Home Opinion Op-Ed Boys as young as 10 under threat of Locked Jaw

Boys as young as 10 under threat of Locked Jaw

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Mashal Narejo |

Karachi. Khaike Pan Banaras Wala – one of the most iconic songs in South Asian cinema – couldn’t possibly have succeeded in enthralling audiences if Amitabh Bachchan had attempted to sing it through bleeding gums, chronic teeth inflammation, missing teeth or worse — a locked jaw — a condition known as submucous fibrosis. Today, 63-year-old Ghafoor Ahmed, who was a teenager in Lyari, Karachi, when the movie was released and remembered watching it in the cinema, can barely talk due to the damage to his jaw from chewing tobacco.

“I and my friends were young boys roaming the streets of Lyari looking for employment when we got addicted to ghutka and betel nut,” he recalled. “It started as an innocuous habit but slowly took over my whole life.” His jaw had deteriorated to such an extent that he had to exert immense pressure to make himself heard. “I can’t sit anywhere or talk to anyone without being conscious about the condition of my mouth,” he explained.

Shaukat Ali’s father had been diagnosed with mouth cancer after decades of consuming gutka. Ali recalled how painful the last few decades of his father’s life had been after he was diagnosed.

Ghafoor recalled that over the years, his wife had threatened several times to leave if he didn’t give up chewing tobacco. “But I felt that I was stuck in some kind of azaab (hell) due to which I couldn’t make myself quit.” Ghafoor has nine children, six of whom are boys and only one is employed. For several years now, his wife dissolves his food into a liquid paste to make it easier for him to swallow.

“Some of the most extreme cases of dental deterioration that I have come across have been male, ghutka addicts suffering from submucous fibrosis,” said dentist Alizeh Baloch of Ziauddin Hospital. “They can only dream about sporting the smile of their dentist-turned-president.”

She explained that the high incidence of men catching the disease was because they had easier access to ghutka, betel nut and other substances that are detrimental for oral hygiene as compared to women.

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Baloch and the president of Pakistan Dental Association (PDA), Dr. Mehmood Shah, pointed out that submucous fibrosis was not just a poor man’s disease or even an old man’s one. “During my time at Civil Hospital, Karachi, I saw several cases of boys as young as 10 developing a locked jaw,” said Shah. “Although it is true that ghutka and betel nut are more easily available to the lower income classes, submucous fibrosis is just as common in the upper classes.”

He recalled the case of a very prominent politician in Sindh who had developed the disease and had visited him in this regard a few weeks ago. “He was at a very advanced stage,” said Shah. “Submucous fibrosis is just one step before mouth cancer – the second most prevalent cancer in Pakistan.”

There is irrefutable evidence of the causal link between tobacco consumption and oral cancer as well as the loss of teeth, as shared by the World Health Organisation.

Shaukat Ali’s father had been diagnosed with mouth cancer after decades of consuming gutka. Ali recalled how painful the last few decades of his father’s life had been after he was diagnosed. “He had been an addict for decades – we grew up watching him chew tobacco,” said Ali, who works as a carpenter in Saddar, Karachi. “Towards the end, his jaw was locked so severely that he could only whistle when he needed to say something.”

Ali added that his father’s gums would be bleeding all the time. “All his front teeth were broken and he couldn’t eat, so he would mostly be surviving on liquids,” Ali added that they couldn’t afford to get him treated and they didn’t get any support from the government either.

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Dr. Shah pointed out that there has been no effort on behalf of the government to develop a fund for the victims of this disease, “not even a superficial nod to the patients,” he said. He believes easy access to tobacco items in residential areas should be tackled at the earliest by the country’s dentist president to ensure Pakistan doesn’t become a toothless country.

A gutka vendor in Karachi, Kamal Khan, who has been running a small tuck shop for 25 years in a very populated locality of DHA’s Phase 5, said he sold tobacco items to “anyone who asked for it”.

“Everyone has their own poison, but betel nut is actually good for your teeth,” he claimed. There is irrefutable evidence of the causal link between tobacco consumption and oral cancer as well as the loss of teeth, as shared by the World Health Organisation.

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“You can go look it up on the news.” There is evidence to support the romanization of betel nut by the media without giving clear warning of the detrimental impact it can have on oral health. “Even Amitabh Bachchan loves to chew betel nut. Haven’t you seen that song Khaike Paan Banaras Wala?”

Mashal Narejo is a Karachi based journalist who has written for several Pakistani newspapers and magazines. The Views expressed in this article are author’s own and do not necessarily reflect the editorial policy of Global Village Space.


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