The recent Betel Nut Culture Exposition and Forum at the Kaohsiung Business Exhibition Center was greeted with great fanfare. It seemed Taiwan wanted to convince the international media that chewing betel nut was part of Taiwanese culture. I find this deeply disturbing.
Research has shown that those who habitually chew betel nut, smoke cigarettes and drink alcohol are compounding their risk of developing cancer.
In the last 25 years, cancer has been the leading cause of death in Taiwan, with oral cancer the fourth-deadliest form. Nine out of 10 people who suffer from oral cancer are betel nut chewers. The oral cancer rate is increasing at an annual rate of 20 percent.
In 2003, the International Agency for Research on Cancer confirmed that the betel nut, without any supplements, is a carcinogen. The National Health Research Institute has said that within five years, Taiwan will lead the world in male oral cancer. Those little green betel nuts are a major public health menace.
My parents were both long-time betel nut chewers. They died from esophageal cancer and oral cancer. Toward the end, they were unable even to drink water, suffered from insomnia and lived with constant hunger pains. Seeing their suffering made a deep impression on me. I have been involved in medical service for nearly 60 years and know the impact of betel nut on public health. I only hope that more people can avoid the fearful and terrible pain of cancer.
Is betel nut culture really something that Taiwan should be proud of and flaunt? Ten years ago, the government started to require helmets for those riding mopeds, a measure that halved the number of fatal accidents and saves 3,000 lives annually. Most people were able to look beyond the inconvenience of strapping on the helmet to support behind the policy.
The Bureau of Health Promotion began to push for betel nut prevention this year, but this job requires a coordinated effort from all parts of the government, not just one bureau.
For example, the Ministry of Education could lend a hand with mass education and the Ministry of Finance could study the viability of doubling the tax on betel nuts. The Government Information Office could spread the word about the risks of chewing betel nut, while the Ministry of the Interior and the National Police Agency could work to ban illegal betel nut stands or betel nut beauties displays.
The Council of Agriculture and the Ministry of Economic Affairs should ban the importation of foreign betel nut while assisting betel nut farmers to switch careers.
The government should try to establish a culture where people refuse to chew betel nut. This plan would be like a helmet, one that could protect people against oral cancer. Taiwan should then be able to proudly tell the world about its declining cancer rate and have its people no longer live in fear of oral cancer.
Chang Chin-wen is honorary chairman of the Taiwan Hospital Association.
Translated by Jason Cox
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