Speech Impediment...!!

Why I wondered was it that so many people in Varanasi were either deaf or dumb or perhaps both? People greeted you with a nod accompanied with some sort of sign language or with a gargle from a pained expression. It wasn't till later that I begin to realize the reason for this peculiarity... PAN, this was the answer.
PAN for people like me that have never heard of it and don't know what it is, is a mixture of beetle nut, tobacco & calcium. It sold in a leaf for about 6 rupees and is put in the mouth and left. This is then transformed into a mouth full of red saliva which in turn is then kept in the mouth and then spat out, but the longer left in the mouth the better. When people talk to you, if they talk to you because sign language is preferable. They tilt their head back and speak from an open mouth which is holding the red spit. So it sounds like they are speaking to you from under water... !! Makes communication very difficult especially if you are not aware of what it is that is making the person disabled in the speach department.