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Pakistan's mistrust of iodised salt is aggravating a deeper health crisis
These four brothers work at a salt factory in Pakistan. Two of them suffer from cretinism, caused by iodine deficiency.
At a bustling general store in Lahore, people ask a lot of questions about one seemingly innocuous product: table salt. If it contains iodine, about 40% of his customers spurn it, according to proprietor Muhammad Waqas Vicky. They won't allow their families to consume what they call "mixed salt", believing it causes infertility. "The majority among them are businessmen and religious people," said Vicky.
Anti-polio campaigns here have been the target of deadly attacks that stemmed from similar myths, but officials blame the iodine-related infertility rumours, at least in part, for a massive health crisis.
How did this happen? Some experts see little mystery in the evolution of what has become one of Pakistan's more bizarre and destructive conspiracy theories. Seventeen years ago, well-meaning government officials launched a maternal health initiative in the face of ever-rising birthrates. To this day, people remember a slide show on official Pakistan television at the time the nation's only channel that pushed prenatal care and awareness of vital nutrients. The penultimate slide promoted one element in particular: iodine.
The final slide, officials recall, credited the initiative to the government's department of primary health and family planning. "There was a communication mistake," Tariq Aziz, an expert on iodised salt production, said of the 1995 broadcast. "People thought this was purely a family planning initiative."
After the public conflated iodine with government-enforced birth control, rumours took off about an international scheme to limit Muslim population growth through iodised salt. The falsehoods became especially potent in a society that prizes large families and where contraception use is low.
"Once I bought a packet of salt along with other household items and my wife refused to use it," said Muhammad Zafar, a labourer from a village 100km from Lahore. "Even some of my friends have told me stories that the doctors have advised them to not use iodised salt if they want to avoid infertility."
Mosque leaders also continue to argue that iodine is a health scourge, or at very the least a western plot. "I do not use iodine salt, and I advise my relatives and friends not to use it as well," said one Lahore cleric, Maulana Muhammad Asim. "I do not have any evidence to prove that it is causing infertility. But my question is: why are the US and the west so worried about the health of Pakistanis that they are forcing us to use iodine? They have an agenda."
In Pakistan, some non-governmental public health organisations have resorted to what amounts to stealth iodisation, providing subsidies to salt factory owners who add the micronutrient during production. The salt often reaches markets unpackaged, to be vended by weight.
"It is sold in bulk, unbranded it is open-bag salt, and consumers will not know if contains it iodine," said Muhammad Yasin of the Micronutrient Initiative. "They get the health benefit even if they don't know it."
Additional reporting by Babar Dogar
^^ Wonder who came up wit this idea? Unless the salt is refined to greater levels, and then packaged in moisture-proof continuous film packages, the iodine is bound to evaporate very rapidly.
These four brothers work at a salt factory in Pakistan. Two of them suffer from cretinism, caused by iodine deficiency.
At a bustling general store in Lahore, people ask a lot of questions about one seemingly innocuous product: table salt. If it contains iodine, about 40% of his customers spurn it, according to proprietor Muhammad Waqas Vicky. They won't allow their families to consume what they call "mixed salt", believing it causes infertility. "The majority among them are businessmen and religious people," said Vicky.
Anti-polio campaigns here have been the target of deadly attacks that stemmed from similar myths, but officials blame the iodine-related infertility rumours, at least in part, for a massive health crisis.
How did this happen? Some experts see little mystery in the evolution of what has become one of Pakistan's more bizarre and destructive conspiracy theories. Seventeen years ago, well-meaning government officials launched a maternal health initiative in the face of ever-rising birthrates. To this day, people remember a slide show on official Pakistan television at the time the nation's only channel that pushed prenatal care and awareness of vital nutrients. The penultimate slide promoted one element in particular: iodine.
The final slide, officials recall, credited the initiative to the government's department of primary health and family planning. "There was a communication mistake," Tariq Aziz, an expert on iodised salt production, said of the 1995 broadcast. "People thought this was purely a family planning initiative."
After the public conflated iodine with government-enforced birth control, rumours took off about an international scheme to limit Muslim population growth through iodised salt. The falsehoods became especially potent in a society that prizes large families and where contraception use is low.
"Once I bought a packet of salt along with other household items and my wife refused to use it," said Muhammad Zafar, a labourer from a village 100km from Lahore. "Even some of my friends have told me stories that the doctors have advised them to not use iodised salt if they want to avoid infertility."
Mosque leaders also continue to argue that iodine is a health scourge, or at very the least a western plot. "I do not use iodine salt, and I advise my relatives and friends not to use it as well," said one Lahore cleric, Maulana Muhammad Asim. "I do not have any evidence to prove that it is causing infertility. But my question is: why are the US and the west so worried about the health of Pakistanis that they are forcing us to use iodine? They have an agenda."
In Pakistan, some non-governmental public health organisations have resorted to what amounts to stealth iodisation, providing subsidies to salt factory owners who add the micronutrient during production. The salt often reaches markets unpackaged, to be vended by weight.
"It is sold in bulk, unbranded it is open-bag salt, and consumers will not know if contains it iodine," said Muhammad Yasin of the Micronutrient Initiative. "They get the health benefit even if they don't know it."
Additional reporting by Babar Dogar
In Pakistan, some non-governmental public health organisations have resorted to what amounts to stealth iodisation, providing subsidies to salt factory owners who add the micronutrient during production. The salt often reaches markets unpackaged, to be vended by weight.
"It is sold in bulk, unbranded it is open-bag salt, and consumers will not know if contains it iodine," said Muhammad Yasin of the Micronutrient Initiative. "They get the health benefit even if they don't know it."
^^ Wonder who came up wit this idea? Unless the salt is refined to greater levels, and then packaged in moisture-proof continuous film packages, the iodine is bound to evaporate very rapidly.