Regulating khat - Dilemmas and opportunities for the international drug control system

Background: The regulation of khat, one of the most recent psychoactive drugs to become a globally traded commodity, remains hotly contested within different producer and consumer countries. As regimes vary, it has been possible to compare khat policies in Africa, Europe and North America from different disciplinary perspectives. Methods: Field research was conducted in East Africa and Europe, using a combination of semistructured interviews, participant observation and the analysis of trade statistics. Results: The research established the significance of khat for rural producers, regional economies, as a tax base and source of foreign exchange. At the same time, khat as a psychoactive substance is associated with health and public safety problems that in turn are met with often ill-informed legislative responses. Bans have in turn lead to the criminalisation of users and sellers and illegal drug markets. Conclusion: The empirical work from Africa provides a strong argument for promoting evidence-based approaches to khat regulation, harnessing the positive aspects of the khat economy to develop a control model that incorporates the voices and respects the needs of rural producers. Ultimately, the framework for khat may provide both a model and an opportunity for revising the international treaties governing the control of other plant psychoactive-based substances

The rise of injecting drug use in east Africa: a case study from Kenya

Studies on injecting drug use in East Africa are reviewed. The existingstudies document the spread of heroin injection in Kenya and Tanzania, both countries where HIV rates are high. No data from Uganda on injecting drug use was found by the authors. A case study of the growth of heroin injection in a Kenyan coastal town is presented. The need for needle-exchange programmes and other prevention services is discussed

Khat in East Africa : Taking women into or out of sex work?

Women's drug use is often associated with sex work as a means of raising money for consumption. Similarly, in Kenya and Uganda, journalists, the general public and aid agencies associate female consumption of the stimulant drug, khat (Catha edulis), as pulling women into prostitution. In contrast to Yemen and Ethiopia, these views are expressed by people living in areas where there are no rituals or traditions of female khat consumption. This paper presents data from a study carried out in Kenya and Uganda in 2004 and 2005 that documents that the majority of women engaging in khat chewing are not sex workers. Frequently, however, women who retail khat are often assumed by men to be sexually immoral. The role of women in the retail and wholesale khat trade is examined. The stigma attached to selling khat is linked to the overall situation of independent women in East Africa and the place of commercial sex in urban life

East African discourses on khat and sex

Aim of the study: The study aims to review and analyse the varied East African discourses on the effects of khat use on libido, fertility, transmission of HIV, prostitution and rape. Materials and methods: The data were gathered between 2004 and 2009 in Kenya and Uganda. Between 2004 and 2005 across Kenya and Uganda a broad survey approach was adopted, involving identification of and travel to production areas, interviews with producers and consumers in rural and urban settings. In addition, a survey of 300 Ugandan consumers was carried out in late 2004. Between 2007 and 2009, an in-depth study of khat production, trade and consumption was conducted in Uganda. This study also employed a mixture of methods, including key informant interviews participant-observation and a questionnaire survey administered to 210 khat consumers. Results: Khat is associated, by consumers and its detractors alike, with changes in libido and sexual performance. Although there is no evidence to support their claims, detractors of khat use argue that khat causes sexual violence, causes women to enter sex work, and that chewing causes the spread of sexually transmitted diseases, including the HIV virus. Conclusions: In East Africa the discourse on khat and sex has led to consumption of the substances being associated by many people with uncontrolled sexual behaviour. There is no evidence that khat use fuels promiscuity, commercial sex, sexually transmitted diseases or rape. The current discourse on khat and sex touches on all these topics. Local religious and political leaders invoke khat use as a cause of what they argue is a breakdown of morals and social order. In Kenya and Uganda it is women khat consumers who are seen as sexually uncontrolled. In Uganda, the argument is extended even to men: with male khat chewers labelled as prone to commit rape. (C) 2010 Elsevier Ireland Ltd. All rights reserved

How ‘Cool’ is heroin injection at the Kenya coast

Qualitative research methods were used to contact, observe and interview about 40 heroin users living in a Kenyan coastal town with a lively tourist industry. It was found that injecting practices were similar to those reported in other parts of the world. High status, or 'cool', among heroin users was associated with injecting alone and with personal autonomy. The sharing of injecting equipment, however, did occur. Most users were ill informed about the risk of transmission of HIV through injecting equipment. Injecting heroin can be status enhancing within this subculture. 'Cool' among these heroin users was associated with personal self-control, a key attribute of Swahili culture. Intervention measures should build on local values of the need to maintain individual self-control and discourage the sharing or communal use of equipment to inject heroin

Khat chewing as a new Ugandan leisure activity

A culture of hedonism that attaches a high value to leisure has prevailed in much of Uganda. Having in the past been associated only with Somali and Yemeni migrants, khat consumption has spread among all ethnic groups and to all parts of Uganda. The locus of consumption has moved from the living room to video halls, alleyways and the ghettos of both urban and rural areas. Khat chewing, which takes several hours if the full sequence of effects is to be achieved, is viewed as idling by mainstream society, and as an affront to the core Ugandan values of hard work and education. There are two types of consumer: 1) the traditional users, maqatna, who chew khat accompanied by soft drinks; 2) the mixers who combine khat sessions with alcohol and/or cannabis use. The mixers have abandoned the rules and rituals of consumption that pertain in other khat-using settings. Many Ugandans confuse cannabis and khat, condone alcohol use, and brand khat chewers as, at best, idlers, and at worst violent criminals

'Idle and disorderly' khat users in western Uganda

Aims: To describe and analyse patterns of khat consumption and the response of the authorities to such drug use in Western Uganda. Methods: Participant-observation and key informant interviews were carried out in Western Uganda during 2007, 2008 and 2009. Findings: Khat is legal in Uganda but its use, especially when combined with alcohol and cannabis, is linked with violent crime by many Ugandans. In Western Uganda local government authorities have attempted to crack down on khat: in Bushenyi District they have introduced a by-law; in other districts khat traders and consumers face arrest and charges of being 'idle and disorderly'. Conclusion: The authorities, by clamping down on khat, because they perceive it to be a cause of violent crime, are targeting a substance that is widely reported in the academic literature to cause apathy, not violence

What harm? Kenyan and Ugandan perspectives on khat

What harm does khat actually do to users and the communities in which they live? In this article, the health-related, social, economic, and religious arguments of Kenyans and Ugandans for and against khat consumption are reported. The medical evidence for harm from khat is far from compelling, and the East African debate on khat is informed by local political discourses that often are closely connected to issues of ethnicity and the control of resources. As a result, the harm attributed to khat consumption is contested. The objective of most local efforts to curb the use of khat in East African towns is the reduction of social and economic ills. Yet, eliminating khat consumption would not reverse the problems that it is identified as causing