Around 20,000 people die each year from eating a popular dish, but many still refuse to stop. If someone told you that a meal could kill you, you’d likely avoid it, right?
However, that’s not the case for everyone. In Thailand, Dr. Narong Khuntikeo regularly warns his patients to avoid a particular dish, yet many ignore his advice. The dish, called koi pla, is made with raw fish and is especially popular in Isaan, one of the country’s poorest provinces. Tragically, Dr. Khuntikeo lost both of his parents to liver cancer caused by eating this dish.
A report estimates that 20,000 people in Thailand die each year from liver cancer linked to eating koi pla. The fish used in this dish often come from water sources in the Mekong region, which are infected with parasitic flatworms. These flatworms carry a deadly cancer called bile duct cancer, leading Isaan to have the highest rates of this disease in the country.
“It’s a huge health issue here,” said Dr. Khuntikeo. “But no one talks about it because people die quietly, like leaves falling from a tree.”
For the past four years, he and a team of doctors and researchers have been testing villagers in Isaan for the parasite. Using ultrasounds and urine tests, they found that up to 80% of people in some areas had ingested the parasite. Despite spreading awareness, he faces resistance, especially from older generations.
When asked why they continue eating koi pla, many elders respond with, “Oh well, there are many ways to die.” Dr. Khuntikeo said, “I cannot accept this answer.”
To fight the problem, he’s worked with health officials to create school programs teaching children about the dangers of eating raw foods. Still, some people refuse to stop.
One farmer, Boonliang Konghakot, admitted, “I used to just catch fish from the pond—it’s so easy to eat raw.” Another villager, Thanin Wongseeda, who was being tested, shared, “I’ve eaten koi pla since I was little, so I think I probably have the parasite.”
Despite the risks, the tradition of eating koi pla continues for many in Thailand.
