KARACHI, Feb 4: Claiming that frequent consumption of chhalia (betel nuts), gutka and tobacco was behind the increasing cases of oral cancer, speakers at a seminar on Saturday suggested that a civil society and city administration coalition be initiated to eliminate their use in the city.

One of the speakers said that even babies were indirectly exposed to hazards due to their mothers’ consumption of gutka and mainpuri — concoctions of betel nuts, tobacco, lime, flavouring colourants, catechu and some other ingredients.

The seminar was held to mark the World Cancer Day by the administration of District Central in collaboration with a couple of nongovernmental organisations, and to highlight the hazards of gutka and mainpuri on human health.

Participants were told that Pakistan was one of the 15 countries of the world which housed two-thirds of the world tobacco users. Up to 75 per cent of oral cancer patients present in hospitals admitted that they had used chhalia, gutka or mainpuri. About 7pc children in the city used gutka.

ENT surgeon Dr Qaiser Sajjad said that surveys had revealed that chhalia, gutka and mainpuri imported or manufactured and marketed in the city largely contained artificial (textile) colour, artificial sugar, addictive substances, chemicals and animal blood. Beside the different preparations sold in colourful packings, chhalia even in its simple form could act as a carcinogen, he said while showing slides of patients who either died from or were under treatment for oral cancers.

He said it had also been established that betel nuts used in these items were mostly of low quality and were often found with fungal infections. Apart from the carcinoma of the oral cavity, the betel nuts, gutka and mainpuri caused submucous fibrosis in teenagers using them, and led to build-up of constricting bands of collagen in the cheeks and adjacent structures of the mouth. The doctor, a senior office holder of the Pakistan Medical Association, said mothers in certain coastal populations used gutka before breastfeeding their babies. The mothers admitted that their chewing habit caused sleepiness in the babies, Dr Sajjad said, adding that only a special awareness session could make them realise the hazards they were transferring to their babies.

Smoking ban

Dr Sajjad called for a complete ban on smoking at public places, educational institutions and all government and non-governmental organisations, and sale of tobacco within and around educational institutions. Ban on import, manufacture, advertisement and sale of chhalia and gutka also be imposed without any discrimination in all parts of the city.

Karachi Commissioner Roshan Ali Shaikh said the Sindh government had already imposed a ban on manufacture and sale of gutka and mainpuri across the province, following which about 400 kilograms of gutka and mainpuri had been seized, four people were arrested and cases instituted against them for violation of the order.

However, he noted that mere seizure of the products and sealing of manufacturing premises would not help control the sale and consumption of the prohibited or medically unfit products. The government’s efforts could not bear fruit unless supported by the people at large through creating awareness, change in behaviour of individuals, including workers and students. He said civil society, parents and families could play a vital role in making children and relatives aware of the diseases pan, gutka, supari, chhalia etc could cause.

Deputy Commissioner (Central) Dr Syed Saifur Rehman told the participants, mostly school teachers, civil servants and police officials, that a strong campaign against gutka and mainpuri would be launched in a couple of days in the central district. About 50kg of seized gutka and mainpuri were burnt before the seminar began. “We need to do more as cancer treatment is expensive, and developing countries like Pakistan cannot bear the burden of such a disease,” he said.

The director of the medical services of the KMC, Dr Nasir Javed Shaikh, said he saw a good combination of the administration and civil society members at the event, who could effectively address problems of the health sector.

Members of the Pakistan Medical Association and the Pakistan Youth Health Forum and teachers and staff of the Public School and College, Sir Syed Town, North Karachi, collaborated with the office of the deputy commissioner (central) in organising the event.