In an operation carried out by police this year, at least one person was reported dead due to a road accident in the districts of Gasabo, Nyagatare, Gatsibo, and Kayonza in the month of August. Chief Superintendent of Police (CSP), Gerard Mpayimana, the deputy commissioner of Operations for Traffic and Road Safety department, says although traffic operation is done on a daily basis, the aforementioned reports steered them to take serious action and conduct general screening for drivers for prevention purposes. Mpayimana says the increase in the number of road fatalities is mainly due to drunk driving. “We strongly suspect that alcohol consumption is the main cause of over speeding, wrong overtaking, manoeuvres, among other reckless behaviours by drivers,” he says. Through recent operations across the country, Mpayimana says he has personally come across cases of accidents that were caused because of driving under the influence of alcohol. For instance, he says, one such case was in Kabuga sector where a driver hit five pedestrians — one died on spot. The driver was found to be driving under the influence of alcohol. Another case involved a lady who hit two people in Kigali. The two are just some of the cases of accidents caused by driving under the influence of alcohol, discovered in the ongoing road operations that have intensified and are done on a weekly basis. Mpayimana notes that there has been a slight decrease in the number of road accidents across the country due to this operation. “Over the last four weeks, there has been a reduction in the number of accidents, although we can’t say alcohol consumption is the immediate cause, the consequences of drinking beyond the level allowed can reduce accidents,” he adds. EFFECTS In Rwanda, like everywhere in the world, driving under the influence of alcohol is prohibited. Alcohol abuse can destabilise the normal functioning of the brain of an individual. Dynamo Ndacyayisenga, the in-charge of management of alcohol and drug use disorders at Rwanda Biomedical Centre (RBC), says after alcohol consumption, the blood contains an alcohol particle which stimulates the neurons, and this, according to him, affects drivers in many aspects. This, he says, includes judgment, stability, attitude, perception and their capacity to control what is happening around them. He adds that alcohol use may also cause lack of caution, reduced sight, low reasoning capacity, and a decline in performance when driving. Rwanda Integrated Health Management Information System (HMIS) data shows an increase in the number of consultations due to injuries sustained under alcohol influence in the last five years. For instance, in all hospitals across the country, the number of injuries recorded were 10,897 in 2014, 5,743 in 2015, 6,361 in 2016, 7,229 in 2017 and 8,321 in 2018. According to Irene Bagahirwa, Ag. Director of Injuries and Disabilities Unit, Non-Communicable Diseases Division at RBC, at the moment, they are unable to get the injury data providing enough details on causes of injuries, precipitating factors, nature, severity, and clinical outcomes of all cases of injury reported at health facilities. To solve this issue, she says, they plan to initiate a national trauma registry. The registry is already being piloted in University Teaching Hospital of Kigali (CHUK), Rwanda Military Hospital, University Teaching Hospital of Butare (CHUB) and Ruhengeri Hospital. “We expect that the results will inform future initiation and scale-up of trauma registry across the country,” she says. IMPACT Experts say alcohol and road accidents are two interconnected elements that can lead to not only health issues, but death as well. For instance, they say alcohol is a catalyst and after consumption, road accidents are inevitable. Ndacyayisenga notes that excessive consumption can even lead to other misfortunes, like bar fights. He says people should understand that life without alcohol consumption is possible. He notes that this can be achieved by instead consuming healthy foods like fruits, fresh juices and vegetables. He warns young people about the dangers of alcohol consumption because they are still in the growth stage. This group, he says, abuses alcohol for various reasons, including, peer pressure, curiosity, family conflict, and emotional or psychological problems, among others. Research from HMIS conducted in 2012 and published in 2015 shows that among youth aged 14 to 35 years, 7.46 per cent suffer from alcohol abuse disorders. “Excessive consumption of alcohol is harmful to health, specifically to the liver,” he says. In Rwanda, statistics from WHO show a reduction trend from 13.8 litres per year in the year 2015, to 9.9 litres per person in 2018. PSYCHOLOGICAL SUPPORT Mayo Clinic defines alcohol use disorder (which includes a level that’s sometimes called alcoholism) as a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking. Emmanuelle Mahoro, a psychologist working with Caring for Impact Ministries (CIM), an NGO that promotes life among the youth, says a clinical psychologist must assess and know the reasons behind one’s abuse of alcohol, then decide the treatment plan accordingly. The purpose behind the treatment, she says, is to help the victim stop, or reduce, alcohol consumption and improve quality of health. Depending on how big the problem is, treatment can include detoxification. This, she says, is for people with severe addiction, with withdrawal that’s medically managed. She adds that goal setting, behaviour change techniques, counselling and follow-up care should be part of the treatment. Sylvester Twizerimana, a Rubavu-based psychologist, says the most important thing when it comes to helping sufferers of severe alcohol consumption, is providing counselling and therapy. This, he explains, helps them understand better their problem with alcohol. He says that alcohol consumption is not a health problem, but when abused, it is termed as alcohol use disorder. Twizerimana says that recurrent alcohol use results in a failure to fulfil major role obligations at work, school, or home and that this is a sign of alcohol use disorder. He says, sometimes alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol to begin with. He adds that alcohol use disorder commonly occurs with other mental health disorders, such as depression and anxiety. INTERVENTION There has been a decrease in alcohol consumption in Rwanda due to awareness and other measures, such as control of harmful use of alcohol. Mpayimana says driving under the influence of alcohol, and those who disregard speed governors, are handled accordingly, making it part of the measures to help reduce road accidents. There is also the 52-week campaign dubbed ‘Gerayo Amahoro’ (arrive safely), to influence behavioural change among road users. Media use and education about road safety are just among the measures put in place to help reduce the number of accidents on the road. Problem-oriented policing is another intervention where the focus is mainly put on the problem identified. When found driving under the influence of alcohol, a fine of RWF 150,000 is among the penalties, including prosecution. There are also cameras used on the roads to monitor speed, and of course, the alcohol test devise. editor@newtimesrwanda.com
