dr Leslie Ramsammy
Dr Leslie Ramsammy

Those are just the latest instalments in the ongoing saga of alcohol abuse in Guyana and there is growing fear that what is now a huge problem could deepen if serious interventions are not made.

According to Minister of Health Dr Leslie Ramsammy, alcohol abuse costs the health sector millions of dollars a year in hospital bills alone. For years, he has warned that alcoholism is a serious health problem and while the ministry has taken small steps to address the issue, he admits that there is still much more to be done.  “I am not satisfied that we have enough [being done],” Ramsammy told Stabroek News. “I am not satisfied that we are near enough; we will need overwhelmingly more to be done.”

The minister noted that alcohol contributes to a host of negatives in the society, including violence, especially domestic violence and sexual abuse, as well as lifestyle challenges like ill health and hindrance to educational progress.

The ministry sees alcoholism as a disease and its new drugs programme includes persons being medically treated for the illness. Although the ministry has recently made programmes available to help those who are addicted, Ramsammy explained that the demand has outgrown the service. To address this problem, he said the ministry will soon be taking the service to other regions. Earlier this year, the ministry established a support group for substance abuse, including alcoholism. It will be administered at the Georgetown Public Hospital (GPH), under its mental health programme. The ministry also launched an anti-drug sensitisation programme, using radio and television series to target substance abuse, particularly alcoholism.

Ramsammy also said some Non-Governmental Organisations (NGOs) have joined the fight by attaching alcohol abuse components to their HIV programmes, but he pointed out that it has been difficult to convince them all  since they do not see money coming in directly for such inclusions.

Admitting that more needs to be done, the minister said success would depend on a coordinated approach that would involve other government departments, like the Human Services, Education and Home Affairs ministries.

Human Services Minister Priya Manickchand agrees. There are no statistics from the reports of domestic violence to the ministry, but Manickchand told Stabroek News that it is safe to assume that around 90% of them are alcohol-related. While she was quick to point out that alcoholism should not be blamed for some of the heinous acts, Manickchand acknowledged that many of the perpetrators act under the influence.

According to statistics gathered by Help & Shelter, alcohol contributes largely to domestic violence.  Between November 1995 and October 2006, 1159 cases of spousal abuse were alcohol or drug related. There were also 86 cases of non-spousal abuse in the home and 16 cases of child abuse during the same period, all alcohol or drug related.

Raising awareness

Manickchand said while her ministry plans to get involved in the alcohol abuse awareness programmes, it is important that companies which produce alcohol and large distributors get on board.

She feels that the producers and distributors should direct some percentage of their profit to awareness programmes and provide counselling for those who are already hooked.  “But I don’t see that… and it is something that we need to look at,” she observed.

Meanwhile, Ramsammy said the ministry has been engaging alcohol producing companies, especially since like in other countries, Guyana has seen an increase in alcohol advertising. “We have been talking with the companies quietly…” he explained, though he was not prepared to divulge what the discussions were centred on.

Awareness programmes, according to him, are an important aspect of the fight since they can prevent persons from becoming substance abusers. “How do we get people, first of all young people, to abstain? And secondly, how do we get older people, who are already consuming alcohol, to stop the abuse of alcohol? Alcohol was never meant to be consumed in unlimited amount, it was never meant for anyone of us to test of capacity…,” the minister said.

The minister said that for the awareness programmes to be effective the messages need to be taken to the schools, social clubs, churches and the family.  But finance remains a bugbear. “The resources we need to constantly bombard people with the alcohol message are simply not there and so if you compare what we do in terms of HIV and what we do in alcohol, it is night and day differences,” he said.

“It is not that I don’t want to, it is whether we have the resources to do it.” At the same time, he was also quick to point out that the fight is not just the government’s responsibility, saying that the private sector entities, such as the media, could join the fight on their own.  In this vein, the minister complimented organisations which have been promoting recreational events that are non-alcoholic.

Support systems

Many people who abuse alcohol, according to Ramsammy, do not want the lifestyle and want help to change.  “They want help and they can’t get it,” he said.

In the recent past, only the Salvation Army provided any sort of assistance to alcoholics and even then it was only in small numbers. But the minister noted that many of the people who were treated in the programme went back to the same lifestyle after completion because they had no support network afterward. “If you don’t have local support systems, you would fall right back into it,” he said. The Salvation Army was later joined by Phoenix Recovery Programme and now the Health Ministry’s programme at the GPHC. But the hospital programme is a non-residential one.  “For some people that doesn’t work,” he said. “You have to force abstinence for them to benefit.”

Ramsammy said the ministry currently has ten times the capacity that it had last year. “But guess what? Our ability to deliver has been overwhelmed by the demand,” he said, adding that there is no longer a problem to get persons to seek access of the programme since the courts and the police have been pro-active and are sending persons to access the programme. He called it a “promising start” and said the ministry “would continue to build.”

He said the ministry will ensure that Georgetown is a centre of excellence and that the big urban areas, like New Amsterdam, Linden, Parika, Anna Regina, Suddie, Mabaruma, Lethem and Bartica would  have non-residential services in place by the end of next year. The ministry is currently working on a residential area in Region Six, after which Linden will be the focus for the establishment of such a centre.

But as the minister said before it is not only the ministry which should be fighting the fight and in this regard Georgetown and New Amsterdam will be used as training bases for religious representatives and other persons so that they can also start their own non-residential facilities.

In addition to the institutional approaches, Ramsammy feels that the implementation of the new Evidence and Motor Vehicles and Road Traffic Amendment Bill 2008, passed in Parliament in June, will help to address alcoholism.

It is to be enacted upon completion of a public education programme for motorists.

The new law aims to curb driving under the influence of alcohol and makes provision for police to use breathalyser tests to verify whether motorists have exceeded the prescribed blood-alcohol limit. It is estimated that motorists would only be able to have the maximum of two beers. But the minister added that more can be done and he called again for a law stipulating who can access alcohol, explaining that too many children can walk into rum shops and purchase it.

He said the law should also address who sells alcohol, since many persons are doing so without the requisite licence. “I know there are laws but I am not quite sure that they are as modern as we want, to address at what age you are permitted to buy alcohol and drink alcohol in public places like bars and nightclubs,” he said. “I don’t need to tell the Guyanese public that there are too many 14-year-olds and 16-year-olds going to the nightclubs and drinking. I don’t think people need me to tell them that that happens.”

He also called for increase on the taxes for the importation of alcohol, arguing that it is far too affordable.