Along the coastal belt of Sindh and Balochistan lurks a formidable foe. Gooey or dry, powdered or chunky, gutka in Pakistan is available in many forms and appearances and it is nowhere as widely consumed as it is in the southern parts of the country. Although the substance was banned by the Sindh government in 2011, doctors estimate that around 10 million people consume different varieties of gutka in the country today, indicating a sharp surge in demand over the last 10 years.
The origins of this addictive concoction made from betel nut, choona and tobacco are unclear. Some believe it came from Hyderabad, while others trace it back to Karachi. “Chewing tobacco like paan wasn’t part of Sindh’s culture before Partition,” says Dr Fateh Mohammad Burfat, a professor at the Sociology Department of the University of Sindh. It was then that paan crept into the region. But something happened during the 1971 war: paan’s popularity diminished and gutka began to take over. Soon it turned into an immensely lucrative business, turning the penniless into millionaires.
Since gutka is so readily available, teenagers and at times even pre-teens fall into its addictive trap. PHOTOS: ARIF SOOMRO
“Gutka-making started in Ibrahim Hyderi after 1971,” claims Chairman of the Pakistan Fisherfolk Forum Mohammad Ali Shah. Shah says the late Ustad Jhando made gutka for the first time in Sindh, following the war. This prompted fishermen to switch from paan to gutka, which was cheaper and stronger.
In the early years of its rise, gutka was restricted to a handful of major cities like Hyderabad, Thatta, Mirpurkhas, Kot Ghulam Mohammad and Karachi. Now, one can find it nearly everywhere. From cabins to factories, makers are churning out their own brand of gutka.
“If you have contacts within the police, you can earn a lot of money within a few months,” explains Abdul Ghafoor, a resident of Tando Allahyar, of the business. “It’s controlled by a mafia and selling gutka openly is not possible without the support of the police,” he alleges.
Haji Mohammad, who has been addicted to the substance for enough years to remember, says people can be quite picky about the product they consume. “A user of a particular ‘brand’ will not prefer another due to the taste. I have to stock up when I leave my area,” says Mohammad, adding that he spends Rs130 a day on gutka.
A gutka-maker from Badin says the profession is not difficult, but can be a tricky one at times. Officials need to be appeased to ensure a smooth supply of betel nut from bigger cities like Karachi and Hyderabad. “If you are smart in your dealings, you can be a very wealthy person,” he says with a smile.
The origins of this addictive concoction made from betel nut, choona and tobacco are unclear. PHOTOS: ARIF SOOMRO
Paan-selling cabins would soon go out of business if it wasn’t for selling gutka. “No one will come to you if you don’t sell gutka or other chewable tobacco products; you will earn nothing,” says Saleem Bhai, who runs a cabin in Karachi. Beside the locally made mainpuri and maava, cabins also sell packaged chewing tobacco products smuggled from India, such as Pan Parag, Gaj Guru, Ali Baba, City and JM among others.
The coastal factor
Mohammad Ali Shah says 90% of fishermen consume gutka. He sees the trend spreading to upper parts of the region at an alarming pace. “It was not so common before 2008. Now, there is no way to stop the menace. I fear it will be uncontrollable in the coming years.
Mohammad Yousaf, a resident of Seerani city, some 24 kilometres from Badin and 18 kilometres from the Arabian Sea, says it is the atmosphere that compels a person to consume gutka. Where he lives, no one considers consuming gutka a bad habit, not like smoking hashish or taking heroin anyway. “People don’t even smoke cigarettes in front of their elders, but use gutka openly.” He adds that some people understand how unhealthy gutka is and try to discourage others, but its overarching popularity is no match for such little opposition.
Sultan Adam, a native of Sindh, says his consumption increases when he goes to areas near the sea, such as Ketti Bunder or Ibrahim Hyderi. But he does not feel the need to use gutka when he visits Islamabad or Lahore. “I just don’t need it in the upper parts of the country.” Adam cannot really put his finger on what it is about being near the sea that triggers this desire to consume gutka, but he cites availability as one of the major factors. “It’s expensive to use tobacco products imported [from India]. Gutka is cheap and easily available everywhere.”
A user of a particular ‘brand’ will not prefer another due to the taste. PHOTOS: ARIF SOOMRO
This observation is validated as one travels to the upper parts of Sindh. Although many consumers can be found in Jamshoro and Hyderabad, and even as far as Hala and New Saeedabad, the use of gutka is not nearly as pervasive as it is in lower Sindh and Balochistan.
Killer on the road
When senior dentist at Civil Hospital Thatta Dr Shayam Kumar started his career 16 years ago, there were only two to three cases of patients a month with mouth cancer attributed to the use of gutka. Now, that number has spiked considerably. “Around 100 mouth cancer patients are reported in a year from Thatta alone. Twenty-nine cases were reported from Thatta hospital in just April this year,” he shares.
“Every family in Thatta consumes gutka. They consume gutka more than they consume food. They can’t give up the habit now,” says Dr Kumar. What is more ominous is that a large number of these patients are women and children. Since gutka is so readily available, with the government not particularly interested in stemming its supply, teenagers and at times even pre-teens fall into its addictive trap, he adds.
The health problems that come with consuming gutka make for a high demand for dentists in Thatta, Sujawal, Badin, Tando Allahyar, Mirpurkhas and Hyderabad, among other cities of Sindh. “I hardly get any time for my family and friends. The hospital is always crowded,” says Dr Kumar. It is a painful addiction, he warns. Consumers face multiple ailments including abdominal diseases. “They can’t even brush their teeth properly,” he says.
Zulfiqar Ali, with his red-stained teeth, agrees. “I don’t brush [my teeth]. Actually, I can’t. It hurts my gums and they start to bleed,” he laments. He doesn’t even feel hungry like he normally would. “Sometimes, I feel like eating something delicious like biryani, but I can’t.” Yet, he cannot kick the habit. “I don’t feel good when there is no gutka in my pocket.”
Dr Kumar says gutka consumers lose their sense of taste over time. They can’t eat any spicy food due to blisters in their mouth. Moreover, a lot of people go to sleep with gutka in their mouths. This not only poses a fatal choking hazard but also aggravates the negative side-effects of consuming gutka. The sight of red-stained bed sheets and clothes isn’t one for sore eyes either.
Dr Burfat blames parents. He says children often emulate their parents after seeing them consume gutka. Depression, economic conditions and lack of recreational activities also steer the youth towards tobacco, he adds. “No one considers it a bad thing or a harmful habit,” he says, lamenting the apathy of religious and educational institutions in discouraging consumption.
Paan-selling cabins would soon go out of business if it wasn’t for selling gutka. PHOTOS: ARIF SOOMRO
Sociologists agree. They say it is the government’s job to launch awareness campaigns and impose stricter regulations to ensure an effective ban on gutka. Health is the most apparent casualty, with mouth cancer being the most common cancer after breast cancer in Pakistan. However, there are cosmetic concerns too. Paan and gutka users have painted their cities red. The walls of nearly every building in a city like Karachi have paan and gutka stains on them, and the crevices of buses and other public vehicles are chockfull of the sticky residue. Unfortunately, as it stands, there is little reason to believe gutka is going away anytime soon.
Sameer Mandhro is a Karachi-based reporter for The Express Tribune.
He tweets @smendhro
Published in The Express Tribune, Sunday Magazine, October 11th, 2015.