Devastating impact of nutrient deficiencies

Up to 60 percent of Swazi infants are likely to incur brain damage due to vitamin deficiencies, while a wide spectrum of the population are at risk of malnourishment, according to a United Nations Children's Fund (UNICEF) report released on Thursday. "The price of the current food shortage crisis is being paid by children and others, who are suffering stunted growth and diminished performance at school and on the job," Siddharth Nirupam, UNICEF Swaziland's programme officer for health and nutrition, told IRIN. Nirupam said new programmes were already in place to boost vitamin consumption, but data was not yet available to assess their effectiveness. One such programme is targeted at vitamin A distribution among children under five years - the national prevalence of vitamin A deficiency in children aged under six is 40 percent and causes the deaths of 600 children annually. Vitamin A deficiency leads to stunted growth, greater susceptibility to infection and more frequent ill health. A lack of folic acid (one of the B vitamins), required for the production of normal red blood cells, can cause a type of anaemia, severe birth defects in children and increased heart disease and strokes in adults. The UNICEF report estimates that 4,000 Swazi babies are born each year with intellectual impairment caused by a lack of iodine in the mother's diet during pregnancy. "In countries where the goiter rate [enlargement of the thyroid gland, usually caused by too little iodine,] is 10 percent or more, as in Swaziland, iodine deficiency is estimated to be so widespread as to lower the average national IQ by as much as 10 to 15 percentage points," the report said. Worldwide, iodine deficiency is the leading cause of preventable mental impairment and diminished work potential. Lower productivity in the workforce, caused by iron and iodine deficiencies that lead to illness and general lethargy, has slashed 0.6 percent off the nation's gross domestic product. Given that Swaziland's GDP growth this year is only 2 percent, the impact of vitamin deficiencies on the economy is devastating, said health officials. The finance ministry has noted that the country needs a GDP growth rate of at least 3.6 percent to maintain present standards of living. Two-thirds of Swazis already live in chronic poverty, according to the UN Development Programme, and HIV/AIDS cuts one percent off GDP growth annually. "The increased ill health due to vitamin deficiencies, which can be remedied, is putting further pressure on an overburdened health care system," Nirupam commented. Swaziland is not one of the 49 countries in the world that require flour to be fortified with iron, and was thereby "missing an opportunity to protect the nation's mental and physical health, and increase national energy and productivity," said the report. Neither is Swaziland among the 38 nations that require wheat flour to be fortified with folic acid. No data is available on the availability of iron supplements, which reduce anaemia - around 30 percent of Swazi women and 45 percent of young children are now anaemic. However, 60 percent of Swazi children consume household salt fortified with iodine and health organisations are seeking to raise that figure. Fortified salt is one of the staples distributed by the UN World Food Programme, the Baphalali Swaziland Red Cross and other food aid groups to about a quarter of the population requiring food assistance. The report recommended the fortification of staple foods like flour, sugar and salt with vitamins and minerals. "Fortified foods have long protected people in Europe and North America. It is now time that they did the same for the developing world," the report remarked. Programmes to distribute vitamin and mineral supplements in low-cost capsules and syrups to young children and women of childbearing age were also recommended, as was community education on the need to expand the Swazi diet, which typically consists of maize meal, spinach, cabbage and, occasionally, meat.