Iodised salt: A simple way to prevent illness
Developing countries, such as Indonesia, often have recurring public health problems that are not related to disease, but to the lack of something very basic. One problem over here is the lack of use, of iodised salt. I didn’t know this until recently, but the salt sold in bulk is not iodised, meaning it does not contains iodide salts. This can lead to iodine deficiency, which leads to illnesses including goiter. There is a trinket seller next to Internet Outpost on Poppies II in Kuta, who has goiter.
Here’s more from the Jakarta Post.
Just a pinch of iodine makes all the difference
Features – October 18, 2006
Duncan Graham, Contributor, Surabaya
If you’re reading this paper during a meal, pause a moment and reach for the condiments.
Is the salt on your table iodized? If bought already packaged from a supermarket the answer is probably yes; nevertheless, check the label’s small print. (In Indonesian “iodine” is yodium).
However if it came in bulk from the local market the chances are it won’t have the essential additive, but may include some unwanted nasties.
“The problem is that although salt is cheap at around Rp 2,000 (20 US cents) a kilogram, the iodized product is marginally more expensive,” said Sinung Kristanto of the United Nations Children’s Fund (UNICEF) in Surabaya.
“Offsetting this is the fact that the iodized salt is cleaner and tastes saltier. That’s because it’s more concentrated through processing. Unfortunately, people don’t know this and their shopping is driven by price alone.”
Mineral trace element deficiencies in the diet have long been known to cause serious health problems. A lack of iodine affects the thyroid gland that in turn can lead to goiter (swelling of the gland) and mental deficiencies (see sidebar).
Indonesia introduced a salt iodization policy in 1979 and is widely regarded a world leader in eliminating iodine deficiency. Despite this it’s not difficult to find examples of the problem in isolated parts of the archipelago.
“The East Java government estimates that less than 40 per cent of the population is using the additive in at least two areas — Probolinggo on the north coast of East Java and Sampang on the south coast of Madura Island,” said Kristanto, UNICEF’s project officer for East Java and West Nusa Tenggara (NTB).
“So we’re concentrating our efforts there as part of our health and nutrition program. This isn’t a cosmetic issue — it’s extremely serious. But getting the message across isn’t easy.
“Some people think goiter is a condition inflicted on them by God for their sins.
“Much of the salt sold in the markets is made by farmers in Madura who evaporate seawater. It’s known as kerosok. It’s not washed and has a high moisture content. Better-quality salt is made in Lombok by boiling and distilling water.
“Salt can be bought cheaper in bulk from Australia. It’s cleaner and more than 99 per cent dry. But local producers object to imports for fear they’ll lose income.
“Farmers also eat the salt they buy for their cattle, or pick up salt from the seashore for the kitchen. Of course that hasn’t been iodized.”
The Australian salt isn’t iodized. It’s mainly produced for industry where it’s used for the manufacture of plastics and chemicals, so imports are iodized locally.
The addition of only 30 to 80 parts per million of iodine in salt is needed to prevent health problems.
(Attempts by this reporter to visit a Surabaya salt factory to see the process were thwarted by staff. They feared the request was a ploy to steal the technology and get the salt treated in Australia.)
The East Java public health information campaign includes promoting a logo of a smart kid wearing a mortarboard and a purple sash (the color of iodine vapor). This is to emphasize that iodized salt aids intellectual development. The other tactic is legislative.
The local and international import and export of noniodized salt has been banned by administrations in NTB but not in East Java. This isn’t the total answer as people can still make or gather their own salt.
UNICEF has just celebrated its first 10 years in Surabaya. It’s an advocacy and technical assistance agency with only 14 staff to run operations. It works with government and nongovernment organizations to implement programs in health and nutrition, education, HIV/AIDS prevention and child protection.
UNICEF’s annual budget for East Java and NTB is Rp 20 billion (US$ 2.2 million) and includes funds from government aid agencies in Australia, the U.S. and Japan.
Promoting iodized salt through UNICEF is also backed by a Canadian not-for-profit organization called the Micronutrient Initiative, run by nutritionists and scientists. The global goal is to eliminate malnutrition through the lack of vitamins and essential minerals.
Kristanto said that to ensure corruption was minimized projects were audited ahead of implementation to decide a unit cost of delivery. This meant the number of people who would be expected to benefit had to be determined and all purchases monitored.
Where flaws had been detected and corruption identified funding was cut for a year.
“We have to be tough,” he said. “We cry for the children who suffer as a result, but we have no choice. If we continue with the funding the corruption continues. It’s better to stop for a while so people know we’re serious.”