View from the Field – on the recent ban on non-iodised salt
East Champaran (Bihar): A large number of districts of Bihar – East and West Champaran included – are known to be IDD-endemic districts. Iodine deficiency disorders (IDD) are rooted in low iodine content in the top soil. Low awareness levels about IDD and inadequate iodine content in salt have also added to the increased threat of IDD.
The Health Minister of India, Dr. Anbumani Ramadoss’ recent announcement at a UNICEF conference in New Delhi that India will ban the sale of non-iodised salt from August 15, India’s Independence Day came as a much-desired item of news. UNICEF has been advocating for the ban and has welcomed it. “We are very happy. Millions of children will benefit due to the protection from iodised salt,” said UNICEF India Representative, Cecilio Adorna.
Five out of every 100 children in some of the endemic areas of the state show symptoms of goitre, an iodine deficiency-related disease.
The people of Kuraiyan village in East Champaran district of Bihar, for instance, know little about iodine deficiency disorder (IDD), or the fact that their flood-prone district is one of the endemic districts for IDD in Bihar. They are also unaware that the cheap, wet salt they buy flavours their food but does not protect them against IDD. However, what they do know is that many of their children and adults have “some sort of swelling in the throat region”, which is not due to inflamed tonsils. “We don’t know what it is but we are worried,” says Mohammed Qayyum, whose eight-year-old daughter is suffering from a similar swelling.
A recent study conducted by UNICEF, the Government of Bihar and Micronutrient Initiatives found that five out of every 100 children in some of the endemic areas of the state show symptoms of goitre, an iodine deficiency-related disease. Moreover, the deficiency is not limited to merely East and West Champaran but is more widespread. The study also found strong evidence of insufficient iodine levels in salt – the preferred way of dealing with iodine deficiency. It found adequate iodine in only 40 per cent of the samples. While inadequate iodine was found in around 44 per cent of the samples, around 16 per cent of the salt samples were found to contain almost no iodine at all. “The study has helped us identify where the problem lies and what we need to do about it,” says UNICEF Bihar and Jharkhand Representative, Bijaya Rajbhandari.
UNICEF is currently engaged in supporting the Government of Bihar at the state level and the Government of India at the national level to put in place policies that lead children to safety from IDD. “We have success at hand, but there is more work to do,” says Mr. Adorna.
Floods have, for years, affected extensive areas of Bihar, and are believed to be the reason behind the low content of iodine in the vegetables and crops grown in the affected region.
The Secretary of the Bihar Iodised Salt Traders’ Association, Rajendra Mishra welcomes the ban on the trade of uniodised salt. “It is a welcome move, and has the potential of ridding India of IDD,” he says. The challenge, however, he says lies in ensuring that salt is “well iodised” and that “retailers and traders ensure that the iodine levels in salt are adequate.” Inadequate iodisation as well as poor storage by retailers are major reasons why people consume salt with low iodine level.
Currently, a large amount of sub-standard salt is being sold as iodised salt. This salt is cheaper than the good quality salt. In the Tirkaulia block of rural East Champaran, many salt traders were found to be stocking a certain brand of “iodised” salt. In Bairiya Bazar, Tirkaulia, a trader claims selling around 700 kilos of poor quality salt (which he stores in the open) against less than 50 kilos of quality salt. “This is what people demand,” he says.
“The ban will make people aware. In awareness lies the promise of safety”
When tested with a kit that is being provided by UNICEF to Anganwadi Centres as a ready-reckoner for salt iodisation, the salt does not turn sufficiently purple, as good salt should. Mishra says the challenge lies in ensuring that only good quality salt is sold. “At the moment, iodine levels are not being monitored adequately. A large proportion of families are consuming poor quality salt,” he says. Mishra also calls for bridging the gap between iodised and non-iodised salt, and is preparing to launch a low-cost adequately iodised salt brand in the market.
Individual findings at the field level, obtained through the iodine-testing kits recently provided by UNICEF to anganwadi centres, corroborate the findings of the study. The Anganwadi Sevika at Kuraiyan, Ritu Sinha, says that she tested around twenty samples with the kit and found inadequate salt levels in about 50 per cent of the samples. “Most of the poor people are consuming cheap salt, without knowing of the consequences,” she says. As a patient of goitre, Sinha understands the seriousness of the issue. “The ban will make people aware. In awareness lies the promise of safety,” she says.