Khat Chewing Amongst the Somali Community in the UK - Essay Example

of the of the Concerned Health Sciences and Medicine 12 December Khat Chewing Amongst the Somali Community in the UK Introduction It goes without saying that in a practical context, Britain is a multicultural society, with each specific community group affiliated to varied social issues and related health problems. The paper here intends to focus on the problem of Khat chewing and Khat addiction amongst the Somali community in the UK. Khat is a plant grown in the Horn of Africa that has stimulant properties owing to certain alkaloids present in its green leaves. Within the Somali community in the UK Khat chewing has long been seen as a social custom that boosts socialization and extends an opportunity for recreation. However, in recent times it has been seen that Khat addition is not only giving way to many health problems amongst the Somali community residing in the UK, but also happens to be responsible for aggravating the social problems peculiar to the Somali community. The first section constituting the body of the paper takes a look at the history and demography of the Somali community residing in the UK. The next section delves on the origins of Khat, its history in relation to the Somali community and how it is addictive. This is followed by an elaborate discussion on the health problems and psychiatric problems associated with Khat chewing and how Khat chewing in tandem with the socio-economic issues faced by the Somali community gives way to many mental health issues. It is followed by a discussion on the social repercussions of Khat chewing. The conclusion in the end is followed by apt recommendations aimed at tackling the problem of Khat addiction in the Somali community. I have a Somali background and the health issues facing the Somali community are close to my heart. The Somali community plays an important role in my life as I was brought up and I grew up in this distinct culture. The British Somali community has influenced me in more than one way. However, throughout my teens I observed how vulnerable this community is owing to language problems, unemployment, poverty and lack of state help. Khat chewing is one major health issue impacting the Somali community. So I decided to focus on this topic. Somali Community in the UK The Somali community in the UK comprises of British citizens who were born in Somalia or those British citizens whose ancestors were from Somalia. The United Kingdom is the home to the largest Somali population in the Europe. As per the 2001 Census, the number of Somalia born residents in the UK stood at 43,532. Also, as per the Office for National Statistics, on March 2010, the number of Somalia born immigrants within the UK stood at 108,000. In a historical perspective the earliest Somalis arrived in the UK as seamen and merchants. Some Somalis also arrived in the UK during the 2nd World War, along with the Royal Navy. The Civil War in Somalia in the 90s witnessed a large scale immigration of Somalis to the UK, who constitute the majority of the Somali community at present living in the UK. Though a great number of Somalis have given way to many success stories in the UK, it is a fact that the Somali community within the UK faces many social problems and challenges at present. Khat chewing is one big problem being faced by the Somali community in the UK. It goes without saying that Khat chewing has a long standing cultural, historical and social tradition in the Somali community. Khat consumption is legal in the UK and it is mostly sold at the commercial establishments known as mafrishes. Amongst the Somali community Khat chewing is recognized to be a legitimate indulgence, and is not detested like alcohol and varied other forms of drugs. However varied professionals and health professionals do believe that the long term Khat usage is giving way to many health and social problems within the Somali community in the UK. The voices against the Khat usage have begun to arise within the Somali community itself. Varied Somali community groups and social activists are challenging the legal status of Khat in the UK. About Khat Primarily speaking Khat is a plant that bears green leaves which have been chewed since centuries owing to their stimulant properties. The origins of Khat could be traced to the Horn of Africa (Dupont 1997). Khat is also grown in Yemen in the Middle East, Southern Africa, and East Africa (Dupont 1997). So Khat chewing has been found to be amply prevalent amongst the British communities originating from Yemen, Somalia and Ethiopia. It goes without saying that influenced by immigration; the patterns of Khat usage have immensely changed amongst the Britons of Somali origin. It is feared that the usage of Khat in Britain by the Somali immigrants have assumed problematic proportions. Khat chewing is being increasingly recognized to be a serious problem even by the Somali community residing in Britain. Somali Khat Tradition Khat (Catha edulis) is also known by varied other names in the Somali community in the UK like miraa, qat or chat. Khat has been found to grow as a wild plant in the high altitude regions in Africa and Asia. The earliest usage of Khat was confined to the Ethiopian and Yemini highlands (Dupont 1997). Somalia being a low lying and arid region was never so favourable for Khat plantation. Hence, most of the times the Somalis acquired Khat as a result of trade between them and the highlands located in the Horn of Africa (Dupont 1997). However, in the earlier times, being unable to procure fresh Khat when the psychoactive compounds within it are the most active, the usage of Khat in Somalia was confined to medicinal purposes (Dupont 1997). However, fresh Khat became easily accessible to the Somalis after the establishment of road connectivity with Ethiopia in the 30s and 40s. Soon Khat chewing assumed the form of a popular past time amongst the Somalis. In the last three decades the rapid onset of air connectivity has made Khat easily available within the UK. However, Khat chewing is predominantly prevalent in the communities that have a Khat chewing tradition. Khat chewing has failed to gain grounds amongst the British mainstream population. Khat stands to be biphasic in its impact, beginning with a rapid stimulation of the central nervous system resulting in garrulous behaviour, followed by a tranquil phase. Khat chewing by the Somali community in the UK has an essential social dimension (Cole 2003). There is no denying the fact that the Somali community in the UK tends to be a hard working population and Khat is mostly used by its adherents as a popular stimulant. Khat chewing commands popularity amongst all the layers of Somali community in the UK, be it the students, workers or merchants. The stimulating impact of Khat could be traced to the two alkaloids, which are cathinone and cathine, found in the fresh Khat leaves. The irony is that both cathinone and cathine are classified as controlled substances in the UK. The extraction of cathinone and cathine is banned within the UK. However, one is allowed to import fresh Khat leaves anytime in the United Kingdom. Khat chewing is envisaged through multiple perspectives amongst the Somali community in the UK. A significant proportion of the Somali community in the UK perceives Khat chewing to be legitimate and normal. Some Britons of the Somali origin believe that Khat chewing is exacerbating the medical and social problems amongst the Somali community in the UK. As per an ACMD 2005 report, nearly 35 percent of the Somali community residing in the UK acknowledges itself to be the users of Khat in a current context. While there are other social and medical activists that hold that the economic and social problems being faced by the Somali community in the UK and the resultant adjustment problems are contributing to the widespread usage of Khat amongst the British Somali community. Certainly there is no denying the fact that the difficulties originating from the trauma that they had to bear with, and the consequent migration to a society to some extent imbued with marginalization and poverty is to a great extent promoting Khat usage amongst the Somali community in the UK. However, in a medical context, one simply cannot choose to sideline this issues until the social and economic conditions get more favourable for the Somali community in the UK. Khat chewing is largely also giving way to many medical problems amongst the Somali community in the UK. Why People get Addicted to Khat The addictive impact of Khat is primarily traced to an alkaloid found in Khat leaves known as Cathinone which if consumed could give way to the same side effects as those developed by the usage of amphetamines (Cole 2003). People tend to get into a euphoric state of mind after chewing Khat leaves, which is why they get addicted to Khat. Besides Khat in the recent years emerged as a primary street drug amongst the Somali community in the UK, which when combined with tobacco, drugs and alcohol could give way to lethal consequences. Though the moderate usage of Khat has not been found to be addictive, still it is sufficient to give way to drastic health impact. Health Risks Associated with Khat Though not a direct risk of respiratory problems could be associated with Khat, the circumstances and settings in which Khat is consumed has often been found to be sufficient to cause respiratory problems. Most of the times the mafrishes tend to be ill ventilated, and besides considering the fact that many of the Khat users smoke profusely, there is always a risk of the Khat users contacting respiratory problems owing to direct and second hand smoking. Besides going by the fact that at mafrishes, many a time water pipes are used and the Khat users prefer to share the same mouthpieces, so Khat chewers are always at the risk of contacting respiratory diseases like Tuberculosis (Kalix 1987). It has also been found that the Khat chewers mostly tend to drink sugary drinks to cover the acerbic taste of Khat, which leads to oral problems like dental caries. There also exists ample evidence to prove the fact that prolonged Khat chewing could also give way to various types of oral cancers. Studies conducted by WHO found out that the Khat users are always at the risk of contacting infections going by the fact that Khat is mostly consumed in unhygienic conditions (1964). Man a time the Khat users do not care to wash Khat leaves so they tend to contact parasites. Besides it is a commonly known fact that in social conditions in which Khat is consumed, the Khat users share the same utensils and use the same toilets that are unkempt and unhygienic, which manifold increases the risk of acquiring infections. In the Horn of Africa, the Khat growers are resorting to heavy usage of pesticides. So the residual pesticide found in the Khat leaves is an increased cause of concern for all the Khat chewers. Though research is under way to identify the impact of residual pesticides on the members of Somali community consuming Khat, there is still a dearth of apt and pragmatic data in this context. As has been mentioned that many a times the Khat chewers use sweet drinks to cover the pungent taste of Khat, in case of diabetic Khat chewers consuming these sugary drinks, the risk of developing serious complications is always high. Considering that Khat is a stimulant, Khat chewing certainly increases the blood pressure (ACDM 2005). Besides as per the traditional Somali norms, during Khat sessions the Khat chewers are also known to smoke profusely, thereby increasing the risk of cardiovascular diseases (ACDM 2005). However, it goes without saying that till now no direct evidence has been found as to linking Khat chewing with cardiovascular diseases. Besides, there exists a general perception amongst the Somali community in the UK that the profuse usage of Khat is linked to multiple health and psychiatric problems. Khat has been reported to cause constipation and appetite loses. The usage of Khat by the young members of the Somali community in the UK is also fraught with risks in the senses that it could be the first step towards smoking or the consumption of more serious drugs. There exists a big body of data associated with the usage of Khat, but still it is difficult to establish a direct causal relationship between Khat and a whole range of diseases attributed to Khat chewing. Still, it would be appropriate to discourage the members of Somali community in the UK from using Khat, as the tentative evidence available is sufficient to warrant this precaution. M any researchers have tried to associate Khat chewing with psychiatric problems (Gough & Cookson 1984). As per the 2005 ACDM report, though there are very few systematic studies that could link Khat chewing to a range of psychotic symptoms, there seems to be no harm in assuming that the combined impact of the trauma that the members of the Somali community in the UK had to deal with owing to the prolonged civil war and Khat chewing could give way to detrimental psychiatric problems. Going by the fact that the Somali community in the UK owing to poverty, marginalization and stress is more vulnerable to psychiatric problems, Khat chewing could further acerbate such psychotic symptoms. However it needs to be mentioned that there is no practical evidence directly linking Khat chewing to psychiatric diseases. However, as per the observations of the members of the Somali community in the UK, regular and long time usage o Khat may give way to sleep related problems, anxiety and anorexia. It is also a widely known fact in the British Somali community that Khat chewing is also associated with smoking, caffeine based beverages like tea and coffee, soft drinks and sometimes uses of alcohol and other intoxicants. However the combined impact of these substances on mood disturbances is still not fully understood. Social Consequences Based on the experience and observations of the health workers and medical professionals from the Somali community, it is a fact that Khat chewing is linked to multiple social problems. There is known to exist a close link between high unemployment rates amongst the Somali community in the UK and prolonged and excessive Khat usage. The combined impact of high unemployment and Khat chewing amongst the British Somali community is fast giving way to a rapid breakdown of the families and communities. Influenced by the mood changes experienced by men chewing Khat, many find themselves unwilling to engage in productive work to support their families and communities. Language problems, poverty and unemployment in the war torn Somali community is already putting a severe stress on the mental health of young immigrants coming to UK for a better life. The risk of developing mental disorders is manifold multiplied by the excessive and long time consumption of Khat. Considering high unemployment and social exclusion faced by the British Somali community, it is very difficult to give way to Khat free socializing structures in the British Somali community. Though many relevant studies are underway to research the health risks and social problems associated with Khat chewing, the information accrued through commonsensical observations by the members of the Somali community are sufficient to recognize Khat chewing as a potential health problem. Conclusion UK is the home to the largest Somali community in Europe. Earliest Somali’s came to the UK as merchants and seamen. Later on many Somali’s came to Britain with the Royal Navy in the 2nd World War. The recent influx of Somalis in the UK has been owing to the civil war raging in Somalia. The trauma of war combined with alienation, unemployment and poverty makes the Somali community in the UK very vulnerable and prone to many addictions. Khat is a green plant grown primarily in the Horn of Africa whose fresh leaves are known for their stimulant properties. With the onset of road connectivity across Africa, Khat chewing emerged as a legitimate social pass time amongst Somalis. Owing to accessible air connectivity, the Somali community in the UK has an easy access to Khat sold at outlets called mafrishes. The addictive potential of Khat is owing to the alkaloids called cathinone and cathine found in the fresh Khat leaves. Still, Khat consumption is legal in the UK. The negative health impact of Khat originates from the combined impact of poor hygiene maintained at mafrishes, the use of Khat along with other drugs, alcohol, tobacco and sweet beverages. Consequently, Khat chewing has been found accountable for many respiratory, cardiovascular, oral and liver problems in the Somali community. Tagged to the trauma of war, alienation and poverty, Khat chewing also gives way to many psychiatric problems in the Somali community. Khat has severe social repercussions in the sense that it is accountable for the breakdown of families and communities. Recommendations The following recommendations are made to dilute the rampant usage of Khat in the Somali community in the UK: The health facilities should extend social support and counselling to the Somali community and cooperate with the local civil authorities to create avenues where the members of the Somali community can interact in a Khat free environment. Somali youth should be educated about the detrimental health impact of Khat chewing and dedicated awareness drives need to be carried across the British Somali community to enhance awareness regarding the issue of Khat addiction. Special health education programs must be initiated and essential Khat information needs to be disseminated at the cafes and other social avenues frequented by the Somali community. Special drug treatment facilities need to be setup for the people addicted to Khat. Volunteers from the Somali community need to be trained in health education and drug treatment to empower them to help their community fight Khat addiction. Broad based community developments programs need to be set to help the Somali youth with education, employment and recreation, thereby mitigating the factors that encourage Khat chewing. Setting up of family based community support programs need to be undertaken. Steps need to be taken to make Khat consumption and use illegal if possible. Reference List Cole, Michael D 2003, The Analysis of Controlled Substances, Chichester, Wily. Dupont, Robert L 1997, The Selfish Brain: Learning from Addiction, American Psychiatric Press, Washington, DC. Expert Committee on Addiction-Producing Drugs: Thirteenth Report, WHO 1964, pp. 53-55. Gough, S & Cookson, I 1984, Lancet 834, p. 45. Khat: Assessment and Risk to the Individual and Communities in the UK, Advisory Council on the Misuse of Drugs (ACMD), 2005. Kalix, P 1984, ‘The Pharmacology of Khat’, General Pharmacology, Vol. 15, pp. 179-187. Read More