July 14, 2016 Source

Dear Editor,

To say that we at The Caribbean Voice are aghast that barrels of liquor flowed at CPL matches at the National Stadium would be an understatement. We do understand that the liquor companies are businesses that must do promotion and focus on the bottom line. However, we believe it is time for these businesses to recognize that social responsibility goes beyond sponsoring events and activities. To this end we urge liquor companies to recognize the fact that alcoholism is at the very core of many social pathologies in Guyana. We urge them to also craft and execute strategies that would help to tackle this issue, including statements in their advertisements and commercials emphasizing, ‘responsible drinking’, ‘don’t drink and drive’, ‘no drinking by pregnant women’, ‘no drinking by minors’, ‘regular excess drinking can lead to addiction and various health problems’ and the like.

The fact is that statistics show that the Guyanese drinking culture (rum culture) where most persons ‘drink to get drunk’, frequently at excessive and harmful levels, is associated with many forms of entertainment and participation in social events. Flowing barrels of liquor at sports actually play into this cultural trait with no consideration given to its debilitating effects, not to mention the messages conveyed to youth and minors, hundreds of whom were at these matches. So what are the quantitative indicators of this trait and what are its effects?

On average, Guyanese, aged fifteen or older, consumed more than eight litres daily of pure alcohol in 2010, compared to the global figure of 6.2 litres, the World Health Organisation (WHO) said in a 2014 report.  However, the average drinker in Guyana consumed more than 3.5 gallons/13.7 litres of total alcohol daily. One-seventh of this consumption (14%) was unrecorded ‒ homemade alcohol, illegally produced or sold outside normal government controls.

About 15.2 per cent of male drinkers (10% of the population aged 15+) engaged in heavy, episodic drinking, that is, consumed at least 60 grams of pure alcohol at least once per month. Also, 8.6% of males and 5.9% of all Guyanese aged 15 and older are classified as having alcohol use disorder (a pattern of alcohol use which causes mental or physical damage to health), with 3.9% and 1.9% respectively classified as alcoholics.

A 1997 study found that 54% of youths aged between 12 and 25 years, were occasional drinkers and 7.5% were regular drinkers. Also, a 2013 survey by Organization of American States/ Inter-American Drug Abuse Control Commission (OAS/CICAD) found that the overall average among the Caribbean (Guyana included) for first use of alcohol was about 12 years old. Furthermore, the average for males was about 11.9 years and for females 12.5 years. The survey also found that Guyana outstripped all the other Caribbean nations in terms of binge drinking among students.

It must be noted that all the figures quoted above would most likely be higher today.

Also, children and young people who misuse alcohol are at greater risk of suffering negative health and social outcomes compared to adults, because they have not yet fully developed their mental and physical faculties. Data and research on underage sexual activity shows evidence that indicates a positive correlation between early regular alcohol consumption and the early onset of risky sexual activity with attendant high risks of teenage pregnancy (Guyana has the highest teenage pregnancy rate in the Caribbean) and STDs, including AIDS (The Caribbean Voice is aware of a number of such cases with at least one young lady becoming suicidal).

While reliable statistics are not available, it is a fact that alcohol has an overall economic cost to all nations and takes a toll on workplace productivity. In fact alcoholism has been identified as a major reason for absenteeism in Guyana’s sugar industry. Other substantial costs to society include property damage, job loss and health service costs. Alcohol abuse has many potential consequences including accidental falls; burns; drowning; brain damage; impaired driving resulting in accidents, deaths and injuries; poor school performance; work productivity loss; sexual assault; truancy; violence; vandalism; homicides; suicides; lowered inhibitions and increased impulsivity; risky sexual behaviour including early initiation of sexual behaviour and multiple sexual partners often leading to pregnancy and STDs.

Also, it is generally well known that a relatively small proportion of incidents involving alcohol-related violence, are reported to police, making it difficult to determine the full extent of alcohol-related violence. Media reports continually cite

alcohol as an important risk factor for domestic violence, child abuse and neglect. The high rate of alcohol involvement in intimate partner homicide continues to be widely reported. The consumption of alcohol, either by the offender or victim or both, is also a significant contributing factor in incidents of non-fatal domestic violence, with research demonstrating that women whose partners consume alcohol at excessive levels are more likely to experience domestic violence.

Additionally, alcohol use and abuse  often leads to increased family dysfunction and to other family members ending up with mental health problems such as anxiety, fear and depression, as well as increased criminal behaviour as alcohol loosens inhibitions and makes it easier for individuals to become prey to peer pressure, and/or to be coerced and manipulated. Who knows whether alcohol may not be contributing to the current high crime rate among the youth (including teenagers) as inebriated youngsters wanting to fit in, become involved in that first act of crime and then it’s downhill from there. In fact, The Caribbean Voice is aware of a number of such cases.

The direct alcohol death rate for Guyana was 1.6 per 100,000, but again this figure could be much higher today. And since alcoholism also plays a significant part in suicides, as well as in domestic violence and child abuse, which often lead to fatalities, the overall death rate (direct and indirect) would also be much higher.

Against this background existing realities serve to foster alcohol consumption and alcoholism. According to the WHO, while some countries are already strengthening measures to protect people, including increasing taxes on alcohol, limiting the availability of alcohol by raising the age limit, and regulating the marketing of alcoholic beverages, Guyana has, “No written policy adopted or revised pertaining to the fight against alcoholism, no legally binding regulations on alcohol advertising and product placement, as well as no legal regulations on alcohol sponsorship sales. A national legal minimum age limit for purchase of alcohol exists, however, it is not enforced.”

Furthermore, Guyana has only four in-house alcoholism treatment centres, all of which have high costs associated with their programmes, all of which are located in Georgetown and all of which show only about a 25% recovery rate.  Then there are:

• the failure of the criminal justice system to appreciate rehabilitation as an alternative to incarceration as well as a lack of any structured rehabilitation programme in prisons;
• a benevolent attitude towards alcoholics and drinking on whole, often with wives and mothers actively fostering this as a social activity among fathers, husbands and children;
• the easy availability of alcohol not only with respect to licensed liquor bars/rum shops openly selling liquor to all and sundry, but also with respect to unlicensed bottom house bars springing up all over the place.

So what then, should be done? In addition to the need for liquor businesses to expand their concept of social responsibility as pointed out above, and the need for the implementation of measures referenced by the WHO above, other steps include:

• creating substance abuse-related education, assessment, intervention, treatment and recovery services and making them available nationwide;
• expanding the number of behavioural health provider options in an effort to increase the number of citizens served;
• exploring new funding sources from donor communities for behavioural health programmes, services, and providers and increasing gov’t funding for same;
• partnering with NGOs and faith based organizations to implément evidenced-based prevention programmes that teach personal responsibility for one’s health;
• maximizing the use of social media to its fullest public health potential to educate the public, particularly those under the age of 18;
• improving the internal culture at the Health Ministry by attracting and engaging high quality staff; ensuring professional excellence by concentrating on ongoing professional development and training, providing training funds and tracking all training; developing leadership competencies; and developing a succession plan and mentorship programme;
• leveraging technology/infrastructure by implementing an electronic health record (EHR) system;
• establishing at least one rehabilitation treatment centre in each of Guyana’s ten regions, which was a goal of the previous government.

It must be pointed out that these measures would not be stand alone ones but inclusive and forming scaffolding. Thus treatment centres can also deal with drugs and mental health issues. And social media can be harnessed to promote overall health care. Ditto for funding and training. In fact all of this can be built into an integrated health care system, as advocated by WHO, so that resources are maximized and health care becomes comprehensive and inter-related.

Finally, may we suggest that from next year, the government enters into an agreement with CPL to foster awareness of suicide, alcoholism, drugs use, teenage pregnancy, trafficking and related issues. In addition to posters and banners strategically placed around the stadium (which can be used continuously over time), cricketers can deliver messages via mass media, commentators can deliver messages during commentaries and so on. This collaborative approach is very cost effective and can be a policy that harnesses every opportunity – sports, culture, entertainment, mass assemblies, training programmes, festivals and so on. For example Mashramani is another great opportunity to focus on these issues.

There has been enough rhetoric and excuses; it is time for the government to rework priorities relating to the welfare of the citizenry.

Yours faithfully,

Annan Boodram