5 November 2013: Iodizing Salt to Fight Hidden Hunger in Zanzibar
By Sandra Bisin
Pemba island, Zanzibar, Tanzania, 5 November 2013 - Mbarouk Hamad Yussaf, a salt farmer in Pemba island, Zanzibar, sighs with relief. He has just received a year’s worth of potassium iodate and a manual sprayer. The equipment was distributed through Zanzibar’s Ministry of Health programme aiming for universal salt iodization on the island with the support from UNICEF.
“One kilogram of potassium iodate would cost me 70,000 Tanzanian shillings (44 USD): it’s a fortune!”, Mbarouk Hamad Yussaf says. “Nearly every two years, I have to buy a manual sprayer, which costs me another 50,000 Tanzanian shillings (31 USD). This is more than I can afford.”
This initiative is part of a Government effort to combat Zanzibar’s “hidden hunger”: iodine deficiency, particularly in small children and pregnant women. Iodine deficiency is the most common cause for goitre, but also a major cause of preventable brain damage and learning disabilities. It has an invisible impact on brain development, reducing intellectual capacity at school and in working life, even amongst those with mild or moderate deficiency. Studies have shown that the intelligence quotient of children in communities with iodine deficiency is 10-15 points lower than their peers with good iodine status.
Iodine Deficiency’s Impact on Generations of Children
“Goitre is only the tip of the iceberg, the consequences of insufficient iodized salt consumption will impact generations of children in terms of their intellectual development and economic performance”, says Zanzibar’s Minister of Health, Hon. Dr. Juma Duni Hajj.
In Zanzibar, only one in two families has access to adequately iodized salt. In Pemba island, use of iodized salt is even lower. Only one in four families has access to adequately iodized salt.
Like other salt farmers in Pemba, Yussaf started iodising salt in 2005. His farm produces up to 50 kilograms of salt per year. “We can still see the consequences of decades of using non-iodized salt in our communities. There are a lot of miscarriages among women and many children with low weight at birth” Yussaf adds.
Pemba island produces approximately 2,000 tons of salt every year, mostly aimed for local consumption. The islands of Zanzibar missed the opportunity to start implementing the Iodine Deficiency Disorders (IDD) control interventions in the 1980s to 1990s due to the assumption that the population living on the islands had frequent access to sea foods that are iodine-rich.
In 2001 UNICEF supported a study in Zanzibar which indicated that iodine deficiency was a problem. A year later, UNICEF started supporting the Ministry of Health to train salt producers on the adverse effects of non-iodized salt consumption and on proper salt iodization. In 2011, the Government introduced the Food Security and Nutrition Act, a legislation that promotes use of iodized salt.
“Iodine deficiency is easily prevented if every family member uses salt that has been properly treated”, says UNICEF’s Representative in Tanzania, Dr. Jama Gulaid. “To ensure compliance with the legislation on salt production, we need inspectors to regularly check the quality of salt in the market and stop the sale of non-iodized salt”.
Addressing Remaining Challenges
“We need to sustain our efforts: continue working with the Association of Zanzibar Salt Farmers (AZASPO) to inform communities and train farmers to efficiently adapt simple fortification and proper packing technologies. We are currently facing issues as iodized salt is still not properly packed and stored, which can cause iodine to evaporate. Salt farmer also need to control the level iodine in salt using rapid test kits”, says Francesca Morandini, head the UNICEF’s office in Zanzibar.
UNICEF’s support focuses on: strengthening the technical and managerial capacity of the salt plants, supporting salt farmers with training and distribution of potassium iodate, providing farmers with manual sprayers, training of traders and food inspectors and sensitizing local authorities and farmers on the importance of iodizing salt.
Recently all salt producers in Pemba received training on quality assurance for iodized salt. All the Health Inspectors from the Ministry of Health and Zanzibar Food Drugs and Cosmetics Board received training on quality control. But treatment of salt reserves and enforcement of legislation are lagging behind.
“Zanzibar can eliminate iodine deficiency but this task needs vigilance and a strong partnership among stakeholders - the government, salt producers, retailers, inspectors, public health officials and communities”, adds Jama Gulaid.