When I went to study in Scotland many years back I was told by those who knew better that Scotland was just like Zambia, and I would find it much to my liking.
They said there were two key similarities between the two countries, David Livingstone and alcohol. I found both statements to be true but not for the reasons given. I found the Scottish people to be a warm and generous people if somewhat opinionated.
The famous African explorer, Dr David Livingstone was also born a trains ride from Glasgow where I went to study. His birth place was the village of Blantyre a few miles east of Glasgow on the famous Scottish river, the river Clyde. In respect to alcohol it had the second highest levels of alcohol consumption in Europe.
Zambia of course has one of the highest levels of alcohol consumptions per capita in Africa.
The pub, the local down the road bar was not just a bar, it was an institution, woven into the fabric of the everyday life. In fact, to not appear occasionally at the local pub, was perceived as an antisocial act. I have also learnt in many cultures that a man is judged by his ability to hold down his drink, and that a man who does not drink alcohol is distrusted.
I went to China a few years back and we sat round a circular Chinese dinner table, where our host the Professor of Urology passed round a clear bottle of an alcoholic beverage.
His Assistant indicated that it would be a sign of disrespect if I did not take a few sips. In fact the mark of a good Professor was the ability to hold down a couple of good fortified drinks of alcohol.
Those who have been in the military have told me, that military trainees must drink alcohol, its part of engendering a spirit of camaraderie.

• Drink driving pauses a threat not only to the person but to the general public as well.

Some modest drinking of alcohol is certainly harmless and some studies have shown it to be healthy. The figures of one to two bottles of four percent alcohol (an ordinary bottle of Mosi) daily are considered safe and some would say even healthy.  However, many drink much more than this.
When you look at the figures of alcohol consumption you will be surprised at the correlation between high levels of alcohol consumption, poverty and disease.
In looking at the subject, I’ll attempt to answer three questions.
How does drinking alcohol cause disease?
What diseases are associated with alcohol ingestion?
Can I drink alcohol and still keep my good health?
How does alcohol causes disease is a loaded question? To unpack it,
I’ll answer another question like it. Does alcohol really cause disease? In other words the person who enjoys his drink is a little skeptical. If I feel good and take a couple of drinks socially surely that cannot be a bad thing.
I can hold my drink and I don’t do harm to anyone else. It’s just a bit of fun at the weekends, just a bit of socialising with friends and reminiscing about years gone by. Well if that’s all it was, it would be ok.
However alcohol, whose active ingredient is ethyl alcohol, puts a heavy strain on the body organs and systems.
When it is ingested, the liver makes frantic efforts to break it down into less harmful products. Like acetaldehydes. The liver cells become so preoccupied with this, that they allow their normal work to suffer.
This leads to accumulation of fat in the liver. A condition called fatty liver. The defence cells  in the liver sense a threat and begin to produce chemicals to defend the liver this leads to damage to  the liver cells(alcoholic hepatitis), as the cells get progressively more damaged they become fewer in number and scarring of the liver begins to occur, a condition called liver cirrhosis.
When the liver scars in this way, it is no longer able to acts as a filter to all other dangerous chemicals that can enter the body system through the gut.
So, all hell breaks loose. The liver becomes porous and the body exposed.
One of the main targets of alcohol is the brain. The deceptiveness of it is that alcohol makes one feel exhilarated. From this feeling a mistaken impression is created that the brain is working at peak performance.
In fact the opposite is true. Alcohol suppresses the nerve responses in the body. This initially manifests as disinhibition, failure to regulate emotion, feelings and movements.
The alcohol interferes with the brain signals, slowing down the chemical neurotransmitters that carry these messages from one nerve to the next.
With increasing levels of alcohol, there is a failure of speech, balance, computation and even reasoning. Over a prolonged period the brain will shrink and there is loss of memory and intellect.
Alcohol affects other organs as well, on the heart muscle it cause floppiness and irregularities of the heart rhythm. Alcohol damages the cells of the gut making absorption of food difficult.
The break down products of alcohol directly damages the pancreas, a gland in the back of the abdomen responsible for control of sugar in the body.
Now sugar is the main currency of the body. What the kwacha is to the economy of Zambia, sugar is to the health of the body.
When alcohol damages the pancreas, it severely damages the normal working of
the body and puts the body at severe risk of disease including Sugar disease or Diabetes.
Alcohol will damage the blood cells in the body, reduce immunity, interferes with fertility, damages the skin and increases the risk of cancer. Pregnant women are also at risk of giving birth to deformed children.
What diseases are associated with alcohol? A friend of mine follows this question, with the cheeky comment. Which diseases are not? In other words you will be hard pressed to find any body system that is unaffected by alcohol.
There are 60 diseases directly caused by alcohol and up to 200 Diseases in which alcohol is implicated. Up to 4 per cent of deaths worldwide are attributed to alcohol. This is
greater than the deaths caused by HIV/AIDS, TB and violence.
It is the main risk factor for death of men between 19 to 59years of age. Globally 6.2 per cent of deaths among men are related to alcohol.
In Zambia, up to 68 per cent of Mental illness is related to alcohol and drug abuse. It is well known that people who abstain from alcohol increase their life expectancy by a further 30years.
The main diseases caused by alcohol can be grouped into four categories; Alcohol disorder Organ specific diseases Cancers
Injuries
There is common confusion between the terms alcohol abuse, alcoholism and alcohol dependence.
The first thing to say is that these conditions are the direct effect of an excessive use of alcohol.
Alcohol abuse is a term used to indicate a general pattern of drinking which is likely to result in both health and social effects. This is the guy in the corner office who
is generally okay, but will frequently engage in heavy bouts of weekend or binge drinking, during social events.
Those episodes render him socially inept for a day or so.
Alcoholism or alcohol dependence is one step further. This is the block who drinks at every opportunity he gets.
He is unable to function socially and intellectually without a minimum level of alcohol in his system.
He or She will usually have tremors (shakes) if they have not taken some alcohol.
They will also have alcohol stashed in their office, house, car and always in close proximity. They will try their best to hide this behaviour from those close to them.
So beware of the person who is very sensitive about being criticised for their drinking habits.
The organs of the body most frequently damaged by alcohol are the Brain, the Heart, the Liver, the pancreas and pregnancy.  In the brain mental illness including depression, fits (Epileptic seizures) and strokes are associated with Alcohol intake.
In the heart, floppy muscles (cardiomyopathies), abnormalities of the heart beat (arrhythmias) and high blood pressure (hypertension) are also associated with alcohol.
In the liver, the condition discussed earlier of Liver Cirrhosis and Cancer of the Liver has a common association.
In the pancreas, pancreatic damage (Acute or chronic Pancreatitis) and subsequently Diabetes is a risk from chronic drinking.
In pregnant women, alcohol crosses the placental barrier leading to abnormalities in the development of the brain of the growing child, a condition called fetal alcohol syndrome.
There are six cancers in which alcohol is a risk factor, these in order of the size of the risk, are  Cancer of the food pipe(Oesophagus),Cancer of the Liver, Cancer of the Mouth and Throat, Cancer of the Breast and Cancer of the Bowels.
In Africans, in particular the drinking of illicit brews, prepared in rusted pots increases particularly the risk of Cancer of the Oesophagus.
In relation to injuries, alcohol has been related to suicide and Road Traffic Accidents.
In Zambia Road Traffic Accident has been shown by the Ministry of health as one of the four leading causes of disease in Zambia.
Studies have shown that over 30% of drivers involved in accidents have alcohol levels above the normal limit of  80mg /ml.
Alcohol intake is one of the risk factors for getting infected with HIV. It increases high risk behaviour such as unprotected sex, sex with multiple partners and sex with high risk populations.
In particular married women and teenagers have been shown to be at high risk after alcohol ingestion.
How can I be healthy but still drink alcohol?
That is really the question at the back of every bodies mind. Let’s face it everybody wants to have a good time but still live a long and healthy life.
There is no fun in being healthy if you are not going to have a little bit of fun while you are at it.
This type of thinking though some may call it reckless is fairly prevalent. In Zambia, a reasonable proportion of people are teetotallers. Up to 45% of men in Zambia have never taken alcohol and the figure is higher for women.
There is evidence of a decline in per capita intake of alcohol in Zambia.
In the 1960s it was at eight litres per person, this has reduced somewhat to five litres per person.
So if you can, the best advice is stop drinking alcohol altogether. However, if you cannot, then drink alcohol moderately. What is moderate drinking? If you drink less than one bottle of beer a day, you are a moderate or social drinker.
There are certain patterns of drinking that increase the health risk, these can be grouped as follows;
1.Heavy drinking
2.Drinking illicit brews
3.Binge drinking
4.Adolescent drinking
5.Drink Driving
6.Drinking of pregnant women
Theses forms of drinking result in increased risk of the diseases discussed earlier ,because either of the volumes, the types of alcohol or the vulnerability of the drinker or the drinkers status(pregnancy).
So what is heavy drinking? This is defined as exceeding the standard levels of safe drinking.
So for men it is taking 15 bottles in a week and for women more than eight bottles per week.
The biggest risk in Zambia is what is called Heavy Episodic Drinking (HED) or more simply binge drinking.
This is when in one single episode an individual drinks so much alcohol, as to raise the blood alcohol levels beyond the legal limit of  80mg/ml.
This occurs when 4-5 drinks are taken quickly within a period of two hours.
It is this form of drinking which has brought notoriety to Zambia and was recently reported by the WHO, and was the subject of a Washington Post article.
This is what has come to be known as the kitchen party syndrome. Women who attend a social function for the explicit purpose of binge drinking.
This form of drink is most dangerous to health. The more worrying trend has been the finding of teenage drinking.  In a Global School Health Survey it was shown that among school going children in Zambia aged between 13 to 15 years, a high proportion of boys drink alcohol (38 per cent), and an even higher proportion of girls (45 per cent).
This is a risk not only because it is illegal, but because it exposes the body organs to alcohol for a longer period of time and increases the risk of disease.
Drinking of illicit brews is dangerous, not only because of the contaminants (the brew is prepared in sometimes rusty pots) but also because of the undetermined levels of alcohol.
Some of the brews such as Kachasu, the local distilled brew may contain alcohol levels as high as 45 per cent. Drink driving pauses a threat not only to the person but to the general public as well. In the case of pregnant women, their developing baby is put at risk.
Conclusion
Alcohol is a major threat to health. Its primary target is the brain and the liver. Damage of these organs causes a severe deterioration to
life.
Zambia is notorious as one of the highest alcohol consuming countries in the World.
This is compounded by some of the worst patterns of drinking such as binge drinking, teenage drinking, drink driving, the drinking of illicit brews and day time drinking.
The female binge drinking in Zambia at 41 per cent is one of the highest in the world. Day time drinking among minibus drivers, truck driver and long distance drivers have made Zambia as one of the highest country recording road traffic accidents in the world.
The little secret to your good health and mine in relation to alcohol is to abstain. However, if we cannot, we should drink moderately in
social circumstances only.
If we do this, we can safeguard ourselves from 200 types of disease and have a long and healthy life.