Over the years, the approach to alcoholism has changed in the country. Shobha Warrier spoke to Shanthi Ranganathan, honorary secretary, TTK Hospital, about this changing trend.
If we compare what was happening 20 years ago with what is happening now, is there a difference in the attitude of people towards an alcoholic?
Earlier, everybody thought an alcoholic was an irresponsible and uncaring person who drank willfully. Over the years, there has been a remarkable change in their attitude. Even an ordinary person knows that alcoholism is a disease or an illness. We call it an illness. And it is not just us. Even WHO and the American Psychiatric Association call it a disease. So, everybody knows now that an alcoholic needs help.
More and more people are willing to take help because of this awareness. Earlier, people used to drink, drink and drink, hoping some miracle would happen or the stars would change and they would stop drinking. That attitude is not there now. Many of them understand that it is an illness.
Do alcoholics understand it is a disease?
Unlike other illnesses, alcoholics always deny the problem. They also tend to rationalise it and give excuses. Their families, though, are more aware. More than that, the family is able to see the addict as a sick person. This changes their attitude towards the alcoholic; they become more empathetic. Thus, they are able to motivate her/him to seek help.
Let me stress here that an alcoholic's family needs as much help as the alcoholic himself. Since they live with him, they become angry and bitter. They find it difficult to take care of the children and other family members, as they are preoccupied with taking care of the patient.
So we involve the alcoholic's spouse and children in the treatment. We have separate programmes for the family members, which helps them take a look at their own behaviour. The wife understands how she is affected by his drinking. If s/he is an unmarried person, we involve the parents who normally have a major role to play in her/his life.
From your experience, to what extent has the awareness among the people increased in the last 22 years?
A tremendous amount. We are doing a lot of work in the villages as well. We conduct treatment camps and create awareness campaigns. It was only after we started our hospital in 1987 that the problem of brown sugar surfaced.
Is alcoholism more rampant in rural areas?
Alcoholism is there everywhere. In the rural areas though, it leads to poverty. Most of them earn a reasonable amount, but tend to spend almost all of it on alcohol. More than that, violence is rampant in villages. So it affects them in that sense as well. But, while the impact of alcohol is much higher in the villages, it is a cause for worry in towns also.
Not all drinkers, though, become addicted to alcohol. Only 10 to 20 per cent become addicts. Like, all of us take sugar but only some of us become diabetic. It is only when drinking starts affecting any one aspect of a person's life -- work, family life, physical health and interpersonal relationships -- that s/he can be labelled an alcoholic.
You said you target industries in your awareness programmes. Why did you choose industries?
It is a captive population. Industries are not only very well-organised, they are also concerned about alcoholics. This allows us to function in a systematic manner. If there are alcoholics among them, it affects the industry's productivity and quality. We give lectures and conduct exhibitions and programmes for supervisors and managers, which helps them identify alcoholism at an the early phase through poor job performance.
Actually, no industry has a coherent alcoholism policy. They have policies for everything else except addiction, which is a major problem in all industries. Although labourers earn pretty decent salaries, the quality of their lives does not improve because they spend a large chunk of their earnings on alcohol and drugs.
Is there any difference in society's attitude to alcoholics? What about the difference in treatment available to alcoholics in developed countries and developing countries?
There is more awareness, more services and much more accessibility to treatment in developed countries. Every area has more one or more treatment centres. They also have more prevention programmes, starting from the elementary school level itself. But then, the problem they are facing is much larger. There are stringent laws regarding drunken driving.
One disadvantage they face there is that both men and women drink. Fortunately, in India, many women don't drink at all. Many men, too, don't touch alcohol. In Western countries, the alcoholics face a lack family support; here, the family remains with him and supports him.
What role does family support play in getting an alcoholic cured?
A very, very big role. In many countries, they (the wives of alcoholics) desert or divorce him or leave him at a centre. In India, though, people stay with him, support him, motivate him and play a very, very important role.
In the latter part of 1999, you received the first United Nations Vienna Civil Society Award for your 'Outstanding Contributions in the Fight Against Drug Abuse and Crime,' from UN Secretary General Kofi Annan. You started the hospital because of a personal tragedy. Did you ever expect such a denouement for your efforts? How did it feel to receive an international award?
I feel happy about awards. But, though I don't want to discount them, they don't help you on a day-to-day basis to sustain the programme. On a regular basis, when recovering addicts come and share their happiness, one feels satisfied. Every other day, someone celebrates his birthday, the day he give up alcohol, here. They keep coming and sharing their happiness. These moments which give us the energy to go on with our work.
Like the time we went and gave a talk in a rural school in Manjakkudi. After the talk, a teacher raised an issue. She asked, "Some of our children drop out because of their fathers' alcoholism. They are taken away to work in the fields. Sometimes, some children are forced to sleep in front of the schools as some fathers drive their children out of the house. Some come because they are scared of their father. Can you do something about this?" We decided to do something for the village people and started the camp approach, which has been lauded by many international agencies. It is one of the most cost-effective and ideal programmes for many of our neighbouring countries.
All in all, I would say this hospital gives meaning to my life.