Stunted Growth:Iodine deficiency threatens half of Pakistan

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Iodine-deficiency-threatens-half-of-PakistanPeshawar:  An estimated 50 percent of the Pakistan’s population is at risk of thyroid-related diseases, physical disabilities, mental disorders and other problems caused by iodine deficiency, say health experts.

The Country Director of Micro-nutrient Initiative (MI), a non-governmental organization, Dr Tauseef Akhtar Janjua told New Lens that nearly half of Pakistan’s children and mothers suffered from under-nutrition.

“Iron and iodine deficiency in childhood reduced IQ by up to 25 and 13 percent respectively,” said Dr Janjua. “Stunted growth is believed to result in loss of earnings up to 46 percent in adulthood.”

In Khyber Pakhtunkwa province where a large population live in the mountainous north, around 12 million people are at high risk of debilitating diseases caused by iodine deficiency. Health experts say more than 50 percent of the people in Khyber Pakhtunkhwa live with health conditions caused by iodine deficiency.

According to United Nations Children’s Fund (UNICEF) Nutrition Officer Dr Muhammad Atif, few people in the province know about the importance of iodine in their food and also unaware that it costs only 25 paisas to meet our daily iodine requirement.

But even that may be too much for some, especially for those who live in the mountainous parts of the province – a population with high risk of iodine related diseases but little money or knowledge to combat it.

Shehnaz,35, didn’t know she had goiter – a condition when the thyroid glands in the neck and larynx start swelling due to iodine deficiency – even when she had felt weak for months.

She worried about her health but avoided going to a doctor because she couldn’t afford the doctor’s fee or visit a hospital without the permission of father in law.

“I felt weak and lost weight,” says Shehnaz, a mother of three children. “My husband is abroad and I couldn’t share my condition with my mother-in-law because we cannot afford the high fee of private doctors.”

Shehnaz’ condition gradually deteriorated. A housewife who did all the chores at her home, she took to bed one day. That’s when everyone got worried and brought her to the Institute of Radiotherapy and Nuclear Medicine (IRNUM) in Peshawar. Here she tested positive for thyroid disease.

“The doctors told me my diet was deficient in iodine and i have goiter because of that,” said Shehnaz, who belongs to a small village in Mardan district of Khyber Pakhtunkhwa.

Khyber Pakhtunkhwa Reproductive Health and Nutrition Deputy Director Dr. Qasir Ali said that iodine was essential for healthy development of children. Without iodine, they were at risk of developing goiter that affects the thyroid glands that controls growth, mental illness and disability.

He said thyroid related problems could lead to cretinism – severely stunted physical and mental growth due to untreated congenital deficiency of thyroid hormones.

Ali said in hilly areas – especially in the Chitral district, Upper and Lower Dir, Swat, Gilgit Baltistan, Shangla, Abbottabad and Kohistan – one out of every ten persons had a goiter condition. He said that since 2008, when the government provided iodine-added salt to the local population, the number of people with goiter has decreased in the area.

He said the mountainous areas of Khyber Pakhtunkhwa were among the worst affected by diseases related to iodine deficiency causing stillbirths and infant deaths.

“A large percentage of children and women have goiter in the province,” said Ali. “Many mothers lose their babies before birth and a large number of infants die prematurely.”

UNICEF Nutrition Officer Dr Muhammad Atif said an average adult required one teaspoonful of iodine once in a lifetime to prevent disorders like mental weaknesses, disabilities, stillbirths, miscarriages, and births with congenital abnormalities.

He said that some 28 countries all over the world had instituted legislation to ensure provision of iodine that had reduced the number of people with iodine related diseases in these countries.

According to the National Nutrition Survey report released in 2013, 72 percent children in Pakistan were living with iodine deficiency and more than 1.5 million children were suffering from acute malnutrition which made them vulnerable to infectious diseases that could result in early deaths.

On other hand a large portion of the population in the country is unaware of iodine deficiency and the health conditions it causes. What is more alarming is the negative perception about the use of iodine in food, based on conspiracy theories.

“Iodine is just another conspiracy of the West against Muslims to control their population,” Muhammad Gul a villager in district Mardan, told News Lens. Gul is against the use of iodine. He says non-Muslims want to check the population growth of Muslims and use different tactics such as iodine-added flour and salt, polio and other vaccinations that cause impotency.

According to World Health Organization (WHO) Iodine is a global problem and 1.7 billion people including 43 million babies are affected by iodine deficiency.

Worldwide, around 760 million people live with goiter, some 11 million suffered mental illness, and 43 million were mentally and physically challenged because of lack of Iodine.

According to WHO, most patients of iodine-related diseases were from developing countries like Pakistan, India, Sudan and Senegal.

In 1994, the government had included use of iodine in food rules while in 2002, an act was passed to include iodine in food. But till now they haven’t been properly implemented, said Dr Janjua of Micro-nutrient Initiative.

Khyber Pakhtunkhwa Reproductive Health and Nutrition Deputy Director Dr. Qasir Ali said the government had established food committees at the district level to keep a check on salt-packing industries.

“We have fined some businessmen up to Rs 15,000 to Rs 20,000 for not adding iodine in the salt,” he said.

Ali, however,said that he was not satisfied with the performance of district officers and would demand proper legislation from the government to ensure iodine is added to staple food to control the huge spike in iodine related diseases.

Dr Janjua of Micro-nutrient Initiative said vitamin A deficiency in children soared to 54 percent from 13 percent in 2001-02 while in non-pregnant women, it scaled up to 42 percent from 6 per cent.

About the negative perception of people regarding iodine-added food, he rejected the conspiracy theories.

“There is nothing wrong with the use of iodine,” he said. “People should use in their food daily to avoid debilitating conditions of the mind and body.”

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