National salt iodization gives children a head start in Turkmenistan
By Steve Nettleton
Wedged between the Caspian Sea and the fringes of the vast Garagum desert in Turkmenistan, a seemingly misplaced landscape of white extends to the horizon. This is Guvly, a salt-coated lake that stretches for more than 50 kilometres. A massive drill cuts through the lake’s eight-metre crust, churning it into fine grain, then unloading it into a freight car to transport the salt to the Guvlyduz plant on the lake’s shore.
Guvlyduz is Turkmenistan’s main source of salt. The plant refines more than 30,000 tons per year, enough to satisfy the demand of the country’s entire population. The salt is iodized before it is packaged and distributed across the country to wholesale markets, retail markets and to government shops, where all Turkmen citizens are entitled to 400 grams of free iodized salt per month. This is a process that is helping spare hundreds of thousands of children a debilitating condition, iodine deficiency disorder, or IDD. Iodine deficiency is the foremost cause of preventable mental retardation. Severe deficiencies can also cause stillbirth and miscarriage in pregnant women, while even mild deficiencies can affect the learning ability of populations.
In 2004, Turkmenistan became the fourth country in the world to achieve universal salt iodization, and the first nation in Central Asia to eliminate IDD. The campaign to iodize all salt began more than a decade ago, with a 1996 presidential decree enforcing the use of iodized salt nationwide.
“Before this programme, there were many cases of goitre, which affects fertility,” explains Dr. Dilara Hasanova, the head of the clinical laboratory at the Scientific-Clinical Centre of Mother and Child Healthcare in the capital, Ashgabat. “Since then, the cases have dropped dramatically. Now women are healthier and they can have more children.”
A UNICEF and USAID partnership has provided this laboratory, one of the main centres to test the urine iodine levels of people across the country, with equipment and testing reagents. Regular testing ensures that all salt, locally produced or imported, is sufficiently iodized. At schools, too, children are taught how to check the quality of their salt.
In addition to salt iodization, Turkmenistan is fortifying flour with iron and other nutrients to prevent iron deficiency and anaemia. This is a particularly effective step in a country where bread is the staple of every meal.
Political will and partnerships
Mr. Mahboob Shareef, UNICEF Representative in Turkmenistan, believes that political will and partnerships have proved decisive in the country’s universal salt iodization campaign. “Through the joint efforts of the Government of Turkmenistan and UNICEF we managed to reverse a negative trend, and we avoided a situation in which the mental health of children in Turkmenistan deteriorated,” he says. “I think iodized salt represents a real success story and an example of how decisive and coordinated actions can have a substantial positive impact on the health of children.”
Consuming fortified bread and salt as part of their daily diet, the country’s campaign goes largely unseen by young people like 13-year-old Atabay Uzbayev. Atabay, who is spending the bulk of his summer on the Caspian Sea coast playing in the sand dunes on the beach, has big plans for his future. “When I grow up I want to be a king,” he says. “I would like to build houses for people. I want to get a higher education when I grow up. I want to enter the university and study math.”
By taking measures to ensure that preventable disorders are kept at bay, Turkmenistan is giving more of its children the chance to chase their dreams.