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"I can bet you that every second family has an alcoholic or a drug, or a drug user. I can bet you that everybody knows an alcoholic or a drug abuser, I can bet you that so many people don't want to acknowledge that fact. Nobody wants to know that their loved one is suffering from alcoholism. Is it a sickness really? Is it a sickness or is it somebody who just wants to have fun, who wants to shrug responsibility and live a life of their own disregarding everyone else?"

This opening line in the moving 40 minute video on alcoholism Nobody Kicks A Dead Dog came to my mind on World Mental Health day last week as Minister for Health Charity Ngilu expressed shock at the youthfulness of the patients at a rehabilitation center.

This was actually at the renaming of Kenya's most famous (infamous?) mental health institution from Mathari Hospital to Upper Muthaiga Hospital. Even as she officially opened a drug rehabilitation center billed as "the first of its kind in a government hospital in Africa"; Ngilu emphasised that the renaming of the hospital would remove the stigma associated with the old name.

But what exactly was the stigma associated with Mathari? Well simply put it is the prejudice and ostracism usually conferred on people who are different and for reasons that are not understood. The myths and misconceptions surrounding these social outcasts grow in leaps and bounds over the years and become accepted as fact.

In this group of 'unfortunates', one can include those suffering from epilepsy, cerebral palsy, cleft palates, various mental ailments and of course the all time perennial favourite, the alcoholic.

However changing a name will not magically dispel stigma. For stigma is so ingrained a part of one's belief system that only continous education can eradicate it and only by replacing these ideas with those based on fact.

But the fact that this rehabilitation center would be in the same compound as the main mental health facility in the country only goes on to perpetuate and solidify the myth that people drink alcohol because of psychological problems in which case we must be a nation of psychos given the rate at which we drink.

This actually gives credence to the myth that we become alcoholic because of psychological or emotional problems which we try to relive by drinking and which is a far cry from reality.

In actual fact alcoholics have the same psychological and emotional problems as the next person before they start drinking and all that can happen is that these problems are exacerbated by their addiction to alcohol. For the more the alcoholic drinks to feed his vociferous addiction, the more his or her ability to cope with normal life and its inevitable ups and downs becomes corroded.

While all this is happening the alcoholics moods are not left our either and like a mad (pardon the pun) pendulum it will swing unpredictably out of rhythm whether he is drinking or not. The result is overreaction be it anger, happiness or depression all is overdone.

Thus their addiction to alcohol is not psychological or in the mind, but physiological in their bodies. Later on society itself enables the alcoholic to keep drinking by supplying him with excuses to feed their as well as his denial.

When friend or relatives first begin to feel that maybe so and so is drinking just a mite too much the first reason or explanation they reach for is a psychological one. He is stressed or under pressure in the office or at home are some of the more common reasons given. He was retrenched and hasn't received his 'golden handshake'. Her kiosk was demolished by the municipal council askaris and she has no money to start again.

The alcoholic can now rationalise their problems away and with these society-sanctioned excuses to drink he becomes totally unable to judge his behavior accurately. To understand this clearly we need to go back to the 19th century, 1804 to be precise when Thomas Trotter a physician stated his belief in a paper that 'drunkenness' was a disease and by so doing sparked a controversy which rages on to this day.

Trotter in essence challenged the moral code of society, the basic tenet of the Church and even questioned the medical doctors previous ignoring of the drunkard. In their ground breaking book 'Under the influence A guide to the myths and realities of alcoholism' by Dr. James R. Milam and Katherine Ketcham the authors tell how "without the moral approval of the church or the professional cooperation of the physician, the fledgling 'disease concept' did not catch on. In fact the first attempts to treat alcoholism as something other than a mental or social aberration encountered fierce and effective opposition."

They go on to tell us how almost a quarter of a century later Eli Todd, medical superintendent of the Hartford retreat for the Insane suggested that it might be a good idea to give "inebriates" a separate retreat "rather than lump them with the insane and mentally incompetent." But his indignant colleagues forced him to abandon the idea.

Right into the twentieth century societies attitudes to drunks and drunkenness did not change much and so soon after the temperance movement at the end of the 19th century came in the 20th. in 1919, the Volstead Act establishing national Prohibition in the U.S.

After its dismal failure (it did reduce total alcohol consumption in the US, but no apparent effect on alcoholism but brought other problems like bootlegging, syndicated crime and hijacking) it was repealed in 1933. It was shortly after this in "1935 the fellowship of Alcoholics Anonymous (A.A.) was begun by two men who had been given up as 'hopeless drunkards' by their physicians."

Here was something different for "A.A. demonstrated for the first time that alcoholics in significant numbers could recover, and return to productive useful lives. Most of all it proved that alcoholics, when they stayed sober, were decent, normal human beings and not hopeless degenerates."

In Kenya 162 years after Trotters essay we still want to lump rehabilitation centers with mental hospitals for though treatments have changed tremendously in this the 21st. Century, our attitudes and beliefs and the way we treat alcoholics are still in the 19th century. Stigma is still a major obstacle to alcoholics and other addicts getting treatment.

Minister Ngilu needs to come up with guidelines for the setting up of affordable, properly manned and maintained rehabilitation centers all over Kenya. Indeed the mandate to do this has been in her docket since independence a mere forty years ago yet we are still thinking in the era of Trotters essay.

An 'wet' alcoholic is a burden and terror to everyone in society including himself. He or she needs to get into treatment as soon as possible. Ngilu needs to address the issue of attitude even among the medical profession whose thinking is still unchanged from the time of Trotters essay and who also prefer to leave anything concerning alcoholics to their psychiatric counterparts. A simple name change will not do this.

David Ogot is a freelance journalist/producer and can be reached at goinghomedotcom@yahoo.com Website: www.goinghomekenya.org

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