Abstract
Ethnographers frequently allude to alcoholism and related harms in Indigenous hunter-gatherer communities, but very few studies have quantified patterns of alcohol consumption or its health and social impacts. We present a case study of the Mbendjele BaYaka, a Congolese population undergoing socioeconomic transition. 83 adults answered questions about their frequency and quantity of alcohol consumption, underwent biometric measurements and reported whether they were currently experiencing a cough or diarrhoea; 56 participated in structured interviews about their experiences with alcohol. Based on WHO standards, we found 44.3% of the full sample, and 51.5% of drinkers (excluding abstainers), had a hazardous volume of alcohol consumption; and 35.1% of the full sample, and 40.9% of drinkers, engaged in heavy episodic drinking; consumption habits varied with sex and age. Total weekly consumption was a positive predictor of blood pressure and the likelihood of experiencing diarrhoea; associations with other biometric variables were not statistically significant. Interview responses indicated numerous other economic, mental and physical health harms of alcohol use, the prevalence of which demonstrate some variability between forest camps and permanent village settlements. These include high rates of drinking during pregnancy and breastfeeding (~40%); frequent alcohol-induced violence; and considerable exchange of foraged foods and engagement in exploitative labour activities to acquire alcohol or repay associated debts. Our findings demonstrate the prevalence of hazardous alcohol consumption among transitioning hunter-gatherers is higher than other segments of the Congolese population and indicate negative impacts on health and wellbeing, highlighting an urgent need for targeted public health interventions.
Highlights
Drinking alcohol is associated with pleasure and relaxation worldwide, and many people consume alcohol without experiencing major adverse effects
Problems associated with alcohol use have been identified as a major health risk facing Indigenous communities worldwide [1]
In each of these populations, researchers have suggested that high levels of alcohol consumption have contributed to a deterioration of physical health [6, 7]; social problems of increased violence, domestic abuse, delinquency and rape [2, 8]; and economic difficulties stemming from engagement in exploitative labour activities to purchase alcohol, or in some cases, be paid in alcohol directly [8,9,10]
Summary
Drinking alcohol is associated with pleasure and relaxation worldwide, and many people consume alcohol without experiencing major adverse effects. Ethnographers and other researchers have alluded to the pervasiveness of alcoholism in numerous traditionally hunting and gathering African societies, including the Kalahari San as well as Central African “Pygmy” populations such as the Baka from Cameroon and the Twa of Rwanda and Burundi [2,3,4,5] In each of these populations, researchers have suggested that high levels of alcohol consumption have contributed to a deterioration of physical health [6, 7]; social problems of increased violence, domestic abuse, delinquency and rape [2, 8]; and economic difficulties stemming from engagement in exploitative labour activities to purchase alcohol, or in some cases, be paid in alcohol directly [8,9,10]. These reports usually assert that such alcohol-related problems are principally a consequence of the social, political and economic marginalisation that is concomitant with socioeconomic transition and sedenterisation [11]
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