Betel nut chewing has ripple effects

Letters

DURING the state of emergency (SOE), not one person has died of the coronavirus, as far as we know.
The government has spent hundreds of millions of Kina fighting an invisible deadly enemy.
This is necessary and should continue so as to prevent unnecessary suffering, death and the pain and misery the loss of a family member brings.
When the SOE was imposed, it was declared to be illegal to sell betel nut, claimed by some to be the most widely used addictive drug in PNG.
This addressed the assumption that chewing betel nut and spitting may pose a health risk by contributing to the spread the Covid-19.
However, the sale and chewing of betel nut continued during the SOE, regardless of efforts by the Government.
When the SOE is over, people will continue to sell and chew betel nut and will continue to die from mouth cancers and other associated health problems caused by chewing the nut. Or will they?
The World Health Organisation has classified betel nut as a carcinogen, the chewing of which has been linked to cancer of the mouth and oesophagus, oral submucous fibrosis and tooth decay.
Mouth cancer is among the top three cancers in PNG, the other two being breast and cervical cancers.
Betel nut is also linked with diabetes and heart disease.
Unlike the Covid-19, betel nut is not an invisible killer.
It is right in our face.
It is a health and hygiene issue that is hardly ever seriously addressed by the nation.
NCD has made some inroads into regulating the sale of it but that is more to do with the cosmetics of Port Moresby.
Numerous workplaces forbid chewing betel nut during work time and many have had their employment terminated for ignoring this prohibition.
The cost to the health system of treating betel nut related conditions may or may not be known, but imagine how finance and resources could be better utilised on other health issues, rather than on preventable illnesses associated with betel nut.
The environment also pays a price for the practice of chewing betel nut.
Coral is harvested and burnt for the extraction of lime.
Reefs and breeding habitats for fish and other marine life are destroyed, resulting in reduced availability of a healthy source of protein.
Clearly good health and hygiene are highly valued by the people of PNG.
This is occasionally expressed when concerns are raised about the health and hygiene standards of food bars.
However, these same concerns about good health and hygiene associated with chewing betel nut are rarely addressed, well-known as they are.
Many argue that chewing betel nut is part of PNG culture, originally used mainly for ceremony and hospitality.
However, today in 2020, the frequency of its use has gone way beyond the original cultural intent, now being chewed by some almost all day every day.
As part of the culture of PNG, betel nut promotes a spirit of generosity and sharing.
People willingly and happily share what they have with each other, including the stranger.
When people ask another for daka (mustard) or kambang (lime) it is given joyfully and without question.
It connects people.
There’s a lot to be said for that.
Sadly though, the very practice the culture chooses to express this life-giving spirit of sharing, generosity and hospitality is the very thing which brings about suffering, death and misery.
Is there another way to express this beautiful spirit of sharing, generosity and hospitality, a way that has no negative impact on the health and lives of people and the environment?
Concern has rightly been expressed during the SOE about the loss of income to the mamas (mothers) who sell betel nut.
This is a very real concern.
The mamas really do need that money to feed their family, pay school fees, etc.
This give rise to the challenge to think differently about how mamas can be supported to earn an income in a different way that is not life threatening to family members, damaging to the environment and wasteful of the very limited resources of the health system?
When the SOE was declared, markets were closed to stop the possible spread of an invisible killer.
The effects of chewing betel nut are not invisible.
When the SOE is over and the markets open again, will the much talked about “new norm” have any impact on the sale and use of betel nut?
Will people go back to doing what they always did saying its part of the culture and so that the mamas can make some money?
Or will people face the challenge of this very visible killer and make a positive change?
Is culture so strong that chewing betel nut is valued more highly than the lives of the people we love and the environment that we depend upon to sustain healthy lives?

Bernard White,
Kokopo