07/29/2015, 00.00
MYANMAR
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Mouth cancer-causing betel use sets off alarm bells in Myanmar

The international medical community warns of the side effects of this stimulant. Although it is traditionally used to suppress hunger, it can cause cancer to the mouth, which accounts for a fifth of all of cancer cases.

Yangon (AsiaNews/Agencies) – In addition to creating addiction, betel causes a long list of serious health problems, including mouth and throat cancer, and deeply stained gums and weakened teeth, this according to international health experts.

The small parcels of tobacco, areca nuts, slaked lime and optional spices, wrapped in the vivid green leaves of the betel plant are ubiquitous in Myanmar and Southeast Asia.  Users of betel (aka quid or kun ja) sing its praises as a pick-me-up that increases alertness, boosts energy, freshens the breath, and suppresses hunger.

Sellers can make a good living from it, up to US$ 40 a day, this in a country where the average wage in 2012 was less than 0 a month.

“Myanmar has one of the highest (number of) users of smokeless tobacco globally, especially among males,” Dr Dhirendra Narain Sinha, a specialist at the World Health Organisation (WHO) said.

His research found that just over half of Myanmar’s men use the substance. Among women, 16 per cent use it.

For Dr Sinha, those who chew betel quids without tobacco have a 250 per cent greater chance of developing oral and oropharyngeal cancer than non-users. For those who chew tobacco as well the risk jumps 770 per cent.

Both tobacco and areca nut are known carcinogens, with mouth-related cancers accounting for a fifth of all of Myanmar’s cases of the illness. However, doctors say the message to stop chewing is not getting through.

“People do not know what are the side effects or the health effects of eating betel quids in Myanmar,” warns Dr Than Sein, member of a local advocacy group, the People’s Health Foundation (PHF).

According to the latest WHO figures, Myanmar spends the lowest proportion of its GDP on healthcare in the world -- just 0.5 per cent in 2013. By comparison, the country’s military budget accounted for 4.3 per cent of GDP in 2014.

Helping Myanmar kick the habit will not be easy. Betel chewing is a deeply rooted cultural practice throughout south and south-east Asia, thought to date back several centuries.

Yet, Dr Than Sein says he takes inspiration from neighbouring countries. “If you go to Thailand, you will not see much of the people eating betel quid anymore, even in the rural areas. If you go to Malaysia, the same way. So why do our people still keep the tradition?” he asks.

The PHF has produced leaflets and posters aiming to get its message across, and wants warnings placed at betel kiosks. The Health Ministry says it is studying the proposal.

“I’m so sleepy when I start driving the taxi,” Myo Min Htaike, taxi driver in Yangon said. ”So I eat kun ja to help me stay awake.”

Sitting behind the wheel of his taxi, the 32-year-old man says he is more than aware of the health risks, but after 12 years sees no prospect of quitting.

“I’m afraid (of suffering health problems),” he admits. “But I can’t live without it.”

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