Qat in Yemen...

Qat and Yemen

One of the various surprises that greeted me in Yemen was the hugely swollen cheek of men; and I had sincerely hoped to enrich my surgical experience on parotid. But as days went by, I understood that the swelling was not a pathological one. The cheek was filled with chewed leaves of “qat.” I saw them in many places, at work or leisure. On holidays, I could spot them on the beach, market places, or on the verandah of unopened shops, sitting with plastic bag containing a bundle of tender shoots of qat and a big container of water nearby. They sit through long evenings either alone or in company, usually with an arm pillow to rest, one cheek ballooned with qat. Drivers chew it to keep awake; masons and plumbers to get ‘energy’ to work. Merchants chew qat in their shops or stalls, drivers and their passengers in vehicles, and afternoon workers at their job sites.

Legend is that the property of qat was discovered long back in Ethiopia, when shepherds found their sheep unusually active after eating some particular leaves. Though available in most African countries, it is banned in many countries, including USA and Saudi Arabia.

The Experience

Our Chinese anesthesiologist narrated his experience. He said it tasted bitter and he couldn’t keep it more than an hour in his cheek. (The tender leaves and shoots are stripped off the twigs, wiped clean, smacked by the fingers and gently placed between the molars, chewed and moved into the cheek, the fingers busy getting the next leaf ready. The juice is swallowed with water or carbonated beverages. The accumulating ‘cud’ is spat out only after the session lasting 4-5 hrs is over) He couldn’t sleep either that night or next. And mucosal ulcers developed in the cheek mucosa. He hasn’t used it ever since. A nurse from Russia, married to a Yemeni said she uses it on weekends so that she doesn’t feel tired by the extra household work.

Our Yemeni pharmacist tells us it gives ‘good mood’, and that he chews it regularly every evening. He said it is mentioned in Pharmacology books, and narrated the ‘qat ritual’ every Thursday evening. (The weekend here is Thursday and Friday) The master of the house will sit down in the tidied up room with the arm pillow to his side, his wife would have washed and dried the tender qat leaves for her hubby. After a bath, she is already in a beautiful dress, and well perfumed, hair well combed and usually wears a garland of jasmine. There is a twig of some plant with exotic smell tucked into her hair. She sits near him to chat, and pour the water or soda for him. She may or may not use qat herself. He is euphoric, and children find it the best time to get hard demands sanctioned.

In one study 60% of men and 35% of women in Yemen have been found to use qat. Men get together for consumption of qat in the traditional social setting on some afternoons, starting after a heavy lunch. The juice is washed down with water or soda, while animated discussions go on. This provides for interaction and the structuring social life. It is said qat flares imagination and gives "fantasies of personal supremacy." There was an item in newspaper about medical students using this to keep awake and to remember what they read. There are many who acclaim its virtues, while others disapprove the habit. And reports vary regarding the use of qat as an aphrodisiac. There are health hazards.

The Plant

The botanical name of this exotic plant known for its stimulant properties is Catha edulis. It is a shrub or small tree. It is known as Mirra in Kenya, and Chat in Ethiopia and Jad in Somalia. It is used as a recreational drug in the countries which grow them. It is used by farmers and laborers for reducing physical fatigue, and by drivers and students for improving attention. I understand Coca leaf is used in South America similarly. (Remember “Papillon”?)

One should know…

The stimulant property is attributed to the alkaloid cathinone in the plant. It breaks down into cathine and noradrenaline. No wonder it behaves as a sympathomimetic, increasing blood pressure and pulse rate. In the United States, cathinone is listed with heroin and cocaine as a Scheduled drug.

Qat consumption is known to produce euphoria and excitement. It is also said it can induce manic behaviour and hyperactivity. The effects of qat include alertness, energy and euphoria. Some say one relaxes and get intellectually focused. One may undertake skilled tasks and the creatively talented may write poetry. A psychological dependence may develop, but is not considered as an addictive drug. There are no medically accepted benefits of qat. More than the physical high, there is a cultural side to qat -- the qat chewing sessions. In many houses, there are well furnished qat chewing rooms or halls, a show-piece of the house.

Money, money, money..

Qat is cultivated in mountain terraces and most such areas in Yemen are used exclusively for qat. The farms are guarded by armed personnel. Everyday the harvest is transported to the various geographical areas for sale, which will be over by afternoon. The qat chewing session starts after lunch. One bunch can cost about 500 YR to 7000 YR, depending upon the quality. (1 US dollar = 200 YR approx) One bunch will last for one session, lasting about 3-4 hrs. They say the 7K ones are bought by the very rich to offer to their important guests. Government gets a sizeable amount as tax from qat. Yemenis spend a great part of their income on this pleasure. It is said the harvest is not enough to satisfy the domestic need. So, nobody cultivates ‘cash crops’ to fetch dollars.

Many consider this a social evil. An American soldier writes in www.al-bab.com: “Qat is the drug that made the Somalians feel they were invincible to our US Rangers and Delta Forces. ... Because of our military, they overcame this famine. However, this drug made the Somalians unappreciative of our efforts to help. They felt as if they could conquer the world. … Today, their people are still starving. I'm sorry, but we tried.”

Back to square one

As for us medical staff here, the average employee chews qat and don’t sleep at night, comes to the hospital next morning requesting medical leave, as he is “tired”. WHO has listed qat as a "dependence producing drug" The users will attempt to get daily supplies to the "exclusion of all other activities." It is said qat chewing is a near-daily activity for those who can afford it - and sometimes even for those who can't. When the poor man willingly foregoes food in favor of buying qat, his wife and children get neglected thus. So, some request the government to extend the work day in an effort to reduce qat consumption. But advocates of qat feel that Yemenis are not lazy, there is just not enough work to be done.

Qat chewing distinguishes Yemenis from the other Arabs. It is well woven into Yemen culture through the centuries, and affects its economy and happens to be its life.