A crowd gathers to watch an intoxicated youth as a police officer comes to his rescue in Nyeri town, Central Kenya. Credit: Miriam Gathigah/IPS

By Miriam Gathigah
NAIROBI, Mar 27 2015 (IPS)

Despite legislative attempts to curb drinking, Kenya is still facing its greatest threat from alcohol abuse. Calamities associated with excessive intoxication – dementia, seizures, liver disease and early death – have done little to deter users.

Not even confirmed reports by the Ministry of Health and government agencies such as the National Authority for Campaign against Alcohol and Drug Abuse (NACADA) that illicit brewers have been turning to lethal embalming fluid used in mortuaries have cut the rate of abuse.

“Patrons want to spend as little as possible but drink as much as they can, so they opt for cheap illicit brews, especially spirits,” says Nduta Kamau, who brews home-made alcohol in the sprawling Mathare slums in Nairobi.The [Kenyan] Alcoholic Drinks Control Act was substantially weakened in 2013 with the introduction of “devolved government”. This system of ‘home rule’ means that each county government must ratify the act – an uphill battle because some county leaders are also the owners of bars.

According to Kamau, those who brew illicit alcohol also spend as little as possible “in time and money but produce as much alcohol as they can”, while chemicals used in the mortuary speed up the production process, “so we are able to produce a lot of alcohol in a very short time.”

Kamau adds that illicit brews from dens in the slums are bottled, labelled and sold in pubs across the country. A series of police raids in these dens have found women’s underwear and dead rats in the brew.

The Alcoholic Drinks Control Act of 2010 restricts the sale of alcohol to between 5 pm and 11 pm, but drinkers are finding their way around the curfew.

Data collected by Euromonitor International, a market research firm, revealed that alcohol bought in shops or off trade beer sale during the curfew in December 2012 rose by 4.35 percent to 26.4 million litres.

“They [patrons] lock themselves up in pubs and drink during curfews or they buy the alcohol and drink in their homes exposing their children to alcohol from a very young age,” says Dave Kinyanjui, a bar owner in Nairobi’s downtown area.

The Alcoholic Drinks Control Act was substantially weakened in 2013 with the introduction of “devolved government”. This system of ‘home rule’ means that each county government must ratify the act – an uphill battle because some county leaders are also the owners of bars.

Increased drinking has meant higher profits for commercial brewers. A report last month by the East African Breweries Limited (EABL) noted an average 11 percent increase in profit from beer sales.

According to EABL, the highest growth in sales – at 67 percent – was in spirits, mainly targeting the lower income earners, who are also the target for the many brands from informal sources.

Another report released by Euromonitor International confirmed the steady growth in alcohol consumption, which could rise as the economy improves further, saying that “the alcoholic drinks market is set to expand over the forecast period as the economy is expected to grow tremendously during this time due to bright prospects of oil in Kenya and political stability.”

With the availability of non-returnable bottles and cans, it has never been easier to carry alcohol to the house.

A 2012 national survey by NACADA showed that alcohol is now the most abused substance in the country and of the different types of alcoholic drink, traditional liquor is the most easily accessible, followed by wines and spirits and last but not least Chang’aa (which literally means ‘kill me quick’).

According to an “Alcohol Situation Analysis” for 2012 by the regional office of IOGT-NTO, a global temperance movement: “out of the number of people interviewed, 63 percent had used alcohol and 30 percent had more than five alcoholic beverages per sitting, which is heavy episodic use. Teenagers between 14-17 years of age are having two alcoholic beverages per sitting.”

Government statistics also show that alcohol and drug abuse is highest among young adults aged 15 to 29 years and lowest among adults of 65 years and older.

Under-age and rural children have not been spared. According to NACADA, rural children are more likely to have consumed traditional liquor and Chang’aa than urban children.

David Ogot, national coordinator of Alcohol Awareness in Kenya and a recovered alcoholic, told IPS that “excessive drinking is often viewed as a passing problem until it really gets out of hand, at which point most families hide the issue due to shame.”

He said that there is now a great need to address “alcoholism and to stop justifying the behaviour of an alcoholic.”

Alcoholics wanting to end their addictions have little recourse, according to Dr William Sinkele, Executive Director of Support for Addictions Prevention and Treatment in Africa (SAPTA). While Kenya has over 70 in-patient treatment centres, only three are government-run, he told IPS – Mathare Hospital (with an addiction unit), Coast General Hospital and Portreitz Hospital. The rest are privately owned.

“While is it is good that we have this many treatment centres, most are concentrated around the Nairobi area.  We do not have many centres outside Nairobi.  The average Kenyan with an alcohol or drug problem cannot afford treatment,” he said.

Meanwhile, many of those fighting alcohol abuse in Kenya point an accusing finger at the global alcohol industry which has a big foothold in Kenya and has undermined proper implementation of the Alcoholic Drinks Control Act with aggressive advertising and promotion through musical and artsy events.

A press release from financial advisors KPMG, titled “Incredible Growth of Kenya’s Beer Market“ noted: “Driven by strong population growth, a growing middle class and a dynamic private sector, the beer industry in Kenya has taken off in impressive ways, and is promising of even further developments in the coming decade.” Only inflation and tax increases could diminish this rise, it said.

“To expand its customer base, “the company has accordingly invested in marketing and sales capabilities in this area.”

Meanwhile, in a blog on the IOGT International temperance website,  Brenda Mkwesha wrote: “The odds seem to be against us, but we have heart-driven teams who aren’t willing to stand by while we flush our lives down the toilet. Here’s to a Life Set Free!”

Edited by Lisa Vives/Phil Harris   

A billboard in Freetown, Sierra Leone, urging people to go to hospital to be tested for HIV. Ebola has stopped people from doing that. Credit: Lansana Fofana/IPS

By Lansana Fofana
FREETOWN, Dec 1 2014 (IPS)

The outbreak of the deadly Ebola epidemic in Sierra Leone has dwarfed the campaign against HIV/AIDS, to the extent that patients no longer go to hospitals and treatment centres out of fear of contracting the Ebola virus.

“It is a big challenge for us. HIV/AIDS patients now fear going to hospitals for treatment and our workers, who are also government health officials, are also afraid of contacting patients for fear of being infected,” Abubakar Koroma, Director of Communications at the National AIDS Secretariat, told IPS.“HIV/AIDS patients now fear going to hospitals for treatment and our workers, who are also government health officials, are also afraid of contacting patients for fear of being infected” – Abubakar Koroma, Director of Communications, Sierra Leone’s National AIDS Secretariat

Sierra Leone records one of the lowest HIV/AIDS prevalence rates in the West African region. For over five years, the country has managed to stabilise the figures at 1.5 percent, out of a population of 6 million, mainly because of massive countrywide awareness raising. The authorities also offer free medicines and treatment to people living with HIV/AIDS.

But all this may be reversed if the Ebola crisis is not contained soon.

Before the outbreak of the Ebola crisis in Sierra Leone in April, one key area of success in the fight against HIV/AIDS had been in curtailing mother-to-child transmission. Today, however, there are concerns that it may surge again because pregnant women are now reluctant to go to hospitals for treatment.

In 2004, the prevalence rate among pregnant women was 4.9 percent but, just before the Ebola in April this year, the figure had dropped to 3.2 percent.

According to Koroma, “between January and now, that service [for pregnant women] has dropped by 80 percent. We are worried that the Ebola crisis may worsen the situation.” From the point of view of those already living with HIV/AIDS, this is already happening.

Idrissa Songo, Executive Director of the Network of HIV Positives in Sierra Leone (NETHIPS) advocacy group, says that its members fear going to hospitals for care and treatment and that they are constrained by what he described as a cut in the support they were receiving from donors and humanitarian organisations before the outbreak of Ebola.

“Donors and other philanthropists have turned their attention away from the fight against HIV/AIDS,” he said. “Now it’s all about Ebola. Most organisations have diverted their funding to the fight against Ebola and this is badly affecting our activities.”

Songo added that the core activities of NETHIPS, which include community awareness raising and training of members in care and prevention, have all come to a standstill because of the government’s ban on all public gatherings following the Ebola outbreak.

Given the current crisis, the National Aids Secretariat and the Ministry of Health have set up telephone hotlines to connect with people suffering from HIV/AIDS. The aim is to be able to trace and locate them and then get treatment to them. At the same time, HIV/AIDS patients are now receiving a quarterly supply of the drugs they need, compared with the monthly dosage they were receiving before Ebola struck.

According to Songo, these measures are working because “that way, our members, who fear going to hospitals and treatment centres, can stay at home and take their medication. We know it is risky to go to treatment centres nowadays because of the possibility of contracting Ebola, another killer disease,” Songo told IPS.

Notwithstanding the Ebola crisis, Ministry of Health officials say that they have not lost sight of the fight against HIV/AIDS.

Jonathan Abass Kamara, Public Relations Officer at the Ministry of Health, told IPS that attention is still focused on the fight against HIV/AIDS. “Even though Ebola has taken centre-stage, the Ministry is still very much focused on the fight against HIV/AIDS. We supply drugs to patients regularly and we try our best to give care and attention to them,” Kamara told IPS.

However, while Sierra Leone has made tremendous progress in the fight against HIV/AIDS and its success in this fight surpasses that of almost all countries in the West Africa region, it may well find it difficult to maintain its achievements in this sector if the Ebola epidemic is not brought under control.

(Edited by Phil Harris)