ABSTRACT
Khat-chewing problems
Legislative measures
Enforcement of the prohibition law of 1983
Achievements
Khat in the world perspective
Concluding remarks
Author: A. S. ELMI, Y. H. AHMED, M. S. SAMATAR
Pages: 51 to 57
Creation Date: 1987/01/01
The chewing of the leaves of the plant called khat (Catha edulis Forsk) is a common habit in some countries of East Africa and the Arabian Peninsula. Khat-chewing has a stimulating effect on the central nervous system, which is the reason for the widespread abuse of this plant. From the mid-1960s to the early 1980s, khat-chewing spread from the limited area of the north-western part of Somalia to the whole country, assuming epidemic proportions. Khat-chewing was recognized as a real national problem with adverse consequences for the health and socio-economic development of the country. A law prohibiting the use, importation, cultivation and trade of khat was enacted in 1983, and it has been strongly enforced by a comprehensive national programme that has mobilized the whole country to achieve its objectives. Committees to co-ordinate action on khat control were established at the national, regional and local levels. An information and education campaign through the use of the mass media has been carried out to support the national programme. After the successes achieved in the enforcement of the prohibition law, the national authorities, hampered by a shortage of financial resources, have had major difficulties in providing farmers with adequate compensation for damage caused to them by the destruction of khat plantations.
Difficulties were also experienced in coping with the unemployment of those who were involved in the khat business and in establishing the recreational facilities needed to provide healthy social alternatives to khat-chewing sessions. These difficulties have only been partly solved. Although small amounts of khat are still smuggled into the country and clandestinely consumed, the level of khat-chewing and its associated problems have been substantially reduced. Nevertheless, in order to ensure the complete success of the prohibition law, international co-operation appears to be essential.
The chewing of the leaves of the plant called khat (Catha edulis Forsk) has become a common problem in many areas of East Africa and the Arabian Peninsula. In Somalia, khat-chewing became a widespread problem in the mid-1960s. Before 1960, khat was grown on a limited scale and was chewed only in the northern areas of the country. The problem was initially limited to a small number of people, such as artists and drivers, who for professional reasons resorted to the stimulating effect of khat. Gradually it became an omnipresent phenomenon, which, with the exception of children, involved people of all categories and ages [1] .
Khat-chewing is an insidious habit that affects many aspects of life. With its adverse social, economic and medical consequences it has become a problem of grave national concern. In 1982, Somalia spent $US 57 million on direct khat imports, in spite of the current difficult economic situation [2] , [3] . In addition, the economic problems associated with khat-chewing include the spread of corruption, the theft of public and private property to support the habit, damage to people and to property caused by accidents that occur under the euphoric state induced by the use of the drug, and the loss of many working hours among civil servants and private employees.
In the social sphere, family disruption is a prominent problem, which includes frequent quarrels, breach of family ties, neglect of the education and care of children, waste of family resources, encouragement of prostitution, as well as encouragement of family members to become involved in khat-chewing [3] , [4] .
The chewing of khat is reported to cause health impairment, which has been described elsewhere [1] , [5] - [10] . The types of impairment include stomatitis, oesophagitis, gastritis, increased blood pressure, tachycardia, palpitation, increased body temperature and respiratory rate, constipation, anorexia, decreased sexual potency in men, insomnia and migraine. Myocardial insufficiency, cerebral haemorrhage, pulmonary oedema and hepatotoxic effect have also been described [5] , but these findings need further confirmation.
A study carried out in the Yemen Arab Republic showed that babies born to mothers who were either habitual or occasional khat chewers had a significantly lower average birth-weight [11] .
The active compounds of khat, which have been so far isolated, are two phenylalkylamines: cathinone (s-aminopropiophenone) and cathine (d-norpseudoephedrine). Chemical and pharmacological properties of these compounds are very much similar to those of the amphetamines. In particular, psycho-active, metabolic and cardiovascular effects of the use of cathinone are similar to those of amphetamines [9] , [10] , [12] , [13] .
On the recommendation of the World Health Organization, the Commission on Narcotic Drugs decided at its ninth special session held in February 1986 to place cathinone in Schedule I and cathine in Schedule III of the Convention on Psychotropic Substances 1971 [14] .
Having recognized khat-chewing problems and their adverse effects on health and the socio-economic development of the country, the national authorities of Somalia passed a law on 18 March 1983 prohibiting the importation, cultivation, trade and consumption of khat. The ban on khat and the subsequent anti-khat campaign have achieved remarkable results, which are considered as one of the most important achievements in the recent history of Somalia.
This was not the first time that a law against khat was promulgated. In 1921, and again in 1939, the cultivation, importation and possession of khat were prohibited. Similarly in 1956, the importation and possession of khat were banned. These laws failed to bring results, because the public was not fully aware of the hazards of khat-chewing and the people's degree of compliance with those laws was very low. Another reason for their failure was the absence of a sound programme for khat control. In contrast, the law of 1983 was enacted in much more favourable circumstances. The public was aware of the problem and many people were looking forward to strong measures against khat consumption.
Obviously, the law in itself was not enough to solve a deeply rooted habit of khat-chewing. So the law was only the first in a chain of steps that have been taken to control khat. A decisive step towards the enforcement of the law was the establishment of a comprehensive national programme for control of the use, importation, cultivation and trade of the drug. In fact, the promulgation of the law was promptly followed by:
The institution of khat committees at the national, regional and local levels;
An information and education campaign through the use of the mass media;
The organization of, and active participation in, national and international meetings on the problems of khat.
In short, the whole country was mobilized to help implement the provisions of the law effectively. The highest body responsible for the control of khat is the National Committee for the Eradication of Khat. The members of the Committee are high-ranking State and political personalities. The Committee meets regularly twice a month. Its main responsibilities are:
To ensure the enforcement of the prohibition law;
To establish and maintain a system of khat control;
To conduct mass information and educational programmes on the hazards of khat-chewing;
To provide recreational facilities to serve as healthy alternatives to khat sessions;
(e) To co-ordinate the control of narcotic drugs, psychotropic substances and other psycho-active substances, as well as khat eradication activities;
(f) To co-ordinate the activities of the other khat committees, such as the National Research Committee on Khat and regional and local committees on khat eradication;
(g) To ensure a continuous flow of information on khat control.
The enforcement of the law of 1983 meant redeployment of national resources to achieve its objectives. A number of problems arose, but they were faced with a sense of commitment. The most serious problem was the damage caused to farmers by the destruction of khat plantations. Before such destruction an accurate assessment of khat-cultivated land and the number of khat trees on each farm was made. Unfortunately, the expected means for adequate compensation of damage to farmers was not found. Local resources were not sufficient for the needed technical and financial support. This situation has caused deep concern, and solutions are still being sought.
Another problem that required attention was the joblessness created among persons who had been involved in the khat business. Every effort was made to help them and to channel their energies into positive and socially acceptable activities. There was also an increased need for the establishment of recreational facilities that could serve as healthy alternatives to khat sessions, which were a popular type of social gathering.
It is worth mentioning that the general response of the public to the prohibition law was highly positive. A sense of optimism replaced the feeling of frustration that had been common before the new law. However, there were small groups of people who opposed the prohibition because of the profits they had been making from the khat business or because they were dependent on khat. These people opposed the anti-khat measures and tried to smuggle the drug into the country in various ways. But the consistent enforcement of the law and the gradual stepping-up of the anti-khat campaign made their antisocial tendencies more and more difficult to maintain. Thus, khat imports decreased dramatically in the country, particularly in regions far from the sources of supply in neighbouring countries. Small amounts of khat are still smuggled into the country, but its price has increased 15 to 25 times compared with what it was before the prohibition law.
Thus, in most areas of the country, the objectives of the prohibition law have been fully achieved. In some areas, particularly along the borders, khat is no longer openly used, but small amounts continue to be smuggled in and illegally consumed.
In the Togdheer, Sanaag and North-West regions, where khat had been grown on a limited scale, a systematic destruction of khat fields has been carried out. The roots of some plants burgeoned again, but destruction teams proceeded to uproot them altogether.
The improvement in the social, economic and health conditions of the population that has given up the khat-chewing habit varies from place to place. In some areas, the problems associated with khat-chewing, such as the disturbance of family relations and public morality, are obviously fading away. With the striking reduction in the total amount of khat introduced into the country, it is reasonable to expect a significant decline in the amount of hard currency spent on khat procurement.
All of the above indicates that the programme for eradication of khat and its consumption following the prohibition law of 1983 has been successful.
At present, the problem of khat-chewing affects seriously only some of the countries in the Arabian Peninsula and East Africa. In the latter area, neighbouring countries are affected, but the degree of severity of the khat problem varies considerably among them. As the khat-chewing habit has for centuries been limited to the same geographical area where it has been traditionally grown and habitually consumed, it may also be assumed that the problem will always remain within its traditional boundaries. However, in a world where rapid changes are taking place in the way of thinking and of life, this assumption may prove to be dangerously wrong. Modern communications make the importation of new habits and fashions very easy. An example of this is Somalia, where for centuries khat-chewing had been common only in the north-western part of the country, but the situation changed in just two decades, so that the problem spread over the whole country, assuming epidemic proportions. This transformation occurred without arousing much alarm until it was almost too late.
Furthermore, it has been observed that some foreign experts and visitors fall victim to khat-chewing during their stay in areas of endemic use. On their return home, these new disciples of khat may be tempted to continue in the newly acquired habit, favoured in this by the availability of fresh khat transported by air. It would not be a hard task for them to spread the habit to other eager followers. At present, khat consignments reach some European countries where the drug is consumed mainly by immigrants from areas of endemic use.
It would, therefore, appear highly desirable for the international community to promote co-operation in the area of khat control not only for the sake of rescuing the populations of countries at present affected by this harmful phenomenon, but also to protect possible new victims of khat-chewing in other parts of the world. Some might assume, particularly on the basis of the results obtained in Somalia, that khat-chewing is easier to eradicate than is the use of other drugs. This would be a wrong assumption, because the positive results in Somalia have been achieved only through great efforts, while the most cost-effective strategy for combating the problem would be to make all possible national and regional efforts within the framework of international co-operation. Furthermore, international assistance in the matter of khat control would create the powerful image of a world-wide united front for the control of all types of drugs of abuse that threaten human well-being. In this connection, it should be noted that at the beginning of Somalia's khat prohibition campaign some promises of assistance from the outside world were made, but so far none has been forthcoming, and even the initial enthusiasm shown in the outside world for the Somali action seems to be fading away.
There were no other effective alternatives to the banning of khat as a means of saving the country from its abuse and associated problems. It can now be concluded that the results so far obtained in the anti-khat campaign are encouraging. This is a significant achievement for Somalia, which, with its limited resources, is striving at the same time to cope with other important health and socio-economic problems. Because of its potential to spread rapidly to previously unaffected populations, khat should be brought under international control and there should be international co-operation in the efforts to control it.
A.S. Elmi, "The chewing of khat in Somalia", Journal of Ethnopharmacology, vol. 8, 1983, pp. 163-176.
002M.S. Samatar and M. E. Bullaleh, "The effects of khat on the national economy", in Studies on Khat: Its Social, Economic and Health Effects (Mogadishu, Scientific Research Bureau, 1984), pp. 43-53.
003A. S. Elmi, "Khat: spreading, epidemiology and problems in Somalia", in Proceedings of the Second International Congress on Somali Studies, T. Labahn, ed. (Hamburg, Helmut Buske Verlag, 1984), pp. 271-286.
004M.A. Hassan, "The social effects of khat", in Studies on Khat: Its Social Economic and Health Effects (Mogadishu, Scientific Research Bureau, 1984), pp. 26-42.
005H. Halbach, "Medical aspects of the chewing of khat leaves", Bulletin of the World Health Organization, vol. 47, 1972, pp. 21-29.
006P.H. Hughes, "Khat chewing in Yemen", Proceedings of the Fourth International Institute on the Prevention and Treatment of Drug Dependence (Lausanne, International Council on Alcoholism and Addictions, 1973), pp. 32-46.
007"Review of the pharmacology of khat", report of a WHO Advisory Group, Bulletin on Narcotics (United Nations publication), vol. 32, No. 3 (1980), pp. 83-93.
008A. S. Elmi, "Khat consumption and problems in Somalia ", Proceedings of the International Conference on Khat: the health and Socio-Economic Aspects of Khat Use (Antananarivo, International Council on Alcoholism and Addictions, 1983), pp. 75-86.
009A.S. Elmi and others, "Amphetamine-like effects of khat on some neuroendocrine parameters in humans", in Studies on Khat: Its Social, Economic and Health Effects (Mogadishu, Scientific Research Bureau, 1984), pp. 100-105.
010P. Nencini and others, "Tolerance develops to sympathetic effects of khat in humans", Pharmacology, vol. 28, 1984, pp. 150-154.
011N. Abdul Ghani and others, "The influence of khat-chewing on birth-weight in full-term infants", unpublished research report, 1985.
012P. Nencini and others, "Physiological and neuroendocrine effects of khat chewing in man", Proceedings of the International Conference on Khat: the Health and Socio-Economic Aspects of Khat Use (Antananarivo, International Council on Alcoholism and Addictions, 1984), pp. 148-152.
013P. Kalix and O. Branden, "Pharmacological aspects of the chewing of khat leaves", Pharmacological Reviews, vol. 37, No. 2 (1984), pp. 149-164.
014Official Records of the Economic and Social Council, 1986, Supplement No. 3 (E/1986/23), p. 12.
