Iodine deficiency deformities preventable, says NGO

Education could have prevented thousands of people in rural Lahore, in northeastern Pakistan, from developing painful deformities caused by severe iodine deficiency. A Pakistani NGO maintains that the mostly illiterate villagers remain unaware that the solution to their deformities lies in taking a small amount of iodine salt. A study by the NGO, Lok Sujaag, has revealed that more than 7,000 people in Lahore’s Depalpur District - over half the district’s population - suffer from chronic iodine deficiency. The deficiency stunts growth and ultimately results in goitre, an enlargement of thyroid gland in the neck, which is painful and visible. “We think this could be just the tip of the iceberg, and there could be thousands more suffering in other villages not included in our survey,” said Shafiq Butt, health worker for Lok Sujaag. A person needs 10 microgrammes of iodine per decilitre of fluid in the body to maintain good health, but most villagers were found to have about two microgrammes, the study found. Iodine deficiency, according to Butt, became apparent in the area after a river was washed away around 40 years ago, stripping iodine from the land and water and thereby eliminating the villagers’ main source of the mineral. The deficiency has been prevalent in the area ever since and was only recently discovered when health workers stumbled across the community while conducting other projects in the district a year ago. “Most people can’t afford to see a doctor, so no-one outside their community has seen them. That is why they have not received help sooner,” Butt said. Children are a high-risk group, as their iodine levels are naturally low. The NGO, in collaboration with UNICEF, found more than half of 308 urine samples taken from children in 12 villages to be affected by severe iodine deficiency. “These children will suffer from a low IQ. But this and the initial stages of goitre can be reversed if they take iodine salt now,” explained Dr Nuzhat Rafique from UNICEF, Lahore. The villagers simply have to increase their intake of iodine salt by a few microgrammes. It costs less than one US cent to iodise one kilogramme of salt. “A teaspoon is enough to maintain a healthy body for a lifetime,” Rafique said. When goitres are fully enlarged, the only treatment is surgery costing US $400 - out of reach for the villagers, whose average income is $20 per month. Lok Sujaag said it was still to carry out a detailed assessment of the effects on IQ and learning abilities. However, it has started to educate Depalpur villagers on ways of increasing iodine intake. “We are holding a street theatre, distributing posters and leaflets to educate people, but many of them are illiterate.” Butt added that they were encouraging local shopkeepers to stock iodine salt to render it easily available. Although the government had started a campaign in 1994 to educate people on the dangers of low iodine levels, it was mainly only available through the electronic media, and therefore inaccessible for the target community, Butt said.