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December 2003 - January 2004


Good Health & Nut Chewing Don't Mix

by Kumudini D. Valambhia

Through the medium of this popular and influential newspaper, read at the highest intellectual level, I would like to make a heartfelt plea and profound request to the members of our Asian community, about the danger of using areca nuts, also known as betel nuts (sopari) a fruit of a tropical Asian palm tree, yielding astringent nuts which are widely grown and eaten in Asia and is supposed to be an after dinner digestion aid which also hides the strong smell of garlic and onion.

Apparently this custom, the usage is wide spread, especially among the the older people, mainly ladies who acquired this unsavory habit while residing in East Africa or the Indian subcontinent but the most worrying and distressing trend is that some 15% of our youngsters, schoolchildren are acquiring this habit, what I would like to call a filthy habit, from their grandparents and by the time thay are adults, they will be completely addicted to this habit of nut-chewing, so often with tobacco and chuno or calcium added to the mixture to give it a bite, an added thrill, which makes it even more harmful than pure nut chewing..

The most dangerous nuts are those which are shredded, coloured, perfumed and sweetened, to hide the pungent smell and the bitter taste of the nuts which have gone rotten, passed sell by date and are most harmful to our health, as they contain harmful bacteria.

Recently I had the misfortune to endure one of the most horrifying tragedy, the death of the mothers of two of our best friends. As a practicing nurse of some twenty years, now retired, I have witnessed such tragedies, such deaths on almost weekly basis but when it happens to your own friends and families, it takes on a different perception, a personal persecution.

No amount of nursing training that we receive while qualifying, learning how to remain detached, not to get involved on personal basis with the patients and how to manage, to deal with emotions that such deaths, such tragedies generate, can help or be of any consolation to you when you see some one near and dear to you, involved in your every day life, die of such inscrutable pain, unimaginable suffering that can only be managed by taking a massive dose of morphine to dull the senses and make pain managable. If any thing, these are the cases which may justify euthanasia or mercy killing.
I have the utmost respect for those Health Visitor, the nurses who provide home visits to nurse, to clean and change bandages, often needing nappies rather than bandages, as wounds are so severe. I am sure most of your readers would not take up this noble profession for all the money in the world, yet our nurses are one of the lowest paid professionals in Europe. Who says we live in a civilized, caring, sharing society when some of our top lawyers, footballers, models and tax specialists earn as much as ten to twenty thousand pounds a day, the same as a nurse would earn in a year? No wonder social order is breaking down and prisons are full to the brim in the Western world, particularly in this country.
The nut-chewing, especially with edible tobacco and when it is kept in the mouth for a very long time, some times twelve hours a day, is strongly linked to mouth cancer and the development of the precancerous condition of the oral passage known as oral submucousfibrosis. The recent medical research has also reveled that tobacco nut-chewing may also be associated with the disorder of the digestive system, heart disease and diabetes.
One most horrific aspect of this disease is that it starts very gradually, thus it is rarely diagnosed in it's infant stage. Some times it starts with just a minor irritation of the tongue and a loss of voice. As the disease progresses, the swelling of various glands, such as salivary, thyroid and pituitary glands, oesophagus, larynx and the swelling of the tongue may develop, depending on the type and severity of the cancer.
The disease may take years to develop and one of the person I refer in thus article, had it for 14 years before she finally gave up the struggle, the will to live. The final two years were a torture for the whole family and it would be impossible for a person of a nervous disposition, some one who may be proned to panic attack, to watch the patient lose the fight. It is not the sight for the faint-hearted person.
The skin, the muscle and the tissue start dropping off, exposing the oesophagus and the larynx. The liquid food intake is through a pipe inserted direct into the stomach. It is more like watching a horror movie than a reality. The death, when it comes, is a relief, not only to the patient but to family members as well. I would not wish such a death on my worst enemy.
I apologise for writing this piece in such gruesome detail which may offend some readers but if it brings some awareness in our society and save lives, I consider it worth the effort, worth the pain and the suffering of the grieving family who had to endure such a tragedy.
A charity has been set up for clinical research, as there is a lack of public awareness about the consequences of areca nut chewing on a daily basis and for a long time.I would also like to thank the relatives who encouraged me to write this piece and gave me some of the information that I have included here and who are taking part in the research programme.

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