Boosting nutrition with a pinch of salt

Five-year-old Dina plays gently with her friends around a small public swimming pool in the Kazakh commercial capital, Almaty. But unlike her 13-year-old sister Svetlana, Dina will never go to school and is unlikely to ever reach her full intellectual and physical potential. Dina, like thousands of other under-fives throughout Central Asia is mentally retarded simply because her mother Marya did not consume enough vital nutrients, such as iodine, during pregnancy. Marya was pregnant with her first child during the Soviet era. At that time most salt consumed in Central Asia was iodised. But following independence in 1991, the old centralised production and distribution system collapsed. Today, only one in three Kazakhs have access to iodised salt. The situation in the other four Central Asian republics is little different. "When I had Dina everything was the same as before, but very soon after she was born we knew something was wrong - then someone said the salt had done this to her," Marya told IRIN. A 1995 government health survey found sixty percent of women and children were suffering from anaemia. This is a critical level according to established World Health Organisation (WHO) criteria. "This is nothing short of a national tragedy, since non-iodised salt has become the norm here in Kazakhstan there has been a big rise in cases of IDD (Iodine Deficiency Disorder) over the past five years," Toregeldy Sharmanov, President of the Kazakh Academy of Nutrition (KAN), told IRIN. Sharmanov added that if a child lacks micronutrients in the womb, IQ and physical development will be severely affected. The cost to Central Asia of a generation denied their full potential could be as high as five percent of gross domestic product, according to Asian Development Bank (ADB) figures. But things are changing for the better. The UN children's agency UNICEF, along with the ADB, the Kazakh government and KAN launched a nationwide programme last year to introduce iodated salt and fortified wheat for use throughout Central Asia. The bold plan has financial backing from ADB's Japan Fund for Poverty Reduction (JFPR) to the tune of almost US $7 million. "It has been incredibly difficult getting everybody on board, that includes women's groups, salt and flour processors, donors, NGOs and even customs officials," Zhanara Bekenova, an Almaty-based UNICEF project assistant told IRIN. The good news is that iodising salt is technically simple and very cheap. And Kazakhstan has vast deposits of salt meaning it could become the regional supplier to other countries who suffer from the same problem. "We are working very closely with NGOs, clinics, hospitals and community organisations to help generate demand for these fortified products and show families their importance," Bekenova added. The salt-iodisation programme has been successfully introduced in Almaty and will be extended along with flour-enrichment to other parts of this vast country the size of western Europe when more donor support is forthcoming. More than 360,000 women and children in two poor areas: Semipalatinsk in East Kazakhstan oblast and the western city of Kyzylorda have been targeted in the next phase of the campaign. "We want that children like Dina will be the last to fall to such avoidable conditions," Sharmanov said.