Preliminary Report from CDRS
(Comprehensive Disaster Response Services)
Lack of Iodine in Salt Which is Packaged as Iodized
in the District of Muzaffarabad, Kashmir
(Comprehensive Disaster Response Services)
Lack of Iodine in Salt Which is Packaged as Iodized
in the District of Muzaffarabad, Kashmir
By Judy Sandick MD, Helen Weld RN, MPH
& Muhammed Zubair Makhdoom BSc
April 2007
“Never doubt that a small group of thoughtful
committed citizens can change the world. . .
Indeed, it is the only thing that ever has.”-- Margaret Mead
The issue of iodine deficiency disorders (IDD) in Pakistan has been recognized, studied and discussed at length since the 1970s, yet the situation has not been remedied. It is alarming to see a very high prevalence of goiter, the overt sign of IDD, in the population, which includes small children and adolescents.
IDD, which results in hypothyroidism, can be manifested as both mental and physical growth retardation in children, resulting in lower IQ and poor educational performance. Serious consequences in newborns include stillbirths, low birth weight and poor resistance to infection. Females of reproductive age, who are already severely comprised by iron deficiency and other micronutrient deficiencies, are prone to extreme fatigue and miscarriages.
IDD can be easily corrected by the addition of at least 75 parts per million (ppm) of iodine to salt.
An informal and preliminary survey of salt has been undertaken in Muzaffarabad, Chikar, Reyat, RahimKot and KatKair. We tested one sample of all brands of iodized salt found in each shop in the villages. In MZD we tested random samples from the main wholesale district. Overall, twelve different brands of salt comprising 61 samples have been tested with an iodine test kit from the National Institute of Health, Islamabad. It is extremely disturbing that salt which is advertised on the package label as iodized is either substandard or completely lacking in iodine. One brand, Phool, supplied by AR Foods Pty. Ltd. consistently meets the standard of 75 ppm..
A strategy is being implemented in Chikar to ensure iodization of the local salt. This can be used as a model for other communities and will help create a ‘grass roots’ demand for iodized salt. Meetings have been held with local Chikar shopkeepers who now recognize the problem and are willing to supply ONLY iodized salt. They are prepared to test salt for iodine in the warehouses prior to purchase.
Consumer awareness and education is also an important approach in overcoming IDD. A community health fair will be held in Chikar on 27 April, 2007. This will include the distribution of information and test kits to lady health workers (LHW) who will disseminate and sustain the education initiative. Schoolchildren will bring salt to the fair to be tested, will give speeches, and have educational sessions.
Government agencies and the salt suppliers must ensure strict enforcement of food fortification laws and stop fraudulent package labeling.
IDD can be prevented inexpensively through the universal use of iodized salt. It is time for the people of Pakistan to have the basic right of proper nutrition.
