Saturday, 30 July 2016

Chewing “Buai”: Beyond traditional boundaries!

IN Papua New Guinea today, it is normal to offer and accept betelnut without question.
Betel nut is often the first thing given to visitors to your home, friends you meet, or at large gatherings like funeral feasts or weddings ceremonies.
Betelnut was previously only sold in areas where it grows, but since it became a commodity betel nut has found its way into almost all parts of the country.

There are no formal statistics on the number of betel nut chewers in PNG but we can safely predict that among two-thirds of the population chew betelnut regularly. This includes children as young as eight to the elderly.
The betel nut trade has become a major money earner for grassroots Papua New Guineans in the informal sector.
It is no longer a coastal item. Highlanders now trade and chew betel nut. Everyday along the Highlands Highway, truckloads of betel nut make their way from the coastal buying areas of Lae and Madang into the mountains. Highlanders have been known to hire boats and planes for betel nut buying trips to Popondetta, Wewak, Vanimo, Rabaul, Kimbe and Kavieng.

The commercial value of buai is determined by a ‘ready ripe’ nuts – not too soft, not too strong.
A 10kg roots rice bag full of ready ripe nuts commonly referred to as ‘meat buai’ will cost a hundred bucks. The cost of a single nut ranges between 20-50 toea. At times when supply is low, it can go up to K1 or K1.50 per nut.
Transportation and handling costs also increases prices. In Porgera, Enga province, three betelnuts will cost K5. When supply is low – it can go up to K10.

Medical studies show that chewing betelnut causes mouth cancer.
A study done at the Sir Buri Kidu Heath Institute has shown that betel nut chewing can cause a heart attack in ‘some’ individuals.
Another similar study showed that betel nut chewing reduces the blood supply to the heart which may precipice irregular heartbeats which can cause a heart attack or can cause a sudden spasm of the heart blood vessels causing a heart attack.

Betel nut chewing increases the heart rate which can complicate this process. A 70% narrowing of the lumen of the heart blood vessel is enough to cause chest pain.

Betel nut chewing can also precipitate an acute attack of asthma in asthma patients. This is due to the action of betel nut on the smooth muscle of the bronchi (windpipe) probably by the same mechanism which causes smooth muscles of the blood vessels of the heart to go into sudden spasm. Studies on this were also done in Papua New Guinea.

The active chemical in buai is called Arecoline. This chemical is similar in structure to a naturally occurring chemical in the body called Acetylcholine. Arecoline is therefore called a “natural analogue” of Acetlycholine compared to many “synthetic analogues”. This is because there are many drugs and chemicals that also have a similar structure to Acetylecholine.

Acetylcholine has many functions but more importantly one of the main areas in the body where it acts is on smooth muscles. So Arecoline from buai which is similar to Acetylcholine will naturally also have an effect on smooth muscles of blood vessels, windpipe or the bowels. The chemical reaction between betel nut, daka and lime causes an increase in pH, which occurs in the mouth of chewers. This change in pH increases the rate at which Arecoline is absorbed from the mouth straight into the blood stream thus the effects can be immediate (and sometimes fatal).

It was rumoured a few years back that lime producers were mixing fibro (asbestos) with coral to produce lime. Was this rumour actually true? We may never know because no one bothered to do some random sampling of the lime from markets and test them for the presence of asbestos.

Fibro or asbestos is now a well-established carcinogen i.e. asbestos directly causes cancer by damaging DNA. It causes a kind of cancer of the covering of the lung known as mesothelioma.
The mouth is a place where cells are dividing continuously therefore the introduction of a chemical like asbestos will damage DNA there, no questions asked! Can this rumour and the presence of fibro explain a time when the rate of cases of mouth cancer in PNG seemed to increase at an unusually high rate? Fibro or asbestos is now an internationally banned product for housing.

To the Westerner’s eyes, betelnut chewing is a dirty habit as it involves spitting red spittle everywhere.
The notice on the wall – Reminder, betelnut chewing is strictly prohibited – isn’t really ordering you to stop chewing altogether; it is telling you chew your buai elsewhere.

In schools, teachers restrict students from chewing buai. In hospitals, doctors and nurses advise buai is not good for health. In some churches, chewing buai is sin. In some professional code of ethics such as that of PNG Defence Force, chewing buai is prohibited.

For generations the betelnut was part of our traditional way of life, but now the commercializing of it has seen it go beyond its traditional boundaries.

There is a little concern about the health risks, the filth and littering sellers and chewers create so perhaps there should be policy for betel nut in PNG.

NCD Governor Powes Parkop was not wrong to impose the ban of betelnut in Port Moresby. The socio-economic benefits of the sellers and traders can only be enhanced with maturity and respectful behaviors of consumption. Together with the health problems, the betelnut consumption behavior remains the biggest problem for the society. The spitting of the red stains, the throwing of the husks and the overall hygiene of the betelnut chewing in the public places is still a problem.

It meant to be a change in attitudes of chewing and not necessarily to stop the trading and economic benefits. But the attitudes of chewers still a problem – there is a minimal change in attitude and behavior towards consumption of betelnut from 2012 to date.

The "Buai Ban" in Port Moresby still remains a challenge for authorities.
Photo: "Buai" (betelnut). Image credit: Fay Fay/POM 2016.
Source: Peter S. Kinjap / Port Moresby / July 2016.

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