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Weekly Edition 058: Saturday 6th April 2002

<< Island Ecology by José P Ribas

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An Anthropological View
by Kirk W Huffman

Thinking About Kava - Part Five

For those who have been following this series about Kava, the sacred plant from the Pacific, from whose roots a soporific and relaxing traditional ritual drink is made, it might be of interest for you to go out and try and buy medicinal kava extract or tablets. The latter have been easily available in Health Food shops in England and the US for nearly a decade and in medicinal form from pharmacies in Germany, Switzerland and France for slightly longer than that. Countless thousands of Europeans and Americans have benefited from the medicinal properties of this most wondrous (plant) root by purchasing medicinal kava extract or kava tablets to alleviate those most common disorders of the modern world - stress, tension and anxiety. But is seems those days are over.

As we have seen in the previous articles, recent medical reports and associated press articles have lead people to believe that there may possibly be a connection between kava and liver damage. At least that is what seems to be the conclusion in Switzerland, Germany, France, the UK, and now Australia, Canada and the US. In all of these countries authorities have either introduced a ban or prohibition or advised withdrawal of kava-based medicinal products because of this all within the last few months. This situation really started coming to a head in Germany at the end of last year and most of the international press reports lead back to Germany. Most of the countries cite reports from Germany as the source or reason for the advice to withdraw kava extract products from sale - the UK did this late last year and the US Food and Drug Administration announced the same on 25th March  'citing the other countries' actions'. So if you are in the UK or the US you may go out to buy some medicinal kava extract and not be able to get any. Blame Germany? Well, tear your hair out, but Germany is the only place in Europe now where one can still easily buy medicinal kava extract (for relieving stress) across the counter in almost any pharmacy. Strange world. No 'ban' has officially been announced yet by the relevant German government authority, but meanwhile much of the rest of the 'modern' world have already followed like brain-dead sheep and turned a non-existent 'ban' into a de facto ban that has halted the export of kava roots from the kava-producing islands of the Pacific. This has, and will, severely affect the lives of many Pacific Islanders, for whom kava growing and export has become one of the few sources of income.

It seems 'our' side of the world is shouting 'Beware of kava!' The Pacific Island world is puzzled, and rather angry. Pacific Islanders in the traditional kava-drinking nations do not associate kava-drinking in any way with any form of liver problems and they have drinking kava for longer than England, France and Germany have even existed! Just to rub the salt in a little bit, readers should note that the world's oldest continuously ruling royal family or lineage is also nowhere in Europe, but is the present day royal lineage of the Pacific Island nation of Tonga. And certain Pacific islands have actually been drinking kava from before anyone even lived in Tonga! South Pacific Islanders are famously polite and the Pacific nations have expressed concern - and also disbelief - at European reports linking kava with liver damage. I would agree with them and would, in fact, put a proper reaction in slightly stronger terms by saying, in Vanuatu Bislama (the Vanuatu variant of Pidgin English) that much of these overseas press reports consist of a significant proportion of "shitshit blong bullock". Do I need to translate that last phrase? - I don't think so.

There is possibly or probably quite a difference between the natural kava drunk traditionally in the Pacific and the kava extracts sold in various forms overseas in medicinal form. The extraction processes for the modern products try, in general, to separate and concentrate what are thought to be the relaxing, active, ingredients of the root, the so-called 'kavalactones'. But in the natural plant these kavalactones form only part of the complex chemical ingredients in the root and it is possible that the other ingredients are essential for the full range of 'beneficial effects'. Some scientists in Europe have said that cases of 'damage' to patients outlined in the recent medical reports and the press often concerned cases of individuals sometimes regularly taking 'more than the recommended daily dose' of extracts containing kavalactones. There is a slight problem with that approach, though. Very often kava drinkers in Vanuatu will traditionally regularly drink fresh kava containing much higher concentrations of kavalactones (plus the other ingredients) than even the most exaggerated Euro-American 'extract overdose'. They may sometimes have a bit of a 'wild and exciting' couple of hours at times (I know, it has happened to me too, and I have had some great times!) but many have been doing it for years. If done in the proper, controlled, traditional way, though, it is fine and I know of respected indigenous men on the island of Tanna in southern Vanuatu who have been drinking kava thus almost every single evening of their adult lives over 30, 40 or even 50 years. As with everything one eats and drinks, 'everything in moderation' should be the goal. But maybe 'the white man' in Euro-America isn't healthy or strong enough? Or is there something more complex, a bit like the existence or non-existence of the infamous 'alcohol enzyme' necessary to enable one to drink and digest alcohol without poisoning oneself? As we have pointed out in an earlier article, neither Australian Aborigines nor Amerindians possess this stomach enzyme, which is why alcohol is so dangerous for them (the knowledge of this has not prevented white people selling them nor them from purchasing alcohol). Is there a necessary 'kava enzyme' that lucky Pacific islanders possess that unlucky 'white people' do not possess? I do not think so, as there are now enough Pacific-island - based 'white people' who are regular kava drinkers to allay that thought and the numbers of people around the world who have taken kava extract or tablets over the last decade or so is enormous. In the US alone, where kava tablets etc really only kicked off in a big way from 1998, there was more than $34 million spent on purchasing kava medicines in the short period November 2000 - November 2001!

There is, however, possibly one medical study that links in to this, but I have not yet been able to track down the original version. It may be a French study, as the only reference to it that I have seen surfaced at the end of January in an interview with a hospital biopharmacist and researcher in New Caledonia. According to this researcher, approximately one in every 170,000 people has in his/her liver a rare type of enzyme that, if combined with (?one of the) kavalactones could possibly produce a toxic enzyme. This has the possibility of provoking a kind of allergy that might eventually damage the liver, it was said. There is an extremely rare form of kava allergy that is known in Vanuatu, where the face can slightly swell up - one of my very close ni-Vanuatu (indigenous inhabitant of Vanuatu) friends had it in the early 1980s, but he is still alive, fit and active. There is traditional medicine in Vanuatu for this uncommon condition, and as the condition is so rare one may have to leave one's island to go to the island with the knowledge of the medicine if one thinks one needs to take it. But in general it is known - in Vanuatu - that kava is a lot better for the liver than alcohol. A white friend of mine in Vanuatu got a rather bad dose of hepatitis in the early 1980s and went on to be given a special type of kava medicinally as a liver cleanser. I myself had a rather bad liver around that time after suffering numerous malaria attacks (normal for anyone working in that part of the world) and being given the wrong (and bad treatment) for a particularly bad attack. Up to 1983 I had been a regular drinker of wine, in rather large quantities, but living in the tropics makes one's system work nearly twice as hard to process the alcohol. By '1983, what with alcohol, malaria, and one very bad medical treatment for malaria (I had been drinking kava since 1973, but never on the same day as alcohol), the liver really complained. Since then I have only drunken kava (no alcohol), and there have been no complaints. It is admittedly, rather difficult to drink kava on Ibiza, but I drink fresh kava regularly every evening on my yearly visits back to Vanuatu (I left Vanuatu in late 1989 to come to Ibiza) where I am still pursuing anthropological work (and am Honorary Curator of the Vanuatu Cultural Centre - the nation's National Museum). I mention all this purely to indicate that when I am talking about kava, I am not talking about it like most of the Euro-American scientists, I actually do know a little bit about it! And Vanuatu kava is the world's strongest and the range of different types of kava grown there is vast - over 82 different varieties of the plant, each with their own types of effect. Most of the scientists overseas seem to think there is really only one variety of the plant - and this is not surprising, as eastwards from Vanuatu across the Pacific there are really only between 5-10 subspecies of the plant (and rather weak varieties at that - and they mix their drink with a lot more water than is used in Vanuatu!). This latter region is the area where most studies have been done and where Europe and the US get most of their kava rootstock from to make kava medicines and tablets. At a non-spiritual level, it is rather like the difference between whisky and beer, with the men in Vanuatu being the whisky drinkers (plus one other area in Micronesia, the small island of Ponape) and the rest of the Pacific being beer drinkers. What the 'white man' seems to be complaining about are supposed effects from the Pacific 'beer', without knowing that a hardy nation of whisky drinkers exists where life continues as normal!

The above-mentioned (?French) study hinting at possible levels of one in every 170,000 people maybe being more susceptible to kava is interesting, but if true, is not grounds for the type of 'ban' that seems to be coming into effect. Any statistician looking at that would say that the percentage is statistically insignificant to the extent of being almost non-existent. Excess coffee or alcohol, etc, provide much higher statistical levels of danger to the liver - as do some household chemicals, certain sprays and detergents, and so on. But kava is 'the unknown' (at least to Euro-American governments and medical associations) and therefore more likely to be blamed for all sorts of things that one really doesn't know too much about (a bit like 'the Communist threat' during the Cold War).

This reminds me of a rather charming story that was doing the rounds of the diplomatic 'cocktail circuit' of the kava-drinking nations of the Pacific in the mid-1980s. How accurate it is, I am not sure, but there is no smoke without fire, and I heard it from a good contact. Relatively small amounts of South Pacific kava root and kava powder were being imported into the US from the 1970s for traditional consumption by the small number of Samoans and Tongans living mainly in California. Around 1986, the US government suddenly seemed to put a ban on its import, in spite of the fact that some rather successful experiments had been done with it in a California prison for violent offenders in the early 1970s (these offenders ended up becoming more relaxed and normal, but the experiments were halted when kava stocks ran out - it was not too easy to get regular supplies in those days). Of course, hardly any 'white people' knew much about kava in the US in those days, except for a small number of academics who had worked in the Pacific, a handful of medical specialists - and a few aging CIA operatives who some said had experimented with it amongst the nearly 150 'chemical substances' used in the CIA's 'mind control' experiments of the 1950s, 1960s and early 1970s (under the codenames projects MKULTRA, MKDELTA, Bluebird and Artichoke). However, a persistent advertisement kept appearing in the early 1980s in certain Californian magazines; 'Get your Ounce of Legal South Pacific High', advising readers they could purchase powdered kava by ordering from a PO Box address in, I think, Santa Monica. A drawing with the advert showed a rather cool-looking hippie with large hat and beard smoking a giant joint. Of course no one in their right mind would bother smoking kava, all one would probably get would be an expensive case of sore lungs, but it seems the police went into high alert anyway. Fiji was particularly affected by the US ban on kava imports and the Fijian Prime Minister, Ratu Sir Kamisese Mara, went to Washington to see the Secretary of State. This was during Reagan's presidency, and George Shultz held that position - and he had recently been on an official visit to Fiji. There he had, like all-important visitors, been ritually welcomed with the important ceremonial drink, Yanggona. "Why has your government banned South Pacific Yanggona"? the Fijian Prime Minister politely asked. "No, we have banned South Pacific kava, it's a pinko-commie drug", Shultz was reported to have replied (indicating therefore, I assume, that it might be a threat to democracy)."But kava is Yanggona", Mara said "..and I thought I would bring along as a gift to you these official Fijian press photos of you drinking it during your recent visit". However accurate this story is one may never know, but the US kava 'ban' was lifted shortly after Mara's visit.

Regarding the extremely small numbers of supposed cases of 'kava-induced liver damage' and the vast amounts of kava medicines sold over the last decade in Germany (see last week's article Weekly Edition 057 Saturday 30th March 2002): I discussed this with a number of German pharmaceutical people during the three weeks my wife and I spent there in January. They agreed that the number of alleged cases was infinitesimal. The doctors, though, were of course doing their correct duty in reporting anything. My German brother-in-law, a respected economist and statistician, did say that whoever had done the reports and releases had little idea of statistics. Other pharmacists told me the same, but not in such academic terms. One wondered why there was so much fuss about medicinal kava extract and the liver when, for example, it was known that the aspirin-type painkiller Paracetemol could possibly damage the liver and yet was still easily available. Another said what about Viagra, that was already responsible for 70-80 deaths but whose registration had not been withdrawn (at which point I said 'This just shows that sex and money are more important than death', a comment that was met with a meaningful silence). It was not until recently that I came across a report indicating that by September 2001 a total of 616 people worldwide had died from using Viagra (many, it is said, by using it incorrectly). Remember that Viagra has really only been in use for about five years, not 2000 or 3000 years, like kava and there are more kava-users in the world than there are Viagra-takers, I am pretty sure! Most of these things are probably pretty good and safe, though, if used in the proper way and with the proper supervision.

But if Euro-America (and Australia) want to ban kava products on whatever basis, what about FAVISM? 'Favism'?, you say? Well, I had never heard of it either until a Swiss friend and colleague - a respected botanist and environmentalist who has been known to have a coconut shell or two of Vanuatu kava - put me on to it recently. Favism is an inherited condition, an hereditary (and sometimes fatal) intolerance to beans, specifically to fava beans from the plant vicia faba. These beans are a common element of Euro-American nutrition. Certain Mediterranean populations, especially in southern Italy and particularly Sardinia, possess an hereditary enzyme deficiency that triggers a severe reaction to an intake of fava beans - and sometimes even to fava pollen. Intake can result in acute hemolytic anaemia and even death. Those affected by favism can be up to as much as 4% of Mediterranean populations that have a tendency to lack this enzyme. In Sardinia, though, it can affect up to 35% of the population. For over a century, schoolteachers in Sardinia had noted a strange annual occurrence, mostly amongst their male students. With the arrival of spring each February, a high percentage of students seemed drained of energy and this situation lasted each year for three months. Most just felt lethargic, others died, urinating blood. It was the time when fava pollen was in the air. There are many individuals of southern Italian descent in the United States. Those suffering from favism should not only not eat (fava) beans, but should not take aspirin, vitamin C, certain anti-malarial tablets and certain anti-bacterials and certain heart drugs. Sounds pretty scary. Have you ever heard any suggestion that (fava) beans should be banned? No, of course not. It is part of our 'accepted Euro-American lifestyle', like other potential killers such as alcohol, tobacco and so much of the other paraphernalia of our polluted side of the world.

But these things come from 'our' world and 'we' have become unconsciously inured to their potential dangers, we look upon the level of risk as 'acceptable'. Kava - with no real known risk in the Pacific over millennia (except for possible temporary symptoms if overdone for long periods, normal with almost anything) is not from 'our' world, it is a gift to us from a more ancient corner of the globe, and we seem to have messed it up. The traditional drink of kava is associated with some of the world's oldest religions, with the bridging of that gap between the material and spirit world. That is why so many early (and even some today) missionaries in the Pacific were/are so much against it. For Pacific islanders, this recent Euro-American kava 'ban' is just a continuation of those early bigoted views. It is almost as if this recent ban is a confirmation of a certain type of 'Western' attitude that was so succinctly put once by John Foster Dulles, one of the most important planners of so much of US foreign policy since World War II: "For us there are two sorts of people in the world; there are those who are Christian and support free enterprise and there are the others". Most Pacific Islanders are now, though, devout Christians (which does not mean, however, that the older, traditional, religions have completely lost their relevance) and Christianity now plays a larger part in their lives than in those of most of Western Europe's inhabitants.

Why, then, should worries about kava medicinal extract have created such press frenzy in Germany from the end of last year? There are several factors involved, but one of the major ones was accidental timing. In August 2001 the relevant German government authority officially withdrew from use the anti-cholesterol drug Lipobay (I think it is called Baycol in the US) produced by the German pharmaceutical giant, Bayer. The 'scandal' still reverberates, with possible court cases still pending in the US, and elsewhere. The Lipobay affair had many tentacles, rather like the Enron octopus, but not spreading into the political arena. Of course it had nothing to do with kava, but in Germany it sort of set the scene for any even minor thing happening after that. We are beginning to get into the scary stuff, but that will have to wait until my next column.

Kirk W Huffman

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