Iodization programmes require education and regulations
Iodized salt is the predominant and most effective means for combatting iodine deficiency. However, orally administered iodized peanut oil provides a good alternative in situations where iodized salt is not available. Iodized peanut oil has a longer shelf life and is cheaper than the previously widespread poppy seed oil. These were two of the conclusions from research on 250 children in an iodine deficient area of rural Indonesia, carried out by Juliawati Untoro for her PhD thesis Use of oral iodized oil to control iodine deficiency in Indonesia.
Iodine deficiency forms one of the main malnutrition problems in Indonesia and is responsible for disabilities including mental retardation, and damage to unborn fetuses, Untoro reports. Iodine deficiency takes its toll in areas which have little natural iodine in the soils, from where it is normally absorbed into crops. This situation becomes worse in poor, remote areas where subsistence agriculture is the main source of food, Untoro explains. In 1990, an international coordinated effort was initiated to combat this problem through a special iodization programme. Salt was chosen as the basic ingredient common to all diets worldwide, and almost a decade later, 60% of all edible salt in the world is iodized. In Indonesia the figure is closer to 50%, for a number of reasons. Ungoro: Indonesia has over 300 salt processing plants spread over 24 provinces. Some of these are very small-scale family enterprises, which cannot afford to convert the technology they use. Government regulations are not properly enforced, partly because processors are so widespread, but also due to the lack of political motivation at the moment.
Untoro conducted her research for SEAMEO (South East Asian Ministries of Education Organisation) and Tropmed, a community tropical medicine initiative based in Jakarta. Although her research suggests an effective means of administering iodine to households, she does not see oral iodized oil programmes as the final solution. Instead, Untoro calls on the Indonesian government to initiate policies and educational programmes that encourage people to buy iodized salt. At the moment, non-iodized salt is cheaper than iodized salt, so of course people will take the cheaper option, especially if they aren't well enough informed about the reasons for the difference, she states. Her conclusion: In the long term, all salt should be iodized to effectively combat the problem, but in the short term, oral administration using iodized peanut oil is the best option for Indonesia. Am.S