14ymedio, Luz Escobar, Havana, 9 December 2015 — He woke in a doorway and could not remember how he got there. A few yards away, another drunk was snoring on his own urine. The scene was told in front of the national television cameras by the actor Mario Limonta, proof that the debate on alcoholism is winning space in the media, although it is still a long way from reflecting the seriousness of the problem.
Unlike the known actor, Esther not been interviewed on prime-time evening news, nor has she overcome her addiction. In the Silvia bar, on the corner of Vapor and Principe streets in Central Havana, she is the female “star” of a constellation of men trying to drown their sorrows in alcohol. Tourists who pass by take photos of the suggestive façade, a knife painted green and yellow, while inside the air smells of cheap rum and sweat.
Alcoholism is among the top ten causes of death in Cuba and specialists acknowledge that in the past two decades the consumption of such beverages has increased considerably. The share of men who drink is 47% while in the case of women it exceeds 19%. For females attached to a bottle, the drama is twofold, as they must face greater social rejection: both for drinking and for being women who do it.
Thin and short, Esther isn’t yet fifty years old but she already seems like a old woman. She worked at a downtown hotel in Old Havana for some years. “Every morning she would be all decked out,” remembers a neighbor in her building near the so-called Martyrs’ Park. “Now no one can stand to be three steps from her, everyone scorns her,” adds the lady.
The life of this Havanan sunk in addiction changed when she met Ignacio. With him, “every night was a party,” and at the beginning it was all “glamorous” but as the months went by, “we didn’t care any more which bar it was, as long as they served alcohol,” says Esther sadly, but without shame. Since then she has shared with him hugs and drinks, fights and nights of sleeping in any stairway they find.
She acknowledges she lost her shame the first time she had sex in a dark park with a stranger, just because he offered her a bottle filled with “good rum.” Then came the scandals at home when they didn’t open the door late at night, the fights in the bar because she didn’t have any money and “needed to keep drinking.” She remarked that yes, “in the beginning it is a desire,” but later on “it becomes a necessity.”
Violence is inextricably linked to the consumption of this substance. In Cuba between 20% and 69% of those hospitalized for injuries suffer from some disorder caused by alcohol, making alcoholism into the most prevalent chronic disease of patients with trauma, according to the report Projections of Public Health in Cuba 2015, drafted by the Ministry of Public Health.
To find some exit from the dead-end in which the disease trapped her, Esther’s mother took her by the hand to receive specialized care in a hospital. After receiving treatment and spending days in the hospital, they recommended she visit the nearest Alcoholics Anonymous (AA) group. Before going to the first meeting she had a relapse.
The experience of Alcoholics Anonymous in Cuba dates back to January 1993, after the visit of seven members of that organization from San Francisco. They founded the group Sueño (Dream) that started with nine members in some facilities of the William Carey Church in the Vedado neighborhood. A month later 50 Mexican AA members arrived to sponsor Cubans. Today, there are more than 200 groups throughout the country.
It was not until after her third hospitalization that Esther, “the star” of the Silvia bar, arrived at the AA meeting at Carmen Church, a few yards from her home. The first day she was overcome with shyness and found that of the six people who attended, she was the only woman. She notes that then “I let my tongue go” and “talked up a storm,” but confides with pain, resigned, that she has been unable to “go three months without drinking.”
The psychology student Erika Barrios Mancriff, of the Calixto Garcia Faculty of Medical Sciences, wrote her thesis on the testimony of 25 patients between 25 and 60 years of age, in Central Havana, just where Esther lives. An area which has the district’s highest incidence of addiction in the country, as confirmed by official sources.
Barrios Mancriff found, from the results of her research, that “these patients have low self-esteem while rejecting the behavior patterns of their families – many times their parents are also alcoholics – and yet they repeat these patterns of behavior.”
Esther’s parents, however, are like the neighbors everyone wants to have: quiet, saddened by the actions of their daughter, and willing to help her detox. To get to “their little girl” out of the hole she’s fallen into, they need her to start by recognizing that she needs help. For women it is more difficult to accept that they are addicted.
Women who suffer from this disease are more greatly disadvantaged than men. Esther says that “in the world of drunks, women are frowned upon,” adding that “most men lose no opportunity to take advantage.” She adds mischievously, “That’s why I sought a man equally drunken, like me, because even if he is always falling he defends me.”
She has been with him more than seven years, but he has never managed to overcome it with his stints in rehab or visits to the AA group. She suspects that maybe that is why she has never made it out “of the hole… Every time I get discharged from the hospital I go back to the house and there he is, in the same old thing,” she reflects.
Juan Emilio Sandoval Ferrer, president of the Cuban Society of Psychiatry Addiction Section, found that among the major challenges of the public health system is the prevention of alcoholism through education and promotion of healthy lifestyles in the population.
“There is very little talk about it and much less about the risk for women also,” says this graduate in history who spent more than a decade of her life fighting against the temptation to “tipple.” According to her, “the majority of my women friends take pills, like diazepam, chlordiazepoxide and amitriptyline, but nobody is shocked with that … Now, if I have a drink, everyone calls me a drunk.”
Research suggests that alcohol causes more damage in women who have less body water than men. Thus, the level of saturation or condensation of substances in the body is higher and the toxicity of the substance is faster and more intense. And social rejection makes them take longer to ask for help.
On Sunday, Esther did not go to the Alcoholics Anonymous meeting where her companions in rehabilitation were waiting for her. A few yards from the church where the group meets, in the seedy Silvia bar, her uncontrolled laughter was heard all afternoon.