Man of Cancer


My buddy and I were strolling through an open air market near Agra in India when we noticed a number of red spit stains on the ground. Not that spitting was uncommon in public in India, but these particular spit stains had such nausea inducing appearances with granular content mixed into a dark red thickened fluid. The sheer quantity of the stains in this market intrigued us to look for its source. At first, I imagined there had been a huge street fist fight that everyone involved were vomiting blood in the end and spitting them all along the streets. Alas, there were no fight club of India.

Our investigation quick bore fruit, pun intended. We found this man selling packets of these crushed nuts and leaves. It occurred to me that he was dealing betel nuts, a popular chew for South and Southeast Asians. Betel nuts, also called Areca nuts, were often sold along with tobacco for chewers. After munching on these nuts for a short period of time, chewers spat out the grounds of the betel nuts which created the bloody red spit stains we encountered in the market.

Chewing betel nuts has been linked to the increasing risks of oral and esophageal cancer in South and Southeast Asia for many years. And it’s a habit that many governments and medical organizations are trying control for public health reasons. Not only that the chewers of betel nuts have increased risks of cancer, their copious amount of spit in the streets further propagate infectious diseases like tuberculosis which is not uncommon in South and Southeast Asia.

I took a photo of this man sitting in a street corner near the open air market. He was intensely focused on trimming his betel nut leaves and neatly packaging his betel nuts. He never noticed me taking his photo. Surrounding him in the radius of a mile were these bloody red spit stains spewed on the streets by his customers. This man sitting at the epicenter of hundreds of bloody red spit stains was single handedly creating a public health event and probably didn’t even know it. He was probably just trying to make a living and sending his children to school.

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