The dead spit

One of the most popular activities at Indonesian Independence Day contests is the climbing the greasy pole. The pole in this case is usually the smoothed trunk of a betel nut tree, known in Indonesia as pinang. But in many parts of Indonesia, and in particular in Papua, this tree is better known for the areca nuts it produces, Chewing these nuts, together with sirih leaves and lime, produces a mild stimulating effect. Basically it's a legal recreational drug.

Betel chewing is probably not quite as bad as alcohol consumption, the other scourge of Papua. But it may be no less dangerous in spreading disease. As far as I know, no one has studied whether its stimulating effects match that of other stimulants in driving sexual activity. But that's not the main problem.

The trouble is that, after chewing, the red coloured residue is spit out - usually with complete abandon. You can see the red stains all over pavements - even the corridors of hospitals. The 'makings' (nuts, leaves and lime) are sold by hawkers everywhere, including outside hospitals wards.

Spitting is a really efficient way of spreading TB - which is epidemic in Papua. I'm sure it's a significant cause of this continuing (and probably expanding) epidemic. And of course, TB is the leading cause of death of people with HIV, again particularly in Papua. But to my knowledge, there has been absolutely no campaign aimed at reducing betel-nut chewing, or persuading people not to spit. Changing this habit, as with smoking (and other dangerous habits we all know about) will no doubt be difficult, and probably take several generations. But is this a reason not to start?

I remember as a lad the notices in the public conveniences in London: 'Spitting causes Consumption'. We urgently need to emulate these campaigns in Papua.

Babé