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No betel nuts allowed on premises

By Maripet L. Poso KOROR (Palau Horizon, May 19, 2010) - Minister of Health Stevenson Kuartei is planning to propose to make the Ministry of Health (MOH) a chew-free zone next year for health reasons.

With betel nut chewing being the leading cause of tooth and gum problems, and tobacco use being the common cause of oral and pharyngeal cancer in Palau, the Minister believes it’s about time they made a stand and make the MOH, its hospital, clinics and all vehicles to be a chew-free zone.

"This means that while you are there, you are not allowed to chew," said Minister Kuartei. "We’re not telling people to stop chewing betel nut. We’re telling people that when you’re in the premises of MOH, please don’t chew."

The minister explained that everybody knows that tuberculosis is spread by aerosol, and sputum in the trash can is not hygienic. "We also understand that betel nut chewing is a very difficult habit, and it’s something that we have to be very sensitive about," said the Minister. That’s why the Minister said they are giving it some time for everybody to adjust to the idea so they can decide how they’re going to manage it.

"We will try to mobilize the community to understand and pick a time, maybe in six months or one year, then we are going to declare MOH a chew-free zone," said Kuartei.

Kuartei said that his proposal is the same principle as the no-smoking policy of airlines. "It’s basically how the airline works. People don’t chew while in the airline premises, and people respect that," he said. "We are going to make the MOH a much safer and cleaner place for everybody."

Kambes Kesolei, Chairman of Coalition for a Tobacco-Free Palau (CTFP), and Joe Aitaro Protected Areas Network Coordinator, fully support the efforts and foresight of the Minister.

"I think it’s a wonderful news. We support it fully," said Kesolei. "We stand 100 percent behind the efforts of the minister. And we hope that it’s not only the MOH but eventually spreads to other ministries, other States and the community at large."

According to Aitaro, the Palau community has a lot of respect for Dr. Kuartei, and they are willing to do what the minister asks. "It’s going to be tough," said AItaro. "But I agree with the minister. We need to start it and we need to learn from it. Then hopefully what we learn can also be transferred to the other government offices." Aitaro added that it will be nice to go to offices and not see people chewing and spitting just anywhere.

Kesolei also thinks that it’s going to be a challenge for the MOH because betel nut chewing is deeply engraved in Palau’s culture. "We’re not stopping people from chewing betel nut. But when you spit, spit responsibly. Don’t just spit on flower pots or parking lot. Each individual is responsible for his own chewing habit and then we can all make a better environment," he said.

The challenge, according to Aitaro, lies in handling the stress that it will give to the hospital staff. "In terms of the elders, for example, chewing betel nut is already part of their lives. Will prohibiting them to chew add more stress?" he said. He added that that stress would be translated to the nurses. "Will the nurses get upset because the patients are more agitated or stressed because of not being able to chew betel nut?" He said things like these are to be considered.

In some cases, Aitaro added, it might also cause severe psychology because the more you deny some people, they will just hide and still chew. "We have to make sure that this will be done morally and responsibly," he said.

Kesolei said people are not used to new policies. "Chewing is part of their lifestyle; they have been doing it for so long. But we need to educate people and make them aware of the positive things that will come out of the proposal."

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