Taiwan’s battle with betel nut addiction

Above, a man eats betel nuts in Nantou City of central Taiwan. The chance of a betel nut user developing oral cancer is 28 times the average person, according to the Taiwanese health ministry. (AFP)
Updated 05 October 2017
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Taiwan’s battle with betel nut addiction

NANTOU CITY, Taiwan: For years Huang Sheng-yi helped feed Taiwan’s addiction to the betel nut, planting thousands of the trees on his mountainous farm.
Today he has felled most of them, incentivized by the government to grow something else, as part of its push to reduce availability of the nut, which is a stimulant and also a known carcinogen linked to oral cancer.
But the green nut, which is often wrapped in a betel leaf spread with slaked lime to enhance the stimulative effect, is still ubiquitously available at roadside kiosks across the island and chewed by millions daily.
The chance of a betel nut user developing oral cancer is 28 times the average person, according to the health ministry.
“Simply promoting the health risks is not enough. Betel nut chewing is too deeply ingrained in society,” says Chuang Li-chen, project manager at Sunshine Social Welfare Foundation, an NGO that offers rehabilitation services for oral cancer survivors.
Since a 2003 study confirmed betel nut as a carcinogen there has been a gradual decline in popularity, although around two million people still chew the nut, according to government figures.
The nut, which stains users’ teeth blood red, remains popular among the working class, particularly men, who rely on its stimulant properties to better cope with long hours of manual labor.
The government is attempting to reduce the amount of betel nut available as part of its plan to tackle the issue. It subsidizes farmers as much as Tw$250,000 ($8,315) per hectare if they convert to other crops.
Huang now grows oil-seed camellia which produces an edible extract often likened to olive oil at his farm in Lugu town in the central county of Nantou.
However, the 57-year-old says many are still hesitant to make the leap.
It will be more than two years before he can harvest the oil-seed camellia, he says, and he is only able to stay afloat because he has another tea-growing business.
“Farmers are reluctant because managing a new crop is much harder,” he told AFP.
“There needs to be even greater guidance and incentives to really make a difference.”
Authorities concede the program has not yet made a significant dent since it started in 2014.
Of the 42,940 hectares of betel plantations on the island, only 435 have changed crops under the initiative, although more may have done so without government assistance.
But Su Mao-hsiang, deputy director of Taiwan’s agriculture and food agency says applications have risen this year off the back of government offers of more support.
“We hope more farmers can participate in the conversion,” he told AFP.
Betel nut has been part of Taiwan’s aboriginal culture for thousands of years, used in ceremonies and rituals.
At the height of its popularity it was known as “green gold” because it was such a lucrative crop — second only to rice in value — and many had come to rely on it for their livelihood.
Its skinny palms still pervade parts of the rural landscape and flashing signs at roadside kiosks flag down drivers, although they are lower key than in the past.
Young women in skimpy outfits — known as “betel nut beauties” — often used to staff the stands are less common now after the government crackdown.

Despite the various measures to curb production and use, campaigners say there is still too little awareness of the damage betel nut can cause.
Former addict Chen Yung-an wishes he had believed his doctor when told he had early signs of oral cancer two decades ago.
“I didn’t think it was possible. Other people chewed it for years and nothing happened to them,” said Chen, now 53, who had a tumor removed three years ago, taking out a chunk of his right jaw.
Chen went through 200 a day at the peak of his habit, saying it served as a social lubricant among co-workers.
“In the rural areas betel nut is like fruit. We didn’t have the concept that it was bad for us,” he told AFP.
“It felt uncomfortable whenever my mouth wasn’t moving. While driving back I would buy Tw$200 to eat on the car.”
“My mouth would only rest when I was sleeping,” he explained.
Today he is limited to eating soft and bite-sized foods to avoid choking and has not worked since the disfiguring surgery.
“Of course it’s hard to find a job now. I would have to face the looks people give me,” he told AFP.
The disease can take 10 to 20 years to develop, which means many people do not seek treatment until it is too late, said Chuang.
Only about half of the population is aware of the fact that the betel nut directly induces cancer, even without any other additives, she adds.
“We’ve let the betel nut industry develop for decades. We can’t just ignore the livelihoods of these growers and vendors,” said Chuang.
It needs more coordination between education, agricultural and economic departments, she says.
“We need a comprehensive approach to effectively tackle this problem at its roots.”


Gaza student evacuated to UK with her family after government climbdown

Updated 9 sec ago
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Gaza student evacuated to UK with her family after government climbdown

  • Manar Al-Houbi was initially denied permission to bring her husband and children after changes to UK rules on foreign scholarship recipients
  • Several students still stranded in Gaza as relocation deadline looms, after refusing to abandon family members

LONDON: A student from Gaza granted permission to live and study in the UK has been evacuated from the Palestinian territory, with her family, by the British government.

Manar Al-Houbi won a full scholarship to study for a doctorate at the University of Glasgow. It also allowed her to bring her husband and children with her, and they applied for the required visas. But shortly before her studies were due to start, UK authorities told her the rules for international students and their dependents had changed and her family could no longer accompany her.

Shortly after her story was reported in October, however, the government backed down as said it would consider evacuation of international students’ dependents on a “case-by-case basis.”

Al-Houbi and her family are now in Jordan, on their way to the UK, The Guardian newspaper reported on Friday. The British scheme for the evacuation of students from Gaza is due to expire on Dec. 31. People who have attempted to use it have described it as being riddled with issues, as a result of which some students with scholarships have been left stranded in the Palestinian territory.

Several told the Guardian they had decided not to travel to the UK because they had felt pressured into leaving loved ones behind, including children.

Wahhaj Mohammed, 32, said he was told by the Foreign, Commonwealth and Development Office to travel to the UK alone, and his wife and children would be allowed to join him later. Two months after he arrived in Glasgow, his family are still in Gaza with no time frame for them to follow him.

“The uncertainty affects every aspect of my life here,” he told The Guardian. “It’s difficult to settle, to feel present or to engage academically when the people you love most remain living under constant threat.”

The Guardian said UK officials were “hopeful” his family would be evacuated in 2026 but could offer no guarantee about when this might happen.

Another student, Amany Shaher, said she refused to leave her family behind in Gaza and as a result was denied permission to travel to the UK this week. She does not know whether she will be permitted to defer her scholarship to study at the University of Bristol.

The 34-year-old, who has three children, said: “How can I even consider leaving my children behind in Gaza? Nowhere else in the world would a mother be expected to part so easily from her children. It’s dehumanizing. We have a right to stick together as a family and not be forced to separate — that should not be too much to ask.

“None of us know if the UK’s student evacuation scheme will be extended or not. We haven’t been given any clear guidance or timelines and have no idea what 2026 will bring.”

Mohammed Aldalou also refused to leave behind his family, including his 5-year-old autistic and non-verbal son, to take up a scholarship for postgraduate studies at the London School of Economics.

He said the Foreign Office had suggested to him he travel separately from them, as they did with Mohammed.

“They should ask themselves what they would do if they were in my shoes,” he said. “It’s heartbreaking that after everything we’ve been through, we’re being asked to make this impossible decision.”

Sources told The Guardian it was unlikely the Foreign Office would extend the scheme to allow students to travel from Gaza to the UK later, but that a meeting took place last week with the Department for Education to discuss whether students could begin their studies online.