Alcohol consumption is steadily increasing in Rwanda than in regional neighbour countries, according to the World Health Organisation.

Rwandans consume 9.8 litres of pure alcohol, also known as ethanol, per person per year. By contrast, the African average is six litres of pure alcohol.

Alcohol kills 3.3 million people worldwide each year, more than Aids, tuberculosis and violence combined, WHO said a fortnight ago, warning that booze consumption was on the rise.

Including drunk driving, alcohol-induced violence and abuse, and a multitude of diseases and disorders, alcohol causes one in 20 deaths globally every year, the UN health agency said.

"This actually translates into one death every 10 seconds,” Shekhar Saxena, who heads the WHO’s Mental Health and Substance Abuse department, told reporters in Geneva.

Alcohol caused some 3.3 million deaths in 2012, WHO said, equivalent to 5.9 percent of global deaths (7.6 per cent for men and 4.0 percent for women).

In comparison, HIV/Aids is responsible for 2.8 per cent, tuberculosis causes 1.7 per cent of deaths and violence is responsible for just 0.9 per cent, the study showed.

Yet alcohol addiction is growing in Rwanda, according to Boniface Harelimana, an addiction care worker at University Central Hospital of Kigali.

In 2010, 5.8 per cent of Rwandans were dependent on alcohol and used alcohol in a harmful way, WHO says.

Harmful use of alcohol is defined WHO as drinking excessive amounts of alcohol, poor quality alcohol and consuming it in unusual patterns.

Harelimana said Rwandans have a propensity toward alcoholism due to the country’s traumatic past. Some people use alcohol to self-medicate for the stress and anxiety they feel after the 1994 Genocide against the Tutsi, he said.

More than one-quarter of Rwandans suffer post-traumatic stress disorder from the Genocide, according to a 2009 study conducted by Rwandan psychiatrists.

The underlying dangers

Although Rwandans have to be 18 years old to purchase a beer or spirits in a bar, there is no minimum age requirement for purchasing it in a store for off-premise consumption, according to WHO.

Drinking is linked to more than 200 health conditions, including liver cirrhosis and some cancers. Alcohol abuse also makes people more susceptible to infectious diseases like tuberculosis, HIV and pneumonia, the report found.

Most deaths attributed to alcohol, around a third, are caused by associated cardiovascular diseases and diabetes. 

Alcohol-related accidents, such as car crashes, were the second-highest killer, accounting for around 17.1 per cent of all alcohol-related deaths.

Binge drinking is especially damaging to health, the WHO pointed out, estimating that 16 per cent of the world’s drinkers abuse alcohol to excess.

Excessive drinking also causes impairment of physical coordination, consciousness, cognition, perception, affect or behavior; and reduce our ability to control how much we drink due to dependence on alcohol.

"Our level of alcohol retention and management is not the same,” Dr David Basangwa, a senior consultant psychiatrist at Uganda-based Butabika Mental Hospital, told Healthy Times in June last year.

"One bottle can make a man dizzy but it might take four for another to feel the effect. So this is, first, about how one’s brain is able to contain the toxicants in alcohol, and secondly, other factors.”

It can be difficult to tell if someone is addicted to alcohol; how much is too much?

Usually, behavioural changes such as being unable to stop drinking after one or two drinks, missing work because of alcohol, or fighting with family and friends will show up before physical signs of addiction appear.

"Once one starts depending on it, it becomes hard for them to even do their work without first taking some alcohol,” Dr Chaste Uwihoreye, a clinical psychologist, told The New Times last year.

"If they don’t take alcohol, sometimes they end up with withdrawal effects such as shaky hands, trembling and insomnia.”

Once a person becomes addicted to alcohol in Rwanda, the hospital is often their only place for treatment and support.

"Addiction services are quite new in the country,” Harelimana said.

The World Health Organisation advocates for creating national policies and programmes to regulate the sale, advertising and consumption of alcohol.