Key drivers of alcohol consumption in Karamoja
Shifting livelihood profiles
Karamoja has seen major shifts in livelihoods over the past two decades. Authors have documented the erosion of pastoral production systems as a result of livestock loss, conflict, frequent droughts, limitations on pastoral mobility, growing inequity of animal ownership, and anti-pastoral policies. Local people have had to shift their activities and strategies accordingly, and studies show the extent to which people are relying on wage labour and petty trade to both fulfil household needs and manage risk (Fernandes 2013; Iyer and Mosebo 2017; Stites and Akabwai 2009; Stites et al. 2014). Although livestock-based livelihoods may be gradually recovering (Stites et al. 2016), the widespread loss of animals has had cascading effects on household food security, customary authority, gender roles and future prospects (Carlson et al. 2012; Stites and Akabwai 2010). In addition, the growing inequity in livestock ownership means that while some households may be thriving within or re-entering the pastoral economy, many others remain on the margins (Ayele and Catley 2018; Catley and Aklilu 2013; Marshak et al. 2019). Ultimately, this shift in livelihoods is also a key driver of the changes in alcohol consumption, production and sale.
The most direct connections between shifts in livelihoods and the increase in alcohol consumption, production and sale relate to the increase in urbanization and monetization. The growth of towns and the concurrent decline in livestock ownership means that a growing number of people seek economic activities in towns, whether on a daily, occasional, seasonal or sporadic basis (Stites 2020). Cash is more widely available in both urban and rural households due to extensive informal employment in both urban and rural areas (primarily in farm labour or mining in rural locations) (Iyer and Mosebo 2017). This is a change from the period prior to disarmament, when insecurity deterred trade and people relied more heavily on subsistence production.
The availability of cash is thought by some to be responsible for the increase in alcohol consumption. Prior to disarmament, it was difficult both to find hard liquor in large quantities and to purchase it due to lack of money. Explaining this change, a Jie elder recountedFootnote 12:
Those days people didn’t like having money. People looked at people having money like these are some (other) kind of people. But nowadays people like having money. Everybody has money. That is why everyone is taking too much etule. People never say, “I lack money for drinking etule”.
Although cash is a necessity today in Karamoja as elsewhere, the low wages and rising costs of living in Uganda deter productive savings. Young people, are especially affected by the inability to substantially save their earnings in order to invest in education or training. As recounted by some youth, the problems of poverty force them to spend ‘the coin’ (signifying a small amount of money that is typically earned from daily labour) on liquor because they do not see many prospects for that ‘little’ money.Footnote 13 Whereas this rationale may be extended to other age groups, particularly those in the middle age, youth appear particularly vulnerable to the urge to quickly spend small amounts of cash in hand.
Nevertheless, there is an acute understanding of the ills of hard liquor consumption among community members, young and old. Observations on the effects of excessive consumption of liquor on health, inter-personal relationships, household economy, livelihoods and the community at large were reported animatedly by participants. It was not uncommon to hear that ‘the land is now spoiled’ because of the proliferation and excessive use of hard spirits. Deaths from excessive consumption of waragi were regularly reported by respondents. Respondents were careful to differentiate between local brews and hard spirits, with the former seen as having many fewer negative effects (Stites 2018). The reasons respondents gave for consuming the two types of alcohol also varied greatly. Whereas ‘hunger’ and social/traditional reasons are typically attributed to the consumption of local brew, the triggers for the consumption of hard spirits range from economic to social and psychological reasons.
Livelihood and employment-related stress
Respondents often cite stress related to the loss of livelihoods and the associated economic impacts as contributing to excessive consumption of hard liquor. These struggles appear particularly acute for male and female youth (generally greater for young men). In urban and peri-urban settings, young people have few prospects for skilled or semi-skilled jobs without attaining at least a secondary education. However, the high cost of secondary and higher education are a critical barrier to educational attainment in Karamoja. Compared to average wage rates in the region, covering the costs of education is often an insurmountable task even for urban households with multiple earners.Footnote 14 Businesses fill the gap in qualified applications by bringing in workers from outside the region (Iyer and Mosebo 2017). Because of incomplete education, inability to secure relatively better paid semi-skilled or skilled jobs, and an exploitative and highly competitive labour market, many male and female youth in urban and peri-urban areas express hopelessness in their current and future prospects. This hopelessness, according to youth respondents, is one of the main reasons for alcohol consumption.
The problems are different for rural youth. According to some respondents, the confiscation of guns as part of the disarmament campaign has left a void in the lives of young men in rural areas. In addition to human rights violations which primarily targeted young men, the forced disarmament campaign resulted in widespread erosion of livestock holdings due to the protected kraal policy, whereby animals were kept in enclosures within or near military barracks, purportedly to minimize raids (Stites and Akabwai 2009, 2010). Animal mortality and morbidity were extremely high, young men and boys were prevented from engaging in socially expected roles of herd management, and households suffered from the lack of regular access to milk and blood and the ability to sell an animal when needed for cash or to make a horizontal social exchange. Animal stocks did not recover in the years following the protected kraal policy, and ownership became increasingly inequitable.
The loss of guns coupled with the decline in animal-based livelihoods brought a fundamental shift in gendered responsibilities at the household and community level. While young men in pastoral and agro-pastoral households had previously served critical roles as providers and protectors, in the post-disarmament period, they found themselves with few clear roles or activities. As male youth in a focus group discussion in Namalu Sub-County in Nakapiripirit reported, following the loss of animals, rural male youth have little to do but ‘sleep under the tree’Footnote 15. This idleness contributes to drinking, as explained by a group of men interviewed in Nadunget Sub-County in Moroto:
During those days, the herders were wise enough. People used not to drink ngagwe a lot, the youth also never used to drink…but now there are no animals to care for, we are all just here wandering going to town, there is nothing to herd…what [animals] is there is just for the young kids to herd and the youth now have resorted to drinking.Footnote 16
Complaints about lack of things to do, however, are not restricted to rural male youth. Young men in urban and peri-urban centres also reported a lack of activities to occupy themselves as a reason for drinking to ‘pass time’.
At the same time that young men in rural areas have seen their identities as protectors and providers erode in conjunction with the removal of the weapons and the loss of animals, young women in rural areas have had to step in to provide for their families. As towns and trading centres have expanded and movement has become safer in the wake of disarmament, women have increasingly engaged in exploitation and sale of natural resources (including firewood, charcoal, thatch and wild vegetables), petty trade and services (including working at breweries and in hotels or restaurants and doing casual domestic work). This means that women are away from the homestead for extended periods (which may contribute to drinking by men), women are engaged in the cash economy (making more cash available for the purchase of liquor by household members) and women are moving regularly between rural and urban areas (where hard liquor is cheap and readily available).
The shift in gendered responsibilities at the household level has also increased pressure upon women, who already faced extreme time burdens due to their domestic and reproductive duties. Women recount taking up drinking to remove the stress of managing their households single-handedly in the absence of a contributing spouse and with little earnings. Compounding the issue is the generally low wage rates in sectors dominated by women, such as domestic work, and the high costs of education, food and non-food commodities. These problems are also faced by women who are widowed, divorced or abandoned. A woman in a focus group discussion in Kotido explained:
I have two children. I don’t have a husband; now it’s seven years without a husband. So, I am a mother, I am a father. There is no business I am doing, but the children must go to school, must eat, must dress, (treat) sickness when it is there, and rent. But all these things should be paid. But now, if now I sit only in one place without drinking, the thoughts will kill me (laughter). So I just drink, drink! The child wants food, the child wants soda – I am just there drunk! All these thoughts are not there (then).Footnote 17
A second woman in the same group added:
I have two children. Their father got another woman, and the other woman spoiled his mind. If I go to him sometime to give me some money to buy food for child, [sometimes] he does not give me money. So, I stay stressed. If someone gives me either 1000 or 500 (Uganda shillings), I go and get someone who’s drinking. I also join drinking to forget the stress. …So, when you think of the prices of other things, it just makes you stop and drink. So, you just continue drinking to forget.
For both men and women, low wage rates and an inability to save translated to a lack of ability to invest in productive assets, including education or livestock, drive alcohol consumption. This is especially critical for male youth who aspire to establish a family. For most young men, establishing a livestock herd is the first step in preparing for marriage. Those without animals for bridewealth are unable to secure rights to a female partner. This has negative impacts upon a youth’s status as a ‘man’ within his community, as evident in the discussion by a group of young men in Kotido town:
For us [as] youth, I don’t have anything [animals] that my parents have. I go and engage a lady and she accepts me. Then afterwards, another person comes who has authority [animals]. He comes and takes away my lady when she is already my wife. Then when I go back to the house and I’m lonely, I go and get etule. You drink until you sleep like a dead person and forget those thoughts.Footnote 18
The views expressed by the young men above were common among respondents of both genders in middle age and youth groups. Clubbed under the term ‘thoughts’ (ngatameta), a great number of respondents listed stressors such as marred inter-personal relationships, inability to provide for children, lack of or loss of employment, and problems in sufficiently meeting basic household needs. Forgetting these ‘thoughts’ was a motivating factor in excessive alcohol consumption. Respondents are keenly aware that, due to its high alcohol content, waragi can help them ‘pass out’ and thus, at least temporarily, relieve stress. Importantly, the desire to obliterate thoughts is in stark contrast to the typical reasons for consuming local brews, which are mainly ceremonial, to socialize with kin and non-kin and to alleviate hunger.
We conducted a participatory exercise in an attempt to quantify consumption levels of hard alcohol. Using a daily calendar exercise, male and female respondents indicated that many people drank local brew and waragi from sachets in the morning, kwete in the afternoon and beer and waragi from sachets in the evening. Others explained that local brew was particularly popular in the morning as a warm substitute for porridge and then again at mid-day because it stays in the stomach ‘like food’. On the other hand, the evenings see a mix of both local brew and hard liquor. At times, drinking is regularly continuous and can last for more than 6 h at a time, with expected impacts on functionality.
Dispossession and disenfranchisement
Although not explicitly phrased as such by informants during data collection, what we observe in Karamoja vis-à-vis increased alcohol consumption might also reflect a consequence of disenfranchisement that has blighted the region for decades. This dispossession in recent history began with the coordinated and brutal disarmament exercises by the Uganda People’s Defence Forces (UPDF). While disarmament exercises in Karamoja were a recurring experience since early in the colonial era (Bevan 2008), the disarmament that began in 2006 was significantly more coordinated, prolonged and systematic (Human Rights Watch 2007; Stites and Akabwai 2009, 2010). It was also much more brutal. Data collected from communities in the months and years following the start of the disarmament and one of the author’s first-hand observations illustrated the manner in which communities were cordoned and men were rounded up and exposed to humiliation and painful and degrading treatment (such as lying naked in the hot sun for hours with bricks on their chests), and arbitrarily detained, including in unofficial cells and prisons. Young men detailed that they were afraid to walk to towns or visit markets because soldiers would attack them, beat them in public and accuse them of being raiders and having guns. A number of young men who had experienced detention reported sexual violence in the form of beatings to their genitalia. Numerous young men in different communities told one of the authors, without prompting, of having their scrotums twisted around sticks, which resulted in impotence for some. For their part, women detailed the experiences of attempting to locate and secure the release of male relatives who had been detained. The UPDF did not document or record detentions, and women often had to visit multiple locations at significant costs in order to locate their men. Once found, the primary means of securing release was by turning in a weapon, but many households either did not have a gun or had already given it up. Women reported selling livestock in order to purchase a weapon, which they would then exchange for the release of their male relative.
Not only did this disarmament result in trauma, humiliation and actual loss of lives, it also resulted in widespread loss of livestock and increased dependence on wage labour, petty trade and natural resource exploitation (Human Rights Watch 2007; Stites and Akabwai 2009). In parallel and further undermining local livelihood systems is the on-going large-scale land dispossession in Karamoja, a result of substantial commercial interest in the region following the disarmament (Human Rights Watch 2014; Rugadya et al. 2010; Saferworld 2017; Wambede and Mukooli 2017). By one recent estimate, approximately 3.7 million acres (approx. 1.5 million hectares) of land in Karamoja has been parcelled out for sundry mining activities (Mutaizibwa 2019). Local communities have witnessed not only their land being appropriated for commercial interests that do not directly benefit them, but also mining concessions and activities which sometimes cut directly through critical rangeland areas, indispensable for pastoralist production.
At the same time, policies of the central and district governments and international actors over the past decade have encouraged households and communities to sedentarize and adopt cultivation. For many, this has meant moving away from traditional homesteads and to areas deemed more suitable for agrarian livelihoods. Such shifts by one sector of the population have severed systems of customary authority as well as up-ending the inter-generational transmission of knowledge and practice. Cultivation as a form of livelihood diversification may benefit those households with the resources to remain simultaneously engaged in animal husbandry, and some of these households are benefitting from some rebounds in the pastoral economy (Stites et al. 2016). However, a significant number of households remain ‘livestock poor’ without animals to fall back on as insurance when harvests fail, a common event in a semi-arid region characterized by highly variable rainfall (Ayele and Catley 2018). The loss of livestock has critical implications for household resilience (Little et al. 2001), and diversification into wage labour and petty trade has not proven beneficial for staving off poverty for the majority of the population (Iyer and Mosebo 2017). The mix of destructive policy and practice has spelled further destitution of the pastoralist economy with many ‘moving out’ of pastoralism altogether (Catley and Aklilu 2013). While destitution alone does not drive people to consume excessive amounts of alcohol, numerous respondents for this study spoke of the combination of poverty, despair and a lack of ability to envision a life that looked any different from their current reality. People spoke of the challenge of saving enough money to make any real investments, and, when faced with this dilemma, many saw no reason not to spend a day’s wages on waragi or etule.
Effects on communities of alcohol production, consumption and sale
Effects on physical health and well-being
Respondents in the study were acutely aware of the physical consequences of excessive liquor use and were quick to recount negative health effects. People who drink excessive amounts of waragi reportedly lose weight, become frail, have reddened mouths and lips and look like ‘AIDS victims’.Footnote 19 Respondents reported that etule affects the mind as well as the body. Fighting among family members at night and the inability to remember the fight the next morning is one such manifestation. ‘Madness’ is another, as an elder in Kotido explainedFootnote 20:
When you look at these people moving naked, these people of madness (ngicen), they are becoming so many. Because that thing (waragi) is confusing the brain. Some people drink until the blood becomes only etule. The head goes from normal to something abnormal – then it becomes madness.
Local respondents also associated erratic behaviour with excessive drinking, as explained by men in Loyoro in Kaabong: ‘alcohol is just bad…you see those days, someone drank alcohol, ran mad and started climbing over the mountain’.Footnote 21 A man in Moroto shared a similar account: a ‘bad thing is when someone drinks alcohol; he/she becomes confused [and] mad and can just get up and run somewhere far away because of confusion’.Footnote 22
One of the more notable physical effects of drinking etule, according to community members and health and government officials alike, was the inability ‘to reproduce’. Although scientific evidence is lacking, it is assumed that the heavy consumption of hard alcohol has contributed to male impotence.Footnote 23 In addition, the high level of inebriation is reportedly an obstacle to sexual relations within couples, further undermining strained inter-personal relations, discussed further below.
Medical centre staff listed various health ailments believed to relate directly to waragi consumption. A senior nursing officer in Matany Hospital, the largest hospital in the region, cited alcohol as a factor in the rise of cardiovascular problems, cirrhosis of the liver, and pancreatitis, as well as contributing to trauma, accidents and homicides.Footnote 24 Excessive alcohol consumption was also said to be a leading cause of suicide and depression among young drinkers.Footnote 25
A health officer in Nadunget Sub-County in Nakapiripirit noted that vision loss had been reported in some instances.Footnote 26 A sub-county official in Loyoro said that problems associated with ‘heavy’ alcohol consumption include ‘paralysis, madness, complaints of barrenness, quarrelling, [and physical] fighting’.Footnote 27 The sub-county official added that children suffered in households with heavy drinking.Footnote 28 Some of these impacts are likely emotional due to increased tensions and conflicts within family members, while some are physical. For example, a nurse at Matany Hospital discussed the problems of intoxicated adults caring for children, ‘We have seen children dying as a result of alcohol consumption [by parents]….mothers sleeping on their babies because they are drunk’.Footnote 29 Drinking also has negative impacts on maternal health in the region. The health official in Loyoro mentioned that miscarriage due to excessive drinking was a problem in his areaFootnote 30 and the nurse at Matany reported a connection between heavy drinking and premature births.Footnote 31
Medical officials reported specific and negative physical health impacts for children, including those associated with alcohol consumption by children. However, it is difficult to know either the extent or type of alcohol consumed by children, as evident in the explanation from a health official in Lorengedwat Sub-County in Nakapiripirit:
Sometimes, children are brought to us when they are comatose as a result of alcohol consumption….however, we normally do not document whether they have been given local brew or waragi…we just have to fight to save their livesFootnote 32.
In line with the medical personnel cited above, most of the study participants agreed that the excessive consumption of waragi was contributing to mortality and morbidity among both men and women. Death rates are particularly high around mining sites, where miners are sometimes paid in hard alcohol (Ariong 2018; Eninu 2015). Respondents pointed to convenient packaging, low price points and widespread availability of waragi sachets as factors in the rise of heavy drinking, in addition to the desire to kill ‘lingering thoughts’.Footnote 33
Effects on inter-personal relations
One of the most-cited consequences of excessive liquor consumption is destabilized inter-personal relationships. Drinking waragi is said to lead to fighting between spouses, between children and parents, and between individuals in general. Respondents mentioned increased rates of divorce, separation and extramarital relations. Relations between generations have also suffered. Elders say that they are losing authority as a result of youth’s alcohol consumption, but observations indicate that many elders also drink heavily. As explained by a group of male elders in Nakapiripirit District:
The youth have lost respect for their parents. They are getting spoilt. You can’t advise these young boys these days. They will want to fight you. They have even gone to the extent of abusing and insulting their parents. No respect at all. Sometime even we the parents are the ones who are [in] the wrong. We go and drink and start disturbing these young ones. At the end of the day we end up being beaten.Footnote 34
Alcohol is consumed by and adversely affects most demographic groups, but women and girls appear to bear the brunt of the inter-personal consequences. Numerous respondents cite the role of alcohol in domestic violence, and this was confirmed by medical workers in several locations.Footnote 35 Respondents in Tapac Sub-County in Moroto explained how alcohol was playing a role even in marriage negotiations. Families of grooms are said to ply the brides’ fathers with waragi in hopes of facilitating quick wedding arrangements, sometimes with under-aged girls.Footnote 36 This has reportedly contributed to an increase in the number of adolescent girls running away from their natal homes.