Culture, lifestyle diseases and the commandant’s room

Three hours I sat in a police station breathing second-hand smoke. As a small mercy, the officers would slide the windows open by 5 to 10 centimetres every now and then, and the stiff breeze from outside would cut in and dilute the carcinogens somewhat. Better yet was the whoosh of clean bracing air each time the door opened, but unfortunately it wasn’t often enough. There wasn’t much coming and going.

It was a small room, no more than 2.5 by 3.5 metres. The commandant’s desk occupied nearly half the room; in the other half was crammed a small couch, two armchairs and an old cathode-ray television set. Between four to six officers (including the commandant) would be in the room at any one time, eyes glued to the soccer match between Qatar and Saudi Arabia on TV while bantering away with each other. The commandant had his own shisha, also known here in Jordan as argileh, beside his desk. The junior officers made do with cigarettes. Through the three hours, there was always at least one man smoking. Sometimes, two.

Amazingly, not everyone in this country is a smoker. My driver Hazir does not have the habit, but whether he was as annoyed by the environment as I was, I couldn’t tell. He was mostly on the phone, swearing, grumbling, pleading by turn.

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The news today is that the Malay community in Singapore is disproportionally afflicted by lifestyle diseases. The Sunday Times reported 21 December 2014 that although Malays account for 13.5 per cent of the population, they make up 24.4 per cent of people on dialysis. As for strokes, age-standardised stroke rates for every 100,000 men in 2013 was 296 for Malays, 199 for Indians and 184 for Chinese. Among women, it was 195 for Malays, 131 for Indians and 105 for Chinese. It’s the same dismal picture for cardiac disease. The newspaper, citing statistics from the national health registry, noted that Malays have surged past Indians as the ethnic group with the highest rate of heart attacks since 2010.

It’s not my intention to go into a discussion of the causative factors, except to mention that the lifestyles we adopt are heavily influenced by cultural and peer expectations, as well as family and social habits, often acting far below cognitive consciousness.

It may also be possible to argue that there is an economic dimension to this too. Poverty shapes diet, though it is debatable whether Malays in Singapore are so much poorer than other ethnic groups that this would be a significant factor.

What is clear though is that changing habits and lifestyles is an immensely difficult undertaking. My little incident in the police station is a good reminder that it is very difficult to defy custom, convention and habit even when one knows something is bad for you. When your community cherishes certain foods, when acquaintances, friends and relatives keep pushing rich dishes at you, it is hard to refuse. When your taste buds have been tuned in a certain way, it is hard to eat differently.

And even though our smoking rate is nothing as bad as Jordan’s, it isn’t something great either. Despite decades of painful taxes on tobacco products and ever-tighter restrictions on where one can light up, the smoking prevalence rate in Singapore is stuck at about 13 percent. It was 13.6 percent in 2007, and only a shade lower, at 13.3 percent in 2013 (figures from Health Promotion Board). The rate actually crept up from 2004, when it was 12.6% (21.9% males and 3.4% females). I am not able to find the gender split for the latest figures — can any reader help?

Here in Jordan, about 60% of men and 10% of women smoke. That’s three times the Singapore rate. The result is plain to see, or rather, smell. People smoke everywhere. The hotel lobby was no place to linger. The convenience store had an airborne particulate matter rating in the hazardous zone. Worst of all, even the nicest restaurants were fogged out. Offering diners an argileh is considered to be essential to keep customers happy.

There is a restaurant on Rainbow Street that has three “set meal” menus, all for the same price. Each has a starter, dessert and a coffee, but only two of them have a main course. In the third, the latter is replaced with a shisha!

Shisha is not cheap. In a fancy restaurant, it is about seven dinars (about US$10) for a pipe session. Nevertheless, there is no shortage of takers; every other table would have someone puffing on one. I have yet to see a ‘no smoking’ section. In any case, if there is one, it is very likely to be a mere formality.

If at all anyone in Jordan wants to reduce the smoking rate, it’s a herculean task, and one that is fraught with political risk too since over half the males have the habit. Moreover, relaxing with an argileh may well be associated with class and conviviality, and there will surely be many who would wield the argument that abolitionists are messing with culture and tradition — always a powerful argument against change. But in the same way that it’s hard to imagine how Jordan can promote the lifestyle changes with respect to tobacco, we shouldn’t underestimate how difficult it may be for various communities in Singapore (and not only the Malays) to make the lifestyle changes that are needed. Our lifestyles are invested with culture, history, aspiration and endorphins.

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Several times, I thought about making an excuse to get out of the room. But each time, I decided that it might be taken the wrong way. The police officers were warm and welcoming, and I didn’t want them to think I was spurning their hospitality. In any event, it was chilly outside the room, and my lightly padded windbreaker, while good for sunny daylight hours, was no match for the rapidly dropping temperatures of a desert night. The hot tea was welcome too, though like so much of tea in this part of the world, it had way too much sugar. The commandant kept inviting me to drink another mouthful, and of course I had to oblige, only for him to personally top up my cup almost immediately.

Between the smoke and the sugar, it was a very unhealthy three hours. But it was not a lifestyle I could opt out of.

The relief car wasn’t supposed to take that long. “Two hours,” said Hazir in a moment of calm between irate phone calls to the workshop that had only recently repaired his taxi, assuring him, profusely no doubt, that it was as good as new. The two hours eventually turned out to be three. His friend, unfamiliar with the area, overshot our location and had to retrace the route to find us. He didn’t reach us till 8:40 pm.

Where we had sputtered to a halt, around 5 pm, was on a road in the desert. In the first ten minutes, I counted about five passing cars: one car every two minutes made for a quiet road. It was already sunset, and very soon it became pitch black. With no lights along the road, the stars in the cloudless desert sky came on in full glory, yet they illuminated nothing. There was nothing to illuminate; by then, ten minutes would go by without any passing vehicle at all. This was definitely not a place to spend the night.

Darkness however brought a small blessing. Some unusual pinpricks of light about a kilometre ahead became visible.

“What do you think that is?” I asked Hazir.

“It’s a mosque,” he answered confidently, and at first I assumed he really knew.

But then, “Why would there be a mosque when there’s nobody living out here?” I asked again. “The last house we passed must have been ten kilometres back.” Hazir looked at me, then swiveled his head and looked at the lights. Without saying anything, he turned on the ignition, and we clanked slowly to the lights. It was a Highway Patrol police station.

We explained our predicament and were warmly invited to sit in the only functioning room — the commandant’s office. We demurred at first, saying we’d only get in the way of his duties.

“You cannot wait in the car,” the commandant insisted. “It will get much colder very soon. “Look at the flag,” he added as he pointed to the Jordanian flag stiffened by the desert wind. “See how strong the wind is?” So we squeezed into the room of tobacco, football and diabolically sweet tea. A room with plenty of chatty officers, though hardly any police work that I could observe. But no matter; we experienced the sincerest Jordanian hospitality and culture, carcinogens and all.