Diseases related to iodine deficiency increasing in south

Iodine deficiency in southern Kyrgyzstan continues to be a source of concern among health officials in the region, IRIN has been told. Madina is 20 years old and lives in the southern regional capital of Osh. Despite repeated requests, she is reluctant to marry. "I will think about marriage when I get cured," she told IRIN, trying to withhold her tears. Madina suffers from iodine deficiency and goitre - an acute swelling of the thyroid gland - and is afraid of giving birth to a physically or mentally disabled child. According to the Kyrgyz Ministry of Health, 85 percent of women in the country live in areas with a high risk of iodine deficiency-related diseases, with the situation in the south being particularly serious. Health experts say the problem is growing thoroughout Central Asia, as Soviet-era iodisation programmes of salt, flour and other basic commodities no longer receive priority, or flounder due to lack of resources. Statistics provided by the general directorate on health reforms in southern Kyrgyzstan showed 64,500 new, officially registered cases of goitre in the three southern provinces of Osh, Jalal-Abad and Batken this year. That is 10,000 more than in the whole of 2002. In Osh Province alone, the number of those suffering from goitre almost doubled within three years - 13,700 in 2000 to 26,600 in 2003. In neighbouring Batken, the figure increased by 50 percent within the same period. Moreover, health experts say, goitre is spreading among children of school age - more than half of them in Osh have been diagnosed as having the disease. "The thing is that local people consume non-iodised salt," Rosa Li, head of the endocrinology department of Osh's regional hospital, told IRIN, adding that the majority of people in the region used cheaper, non-iodised salt because of widespread poverty. Some public health messages are getting, however. Health officials told IRIN that the ratio of people buying certified (iodised) salt had reached 30 percent, owing to concerted efforts by the local authorities and health personnel. A small facility producing iodised salt was operating at the local sanitary-epidemiological unit, Li said. However, she claimed some firms still tried to sell low-quality products. Li advocated making the price of iodised salt affordable, based on state subsidies. This would enable the population to have access to a reliable and proven means of preventing iodine deficiency. In an effort to tackle the issue, provincial authorities have tried to prevent the importation and production of non-iodised salt, but IRIN was told the measure has only had limited success due to poor enforcement. Omurbek Almambetov, the deputy governor of Osh, said prohibitive measures were not effective. He emphasised the importance of educating the population about the consequences of iodine deficiency. Other sources of iodine-rich foodstuffs are being sought. However, some officials consider it unrealistic for an impoverished, landlocked country to get supplies of iodine-rich sea products such as fish, sea kale and kelp. "However, the idea of increasing persimmon (a tree with iodine-rich fruit) plantations is already being implemented. Persimmon is becoming a very popular tree in rural areas," Bolot Burgoev, an agricultural expert, told IRIN. The United Nations Children's Fund (UNICEF) mission in Kyrgyzstan country acknowledges the extent of the problem and has been implementing a special project in cooperation with the Asian Development Bank (ADB) to boost salt iodisation and make the product available at realistic prices. The plan is to have universal salt iodisation by 2004. The Kyrgyz government is also trying to tackle the issue. Guljigit Aliev, senior deputy minister of health, told IRIN that a state programme to eradicate iodine deficiency was underway, consisting of stricter control on the import of non-iodised salt, and iodising cooking oil. Mashrabbai Batyrov is a well-known endocrinologist working in Osh. He advocates increasing international aid to help the government's iodisation strategy, adding that iodisation was a relatively cheap way of preventing a whole range of diseases and chronic conditions. Batyrov wants to see widespread production of a cheap salt-analysis device, so that people could check whether the salt they were buying was iodised or not. He said there was a problem with traders passing common salt off as the healthier variety.