Yemeni qat seller Hamdan Hussein’s customers still come daily to the crowded market to buy the addictive green stimulant, despite doctors’ concerns that chewing in groups and spitting it could spread the new coronavirus, Reuters reports.

The vast majority of Yemeni men – and many women – chew the leaves for hours a day, cramming them into their cheeks as they work, chat or sit in contemplation. The stimulant in qat can cause excitement, loss of appetite and euphoria.

“I’ve been selling qat for 17 years and, by God, not one of my customers stopped for a single day … I survive off this daily wage, I can’t close down,” said Hussein.

War-ravaged Yemen, whose malnourished population has among the world’s lowest immunity levels to disease, is now divided between a Saudi-backed government based in Aden in the south and the Iran-aligned Houthi group in the north.

Neither government has managed to shut the qat markets.

“The qat market crowds are a catastrophe,” said Houthi health ministry spokesperson Yousef al-Hadari. “If someone is infected, like the seller or customer or even the bags or cash, this could lead to disaster.”

“We only open one entry point so people can be disinfected on entry, and ensure they are wearing masks. We stress over and over to stall-owners the importance of no crowds.”

The United Nations and aid agencies say coronavirus is spreading largely undetected in Yemen and infections are likely much higher than the 560 cases, including 129 deaths, reported in the south and the four cases, with one death, in the north.

“I advise people that if they need to chew, to do it at home and to avoid gatherings,” said Fuad Muajam, a doctor.

One of the more cautious sellers in the Sanaa market sprays a wad of cash with sanitiser.

“Despite the great concern about the spread of the virus, people are still willing, frankly speaking very willing, to buy qat,” said customer Nabil Mufleh, one of few wearing a facemask.

“So we sterilize our qat supplies, wash them well and may God preserve us.”