Wednesday November 22, 2017

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

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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Experts Say Measles Victims Dropped Below 100,000 in 2016

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Measles Victims Dropped
Foriza Begum, background, a newly arrived Rohingya Muslim from Myanmar, reacts to her daughter Nosmin Fatima's scream as she receives a vaccination to prevent measles and rubella at a makeshift medical center in Teknaf, Bangladesh. VOA
  • Latest reports of WHO, UNICEF, and the U.S. Centers for Disease Control and Prevention say the rate of deaths from measles has dropped.
  • As per experts, a number of people who died from measles in 2016 were about 90,000, compared to 550,000 in 2000.

The World Health Organization, UNICEF, and the U.S. Centers for Disease Control and Prevention say the rate of deaths from measles has dropped 84 percent since the beginning of a global vaccination campaign in 2000.

Experts say the number of people who died from the disease in 2016 was about 90,000, compared to more than 550,000 deaths in 2000. This marks the first time that worldwide measles deaths have fallen to less than 100,000 per year.

Robert Linkins, of the Measles and Rubella Initiative at the CDC, said in a statement that “saving an average of 1.3 million lives per year through vaccine is an incredible achievement and makes a world free of measles seem possible, even probable, in our lifetime.”

Since 2000, some 5.5 billion doses of measles vaccine have been administered to children through routine immunization services and mass vaccination campaigns. The disease is contagious through air particles and can spread quickly. The disease kills more people every year than any other vaccine-preventable disease.

But the WHO says the world is still far from reaching regional measles elimination goals. Since 2009, officials have managed to deliver a first dose of the vaccine to 85 percent of the babies who need it, but there has been no improvement in that rate in eight years. And only 64 percent of the affected population has gotten the second dose, which comes when a child is four or five years old.

The WHO says “far too many children” — about 20.8 million — have not had their first vaccine dose. Most of those children live in Nigeria, India, Pakistan, Indonesia, Ethiopia and the Democratic Republic of Congo.

The disease puts children at risk of developing complications such as pneumonia, diarrhea, encephalitis, and blindness.(VOA)

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Amitabh Bachchan: Privileged to be top most influencer for Unicef

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Amitabh Bachchan
Amitabh Bachchan: Privileged to be top most influencer for Unicef

Mumbai, Oct 25 : Megastar Amitabh Bachchan, who has served as Unicef Goodwill Ambassador for the polio eradication campaign in India, says he is fortunate to be the top most influencer for the organisation.

Amitabh on Tuesday shared a list of names of top influencers.

“Among top ‘influencers’ for fight against polio, a list by Unicef. Privileged to be the top most influencer. Thank you UN!” Big B tweeted.

The actor, 75, has been supporting and promoting various health and related issues such as childhood immunization programme, anti-tuberculosis campaign and the ‘Clean India’ initiative.

“Unicef Polio; World Polio Day, every child deserves to live a polio free life! I worked eight years on it and today India is polio free.”

On the acting front, Amitabh, who has wrapped up shooting for “Kaun Banega Crorepati”, has two films in his kitty — “Thugs Of Hindostan” and “102 Not Out” (IANS)

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Nearly 58% of Rohingya Refugees are Kids Suffering from Severe Malnutrition, Says UN Report

The report highlights the dangers these Rohingya minors faced during the attacks when they were in Myanmar or when they were fleeing the repression to Bangladesh.

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Displaced Rohingya Muslims in Rakhine. Wikimedia.

Bangladesh, October 20, 2017 : Nearly fifty-eight per cent of the about 600,000 Rohingya refugees in Bangladesh are children who suffer from severe malnutrition, a UN report released said.

The UN Children’s Fund (Unicef) report also said that these children were highly exposed to infectious diseases, Efe news reported.

“In a sense it’s no surprise that they must truly see this place as a hell on earth,” said Simon Ingram, Unicef official and author of the report.

Titled “Outcast and Desperate: Rohingya refugee children face a perilous future” was released at a press conference in Geneva, Switzerland.

After two weeks in Cox’s Bazar, a southern Bangladesh town where nearly 600,000 newly arrived refugees are crammed into a crowd of 200,000 Rohingyas who had fled earlier, Ingram described the situation fraught with “despair, misery and indescribable suffering”.

The report highlights the dangers these Rohingya minors faced during the attacks when they were in Myanmar or when they were fleeing the repression to Bangladesh.

The report also highlighted several drawings of children with uniformed soldiers killing people and helicopters spraying bullets from the sky.

In mid-August, the Arakan Rohingya Salvation Army (ARSA) carried out a coordinated attack on security posts in Myanmar, sparking a violent response from the military which led to thousands of Rohingyas in Rakhine state fleeing to neighboring Bangladesh.

Ingram explained that very little is known about what is happening in Rakhine, since humanitarian agencies have not been able to enter the region since August.

Most of the refugees “are already undernourished, since the repression also included the burning of food stores and the destruction of crops”, he said.

According to the Unicef estimates, one in every five children under the age of five is suffering from acute malnutrition and about 14,500 suffer severe acute malnutrition.

Ingram explained that the main danger of infectious diseases have been mitigated with the vaccination campaign against cholera, measles and polio, but much remains to be done to tackle these risks.

He added the situation worsened with the lack of clean drinking water as these children consumed only contaminated water which is another main source of infection.

With regard to child protection, the expert welcomed the fact that the number of unaccompanied children had decreased to 800, with the identification tasks carried out by the various humanitarian agencies on the ground.

Regarding sexual abuse or forced or early marriages, Ingram explained that for now they have only punctual evidence, but that it is a real risk in any situation such as in Cox’s Bazar.

What does occur relatively frequently, he said, is child labour.

In the area of protection, the essential issue is the status of these people.

Not only do they have to be recognized as refugees, but also that newborns in the countryside or along the way, he said, should be able to obtain some kind of birth certificate.

Unicef and the UN High Commissioner for Refugees (UNHCR) are negotiating with the Bangladeshi authorities the possibility of issuing birth certificates for newborn Rohingyas, but the talks are still in process.

The Rohingyas are a Muslim minority that Myanmar does not recognize as citizens and are therefore stateless. (IANS)