Welcome back! Last week we learnt some simple screening tools. This week we will look at what constitutes a drink, how to measure our alcohol consumption, and its effects on the body. So, what is in an alcoholic drink? Well, one Standard drink is equivalent to 10 grams of pure alcohol, which raises Blood Alcohol Concentration (BAC) by 0.02. This is commonly taken as 1 can of beer (330ml at 5 %), a single shot of spirits (40ml at 40%), a glass of wine (140 ml at 12% or 90ml at 18%), or a small liqueur or aperitif (70 ml at 25%). Each milliliter of Ethanol is the equivalent of 0.79 gm of pure ethanol.
One of these standard drinks per hour will raise your BAC by about 0.01-0.03g%. Your BAC is more likely to rise at a greater rate if you are female, a fast drinker, have a low body weight, have not eaten recently, and if you are drinking highly carbonated drinks (e.g. champagne). The liver breaks down alcohol at an average rate of approximately one standard drink per hour, which may vary between different individuals. A liver damaged, for example by hepatitis, will break down alcohol more slowly.
To prevent your BAC rising further doesn’t drink more than one standard drink per hour. The only reliable method of reducing your BAC is to wait out the time for the alcohol to go through your system. Cold showers, black coffee, fresh air, exercise, vomiting and other home remedies will help you feel more alert but will not reduce your BAC.
How does alcohol consumption affect my body? There is totally no consumption of alcohol without a risk. There is a correlation between your BAC and the degree of impairment, intoxication and depression of Central Nervous System (CNS). Death may occur at about 20-30 BAC, dependent on the physiology of the person (age, gender, state of liver etc).
Lets breakdown alcohol’s effect on behavior. Drinking up to 0.05g% will likely cause the drinker to be talkative, relaxed and be more confident. Up to 0.08g% the talkativeness continues, she acts and feels confident, judgment and movement are impaired and inhibitions are reduced. At 0.15g% speech is slurred, balance and coordination are dodgy, reflexes are slowed, visual attention is impaired, emotions become unstable, and usually some nausea and vomiting. Guzzling up to 0.30g% there’s no walking without help, you feel apathetic, sleepy, you have labored breathing, inability to remember events, loss of bladder control and possible loss of consciousness. Pushing it over 0.30g% could sadly result in a Coma or Death!
While the symptoms above might result from a night of festivities, the long term effects can consist of brain damage, addiction and stroke, blurred vision, slurred speech, a bleeding throat, heart disease and an irregular heart beat, stomach ulcers, liver disease and liver failure, muscle weakness, intestinal cancer, intestinal ulcers, impotence in men, infertility in women and osteoporosis!
You may also need to be aware of the link between alcohol use and quarrels, bad moods, a depressed mood, tiredness, irritability & poor appetite. High risk drinking also leads to leads to lower cognitive functioning in decision making, planning, regulation of emotions, motivation, memory (storage, retention and retrieval) and motor control. Other behaviours that could be associated with metabolic changes include the inability to learn from previous mistakes/to detect a previously committed error (Dutch pilot study), and difficulties with abstract concepts of time and money.
Now, let’s redefine and rate the risks of our drinking habits.
Abstinence: Botswana, like most other African countries, has high alcohol abstention rates among men (54.3%) and women (85%) [WHO Global Status Report on Alcohol and Health 2011]. However, among the drinkers, there is significant drinking to intoxication (binge drinking).
Low-risk: No more than 2 drinks a day, no more than 5 days week (WHO). The US agency National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines low-risk drinking for women as no more than 3 drinks on any single day and no more than 7 drinks per week. For men, no more than 4 drinks on any single day and no more than 14 drinks per week.
High-risk drinking e.g. Binge Drinking: NIAAA defines binge drinking as a pattern of drinking that brings BAC levels to 0.08 g%. This typically occurs after 4 drinks for women and 5 drinks for men—in about 2 hours. Alcoholism/Dependency: You should stop drinking if i) You have tried to cut down but not been successful OR ii) You suffer from morning shakes. To be noted, the 2015 DSM-5 now talks Alcohol Use Disorder Diagnostic Criteria as:
a problematic pattern of alcohol use leading to clinically significant impairment or distress as manifested by at least TWO of the following within a 12-month period.
Alcohol is often taken in larger amounts or over a longer period than was intended. Persistent desire or unsuccessful efforts to cut down or control alcohol use. Spending a great deal of time in activities necessary to obtain alcohol use or recover from its effects. Craving or a strong desire or urge to use alcohol. Recurrent alcohol use resulting in the failure to fulfill major role obligations. Continued alcohol use despite persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of alcohol. Important social, occupational or recreational activities are given up or reduced because of alcohol use. Recurrent use in situations in which it is physically hazardous. Alcohol use continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol. Tolerance as defined by either (a) a need for markedly increased amounts of alcohol to achieve intoxication or the desired effect, and (b) a markedly diminished effect with continued use of the same amount of alcohol. Withdrawal is evident by (a) the Classic withdrawal syndrome, specifically described, and (b) when Alcohol (or a closely related substance) is taken to relive or avoid withdrawal symptoms.
Our topic of weighing the risks of alcohol intake will be continued next week. For now remember: “The best way to avoid these problems is to cut down on frequency and quantity of your drinking or to abstain completely from alcohol”.
If you are in any way worried about your drinking, there are resources in the community that can help. You can learn more or get the help you need at Botswana Substance Abuse Support Network (Bosasnet), Gaborone HYPERLINK "http://www.bosasnet.com/" http://www.bosasnet.com/ Cell: +267 72659891, Tel: +267 395 9119/ 391 3490
As well as from Alcoholics Anonymous (AA), Francistown: 73576244 AA Gaborone: 7232 0827 AA Palapye: 71240895 AA Mahalapye: 72846889
See you next week as we learn more about alcohol! By Team Holistic Health
AUDIT-Guidelines for use in primary care-WHO "http://www.alcohol-phaseiv.com/" www.alcohol-phaseiv.com
Project NEADA (Nursing Education in Alcohol and Drug Abuse) kit from www.health.org
NASD(National Alcohol Screening Day) sponsored by NIAAA (National Institute on Alcohol Abuse and Alcoholism) "http://www.niaaa.nih.gov/" www.niaaa.nih.gov
SAMHSA(Substance Abuse and Mental Health Services Administration) "http://www.samhsa.gov/" www.samhsa.gov
“Specifying alcohol-related brain damage among heavy social drinkers” "http://www.eurekalert.org/pub_releases/2004-04/ace-sab040704.php" http://www.eurekalert.org/pub_releases/2004-04/ace-sab040704.php
DSM V Criteria "https://dsm.psychiatryonline.org/" https://dsm.psychiatryonline.org/ https://www.psychiatry.org/psychiatrists/practice/dsm
This is a question that should seriously exercise the mind of every Botswana citizen and every science researcher, every health worker and every political leader political.
The Covid-19 currently defines our lives and poses a direct threat to every aspect and every part of national safety, security and general well-being. This disease has become a normative part of human life throughout the world.
The first part of the struggle against the murderous depredation of this disease was to protect personal life through restrictive health injunctions and protocols; the worst possibly being human isolation and masks that hid our sorrows and lamentations through thin veils. We suffered that humiliation with grace and I believe as a nation we did a great job.
Now the vaccines are here, ushering us into the second phase of this war against the plague; and we are asking ourselves, is this science-driven fight against Covid-19 spell the end of pandemic anxiety? Is the health nightmare coming to an end? What happy lives lie ahead? Is this the time for celebration or caution? As the Non State Actors, we have being struggling with these questions for months.
We have published our thoughts and feelings, and our research reviews and thorough reading of both the local and international impacts of this rampaging viral invasion in local newspapers and social media platforms.
More significantly, we have successfully organised workshops about the impact of the pandemic on society and the economy and the last workshop invited a panel of health experts, professionals, and public administers to advance this social dialogue as part of our commitment to the tripartite engagement we enjoy working with Government of Botswana, Civil Society and Development partners. These workshops are virtual and open to all Batswana, foreign diplomatic missions based in Gaborone, UN agencies located in Gaborone and international academic researchers and professional health experts and specialists.
The mark of Covid-19 on our nation is a painful one, a tragedy shared by the entire human race, but still a contextually painful experience. Our response is fraught with grave difficulties; limited resources, limited time, and the urgency to not only save lives but also avert economic ruin and a bleak future for all who survive. Several vaccines are already in the market.
Parts of the world are already doing the best they can to trunk the pestilential march of this disease by rolling out mass-vaccinations campaigns that promise to evict this health menace and nightmare from their public lives. Botswana, like much of Africa, is still up in the disreputable, and, unenviable, preventative social melee of masked interactions, metered distances, contactless commerce.
We remain very much at the mercy of a marauding virus that daily runs amuck with earth shattering implications for the economy and human lives. And the battle against both infections and transmissions is proving to be difficult, in terms of finance, institutional capacities and resource mobilization. How are we prepared as government, and as citizens, to embrace the impending mass-vaccinations? What are the chances of us succeeding at this last-ditch effort to defeat the virus? What are the most pressing obstacles?
Does the work of vaccines spell an end to the pandemic anxieties?
Our panellists addressed the current state of mass-vaccination preparedness at the Botswana national level. What resources are available? What are the financial, institutional and administrative operational challenges (costs and supply chains, delivery, distribution, administering the vaccine on time, surveillance and security of vaccines?) What is being done to overcome them, or what can be done to overcome them? What do public assessments of preparedness tell us at the local community levels? How strong is the political will and direction? How long can we expect the whole exercise to last? At what point should we start seeing tangible results of the mass-vaccination campaign?
They also addressed the challenges of the anticipated emerging Vaccinated Society. How to fight the myths of vaccines and the superstitions about histories of human immunizations? What exactly is being done to grow robust local confidence in the science of vaccinations and the vaccines themselves? More significantly, how to square these campaigns vis-vis personal rights, moral/religious obligations?
What messages are being sent out in these regards and how are Batswana responding? What about issues of justice and equality? Will we get the necessary vaccines to everyone who wants them? What is being done to ensure no deserving person is left behind?
They also addressed issues of health data. To accomplish this mass-vaccination campaign and do everything right we need accurate and complete data. Poor data already makes it very hard to just cope with the disease. What is being done to improve data for the mass-vaccination campaign? How is this data being collected, aggregated and prepared for real life situation/applications throughout Botswana in the coming campaign?
We know in America, for example, general reporting and treatment of health data at the beginning of vaccinations was so poor, so chaotic and so scattered mainstream newspapers like The Atlantic, Washington Post and the New York Times had to step in, working very closely with civil society organizations, to rescue the situation. What data-related issues are still problematic in Botswana?
To be specific, what kind of Covid-19 data is being taken now to ready the whole country for an effective and efficient mass-vaccination program?
Batswana must be made aware that the end part of vaccination will just mark the beginning of a long journey to health recovery and national redemption; that in many ways Covid-19 vaccination is just another step toward the many efforts in abeyance to fight this health pandemic, the road ahead is still long and painful.
For this purpose, and to highlight the significance of this observation we tasked our panellists with the arduous imperative of analysing the impact of mass-vaccination on society and the economy alongside the pressing issues of post-Covid-19 national health surveillance and rehabilitation programs.
Research suggests the aftermath of Covid-19 vaccination is going to be just as difficult and uncertain world as the present reality in many ways, and that caution should prevail over celebration, at least for a long time. The disease itself is projected to linger around for some time after all these mass-vaccination campaigns unless an effort is made to vaccinate everyone to the last reported case, every nation succeeds beyond herd immunity, and cure is found for Covid-19 disease. Many people are going to continue in need of medications, psychological and psychiatric services and therapy.
Is Botswana ready for this long holdout? If not, what path should we take going into the future? The Second concern is , are we going to have a single, trusted national agency charged with the mandate to set standards for our national health data system, now that we know how real bad pandemics can be, and the value of data in quickly responding to them and mitigating impact? Finally, what is being done to curate a short history of this pandemic? A national museum of health and medicine or a Public Health Institute in Botswana is overdue.
If we are to create strong sets of data policies and data quality standards for fighting future health pandemics it is critical that they find ideological and moral foundations in the artistic imagery and photography of the present human experience…context is essential to fighting such diseases, and to be prepared we must learn from every tragic health incident.
Our panellists answered most of these questions with distinguished intellectual clarity. We wish Batswana to join us in our second Mass-vaccination workshop.
Today is International Women’s Day – it’s a moment to think about how much better our news diet could be if inequities were eliminated. In 1995, when the curtains fell in one of the largest meetings that have ever brought women together to discuss women in development, it was noted that women and media remain key to development.
Twenty-six years later, the relevant “Article J” of the Beijing Platform for Action, remains unfulfilled. Its two strategic objectives with regard to Women and Media have not been met. They are Increase the participation and access of women to expression and decision-making in and through the media and new technologies of communication
Promote a balanced and non-stereotyped portrayal of women in the media.
Today, as we mark International Women’s Day, it’s an indictment on both media owners and civil society that women remain on the periphery of news-making. They cannot claim equal space in either the structures of newsrooms or in the content produced, be that as sources of news or as the subjects of reports. Indeed, the latest figures from WAN-IFRA’s Women in News Programme show just one in five voices in news belong to women*, be they as sources, as the author or as the main character of the news report.
Some progress was evident several years back, with stand-out women being named as chief executive officers, editors in chief, managing editors and executive editors. But these gains appear short lived in most media organisations. Excitement has turned to frustration as one-step forward has been replaced with three steps backwards. In Africa, the problem is acute. The decision-making tables of media organisations remain deprived of women and where there are women, they are surrounded by men.
Few women have followed in the footsteps of Esther Kamweru, the first woman managing editor in Kenya, and indeed sub-Saharan Africa. Today’s standout women editors include Pamela Makotsi-Sittoni (Nation Media Group, Kenya), Barbara Kaija (New Vision, Uganda), Mary Mbewe (Daily Nation, Zambia), Margaret Vuchiri (The Monitor, Uganda), Joyce Shebe (Clouds, Tanzania), Tryphinah Dongwana (Weekend Post, Botswana), Joyce Mhaville (Independent Television -ITV, Tanzania) and Tuma Abdallah (Standard Newspapers,Tanzania). But they remain an exception.
The lack of balance between women and men at the table of decision making has a rollback effect on the content that is produced. A table dominated by men typically makes decisions that benefit men.
So today, International Women’s Day is a grim reminder that things are not rosy in the news business. Achieving gender balance in news and in the structure of media organisations remains a challenge. Unmet, it sees more than half of the population in our countries suffer the consequences of bias, discrimination and sexism.
The business of ignoring the other half of the population can no longer be treated as normal. It’s time that media leaders grasp the challenge, not only because it is the right thing to do, but because it also makes a whole lot of business sense: start covering women, give them space and a voice in news-making and propel them to all levels of decision making within your organisation.
We can no longer afford to imagine that it’s only men who make and sell the news and bring in the shillings to fund the media business. Women too are worthy newsmakers. In all of our societies, there are women holding decision making positions and who are now experts in once male-only domains such as engineers, doctors, scientists and researchers.
They can be deliberately picked out to share their perspectives and expertise and bring balance to the profile of experts quoted on our news pages. Media is the prism through which society sees itself and women are an untapped audience. So, as we celebrate International Women’s Day, let us embrace diversity, which yields better news content and business products, and in so doing eliminate sexism. We know that actions and attitudes that discriminate against people based on their gender is bad for business.
As media, the challenge is ours. We need to consciously embrace and reach the commitments made 26 years ago when the Beijing Platform for Action was signed globally. As the news consuming public, you have a role to play too. Hold your news organization to account and make sure they deliver balanced news that reflects the voices of all of society.
Jane Godia is a gender development and media expert who serves as the Africa Director of Women in News programme. WOMEN IN NEWS is WAN-IFRA’s ground-breaking programme to increase women’s leadership and voices in the news. It does so by equipping women journalists and editors with the skills, strategies, and support networks to take on greater leadership positions within their media. www.womeninnews.org
The eve of International Women’s Day presents an opportunity for us to think about gender equality and the long and often frustrating march toward societies that are truly equal.
As media, we are uniquely placed to drive forward this reflection and discussion. But while focusing on the challenges of gender in society, we owe it to our staff and the communities we serve to also take a hard look at the obstacles within our own organisations.
I’m talking specifically about the scourge of sexual harassment. It’s likely to have happened in your newsroom. It has likely happened to a member of your team. It happens to all genders but is disproportionately directed at women. It happens in every industry, regardless of country, culture or context. This is because sexual harassment is driven by power, not sex. Wherever you have imbalances in power, you have individuals who are at risk of sexual harassment, and those who abuse this power.
I’ve been sexually harassed. The many journalists and editors, friends and family members who I have spoken to over the years on this subject have also been harassed. Yet it is still hard for leaders to recognize that this could be happening within their newsrooms and boardrooms. Why does it continue to be such a taboo?
Counting the cost of sexual harassment
Sexual harassment is, simply put, bad for business. It can harm your corporate reputation. It is a drain on the productivity of staff and managers. Maintaining and building trust in your brand is an absolute imperative for media organisations globally. If and when a case gets out of control or is badly handled – this can directly impact your bottom line.
It is for this reason that WAN-IFRA Women in News has put eliminating sexual harassment as a top priority in our work around gender equality in the media sector. This might seem at odds with the current climate where social interactions are fewer and remote work scenarios are in place in many newsrooms and businesses. But one only needs to tune into the news to know that the abuse of power, manifested as verbal, physical or online harassment, is alive and well.
Preliminary results from an ongoing Women in News research study into the issue of sexual harassment polling hundreds of journalists in Sub-Saharan Africa and Southeast Asia indicate that more than 1 in 3 women media professionals have been physically harassed, and just under 50% have been verbally harassed. Just over 15% of men in African newsrooms reported being physically harassed, and slightly less than 1 in 4 reports being verbally harassed. The numbers for male media professionals in Southeast Asia are slightly higher than a quarter on both forms of harassment.
The first step in confronting sexual harassment is to talk about it. We need to strip away the stigma and discomfort around having open conversations about what sexual harassment is and isn’t. Media managers, it is entirely in your power to create dynamics in your own teams that are free from sexual harassment.
Publishers and CEOs, you set the organisational culture in your media company.
By being vocal in recognising that it happens everywhere, and communicating to your employees that you will not tolerate sexual harassment of any kind, you send a powerful message to your teams, and publicly. With these actions, you will help us overcome the legacy of silence around this topic, and in doing so take an important first step to create media environments that truly embrace equality.
Melanie Walker is Executive Director of Media Development of the World Association of News Publishers (WAN-IFRA). She is a creator of Women in News, WAN-IFRA’s ground-breaking programme to increase women’s leadership and voices in the news. It does so by equipping women journalists and editors with the skills, strategies, and support networks to take on greater leadership positions within their media. www.womeninnews.org