In times of lockdown, the state is facing another crisis apart from COVID-19
Kerala’s response to the national lockdown has been much better than perhaps most other parts of the country.
The decreasing number of COVID-19 positive cases over the past one week after the initial spike is no doubt an indication that the hard work done by the medical fraternity in the state is showing the desired results, at least so far.
Adding to this, the effort put in by the state administration in not shying away from filing criminal cases against people who tread out of their homes without good reason had also ensured that the virus does not get the chance to spread exponentially.
But over the past fortnight a slightly different problem has been staring Kerala in the face.
A week ago, media reports in Kerala were rife about the suicide of nine individuals, all reportedly under withdrawal symptoms due to the non-availability of alcohol since the national lockdown kicked off at the stroke of midnight on March 24.
That only two people were lost to COVID-19 but nine to alcohol withdrawal symptoms induced suicides, as bars and beverage outlets remained shut, underlines the serious implications of the issue at hand.
But since the first week of April the picture seems to have taken a drastic change. Suddenly no further cases of suicide induced by alcohol withdrawal symptoms were being reported from the ground.
More interestingly the withdrawal symptoms that were expected to spread across the state even faster than the Coronavirus suddenly seem to have vanished into thin air. Also, not many patients have reported with withdrawal symptoms since the first week of April which suddenly did not add up at least in the eyes of those dealing with the issue.
Doctor Mohan Roy G is the consultant psychiatrist at the Trivandrum Medical College and has tremendous experience in dealing with patients who show alcohol withdrawal symptoms. But Dr Roy is equally perplexed at the sudden fall in numbers of patients calling in with withdrawal symptoms at a time when liquor is nowhere to be seen.
“As per our own data 1% of the male population in Kerala is severely dependent on alcohol or are likely patients of Alcohol Dependence Syndrome which means out of 1.7 crore male population at least 1.7 lakh should be out there most times showing withdrawal symptoms. If so, my cardinal question is why are we not able to identify these people? Either it means our data is wrong or there is something else afoot that does not push these people to withdrawal symptoms even if there is no official alcohol supply,’’ Dr Roy told The Lede.
The government that is understandably busy controlling COVID-19 and much of the media that is gloating over this presumably successful Kerala model, seem to have little time to fathom this side of the story.
It is here that The Lede’s attempt to draw a clearer picture got us closer to some startling data which show that even though Kerala has shut all possible sources of alcohol down officially, the supply chain has hardly been hit. It is the illicit brew that seems to be taking over.
“See the national lockdown was on 24th midnight. Till 22nd there was even a state government declared lockdown. So people would have got very less chance to actually buy liquor which means by 27th the withdrawal symptoms of the 48 to 72 hour window should have set in. At least by 29th we should have seen a big number calling in with symptoms. But why did we not see that? Was there a parallel supply happening? Or have the people resorted to some other form of intoxication?’’ asks Dr Roy.
The figures accessed by The Lede from the State Excise Department answers at least some of the doctor’s queries if not all.
The excise department over the last fortnight had been literally burning the midnight oil to keep in check what now looks like an imminent revival of the illicit liquor market in the state.
Kerala, like many other states in India, has always had its share of illicit liquor business but what is startling is the sudden exponential rise in the recovery of the raw material for making illicit liquor in the state and that too a hardly week into the lockdown and even with heavy restrictions in place.
“Since the lockdown had started we are having huge recoveries of brew or ‘wash’ that is prepared to make illicit liquor from many parts of the state. Suddenly when liquor seems to be not available in the market it seems to have become an opportunity for not just new but even veterans to get into the field in quick time to meet the demand. Now the challenge before us is to not only stop this at all costs but also to ensure that we are not pushed to the possibility of a hooch tragedy in the state,’’ S Aananthakrishnan IPS, State Excise Commissioner told The Lede.
Now to the numbers that The Lede has managed to access from the Excise Department.
Over the last fortnight since the lockdown came into effect, excise squads across the state have recovered a whopping 53,000 litres of ‘wash’ in statewide raids as of April 09.
Wash is the finished product of fermentation which is then distilled to produce alcohol. Wash is generally stored in large barrels and prepared over a period of seven days mostly in rural parts of India, Kerala being a top source for it.
Now how does this number of 53,000 litres become alarming? Compare this to what the Excise department usually manages to catch over a year, and you hit the bull’s eye.
While 53,000 litres were caught in just the last two weeks, Excise officials say the usual figure for an entire year stands not more than 1,15,000 litres.
That half a normal year’s wash has been recovered over a fortnight shows the desperation to which the tippler in Kerala is experiencing.
But the big question is how can all this be done by individual alcoholics over such a short period of time and that too in the midst of a complete lockdown? Doesn’t this suggest the existence of an organised syndicate that supplies the raw materials, the labour and the land needed for such activity on a scale inside such a short period of time?
“See there are people who might have stopped doing it earlier but then go back into it once they realise there is a business opportunity. Secondly, wash is prepared using raw materials which are easily available in most of the rural parts of the state. So it does not require any big logistics which also means that if the lockdown extends you can expect this to go up. That will be a huge challenge,’’ added the Excise Commissioner.
Grimmer is the daily breakup. If it was just 150 litres of wash that was caught on March 24, a day before the Prime Minister declared a national lockdown, since then it has seen an exponential growth.
6100 litres on April 04, 4500 litres on April 06 and 5500 litres on April 07 and around 10,000 litres between April 08 and 09.
Wash seems to be flowing unabatedly in Kerala and we are only talking about those recovered with the excise department’s meagre infrastructure and understaffed men.
During the same period the average number of cases filed for brewing illicit liquor per day stood at a staggering 35 from various parts of the state.
In each case the least amount of wash being brewed had ranged from as low as 7 litres to as high as 1500 litres, which means that from small dingy rooms in households to large grounds liquor brewing had taken off at full flow in the state in spite of the entire nation being locked down.
The Additional Excise Commissioner (Enforcement) Sam Christy Daniel explains how the Excise department along with cooperation of the state police had even employed drone technology that led to the raid of a private estate in Thrissur on April 06. The Excise department returned with a price catch of 540 litres in that single raid.
“Most of these raids have happened because of highly enthusiastic officers who have their sources’ ears tightly on the ground. Also a lot of common folks tip us off. We can end this evil only with the cooperation of the general public,’’ the additional commissioner told The Lede.
But how can such activity to brew such large amounts take place at such short notice? The answer to this is a matter of investigation.
While the maximum recovery had happened in Thrissur in the last few days, excise officials say that other places in the state are also not far behind.
While hilly tracts of Wayanad and Idukki have been the usual suspects whose forest areas are hotbeds for this activity, what is more significant this time is that many other lesser known areas are also coming into the picture following the lockdown.
Now if we were to connect the dots from these raids back to where we started with the nine suicides, another startling indicator too comes into the picture.
It reinforces why suicide rates suddenly shot down after a spike and also substantiates the theory of the sudden and mysterious disappearance of those with alcohol withdrawal symptoms.
The answer lies at ‘Vimukthi’, a state government project aimed at de-addiction with the mission of realising an ‘addiction free Kerala’.
It has a toll-free number to which people can call in to refer cases of alcohol withdrawal symptoms. It ranges from people who depict violent, depressive or other symptoms because of the person’s inability to cope without alcohol. Such people are picked up and taken to deaddiction centres as when notified by social workers, relatives of the patients or the patients themselves.
Excise officials told The Lede that although a large number of patients or representatives had called in with withdrawal symptoms in the starting few days of the lockdown, that number then very surprisingly came down in the next few days and has almost become redundant by the end of the first week of April.
While on March 28, which is three days into the national lockdown, there were 201 calls received on the Vimukthi toll-free line, the same dwindled to 131 by March 29 and then to as low as 51 patients by March 31. By April 06, just 14 patients had called in.
“See there is no other rational explanation that you can give to the sudden drop in calls that came to the Vimukthi in the last few days. It seems that illicit liquor is being easily made available on a personal level. How much ever we try not to believe that, there is no other explanation one can give for it,’’ added the Additional Commissioner.
The excise department clearly suspects that the fall in numbers of people with withdrawal symptoms is simply because illicit liquor is being brewed at a highly localised level at the backyards of households in Kerala and that is now posing a herculean challenge before the enforcement agency.
As low as seven to eight litres can be brewed using one’s own pressure cooker and raw materials at home. When that can be done, why should an alcoholic call in for medical help ask many officers.
Father Jijo Kurian is a well-known face in Idukki, the hilly district in Kerala which is notorious for brewing illicit liquor. The father who belongs to the Naadukaani Capuchin Monastery, has also been dealing with people having alcohol withdrawal symptoms.
“See it is a reality that we need to live with. Illicit liquor no doubt is being brewed in a large scale over the last few days. There is no use hiding that reality. I am personally aware that this is rampant in Idukki at the moment,’’ Father Jijo Kurian told The Lede.
The Father goes to lay the blame for this illicit liquor outbreak squarely at the door of the state government.
“See COVID is not the time when you can run after addicts. That is a problem to be sorted out on another day. When you have no option but to lockdown everything government should have found other means to ensure that the legal alcohol supply is intact. Without compromising on social distancing and hygienic surroundings this could have been done had the government given it a thought. Rather they started shifting the goal posts,’’ added Father Kurian.
Without doubt the Pinarayi Vijayan government did shift the goal posts which was precisely the reason why the Kerala High Court came down heavily on the state.
While hearing the case filed by Kerala Government Medical Officers Association (KGMOA) against a government order urging doctors to issue a prescription to any alcoholic who approaches them stating that the individual be given alcohol as a medicine for overcoming withdrawal symptom.
The medical community in Kerala protested against such a move in the strongest of terms with a section of them even wearing black badges to work in the midst of fighting COVID-19.
“See we are not against the government selling alcohol in the society. That is the state government’s call. But why should the government shoot from the shoulders of the doctors. Don’t they realise that it is both illegal and against the basic tenets of medical ethics for a doctor to prescribe alcohol as medicine for a patient. Tomorrow if the patient dies after drinking excessive alcohol wont the doctor be liable for his death?’’ asks Dr Joseph Chacko, State President of KGMOA.
The government order which has baffled many clearly said that once such a prescription had been received by an individual, he or she may approach the State Excise Department which would create a ‘pass’ in the name of the individual entitling him to three litres of alcohol per week which would then be home delivered on the first day of every week.
The tipplers no doubt rejoiced at the controversial order. After all they were going to get three litres of alcohol sitting at home.
But the joy was short-lived as the Kerala High Court stayed it which then prompted the government to take a step backwards saying it had only requested the doctors for prescription and had not ordered them to do it.
“The government had nowhere ordered the doctors to give a prescription for alcohol. It was only a suggestion we made on humanitarian grounds to help those with withdrawal symptoms during lockdown. That’s it,’’ reiterated Chief Minister Pinarayi Vijayan.
Not only were the doctors annoyed but the habitual drinker was also left in the lurch after providing him a glimmer of unnecessary hope. With not much choice left at his disposal many now seem to have turned to easier option of illicit liquor.
“It once again reflects the policy crisis that hits the Pinarayi Vijayan government occasionally. It is like the other brain fade moment for the government. Otherwise how will you explain such an order where a state government asks its own doctors to prescribe alcohol as medicine. Nobody is against this government selling alcohol. But then there has to be a proper policy for it. You cannot do that on flimsy grounds,’’ noted political commentator Joseph C Mathew told The Lede.
“The government was all the while well aware of the situation in the state. If it was seriously planning to deal with the issue it could have brought in a whole lot of measures. You could have still sold it from beverage outlets with restrictions. You could have made the sales fully online too,’’ added veteran journalist Roy Mathew.
The state at the moment has close to 1.7 lakh alcoholics who are victims of Alcohol Dependent Syndrome in some degree or the other.
Take the case of 38-year-old Sanoj Kulangara from Thrissur who committed suicide on March 27 after not getting alcohol for two days. His friend recollects Sanoj’s desperation in those days.
“I have known Sanoj for the last 10 years at least. I have not seen him going to work even a single day without drinking. He could not work without having his morning drink. The thought that he will not get his drink for the next 21 days was literally making him mad,’’ a close friend of Sanoj told The Lede in anonymity.
But it is people like Sanoj who would now fall easy prey to the machinations of the illicit liquor market which already seem to have set up shop across the state.
With the days of the lockdown all set to go up, it is beyond doubt that the demand for illicit liquor will also go up, something even the enforcement agency as well as experts in the de-addiction field agree with in one voice.
Hence slowly but steadily that is likely to lead at least a few to experiment and find new ways to increase not just the amount of illicit liquor brewed but also to increase its intoxication strength which ultimately leads to spurious liquor and a looming hooch tragedy.
Kerala is surely treading on a tight rope now, not on COVID-19 though, but on illicit alcohol.