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The Palm Wine Trade: Occupational and Health Hazards L Mbuagbaw1,2, SG Noorduyn2,3

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The Palm Wine Trade: Occupational and Health Hazards L Mbuagbaw1,2, SG Noorduyn2,3 Review This work is licensed under a Creative Commons Attribution- NonCommercial 3.0 Unported License. The Palm Wine Trade: Occupational and Health Hazards L Mbuagbaw1,2, SG Noorduyn2,3 Abstract The palm wine trade is an important economic activity for many tropical rural areas world- 1Centre for the wide. In West Africa, palm wine holds high sociocultural and traditional values. Wine tap- Development of Best Practices in Health pers often climb very tall trees with rudimentary equipment to harvest palm sap and risk (CDBPH), Yaoundé severe injuries in the event of a fall. Furthermore, the wine quickly ferments beyond the Central Hospital, desired taste and alcohol content, reducing the market power of these tappers. Therefore, Avenue Henri Dunant, Messa, PO Box 87, to maximize benefits or to enhance shelf life, a variety of components are added to the Yaoundé, Cameroon palm tree sap, introducing the possibility of deadly contaminants. This paper highlights the 2Department of Clini- public health implications of uncontrolled palm wine production and the relative neglect of cal Epidemiology and Biostatistics, McMas- the wine tapper. We draw from the limited published literature and use Cameroon as a case ter University, ON, study. The palm wine trade can be more productive and safe if tappers work in cooperatives Canada, 3CanChild Centre for to improve their market power. Public health authorities need to monitor the quality of this Childhood Disability cheap and common source of alcohol and enact regulations to protect wine tappers from the Research, McMaster current level of occupational hazards. There are varying levels of progress to control quality University, ON, Canada and ensure safety in different parts of the world. Legislation and collaboration with traditional structures may offer a framework for change. Keywords: Occupational injuries; Wine; Accidents falls; Methanol; Cameroon Introduction wine can also be distilled into whisky-like drinks with higher alcohol content (up alm wine is an alcoholic beverage to 40%). Beyond a certain threshold, the created from the fermented sap of wine no longer gains alcohol content and Pvarious palm trees. It can be col- further fermentation produces vinegar.3 lected (or tapped) from the oil palm tree Many factors including the species of Elaies guineensis or from the Raffia tree the tree, the season of the year, time of Raphia sp. which is shorter and thus day at harvest, and type of soil, impact the more accessible.1,2 alcohol content of the wine.2 In fact, these Fermentation begins immediately af- factors play a key role in the characteris- ter collection as a result of natural yeasts tics of the final product as rudimentary in the air and wine; within two hours, the storage and production facilities do little Correspondence to alcohol content reaches approximately to preserve the product. Lawrence Mbuagbaw, MD, Centre for the 4%. At this stage, the product is a sweet, The sap that provides the base of palm Development of Best Practices in Health white, mildly intoxicating aromatic bev- wine is extracted and collected by a tap- (CDBPH), Yaoundé erage. Continued fermentation for up per (tapster). Palm wine tapping is a com- Central Hospital, Avenue Henri Dunant, to 24 hours results in a more alcoholic, mon occupation in many palm-growing Messa, PO Box 87, 1-3 regions of the world—mainly non-Islamic Yaoundé, Cameroon acidic, and sour white drink. This palm E-mail: mbuagblc@ mcmaster.ca Cite this article as: Mbuagbaw L, Noorduyn S. The Palm Wine Trade: Occupational and health hazards. The Received: Aug 15, 2012 International Journal of Occupational and Environmental Medicine 2012;3:157-164. Accepted: Aug 22, 2012 www.theijoem.com Vol 3 Number 4; October, 2012 157 review The Palm Wine Trade wine tapper, and the public health im- plications of palm wine tapping and con- TAKE-HOME MESSAGE sumption using the wine tapping industry in Cameroon as a case study. ● Palm wine tapping is an important economic activity for the rural poor. The Significance of Palm Wine ● The profession is poorly recognized and very risky. Palm wine is consumed by more than 10 million people in West Africa, and in ● The drink can be contaminated at lower frequencies in Asia, South America, multiple levels of production leading the Middle East and North Africa.1 Due to to high risk of serious health conse- its near-global popularity, palm wine is quences. known by a variety of names in different countries including “Matango,” “Fitchuk,” ● Palm wine production should receive and “Mbu” in Cameroon, “Doka” in Gha- regulations for quality control. na, “Toddy” in India, “Emu” in Nigeria, “Lambanog” in the Phillipines, and “Pa- ● Collaboration with traditional insti- 6 tutions can help to address public nam culloo” in China, just to name a few. health concerns in a culturally ac- Culturally, African literature is rife ceptable manner. with passages describing the production and consumption of palm wine. Chinua countries where alcohol consumption is Achebe's book, Things Fall Apart (1958) not religiously prohibited. In most cases portrays palm wine as the main drink 7 it involves climbing very tall palm trees for entertaining guests. Interestingly, using rudimentary climbing equipment, this was mirrored in modern media af- slashing the palm flower until the sap ter the British Broadcasting Corporation begins to run and attaching a gourd to (BBC) dubbed it a “social lubricant” after collect the wine. Palm wine can also be a visit to Batibo, the “palm wine capital” 8 tapped from felled trees which yield high- of Cameroon. More references are found er quality wine but in much smaller quan- in Amos Tutuola's book, The Palm Wine tities.4,5 Although felling the tree is a much ‘Drinkard’ (1952), which follows the story safer practice, this method of tapping is of a young man who is disheartened by destructive and the sap stops flowing af- the death of his favorite palm wine tapper 9 ter 2–3 weeks.5 Given that the tapper is after a fall from a tree. In Ferdinand Oy- most often not the tree owner, the former ono's The Old Man and the Medal (1956), method is preferred since it preserves the the main character consumes too much tree for many years at the cost of more la- palm alcohol and loses his most precious 10 bor time, effort and risk. Remuneration possession. Therefore, the palm wine is poor and palm wine tappers often lack industry is deeply rooted in African tradi- medical insurance to cover injuries due tions, literature, and lore. to falls. Yet, in many countries palm wine Traditionally, palm wine is deeply root- carries an important sociocultural and ed in West African culture and traditions economic value. and thus is the most frequently consumed 5,11 This paper discusses the significance alcoholic beverage. It is enjoyed at birth of palm wine in communities where it is celebrations, at funeral wakes, and plays consumed, the contrasting neglect of the an integral role during traditional mar- riage ceremonies. It is commonly thought 158 www.theijoem.com Vol 3 Number 4; October, 2012 review L. Mbuagbaw, S. G. Noorduyn to be a very nourishing drink which pro- motes lactation, treats conjunctivitis, and improves eyesight. African traditional healers often infuse palm wine with me- dicinal herbs to produce a wide variety of remedies. Palm wine also plays a role in social fabric and order of the rural village. In some villages in Cameroon, it is still ex- pected that a certain quota of all the wine tapped is given to the Chief of the village. Furthermore, the act of sharing wine with the Chief is regarded as a sign of fidelity and homage.8 Offering palm wine to an- other is a longstanding symbol of grati- tude and is significant in both business and personal relationships. Village social life revolves around the palm wine kiosk Wine tappers work at heights in sub-optimal conditions. and these establishments enjoy popular- ity analogous to European salons and ca- ogy and economics papers. Although the 12 fés. Finally, palm wine is so centric that Food and Agriculture Organization (FAO) a popular music, “meringue” is referred to has shown great interest in the nutritional 13 as palm wine music in Sierra Leone. value of palm products, there is little men- Historically, palm wine tapping and tion of it in public health literature.3,5,19 consumption was discouraged by most colonial and post-colonial governments Injuries because it prevented less economically useful activities and promoted local al- Injuries cause approximately five million 5,14 cohol consumption. However, the eco- deaths per year worldwide.20 More than nomic importance of the palm wine in- 90% of the world's deaths from injuries dustry in a country like Cameroon should occur in low- and middle-income coun- not be overlooked. It employs nearly tries,21 with males in Africa claiming the three-quarters of the male population in highest injury-related mortality rates.22 some villages, providing a monthly in- Falls are an important cause of mortality come of 20 000–35 000 FRS CFA (US$ and burden of disease worldwide.23 Oc- 15 40–70) for many tappers. One village cupations requiring work at heights or in can produce approximately 10 000 L of hazardous conditions are risk factors for 16 palm wine per day. In Nigeria, the per falls.24 Wine tappers often work at heights capita income from wine tapping is es- in sub-optimal conditions and their falls timated to be equal to the country's per have been described as “an all too fre- 17 capita income. Here, up to two million quent tragedy.”25 metric tons of palm wine are produced in one year.17 The palm wine trade repre- The Case in Cameroon sents an important source of income in 2,18 West Africa.
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