The salt of life – how iodised salt protects a generation of Sri Lanka’s children
by Francis Mead
The two women stand close together, and together they step forward, each holding a long-handled pole, a little like a wooden rake, except there’s a flat piece of wood at the end instead of prongs. The women are both wearing white rubber boots and they are standing in a shallow basin, about 30 yards across, which is filled with a few inches of filmy water. In perfect synchronization, they dip their rakes into the water and drag back the white crystals that are hidden just beneath the surface. As they move, a shelf of crystals builds up against their rakes, and they finally sweep their catch into a pile at the edge of the basin.
The women work at a factory at Puttalam midway up Sri Lanka’s east coast. On average they earn about 300 Rupees a day – around $3 USD. The crystals will be ground down into one of the most everyday of everyday commodities – salt.
Puttalam Salt Ltd stands on land that was formerly owned by the king of Sri Lanka in the eighteenth century. A salt road used to wend it way across to the ancient seat of the throne at Kandy. Today the Puttalam Salt plant occupies 700 acres at the edge of a lagoon and supplies about a third of the country’s salt. But the salt coming from the factory doesn’t just add flavour to millions of family meals, it provides vital protection to children, saving them from life-long mental retardation.
The secret is iodisation: by adding potassium iodate to salt, it is possible to ensure that children get the tiny but essential quantities of a micronutrient that allows their brains to develop fully and healthily. If children suffer from Iodine Deficiency Disorder (IDD), mild or severe mental impairment can follow, and women with IDD can face difficulties bringing a pregnancy to full-term. The impact on a whole society can be devastating, severely reducing the potential of millions of children.
Fortunately for Sri Lanka, the last twenty years have brought enormous improvements. In the 1980s around 20 percent of Sri Lankans had goitres – a swelling at the neck that is a tell-tale sign of IDD. But after a government campaign, supported by UNICEF, the proportion of families who have access to iodised salt rose from almost zero in the mid-1990s to over 93% in 2005. In the same year fewer than 4 percent of school children had goitres.
In July this year, UNICEF handed over a new iodisation machine to Puttalam Salt Ltd. This follows the supply of similar equipment to salt factories across the island in recent years – in Hambantota, Mannar, Elephant Pass and Kilinochchi. Major financial backing for this project has come from the governments of Norway and Canada, as well as Kiwanis International, ensuring that the drive to protect children continues.
“It’s difficult to get across to ordinary people the problem of IDD because it’s not very visible,” says D.P. Adikari, UNICEF’s project officer for nutrition in Sri Lanka. He has monitored IDD for ten years, and has been actively engaged in the campaign to eliminate it for the last five. “Iodisation can make a big difference to people’s health. But convincing people has been a real challenge.” Adikari points to new and stricter regulations on food production introduced by the government a few years ago with encouragement from UNICEF, as a critical turning point.
Despite the advances, there are still difficulties to be faced in Sri Lanka, not least the existence of over 300 small salt producers around the island, some of them producing non-iodised salt. And yet here too there has been progress. Just a few kilometres north of Puttalam Salt Ltd lies Puttalam Salt Production Welfare Society Ltd: across the flat terrain, hundreds of small, privately owned salt beds are visible, with narrow causeways running between them. Here and there are little pyramids of harvested salt set out in rows. Each small bed requires 20 people to work the salt, and women, once again, carry out much of the labour, balancing baskets of fresh salt on their heads as they walk back to collection points. The Society has 500 members and 5000 people in total work in the salt beds.
Until six months ago, the Society wasn’t using its salt iodisation machine, which was a also supplied by UNICEF. But after a new government drive on food regulation, the Society began using the machine, and now bag after bag, marked “Iodated Salt”, is stacked on the concrete floor at the producers’ salt production plant.
Salt iodisation has to be carefully controlled, and comes at the end of a lengthy and delicate salt production process. In Puttalam, after salt water is let into the beds from lagoons, salt is allowed to crystallise for 40 days before being harvested. It is then stored for six months in heaps under a natural tarpaulin, made of coconut leaves. Only then will it be taken and crushed. It is in this final stage that potassium iodate is sprayed onto the ground salt crystals. At this point, it is also essential that the salt is kept dry enough, otherwise the newly added potassium iodate will seep downward and leech out of the salt at the top of the pile.
Worldwide, over 20 million people suffer from varying degrees of mental retardation caused by lack of iodine. Around six million are severely mentally impaired. Given that iodine deficiency can be prevented by adding tiny amounts of the micronutrient to children’s diets, this irreversible damage to generations of young people is both tragic and unconscionable. That’s why DP Adikari and his colleagues around the globe have spent years striving to bring attention to the problem.
The salt harvests at both the Society and at Puttalam Salt Ltd provide a living for thousands on the island’s east coast. But through iodisation, the salt they produce plays an even more important, if almost entirely unseen role, in giving a whole generation of Sri Lankan children a chance to thrive.
“It’s one of the most satisfying things I’ve done,” says DP Adikari, who is nearing retirement after thirteen years at UNICEF. “It’s a success story. We have achieved the goal set at the World Summit for Children in 1990 – universal salt iodisation. Really, I’m very happy.”