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Logo of Phnom Penh Post newspaper Phnom Penh Post - Iodised salt push for public health

Iodised salt push for public health

Cambodia’s health ministry is advertising the benefits of iodised salt in a campaign aimed at overcoming diseases and slow development from a shortage of the essential micronutrient

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A worker sifts salt at a salt plant on the outskirts of Phnom Penh.

Relief from Nuclear fallout
During the Cold War people took iodine pills at times when there was a threat of a nuclear attack. Why? Because an exploding nuclear bomb forms radioactive iodine. Those who eat, drink or inhale this isotope can develop thyroid damage or cancer. By taking an iodine pill, potential victims saturate the thyroid gland with iodine thus preventing it from absorbing the radioactive iodine.

Iodine deficiency disorders can seriously damage your health. In addition to stunting growth and causing deafness, dumbness and goitre, iodine deficiency can significantly lower the average national IQ in areas where it is widespread.

In April, the Ministry of Health revived a campaign raising awareness of the importance of a sufficient iodised salt intake, especially among children and pregnant women.

The campaign includes educational television and radio broadcasts, as well as school visits by specially trained health instructors, according to Dr Ou Kevanna, manager of the National Nutrition Council, which was established in 1998 by the health ministry.

"Many Cambodian people believe that their children are not brave or clever because of race or other problems, but they actually lack iodine in their bodies," he said.

"Children who lack iodine cannot learn or remember as well as those with sufficient levels. They are also more inactive."

Short supply

Iodine is a micronutrient naturally present in the food supplies of many regions. However, in countries like Cambodia, where natural levels of iodine in the soil are low, and it is therefore not absorbed easily by vegetables, iodine added to salt provides the small but essential amount needed by humans.

Public health experts say putting iodine in salt may be the simplest and most cost-effective health measure in the world. Salt is an effective vehicle for distributing iodine to the public because it does not spoil and is generally consumed by the population in fairly predictable amounts.

Table salt can be mixed with a minute amount of potassium iodide, sodium iodide or iodate. According to the New York Times, two ounces of potassium iodate, costing about $1.15, are needed to iodise a tonne of salt.

Deficiency of this vital iodine trace element causes sufferers to feel tired, depressed, cold, weak, and they may eventually develop thyroid gland problems, specifically endemic goitre, the most visible symptom of which is an often gross swelling of the neck. On a medical mission in 2001, Canadian endocrinologist Keith McDonald was "impressed" by the high frequency of enlarged thyroids he found, particularly among women.

Children who lack

iodine cannot learn or remember as well as those with sufficient levels.

A lack of iodine can also cause serious developmental delays. In 2007 the World Health Organisation identified iodine deficiency as "the single greatest preventable cause of mental retardation" worldwide.

Cambodia has historically been highly susceptible to various micronutrient deficiencies, and a nationwide survey conducted in 1997 revealed a total goitre rate (TGR) of 12 percent among schoolchildren of 8-12 years of age - rising to as high as 45 percent in some areas.

According to UNICEF Cambodia, "any country with a TGR of 10 percent or more is likely to suffer a population-wide lowering of intellectual capacity from 10 to 15 IQ points," thereby shaving incalculable potential off a nation's development.

To address the problem, in 1997 a National Subcommittee for the Control of Iodine Deficiency Disorders in Cambodia was established within the National Nutrition Council. The country began salt iodisation in 1998, and domestic production of iodised salt began exceeding annual national requirements by 2004. A nation-wide school-based survey in 2008 revealed that 62 percent of households use adequately iodised salt.

This is encouraging. However, UNICEF Cambodia highlighted unresolved issues related to low use of iodised salt in salt-producing provinces including Kampot and Kep, and provinces bordering Vietnam, such as Svay Rieng. "The quality of iodised salt remained relatively low and quality control systems on production levels need improvement," a UNICEF report said.

Reaching out

Doctor Ou Kevanna said it was important people received a daily intake of at least 20 to 50 micrograms of iodine to prevent health problems. The recently revived public awareness campaign reached Neang Sopanhna, 32, a housewife who said: "I use iodised salt every day, but I didn't realise its importance until I watched the Ministry of Health's television broadcast."

Her 12-year-old son, Chiv Sokhour, however, said he didn't believe eating iodised salt made him smarter or a better student.

"I will be a good student because I try to study hard and I listen to my teacher's explanations," he said.

Pen Saroeun, director of the School Health Department at the Ministry of Education Youth and Sport, said that the ministry was cooperating with the National Subcommittee for the Control of Iodine Deficiency Disorders and the Ministry of Rural Development to train instructors in four provinces - Prey Veng, Svay Reang, Kamport and Kep province - to spread knowledge about the importance of iodised salt.



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