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Betel Nut Chewing – Does It Stain PNG’s Culture?

Back in May, when I first arrived in Papua New Guinea, I was a tad bit alarmed to notice the local folks with bright orange-red stained mouth, teeth, tongue, and lips.  As a healthcare practitioner, my mind instantly went to overdrive as I thought of a few medical differential diagnoses that would have explained what I was seeing (i.e. Vit. B12 deficiency, Vincent’s angina, severe gingivitis with resulting gingival hyperplasia, angular cheilitis, glossitis, etc.)  Then, the sidewalks, roads, and even the light posts were also festooned with maroon-colored spit.  I also noticed a lot of the local folks clamoring around these ubiquitous sidewalk vendors selling what I initially thought as citrus limes.  Later on, I learned that they were selling a very popular “produce” which ultimately caused the red stains —betel nut. 

Betel nut (Areca catechu) belongs to the palm tree family palmeacea and is cultivated and grown in warm and tropical climates of Southeast Asia and Melanesia, i.e. Vietnam, Cambodia, Thailand, Laos, Bangladesh, Indonesia, Malaysia, Philippines, Papua New Guinea, Vanuatu, and Solomon Islands.  The actual nut inside the betel fruit contains three major alkaloids: arecoline, pilocarpine, and muscarine.  Not much is known as to which chemical makes chewing so addictive.  Chewing betel nut, or buai’ (boo-ayeh) in the PNG common tongue, has been part of the traditional culture and daily life for every Papua New Guinean folk.  It has been used extensively for four main reasons since antiquity:  curbing hunger pangs, feelings of well-being (euphoria), stress reduction, and heightened awareness.   Aside from increasing salivation, chewing buai’ supposedly suppresses hunger sensation.  This theoretical assertion has a profound implication here in Papua New Guinea.  With the rising prices of food and commodities in the country, it is not unusual for local folks to chew buai’ during the day to curtail hunger and then eat one big dinner meal at home to save money.  Aside from controlling hunger, local folks also feel a sense of euphoria throughout the day after they chew.  In addition, most folks will say that buai’ is PNG’s version of coffee in the morning—an instant eye-opener to start the work day.  Some chew one betel nut at a time intermittently throughout the day while some chew more than one at a time.  On average, locals will chew between 8 to 10 betel nuts in one day. 

The chewing “paraphernalia” contains three items:  betel nut, cumbang (lime powder), and daka (mustard stick).  The lime powder comes from harvested, dried, burned, sieved, and refined stag horn corals.  The mustard stick is a locally grown produce with seeds.  Interestingly, chewing betel nut with all three ingredients is relatively cheaper compared to more useful commodity like food—one betel nut range from 30 to 50 toea (cents), depending on the size of the actual betel fruit.  So how is it done?  The fibrous and somewhat soft fruit exoskeleton is cracked open using the teeth and the nut is obtained inside.  The nut is chewed until it breaks and the juices from within are released.  The tip of the mustard stick is moistened with saliva (mixed with nut juice) and dipped in lime powder.   The tip of the mustard stick, now covered with lime powder, is also chewed together with the betel nut.  Descriptions of the concoction flavor vary among individuals.  Some describe it as somewhat sweet; others describe it as combination of bitter, salty, and sweet.  Most importantly, the mixture of the three ingredients produces a chemical reaction that gives rise to the flagrantly maroon clay red color.  Salivation increases extensively while chewing.  Sometimes the “spit” is swallowed together with the mixture, but often, local folks spit out the excess saliva, giving rise to the ubiquitous maroon red discoloration of the sidewalks, streets, roads, and streetlamp posts. 

In an environmental point of view, seeing chewers spit out the red residue of betel nut and “painting the whole town red” is very disheartening.  There are numerous billboards and posters in Port Moresby that admonishes citizens to “Lukautim town.  Noken kaikai em spitim buai’” (Respect the town.  Do not chew and spit betel nut).  In a healthcare point of view, there are numerous implications in chewing betel nut.  Imagine one local folk who has TB that is extensively multi-drug resistant chewed and spat on the sidewalk, or share the lime powder in a container with everyone else at the vendor stand.  It is not unusual to see local folks walking around town barefoot.  Imagine walking on the sidewalk haphazardly decorated with red spat from buai’ chewers.  The spat, and whatever pathogens it contains, will most likely end in somebody else’s house. 

Most of you, like me, still have a few unanswered questions about chewing betel nut—Are there are undesired and untoward physiological effects, other than the reddened teeth, gums, lips, tongue, and spit?  What is the exact role of the mustard and lime powder?  Will the concoction, if swallowed, also discolor the skin, urine, bowel movement, and lining of the gastrointestinal system in the long run?  For now, suffice it to say that betel nut chewing is imprinted in PNG folks’ daily lives.  Most of my colleagues and friends asked if I ever tried chewing it—the answer is a big and resounding NO!