In many parts of the
world consumption of alcohol is commonly observed in community gatherings.
However, alcohol consumption results in the increase risk of adverse health and
social consequences due to its toxic and dependence-producing properties. There
have been significant elevations in the consumption of alcohol globally and the
WHO has prioritised an epidemiological and monitoring system providing support
and guidance to control medical conditions relating to alcohol. Currently, the
WHO has stated the most important task is the collection of epidemiological
data of alcohol use within developing countries to provide knowledge to the
general public. The Global Information System on Alcohol and Health [GISAH] is
a further development in response to these mass data collections by the WHO and
has been actively providing easy and rapid access to a range of alcohol related
health problems, social implications on alcohol associated harm and policy
responses in countries. The following is the most current WHO published data
figure implicating the global mortality levels in 2004 associated with
consumption of alcohol
However, these official
figures have changed rapidly over the past few years. According to the WHO
records published in 2004 the percentage of deaths associated with alcohol use
globally was 3.6% and within developing countries such as Sri Lanka, India,
Bangladesh etc were collectively around 4% while the percentage of
disability-adjusted life years [DALYs] amongst populations with alcohol use
globally was 4.4% with developing regions reaching 4.2% and 6.7% within
developed regions. DALY was calculated by the addition of lives lost due to
premature mortality and the number of years lost due to living with a
disability while the number of years lost due to disability was determined from
morbidity. An estimated 2 billion of the global population is said to consume
alcohol.
In 2002 it was reported
Sri Lankan populations consumed around 56.7 million litres of malt liquor, 3
million litres of foreign liquor, 56.6 million litres of arrack and 7 million
litres of toddy while the amount of illicit and illegal liquor consumed within
urban, rural and estate areas are said to be the same as the consumption of
arrack although the official figures have not been made available. Thus, the
illicit liquor consumption would double the original figures. In 2002 alone,
15.8 million litres of foreign liquor valued at Rs 1,785 million was imported.
Production and distribution of alcohol in Sri Lanka is regulated by the
Department of Exercise in accordance with the exercise ordinance act 1964 which
sets limitations for alcohol content within liquor sold or bought within the
island. However, advertising restrictions to liquor does not apply within the
legislations itself (WHO, 2002).
Consumption of alcohol
within Sri Lanka is associated with both gender and culture resulting in
elevations in drinking habits; frequency and amounts consumed vary amongst the
various ethnic and religious groups along with different socio-economic
classes. The highest consumption of alcohol was observed amongst the Tamil
estate workers followed by the Roman Catholic and Christian populations in
parts of northern Colombo city. This community is said to be more western and
largely educated and many of the females also contribute to these figures as
serving household liquor is customary amongst these communities. Drinking is
said to be less frequent in other parts of the country and female drinking is
said to be negligible although consumption of alcohol is frequent amongst
upper-class females’ at most social events. However, the underlying conclusion
has been that alcoholism has been related to low education, heavy-manual work
and poverty (WHO, 2002).
Data associated with
alcohol related morbidity and mortality is unavailable at present. The most
common forms of alcohol associated conditions are said to be chronic liver
disease and cirrhosis of the liver although official figures are yet to be
established. Some of the more serious health conditions such as mental
disorders relating to alcoholism are consistent amongst 1 in 4 individuals in
Sri Lanka according to records published by the Department of Health Services
in 2002. However, some data has been made available by the Registrar General,
the Department of Police, the Department of Health and Department of Prisons. A
major issue within Sri Lanka is the lack of support researchers are faced with
due to miss-communication and lack of organisation within departments that
publish annual administrative reports which consist of relevant data required
for the purpose of implementing strategies to manage and/or prevent alcoholism
and associated social and health implications. The figures below shows a
dissected version of the National Health Services of Sri Lanka in 2002
according to the WHO.
|
FACILITIES
|
YEAR
|
NUMBER
|
LEVEL
|
WHO
|
|
Number of
Hospital beds
|
2002
|
59,144
|
5
|
Medical
Statistic Unit
|
|
Hospital beds
per 1,000 population
|
2002
|
3.1
|
5
|
Medical
Statistics Unit
|
|
Number of
Hospitals
|
2002
|
576
|
5
|
Medical
Statistical Unit
|
|
Number of
central dispensaries
|
2002
|
411
|
5
|
Medical
Statistical Unit
|
|
HUMAN
RESOURCES
|
YEARS
|
NUMBER
|
LEVEL
|
WHO
|
|
Physicians per
100,000 population
|
2002
|
50.1
|
5
|
Medical
Statistical Unit
|
|
Population per
Physician
|
2002
|
1996
|
5
|
Medical
Statistical Unit
|
|
Nurses per
100,00 population: Professional Nurses
|
2002
|
24.6
|
5
|
Medical
Statistical Unit
|
Official records by the
WHO and the UNO for the past 5 years have published the rising levels of
alcoholism, thus, its association with health problems have become increasingly
prominent within the Sri Lankan population. Although, alcohol use was
traditionally amongst men, there have been increases within the female
population in the island within the past 5 years. However, a significant level
of life-time abstainers with a large proportion of dependent users has been
observed by watch dogs. The number of occasions within the country has reduced
although the amount of alcohol consumed within these occasions is extremely
large. Religious groups within Sri Lanka are in the fore front of calling for
National Legislation to address issues caused by alcohol. A global strategy
could promote awareness to generate the benefits of an alcohol-free life style
and effective alcohol policies on alcohol production and trade that produce
short and long term contingency plans to promote healthier life styles. These
global strategies could ensure consistency and clarity for those involved in
the health sector where local authorities would be able to have a pro-active
role in early detection and prevention of alcoholism and its complications.
Currently, the WHO is addressing a network of global strategies to combat
alcoholism and associated medical conditions with the hope of increasing life
expectancy and the quality of life for current and future generations.
