Banjul, The Gambia – On a humid March afternoon on the outskirts of Banjul, a woman known only as Safcarries a basket of plants from her garden. Moving with urgency to avoid prying eyes, she makes her way to a hidden location, where the air is thick with the earthy scent of raw, unprocessed tobacco leaves waiting to be turned into the popular drug taba.
Suddenly, her phone rings. A customer. She smiles knowingly. “She’s one of my favourites because she keeps coming back,” says Saf, whose name is a code word that means “sweet” in Wolof.
Secrecy is important, says the 68-year-old taba seller, who for decades has made and discretely sold the substance to women.
Taba, a local Mandinka word for powdered tobacco, has been consumed in The Gambia for generations, usually through smoking, snuffing and chewing. But in recent years, taba, modified by adding other substances to the tobacco powder, is being used for different purposes.
Sellers like Saf take regular taba and mix it with potent chemicals to enhance its intoxicating effect. Many women then use it intravaginally, believing it enhances sexual pleasure.
Meanwhile, others, including some traditional healers, insist its intravaginal use has medicinal properties – from helping treat genital infections and headaches to conditions like epilepsy, hypertension and infertility – though these remain medically unproven.
Though taba is not illegal, health authorities, doctors and activists in The Gambia warn of its dangers and caution against its use. But many women continue to seek it out.
For Fatmata*, 36, “taba works wonders.”
Married for a decade, Fatmata’s husband left for Europe just three years into their marriage. Struggling with his absence, a close friend introduced her to taba.
“I don’t want to have extra-marital affairs for religious reasons, so I resort to taba,” she says, shyly.
‘Worst mistake of my life’
For others, the effects have been less favourable.
The first time Rose*, 28, used taba after a friend suggested she try it, she felt an overwhelming sense of dizziness and nausea before violently vomiting. She continued trying, but the third time she used it, she says she nearly lost her life.
“I remember the burning sensation, the excruciating pain, and how my body reacted as if my insides were on fire,” she says. “I could barely breathe and thought I was going to die.”
The pain was intense but brief, she says. Afterwards, she fell asleep, and when she woke up, there was an uncomfortable ache between her legs. But she did not seek medical help, fearing it would expose her as a taba user at a time was the government was warning against it.
After her ordeal, she pledged never to touch taba again.
“It is dangerous, and women need to stop inserting it into their genitals before it’s too late,” she warns.
Taraba*, 28, and Isatu*, 42, began using taba to address health concerns.
“Taba damaged my system,” says Taraba, who initially took it in an attempt to cure gonorrhoea.
“At first, I only used it for that purpose. But a month later, I began inserting it into my vagina for pleasure. That was the worst mistake of my life.”
What followed was excruciating. “It felt like fire burning inside me, and my whole body became [temporarily] paralysed.” Unlike Rose, whose pain was brief, hers lasted for an entire week.
Isatu also first used it as a supposed remedy for gonorrhoea. “I first heard about this powder three years ago from a colleague. She told me she had used it in her vagina to relieve a bad headache, and it worked.”
But when Isatu tried it, “I was bleeding profusely; I nearly died.”
Neither Taraba nor Isatu sought medical help, choosing instead to endure their pain in silence. Isatu says she remains traumatised from the experience.
Regular user Fatmata, however, insists that taba has no harmful effects on her health and claims most women use it with no complaints.
Taba seller Saf agrees, saying most of her customers have been buying from her for years. “If it was harmful, they wouldn’t keep coming back.”
‘Intravaginal taba is harmful’
Little is known about the health consequences of intravaginal taba, according to the peer-reviewed journal, Tobacco Control. But it is “likely to have negative health effects” based on what is known about the use of other smokeless tobacco, said the authors of a 2023 paper on taba.
“Intravaginal taba is harmful,” insists Dr Karamo Suwareh, a gynaecologist at Kanifing General Hospital, the second largest public hospital in the country.
“It causes irritation, infections, burning sensations, itching, foul-smelling discharge, and bleeding during intercourse,” he tells Al Jazeera.
Dr Suwareh warns that taba contains carcinogens, and says research is needed to see whether it could lead to cervical and vaginal cancers. During pregnancy, the nicotine and other unknown substances may increase the risks of preterm labour, foetal growth restriction, and stillbirth.
“Taba disrupts vaginal pH, making women more vulnerable to STIs like gonorrhoea, syphilis, and HIV. It damages tissue instead of healing it.”
Gambia’s Ministry of Health has been vocal about the potential health risks of using taba intravaginally, cautioning that it could pose an increased risk of cancer or life-threatening complications during childbirth. Some women use it in an attempt to ease labour pains, but medical experts warn that it can cause severe harm instead.
The ministry has used social media to educate the public on the risks, and in a video that went viral, Minister of Health Lamin Samateh was seen addressing a gathering in a local language to warn about its harmful effects.
“Taba is dangerous, and women should reject it,” said Minister Samateh in the video that first emerged on