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Books - The health and socio-economic aspects of Khat use
Written by C.K. Maitai   


The euphoric and stimulating properties of khat have been known for many centuries but details of how the plant was discovered have been lost in antiquity. One of the earliest recorded reference to khat was in a medical prescription in the 13th century, aimed at relieving depression. Yet another early reference to khat was in a chronicle on Amde Seyon who reigned in Abyssinia 1314-1344 A.D. In this chronicle it is said that Sabr Ad Din, then king of Ifat, before embarking on a holy war against Amde Seyon said, "As for Marade his capital, I shall make it mine and shall plant khat, because the Muslims like it."
From these direct and indirect references to khat it becomes clear that the use of khat predates the recorded history.
The problem of khat was brought to the attention of the outside (European) countries by Vaughan who was a port surgeon at Aden in the 1850's. He noted the keen interest that the Arabs had for khat which was brought down from the mountain areas North of Aden on camel back almost daily. He also noted that there was a controversy as to whether use of khat was against the Islamic teaching, "thou shall not drink wine or anything intoxicating". This point is, apparently, unclear even up to this day.
Today, the growing and use of khat is confined to a few countries such as Democratic Yemen, Ethiopia, Kenya, Madagascar, Somalia, Tanzania and Yemen Arab Republic. Even within these countries the problem is often very much localised. In Kenya, khat is cultivated in the Kangeeta Division of Meru District close to the slopes of Mount Kenya. In Ethiopia, khat is grown mostly in the Harar region. It is perhaps possible to explain why the khat problem has tended to remain localised.
1. Khat is consumed fresh and must therefore reach the retailer soon after harvesting, usually within 20 hours. The retailer must sell the material within one to two days or else it will be rejected by the consumers. From a purely marketing point of view, there are imponderable difficulties involved in exporting this material from one country to another and even within the same country. A reliable and elaborate system of transport and distribution is crucial to the success of the khat trade.
2. The fresh material is very bulky, the moisture content being about 65%. Thus only a limited amount can be transported by air at any given time and the cost of transporting material is usually considerable.
3. Transportation of plant material (regardless of what it is) across international borders is generally strictly regulated because of the danger of introducing diseases, particularly plant virus diseases. Often the material has to be chemically treated and dried and this would tend to restrict international trade in khat.
4. Anyone who has witnessed the chewing of khat will appreciate the fact that the process of peeling the bark, chewing and spitting out the fibrous material is "messy" and "undignified". It is not something one can do conveniently in an office, toilet or while driving or travelling by public vehicles. Most poor people who can not afford the expensive commercial grade of material often chew leaves which are normally discarded or given to goats.
Export of khat to neighbouring countries, usually by air transport, is often possible and in Kenya, which appear to have surplus of this commodity, the material is exported to Tanzania, Uganda, Somalia and to a lesser extent the Middle East countries.
Because of the problems listed above, it is unlikely that trade in khat to distant countries of America, Canada, Great Britain and Far East will ever reach a significant level to warrant international concern. Indeed the real issue appears to be as how the problem of khat can be contained or minimised in areas where it grows. There are certain reports indicating that some people in America have illegally experimented with smoking khat but I would regard such reports as being either speculative or of no consequence. Certainly the active constituents in khat are not very volatile and only a small amount of the plant material can be incorporated in a normal size cigarette.
Khat is also found in some botanical gardens in America and elsewhere, but there is no evidence to suggest its use to induce euphoria.
In a random survey carried out in Kenya, involving 500 khat chewers, about 50% of those encountered were Muslims (Somalis, Borans, Swahilis and Arabs). This is significant since the Muslims in Kenya account for less than 20% of the total population of 16 million. The other single significant ethnic group encountered in the survey was the of Meru who grow the plant. To the Meru, chewing of khat has some cultural significance and it is not just to induce euphoria. All indications suggest that the pattern of khat chewing with respect to ethnic distribution is fairly stable. Indeed, considering that khat as a cash crop brings in a lot of money and the demand is high, it is surprising that the growing of this plant has not spread to other regions with suitable soil and climatic conditions within Kenya. The observations made in Kenya are, no doubt, relevant and probably similar to those made in other countries where khat is grown.
The immediate question then is, whether the problem of khat is worse today than it was in 1956 when the United Nations Commission on Narcotic Drugs at the request of the League of Arab States, considered the problem. It is well recognized that until the late 1950s the problem of Cannabis sativa (bhang) was relatively minor. The situation was aggravated by the wide publicity it received in the mass media in the 1960's. It was also closely intertwined with the hippie-culture which was an off-shoot of mass protests against US involvement in the Vietnam war.
The international news media has not highlighted the problem of khat and outside the countries where khat is consumed it remains relatively unknown. Today, international trade in bhang is controlled by people with a lot of financial resources and political support or connections. It is estimated that approximately 300 million people throughout the world smoke bhang fairly regularly. For this reason, it has proved very difficult to control the illicit bhang trade despite the fact that most countries are signatory to the 1961 Single Convention on Narcotic Drugs, aimed at minimising the use of dangerous drugs (opium, bhang, etc.).
In contrast:, regional trade in khat does not enjoy similar financial and political patronage and should be easy to control. Some people have expressed the view that the khat problem has been given undeservedly high place in the WHO publications*. Perhaps this question will be answered by the deliberations of this conference which looks at the khat problem from different perspectives.
We are dealing with a practical problem which must be considered in the right context. For example, observations made on laboratory animals using cathinone and d-norseudoephedrine should not be extrapolated to predict possible effects in humans without relating this to the actual situation.
We are grateful that the International Council on Alcohol and Addictions has provided forum for these deliberations.
* Textbook of Pharmacology, by Bowman and Rand, 2nd Edition, pp. 42-85, Blackwell Publications.

Our valuable member C.K. Maitai has been with us since Sunday, 19 May 2013.

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