Wednesday February 21, 2018

Lack of Iodized Salt Causes ‘Serious Public Health Problem’ in Cambodia: UNICEF

Just four years earlier, UNICEF had stopped providing iodine to salt producers at the end of a decade-long, largely successful government-run iodization program

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Iodine-Deficiency Once Again a Cambodian Public Health Issue, VOA
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Phnom Penh, Apil 8, 2017: When Arnaud Laillou, a nutrition specialist with UNICEF, led a salt iodization study in 2014, he wanted to be sure that salt producers were not adding too much iodine.

Just four years earlier, UNICEF had stopped providing iodine to salt producers at the end of a decade-long, largely successful government-run iodization program.

Laillou was stunned to find that 90 percent of coarse salt and 40-50 percent of fine salt was now not iodized. And all of it was labeled as iodized.

“It was a real shock for us,” says Laillou of the findings of the paper that was published last year in the online journal Nutrients.

Serious public health problem

That paper said iodine deficiency in Cambodia had become “a serious public health problem” just years after the issue had largely been dealt with, and warned that poorer families and rural families were worst affected.

That was at odds with a study carried out three years earlier that showed salt producers were adding iodine, and that authorities were enforcing a 2003 subdecree that mandated iodization.

Iodine is essential to brain development and hormonal functions. If a pregnant woman is iodine-deficient, for example, her baby’s brain will not develop properly. The mineral is vital for brain development in children, too, and for proper hormone functioning in all ages. Iodine is so important that the World Health Organization has described iodine-deficiency as “the [world’s] single greatest preventable cause of mental retardation.”

Iodizing salt is widely regarded as one of the cheapest and most effective public health measures: it costs 2 cents per kilogram of salt.

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Children hurt most

Iodine-deficiency, Laillou said, is particularly damaging for children.

“For example, Cambodia is investing a lot of money at the level of the Ministry of Education to improve the education of their children,” he said. “But having a lack of iodine in the brain, it decreases [their] IQ by 13 points.”

That, he points out, compares with the loss of three IQ points for a child who is not breastfed for the first six months of life.

Wholesale failure

In theory, adding iodine to Cambodia’s annual output of 80-100,000 tons of salt should be simple: close to 100 percent is produced by the SPCKK cooperative in the southern province of Kampot. SPCKK produces coarse salt, which it sells in bulk to middlemen who operate boilers that refine that into fine salt.

By law, SPCKK must iodize all of its salt output. But over the years several of the iodizing machines it was given have broken down, and SPCKK has not sourced spare parts. Now it has four working machines and that’s not enough.

And so, as SPCKK’s technical chief, Bun Narin told VOA, its workers often spray iodine by hand, a method that is at best imprecise.

“Large companies [outside Cambodia] use machines to monitor, whereas we are still using labor and so it’s not always accurate,” he said.

That is putting it mildly, given that Laillou’s research found 90 percent of the country’s coarse salt lacks any iodine. Despite that, SPCKK’s output is labeled as containing the mandated amount of iodine.

If boilers don’t test for the concentration of iodine in the coarse salt that they buy, and if, further along the production line, salt repackagers, like 57-year-old Koy Rithiya, don’t test for the concentration in the fine salt that they buy from the boilers and then add iodine where needed, the result is noniodized salt.

Which is exactly what has happened.

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Routine testing

When Rithiya set up his business in Phnom Penh 15 years ago, he didn’t know he needed to add iodine; he started doing that a decade ago after being advised by UNICEF.

These days he uses an electronic monitor to test the concentration of iodine in the 500 kilograms of fine salt that he repackages each day, and adds iodine where needed to meet the mandated standard of 30-60 parts per million.

He doesn’t yet use the monitor to test his daily output of 400 kilograms of coarse salt; instead he relies on a test that merely shows whether iodine is present or not. That test, however, does not measure the concentration.

Rithiya reckons the problem of iodine-deficiency has emerged in part because some producers use expired iodine, “but also because some producers combine salt with iodine without correctly balancing it.”

“And some don’t bother to use it correctly,” he said.

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A lack of enforcement

The report makes clear where the problem lies: on the production side is SPCKK, as well as some boilers and salt repackagers; on the enforcement side are the authorities for failing to ensure that producers follow the law.

The irony is that by 2010, the government’s program meant the health problems associated with iodine deficiency in Cambodia were largely a thing of the past. A decade earlier, nearly 1 in 5 primary school children had goiters, a condition where the thyroid in the neck swells up. Many adults did, too. By 2010, that was no longer the case.

But when iodine prices tripled after the 2011 Fukushima nuclear disaster in Japan, many salt producers in Cambodia stopped buying the additive, and the authorities failed to make sure they were iodizing. The result: a re-emergent public health issue that has, to date, remained largely invisible.

The situation, though bad, should start to improve. UNICEF is working with a government subcommittee to devise a certification standard for all producers, although that could take two years to implement.

Ven Keahak, who heads the subcommittee on salt iodization, says the new licensing system will mean producers “have to have a machine, iodine powder [in stock], a brand name, and salt with proper quality in order to get a license.”

“It’s a legal enforcement that the ministry has to conduct,” he said.

A lack of enforcement has been part of the problem, but Keahak would not comment on the failure of government agencies to apply the current law. He did confirm that no one has been prosecuted for failing to add iodine or for failing to monitor the system.

The difficulty for concerned Cambodians is that every bag of salt carries the logo stating that it is iodized. To deal with that, the Ministry of Planning will now test all salt brands and will place advertisements in newspapers to tell people which brands they can trust.

Until then, the failure to police the country’s salt output will keep damaging lives in what experts say was an entirely avoidable public health issue. (VOA)

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Why Is India Still carrying The Social Stigma Of Women Infanticide?

The matter of female infanticide is something that has deeply touched our heart and we feel it as our prime agenda to raise our voice against it

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Female Infanticide has been going on for many years and has resulted in the deaths of countless girl foetuses. Wikimedia Commons
Female Infanticide has been going on for many years and has resulted in the deaths of countless girl foetuses. Wikimedia Commons
  • A lot of social evils which have disgraced our history are still very much prevalent
  • Female infanticide is known to be the intentional killing of female just-born owing to people preferring male just-born
  • In China and India alone, an estimated 2,000,000 baby girls go “missing” each year

Even after so many years of independence, we are not in a position to call our country a superpower. It is not hard to believe this because in an independent country like ours exist horrific acts like the merciless killing of the girl child. A lot of social evils which have disgraced our history are still very much prevalent. The matter of female infanticide is something that has deeply touched our heart and we feel it as our prime agenda to raise our voice against it.

Female infanticide is known to be the intentional killing of female just-born owing to people preferring male just-born. This has been going on for many years and has resulted in the deaths of countless girl foetuses. People are of the opinion that the girl child is inferior to the male child and this is clearly reflected in the fact that in many parts of the world, women are still not given a status equivalent to that of men. This is no doubt the highest level of brutality and the most destructive kind of bias existing in our country and in many other countries.

Also Read: Is The observance of Valentine’s day a Commination For The Indian Culture?

A direct proof of these facts comes from UNICEF which in its recent report concluded that 50 million girls and women are missing from the population of India because of this bias. As a matter of fact, in most countries for every 100 male births, there are approximately 105 female births. In our country, the 105 comes straight down to 93! This owes itself to 2000 odd abortions which happen illegally all over the country daily. Our people are of the opinion that only sons can provide income for the family. The system of dowry is still prevalent in some parts of the country. All these reasons have their roots in cultural beliefs of families and if female infanticide is to be stopped, then these beliefs have got to be challenged.

The government has initiated a lot of programmes to bring about a change in the attitude of people and stop these kinds of social evils. Wikimedia Commons
The government has initiated a lot of programmes to bring about a change in the attitude of people and stop these kinds of social evils. Wikimedia Commons

In countries with a history of female infanticide, the modern practice of sex-selective abortion is often discussed as a closely related issue. In several nations such as China, India and Pakistan, female infanticide remains to be a major cause of concern. It has been argued that the “low status” in which women are viewed in patriarchal societies creates a bias against females. The practice of female infanticide is found dominant among the indigenous peoples of Australia, Northern Alaska and South Asia, which seems to be “almost universal”, even in the West.

In 1990, Amartya Sen writes in the New York Review of Books estimated that there were 100 million fewer women in Asia that would be expected and that this amount of “missing” women “tells us, quietly, a terrible story of inequality and neglect leading to the excess mortality of women.”  Initially, the Sen’s suggestion of gender bias was contested and it was suggested that hepatitis B was the cause of the alteration in the natural sex ratio.

Also Read: Padman Review: Social Issue Presented Right

The numerical worldwide deficit in women is widely accepted due to gender-specific abortions, infanticide and neglect. Before Islamic culture became established in Arabic country in the seventh-century, female infanticide was widely practised.  According to scholars, the fact was attributed that women were deemed “property” within those societies. Some speculated that some women wanted to prevent their daughters from a life of misery, and thus would kill the child. But with the introduction of Islamic rule, the practice was made illegal.

People in India are of the opinion that only sons can provide income for the family. Wikimedia Commons
People in India are of the opinion that only sons can provide income for the family. Wikimedia Commons

In India, dowry system is one given reason for female infanticide; over a time period spanning centuries, it has become embedded within Indian culture. Although, there are several steps taken to abolish the dowry system but the practice still persists. For the rural families, female infanticide and gender-selective abortion are attributed to the fear of being unable to raise a suitable dowry and then being socially boycotted.

In 1789, during the time of British colonial rule in India, the Britishers discovered that female infanticide in Uttar Pradesh was openly acknowledged. A study by the scholars shows that the majority of female infanticides in India during the colonial period occurred for the most part in the North West. However, not all the groups were involved in this practice it was widespread. It was only after a thorough investigation by the colonial authorities in 1870 that the practice was made illegal.

Also Read: 7 new-age social issues in India that need a check

Some age-old practices seem to be deeply rooted in the Indian culture and making India undergoing a type of “female genocide”. As per one of the reports of the United Nations, India stands out to be the most deadly country for female children, and that in 2012 female children aged between 1 and 5 were 75 percent more likely to die as opposed to boys. One of the children’s rights group called CRY has acknowledged that of 12 million females born yearly in India 1 million will have died within their first year of life. According to the United Nations, there could be a possibility of such a severe crisis that less number of females will lead to a sharp increase in sexual violence.  A consequence of this will be a complete deterioration of social values. This practice of deselecting females is mainly due to factors like religion, economic factors and socio-cultural factors.

In several nations such as China, India and Pakistan, female infanticide remains to be a major cause of concern. Wikimedia Commons
In several nations such as China, India and Pakistan, female infanticide remains to be a major cause of concern. Wikimedia Commons

The economic factor arises from the belief that sons will provide economic stability to the family by earning wages, providing farm labour for family business and support parents during old age. People tend to think that after marriage, a son brings a female addition to the family who provides help in household work as well as dowry payment brings some sort of an economic advantage.

Coming to the socio-cultural factor, it is believed that having at least one male child is essential to continue the familial line and the respect of a family in the society is proportional to the number of male children in it. According to a certain Hindu tradition, only sons are permitted perform the funeral of their parents which assists in the attainment of salvation for the deceased.

Also Read: Today’s Social Issues and their Answers to Children

The government has initiated a lot of programmes to bring about a change in the attitude of people and stop these kinds of social evils by introducing various laws, schemes and acts which favour the education of the girl-child, equal rights and equal property share. In spite of all these steps taken, there is much left to be desired.

In China and India alone, an estimated 2,000,000 baby girls go “missing” each year. They are selectively aborted, killed as newborns, or abandoned and left to die. Other countries with similar cultural traditions, who have also faced this problem are South Korea and Nepal. The root causes of female infanticide are similar but not exactly the same in Confucian countries like China and South Korea, versus predominantly Hindu countries such as India and Nepal.