In 2004, the World Health Organization’s global status report on substance abuse placed Uganda at the highest adult-per-capita consumption of alcohol in the world. This means that the country is an origin of alcohol and substance abuse, which accounts for 14% of all mental heath cases,  according to a Mental Health Policy report in 2007. In relation to HIV/AIDS, people living with HIV often start taking alcohol or drugs to overcome emotional trauma and mental illnesses like depression that come with testing positive. In some cases, however, due to alcoholism and substance abuse, the chances of people engaging in unprotected sex and sharing needles for injection of drugs expose people to higher risks of contracting HIV. Alcohol is a major cause of poor adherence to medications, since some of the communities ROM serves engage in local alcohol brewing and selling. In 2015, the Alcoholic Support Club was created to address this problem. Two counselors were placed at Butabika Hospital at the Alcohol and Substance Abuse unit for mentorship. These counselors are responsible for running the club, which meets monthly with support from the hospital. See this blog post for more information.

“Nothing good ever came out of me being an alcoholic. I had no appetite and could take waragi- local brew – all day long, and even forget to take my ARVs or take an overdose for the few times I remembered to take,” one gentleman said at an August 2016 meeting.

The man had now achieved 4 months sober.  “I was married some years ago and all was well until I discovered that my husband was taking ARV’s in secret. I was devastated by the discovery and went to test at ROM. I became a client of ROM 3 years ago after I tested positive.”
Her husband died soon after, leaving her pregnant with their son. This depressed her – she felt like her life was falling apart and she resorted to taking alcohol, which interfered with her adherence to the daily ARV medication.
“When the doctors noticed that I was failing on my medication, they made me report weekly to the site for counseling and pill counts to ascertain whether I had taken my medication,” she said.
Her children, now aged 13, 9 and 3 years, are all negative.

“I am now about 4 months sober, and I wash people’s clothes for a living. On a good day, I may earn about 15,000/- shillings, which I can use to meet my basic needs, which was not the case when I was taking alcohol too much.”

“I have no use for alcohol now, it never brought me anything good,” Christine Acan confided when asked about her journey from alcoholism.
Acan Christine, is one of ROM’s first clients, having joined Reach Out in 2003. For her, alcohol had always been a part of her life and her livelihood, considering the fact that she too used to brew it herself and thus could easily indulge in it without a care in the world.
Over time, she started failing on her medication and her viral load was very high. ‘’They used to counsel me all the time because of alcohol. Every time I would come to clinic, they would make me see a counselor.”

“It is true I wasn’t talking my medicine /ARV’s well, because sometimes I would take either an overdose or an under-dose of the ARV’s. When drunk you cannot remember whether you took today or yesterday, and because the counselors always instill in us that we shouldn’t forget to take medicine, you end up taking more than twice because you cannot recall.”
“I stopped taking alcohol before I was taken to Butabika (Mental Referral Hospital) and now crave soda and fruit juice instead.”

She still runs a bar to earn some money but boasts of being 8 months sober.
She is married to Musingo Stephen, a recovering addict who also boasts of a sobriety of over 3 months. Interestingly, their relationship started at a bar when she gave him a place to stay for the night, because she noticed he was extremely drunk and yet he was carrying a large sum of money on him.

The eastern part of Uganda, Mbale, where Stephen originates from, is known for its homemade local brew “malwa / ikwaata made out of sorghum and other grains. Growing up, his parents used to brew alcohol at home and sell it to the villagers who would come and convene to share the brew in the evenings and at a tender age, Stephen and his siblings were given a jug of local brew, diluted with water, to drink away from the adults.
That was the start of his journey into dependence on alcohol, and at about 13 years, he started using drugs. “They made everything look so easy,” he said of how the drugs made him feel. At 18, he made a girl pregnant and her parents wanted to have him arrested, so he fled the village and went deeper to his grandfather’s home, where they too used to brew alcohol on a daily basis. His grandmother was a drunkard and would keep sending him to the shops to buy “waragi,” and he too would take some of it before returning home to take it to her.
He even joined a vocational institute, received training in carpentry and later started conning people of money by assisting a fake witch doctor in convincing his clients that spirits could speak to him. “We used to take alcohol all day and alter our voices to the client’s need; we made a lot of money from unsuspecting clients by asking for anything that we wanted.”
During that time, alcohol was his fuel, and he had become such a disgrace to his family that he hated and detested them so much. He fell out with his witch doctor friend over failing to pay him, and Stephen allowed his elder brother to take him to Kampala for work.
While in Kampala he did a few odd jobs and a lot of carpentry, married and had three children. Unfortunately, two of his children died, one because of a strange illness and one at birth, which also claimed his wife’s life.
He continued in his drunkard ways after sending his surviving child to the village. Finally, he met his current wife at a bar after she offered him a place to sleep and cautioned him about thugs that could take advantage of him since he was drunk and had a lot of cash on him.
See below for Stephen’s remarks on how he quit alcohol.
When asked about the journey to quit alcohol, Stephen Musingo said: “The counselor was so helpful, even when I tested positive and insulted her and trashed everything she told me. I was so arrogant, but all that was because I was always drunk. I thank God that she never gave up on me. I am now a better person, and I can work and sustain a job. My health is doing better, and I am on better terms with my family, who I had earlier abandoned.”

“I went to the Alcohol and Drug Unit in Butabika and listened to the testimonies of others who were being rehabilitated, and I was moved to change my attitude. Alcohol and drugs were not worth it.”