Not long ago, Vincent Njarekaden was driving on the back roads of Irinjalakuda. The rural district lies in the central Indian state of Kerala about 40 miles northwest of the port city of Cochin. Mr. Njarekaden is the camp coordinator of Navachaithanya, a drug and alcohol rehabilitation center established in 1991 by the Syro-Malabar Catholic Eparchy of Irinjalakuda.

As he passed a toddy shop, Kerala’s version of the neighborhood bar, Mr. Njarekaden recognized a former patient, Antu, walking in its direction. Mr. Njarekaden pulled over and summoned Antu to the jeep. “Where are you going?” Mr. Njarekaden asked. The former patient gestured toward the toddy shop.

Economists often cite Kerala as a model of human development in India. The state has achieved a literacy rate, standard of health and women’s empowerment to a greater degree than the country at large.

But there is a dark side to this progress: Unemployment in Kerala stands at about 35 percent, the worst rate of any state in India, according to India’s Labor Ministry. Kerala’s crime rate nearly doubles the national rate, according to the Ministry of Home Affairs. A conference on suicide prevention, held in the state capital of Trivandrum in 2004, reported that there are more reported suicides in Kerala than in any other state.

But alcoholism is perhaps the state’s worst social malady.

“When there is high unemployment, it is not uncommon for many people to turn to alcohol,” said Dr. M. Prasanna Kumar, a health consultant in Trivandrum.

Kerala has the highest consumption of alcohol per capita in the country (about 20 percent of Indians drink alcohol, and of that number 5 percent are alcoholics, reported The Hindustan Times last year). Each year, the state consumes 2.2 gallons of liquor per capita, about three times the national rate, according to India’s Outlook magazine.

“In Kerala, people tend to start drinking once they are 18 years old, which is the legal age for being able to purchase liquor,” said Father Titus Kattuparambil, a Syro-Malabar priest of the Eparchy of Irinjalakuda and assistant director of Navachaithanya.

“Among the bad cases, you’ll see people who earn about three dollars a day, and they’ll blow two dollars of that on alcohol.”

Both national and local governments have acknowledged the problem of alcoholism, and alcohol advertising is illegal. Kerala’s state government also funds several detoxification centers at public hospitals. But at the same time, Father Titus pointed out, the government in Kerala – as in other Indian states – draws revenue from liquor taxes and therefore has a fiscal disincentive to curb alcohol consumption.

Nonetheless, in 1996 the state government banned the consumption of arrack, a potent liquor made from fermented palm sap (and not to be confused with the arak liquor of the Arab world). The government thought the ban on arrack, which is much stronger than toddy, would help curb alcoholism. The prohibition, however, only encouraged illegal traffic and production. Hundreds of Keralites have been killed or blinded from drinking bad batches of home-brewed arrack. And alcohol consumption continues to rise.

It has largely been left to religious organizations and NGOs to treat Kerala’s alcoholics.

“Alcohol has always been a problem here, it’s not just recently,” said Syro-Malabar Bishop James Pazhayattil of the Eparchy of Irinjalakuda. “Several years ago, people approached me about the problem in our community and we started Navachaithanya.” Since then, the center has treated more than 8,000 men for alcoholism or drug addiction, though alcohol is by far the area’s larger problem.

Nearly every village has a toddy shop. They dot the rural byways like rest stops. The shops, typically dark wooden shacks, have good, cheap curries. But they are better known for their toddy, a pungent liquor made from coconut trees. Inside the shops, men – and only men – can be found sipping tall bottles after a day in the fields. Conversation is muted. The men drink purposefully. They are there to get drunk.

Six months ago, Antu attended a month-long detoxification camp at Navachaithanya. He had been sober for five months, he said, but had started drinking a month ago.

Antu recounted his story matter-of-factly; he did not seem ashamed of being caught by the camp administrator. He had spent the whole day climbing coconut trees, collecting fruit. And now he wanted a drink. Antu said he would probably drink four liter-bottles of toddy – which all told will cost him about two dollars, or half of his day’s pay – and then go home and pass out. He claimed he would not be hung over the following day when he woke up to climb more coconut trees. Scolded but undeterred, Antu resumed his walk toward the toddy shop.

Each month, about 50 men arrive at the center for the detoxification and rehabilitation camp. Most men come of their own will, Father Titus said. Others are referred by their families, employers or local police.

The Navachaithanya compound is up a slight hill, off the main road in the town of Aloor, and includes a seminary and a convent as well as the detoxification center. The accommodations are ascetic. During their stay the men sleep in bunks with thin mattresses, in crowded rooms where the heat can be stifling. There is no air-conditioning and little shade to be found in the central courtyard.

The campers receive medical treatment at a nearby clinic. Dr. V. J. Paul, who runs the clinic, treats campers with a combination of the classic Western detoxification cocktail – such as thiamin hydrochloride and sodium valproate – and local herbs and oils common to the local practice of Ayuvedic medicine. (Dr. Paul employs a different regimen to treat smokers.) Ayuvedic medicine, a holistic system of healing that originated in India some 3,000 to 5,000 years ago, remains popular throughout India. Shops containing herbal and other plant extracts are more common than modern pharmacies.

Throughout the day, campers participate in discussions and exercise groups as well as prayer sessions. Most of the campers are Christians, but Hindus and Muslims also take part and are not compelled to join in the Catholic services.

“I have no problems being here,” said Razia, a 25-year-old Muslim camper who is trying to quit smoking. “My father told me about this place and sent me here. I’ve been here for three days, and I’ve never been made to feel uncomfortable for being Muslim.”

At the same discussion group, Vijaya Kumar, a 53-year-old Hindu civil servant, shared his experiences. Like many, he began drinking in college. But he did not start drinking heavily until his first marriage collapsed. He remarried, but said he could not understand his new wife. “We didn’t have a good relationship and I was bitter at the situation so I began drinking heavily,” Mr. Kumar said.

In October 2004, he went to Dr. Paul’s clinic for treatment and stopped drinking. But then the tsunami came. “I work in the fisheries department,” Mr. Kumar said. “I was on the river that Sunday and saw the water rise. All week, we were busy with the relief work. So many lives and fishing vessels were lost. “I started drinking again, and I started to hear music that was not really there,” Mr. Kumar said. “I directly came back to the clinic, because I realized drinking was not a solution to my problems.”

The extraordinary tragedy of the tsunami aside, recidivism is a problem for alcoholics under any circumstances. Of those who complete Navachaithanya’s detoxification program, 60 percent relapse, Father Titus said.

This is why program directors encourage graduates to join support groups. There are about 40 such groups, supported by Navachaithanya, throughout Kerala. Both priests and members refer to the groups as “Alcoholics Anonymous” groups, borrowing the name of the program that was founded in the United States in 1935 and has had millions of members. But there is no affiliation, and in Kerala the name is a misnomer. For one, there is no anonymity in the group meetings. Everyone knows each other.

At one recent meeting, recovering alcoholics brought their families with them. About 100 people crammed into a small room, the men on one side and their families on the other. All joined in to sing several hymns before the discussion started. From their stories, it was apparent that the main victims of the men’s alcoholism were their wives.

“I never expected to marry a drunk,” said Thankamma, whose husband, Francis, 55, began drinking when he was 22 and recently completed the detoxification program. Like most marriages in Kerala, Thankamma’s was arranged. It is not unusual, in the interests of getting their children married, for parents to hide their children’s foibles.

When he was drunk, Francis sometimes would abuse himself, occasionally dipping his hand in boiling water, Thankamma said. But more often he would beat his wife.

“There was nothing I could do,” she said. She could have petitioned the police, but they would not have intervened in a domestic dispute. Divorce, while increasing in Kerala, is still taboo, particularly in the Christian community.

At another meeting, Ammini, 53, talked about the trials of her long marriage to Joseph, who three years ago was treated for alcoholism. (He has since relapsed.)

“The day we got married was the only day he did not drink,” Ammini said to the laughter of other members and their wives, who nodded in empathy. “And when he drinks he is an animal. When he does not, he is an angel.”

At several meetings, I asked for a show of hands from the women. How many of them had been beaten by their husbands? Invariably, almost every woman raised her hand.

“That’s the problem of all this drinking,” Father Titus said. “The alcoholics beat their wives and children.”

No doubt, alcoholism contributes to spousal and child abuse in India, just as everywhere else. But the problem is more fundamental. Sober husbands beat their wives too, and to a greater degree in India than in the West, where women’s rights are better protected and abusers are more apt to be punished.

Having conquered their addictions, the men are less likely to beat their wives or otherwise create trouble, Father Titus said. They are less likely to blow what little money they earn.

“Generally, there is not much done about alcoholism in Kerala – not by NGOs, not by the government,” Father Titus said.

“But it’s a huge problem and contributes to other problems like violence and suicide. It’s an area where the church can step in and fill the void, and that’s what we’re trying to do.”

Paul Wachter is Assistant Editor of ONE.