Diseases caused by iodine deficiency in the south on increase

Doctors are reporting a worrying increase in iodine-deficiency related illnesses in southern Uzbekistan. Begam Kurbanov, head of the provincial endocrinology hospital based in Termez, capital of the southern Surkhandarya province, told IRIN that the number of such diseases was on the rise in the region. 15-year-old Sarvinoz Achildieva suffers from goiter. It's one symptom of iodine deficiency resulting in the thyroid gland in the throat enlarging abnormally. This mass compresses the trachea (windpipe) and esophagus (swallowing tube) leading to symptoms such as coughing, lack of breath while sleeping, and the sensation that food is getting stuck in the upper throat. Once a goiter gets this large, surgical removal is the only means to relieve the symptoms. Another Termez resident, Madina Yarasheva, 12, has goiter too. The two girls regularly undergo treatment at the Surkhandarya provincial endocrinology hospital in the area. "I did not notice how the disease struck me," Sarvinoz told IRIN. "In the beginning I was very stressed, I cried a lot. Two years ago I was diagnosed." Madina is not the only child in her family that suffers from goiter, her 16-year-old sister Zebo is also sick, and now awaits treatment in the endocrinology dispensary. Some 30 percent of children and teenagers in Surkhandarya were sick with iodine-deficiency diseases, Salimov, a paediatrician endocrinologist at the provincial endocrinology hospital, told IRIN. According to official statistics, the number of people suffering from iodine-related illnesses in the province increased from some 152,000 in 2000 to almost 160,000 in 2003. The population of Surkhandarya province is slightly more than two million. Growing children and teenagers need iodine, Salimov explained, noting that the iodine deficiency diseases prevalence became more common after Uzbekistan gained its independence in 1991. "There are over five billion people on the planet, of which 1.5 billion live on territories which lack iodine," Kurbanov, head of the endocrinology hospital told IRIN, adding that Surkhandarya was within those territories. During the Soviet era Uzbekistan, Central Asia's most populous nation, imported iodised salt from other republics as part of its centrally planned economy. After independence and economic relations with the other former Soviet republics collapsed, this system broke down and the local population began to buy non-iodised cheaper salt, which led to the spread of the disease. Up to 60 percent of the region's population wasn't getting enough iodine with food and water, Kurbanov maintained. "The disease is widely spread on the whole territory of the province," he said. "But it is more common in the mountainous areas, including Baisun, Sherabad, Uzun, Sariasiya and Denau." "For the last five years we have been observing an increase in people sick with goiter," an endocrinologist from Sherabad district hospital, Oysoat Eshmuradova, concurred. There are over 135,000 people in the district, of whom 5,000 are registered with having goiter, Eshmuradova told IRIN, noting that the situation had worsened by the fact that people couldn't afford medicine. Meanwhile, a doctor from the local hospital in Baisun district, Safar Ramazonov, confirmed that goiter was on the rise among local people, saying that it had been growing for the past few years with at least 30-40 percent of people suffering from the ailment. According to the health official, poverty was endemic, with inhabitants having limited or no access to employment. Many people are forced to live on the pensions of their parents. Therefore, they buy cheaper salt and other non-iodised foods like flour from illegal traders. But health authorities expect things to change after efforts to iodise salt kicked off in the region. "Since 1998, a [new] technology has been developed to add iodine into white salt, which is mined from the salt mines in Sherabad district. This way we aim to overcome iodine deficiency," Kurbanov explained. Also, other Uzbek factories have been producing iodised salt since 2002 - another step towards improving the situation of iodine-deficiency related diseases.