Niren Tolsi looks at a World Health Organisation study on the relationship between alcohol and injuries.
Weekend nights at the emergency and trauma unit of Durban’s Addington Hospital on the fabled beachfront are not for the faint of heart: this is where the drunken fallout of broken, sometimes eviscerated, bodies end up.
Ask Dr Sharan Rambarran, a surgeon who has worked in the trauma units of both King Edward and Addington hospitals, what it’s like.
“I get between 50 and 100 patients coming in on Friday and Saturday nights who’ve been injured because of binge drinking. Guys come in with their insides hanging out, and the funny thing is, it’s usually a friend they’ve been drinking with who has done this to them.”
Drunk and stupid
Typically, says Rambarran, drink-related injuries are caused by violence, road accidents and “acts of stupidity”.
“I had a white guy once who had jumped head first into a plunge-pool. His skull cracked open and there was bleeding into his brain. He is a vegetable now.”
Rambarran runs through a list of horrors that includes casualties who drunkenly walk in front of trains and buses and a two-year-old who is about to undergo a foot amputation after being run over by a drunk driver.
In a World Health Organisation study last year on the relationship between alcohol and injuries conducted among people admitted to emergency rooms of 12 medical centres in 12 countries, South Africa had the highest number of injury cases where alcohol was consumed in the six hours before admittance.
South Africans, it seems, are susceptible to a suspension of intelligence when drinking. We drink stupidly, sometimes violently.
Our tendency to drink ourselves into oblivion has raised concern from the medical sector to government.
“It seems we have developed a culture where being drunk is considered okay, normal almost—that to have fun, you must go to a shebeen or a pub,” says Social Development Minister Zola Skweyiya. “It is a culture that young children are growing up in and must be discouraged.”
Skweyiya, a minister whose portfolio means he sees some of the worst consequences on families and communities of the nation’s drinking (and drugging) habits, hopes the holistic approach to treating addiction laid out in the National Drug Masterplan (NDMP) 2006-2011 will provide an antidote.
According to the Department of Social Development’s NDMP, binge drinking on weekends is a growing phenomenon. Risky or binge drinking is defined by the single-day consumption of nine tots of spirits or more, or a bottle or more of wine, or two litres of beer.
In 2004, a Medical Research Council (MRC) study investigated violent injuries dealt with at public hospitals in three rural Western Cape towns—Hermanus, Vredenburg and Worcester.
In a two-month period, 2 709 casualties were reported and the links between alcohol and injury were brutally clear. Two-thirds of the male-on-female acts of violence were alcohol related and three-quarters of male-on-male incidents were alcohol related.
The picture is distressingly similar in urban areas. An MRC Crime, Violence and Injury Lead Programme report in 2004 found that 67% of domestic violence cases in Cape Town were alcohol related.
Forget the common notion that the reprobate youth are the most debauched drinkers around. More than half the teenage population may be regular drinkers by the time they hit grade 11, but it is their parents and grandparents who are setting the pace.
According to the 1998 South African Demographic and Health Survey, 39% of South African men aged between 34 and 44 binge drink—mostly over weekends.
Perhaps most startling of all is the figure that shows this country’s heaviest binge drinkers are middle-aged women.
According to the now 10-year-old survey, 35,3% of women aged between 45 and 50 who drink alcohol are binge drinkers.
An updated survey, which was due for release in 2006, is still on the horizon.
Other research shows that while South Africans are not, per capita, the world’s biggest drinkers—Ugandans consume 18,6 litres of pure alcohol a year compared with our average nine or 10 litres—we’re more likely than most to become violent when intoxicated.
In a paper delivered at a Human Sciences Research Council seminar in Pretoria last year, a visiting United States behavioural scientist, Dr Isidore Obot, noted: “The way South Africans drink is risky. The typical pattern of drinking on the continent is drinking to get intoxicated, which is detrimental — [And] tends to lead to serious social problems like crime, violence and abuse.”
Mohamed Shaik* (29) is a city-based lawyer who appears to typify this propensity for binge drinking.
This past weekend he drank 10 draught beers (500ml each) and “five or six” Jägermeister shooters on Friday night. On Saturday, Shaik took his liver out for dinner and treated it to four beers and 12 shots of whisky while he ate. The blitzkrieg on his organs continued on Sunday with 20 shots of whisky and two bottles of beer.
“I enjoy drinking. It makes ordinary moments more interesting, especially when engaging with people in conversations,” he says.
By the time one reaches Shaik’s age, most South Africans’ livers and kidneys are battle-hardened: According to the 2002 South African National Youth Risk Behaviour survey, 40% of children aged 13 or under have drunk alcohol, with 16% stating that they drank more than five drinks at once.
In the Western Cape, almost 20% started drinking before the age of 13, and by grade 11 more than 60% were drinking regularly.
The most recent South African Community Epidemiology Network on Drug Use report for January to June last year, which surveys rehabilitation clinics in eight provinces, found that alcohol was the “dominant substance of abuse” in all of them, aside from the Western Cape, where the scourge of tik continues to gain momentum.