In the Pacific, chewing betel nut (or areca nut from the areca catechu palm) is a practice restricted up until recent times to a few island nations yet it is estimated that between 10 and 20 per cent of the world's population chews areca nut in some form.
This makes areca nut the fourth most widely used psychoactive substance, after nicotine, ethanol (alcohol) and caffeine.
The immediate effects of chewing areca nut include mild euphoria and a sense of well being; feelings of general arousal and increased alertness, heart rate and blood pressure; palpitations; sweating and facial flushing; and a warm sensation in the body.
My father, used to tell me stories about it in PNG when he was there during the war; how everywhere you looked there was red spray where the nut had been chewed up and spat out as if with a high pressure hose: on the ground, in gutters, on walls, beside rubbish bins.
He told me how the mix of lime and nut would turn the chewer's lips and mouth scarlet. As a child I couldn't see the sense in it. Besides, at that time, I was too far removed from Pacific Island culture to have any real concern.
Now, as a Fiji citizen, and having visited several countries where betel nut is a part of the culture in the same way kava is to Fiji, I am seriously disturbed by the socio-economic and health burden it has for a nation. Betel nut is a viable cash crop in PNG and other chewing countries.
A man happily chews betel nut, which is said to give a mild sense of euphoria and feelings of general arousal
Vendors trading in betel nut are no different to drug dealers except only by its legal status.
There is evidence that people can develop a tolerance for betel nut and those who chew large amounts on a regular basis may become dependent on it and may experience withdrawal symptoms when they stop using it.
I am equally concerned to see not only betel nut being sold in the Suva market but councils choosing to plant areca palms in centre-road garden beds and beside roads.
Granted, they are quick growing and very graceful with beautiful deep dark green foliage but is it a responsible choice when there are so many other varieties as equally attractive with far less potential for encouraging the practice?
I first saw it for myself in Palau. I was met at the airport by staff member of the Palau Conservation Society with whom I had arranged to have a series of meetings. I couldn't help but notice how one of her cheeks bulged as she must have just prepared a betel nut and started chewing it. I could barely understand her when she spoke as this nut, about the size of a small egg, filled one side of her mouth and made talking extremely challenging.
On our drive to the office she told me that in Palau most people 'chew' and I was soon to find this out.
They carried around their necks containers for spitting and a pouch for their mixes -leaves, lime powder and other optional extras such as tobacco, cloves or other spices and flavour and drug enhancers. As she drove and in between chatting to me, she would spit into her tin, not discreetly but boldly and loudly.
It got a lot worse than this. During all the meetings, some attended by senior government officials, everyone chewed and spat. It was like out of a scene from the Mad Hatter's tea party if it wasn't so serious. I wondered if anyone was concerned about )
the dangers of chewing. These were intelligent, environmentally astute individuals
yet there was no evidence of their concern
for the conservation of the human species. At the least, it seemed a bizarre and anti-social practice.
It was in Honiara in Solomon Islands that I was mortified to witness first-hand what chewing betel nut has on the teeth and mouth. It can cause mouth ulcers, gum disease and extreme tooth decay.
To be greeted by a friendly smile where the entire mouthful of teeth were rotted to the roots and looking like dead tree stumps was not only commonplace but for me, highly disturbing.
I wondered just what terrible toothache these chewers must suffer. In fact, they do, as the caustic lime that is mixed to enhance the effect of the nut corrodes all the tooth enamel.
There in the capital I saw many upsetting sights of mouth and throat deformities. Long-term chewing causes oral submucous fibrosis and oral cancers, including squamous cell carcinoma, peptic ulceration and increased risk of cardiovascular disease.
There is the ever increased risk of Fiji becoming a nation of 'chewers' especially with greater inter-island travel and the readiness to share cultural practices.
Adolescents, amongst society's greatest risk-takers are prepared to try different things with little regard for the serious consequences of their actions.
It is important to understand the potential dangers of betel nut chewing in Fiji for the sake of the health and well-being of the population.
If we all can, in our own ways, large or humble, do something toward discouraging this evil practice then Fiji can continue to be known as a nation of happy, smiling and friendly people.
nJulie Sutherland is a regular contributor to The Fiji Times on a range of health and social issues affecting Fiji. She was formerly Advisor Development (Social Sector) with the European Commission, Delegation in the Pacific.
Thursday, October 28, 2010
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