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THIRUVANANTHAPURAM, Oct 4

KERALA Sastra Sahitya Parishad (KSSP), which deservingly considers itself as the salt of the earth having been famously associated with many a progressive movement in Kerala, seems to have taken the Indian Medical Association (IMA) drive to universalise salt iodisation with just that pinch.

It may be recalled that the State unit of the IMA had in recent times launched a campaign to popularise the use of iodised salt with a view to preventing the incidence of iodine deficiency disorders (IDD) in the State.

While appreciating IMA's sense of concern over threat to public health, KSSP has sought to debunk the alleged move to dub the entire State as an endemic area.

In this manner, salt as a preventive cure largely constitutes an assault on the health consciousness of the State's population, it said.

In a letter to Dr P.T. Cherian, President, State IMA, Mr N.K. Sasidharan Pillai, General Secretary, KSSP, said that pushing salt iodisation in such non-endemic areas is unethical.

"The IMA campaign is based on a study report conducted by a New Delhi-based agency in collaboration with Government Medical Colleges in Kerala and the Unicef. In KSSP's view, the conclusions of the study are flawed and warrant outright rejection."

Apart from the determination of thyroid size and estimation of the prevalence of goitre, other components of data collection required for assessment and monitoring an iodine deficient population are the assaying of the urine iodine excretion and the determination of the level of T4 and TSH in the blood.

However, the median urinary iodine obtained in the study was above the prescribed standards that define a population to be iodine-deficient.

In other words, Kerala did not qualify to be an IDD-endemic region, KSSP said.

According to KSSP, the National Family Health Survey (1998-99) found that only 39.3 per cent of Kerala households consumed iodised salt.

If, in spite of this, the population iodine levels are adequate, what is the need to campaign further for iodised salt consumption, it argued.

IMA counter: Responding to the KSSP outburst, the IMA local unit denied that it was involved in any activity or campaign for promotion of the "exclusive use of iodised salt".

While admitting paucity of data about the Kerala situation, it said that available data pointed to the fact that several regions in the State are endemic to IDDs.

"When quantitative data is not available in some areas, one can go by epidemiological evidence and even anecdotal evidence,'' Dr Cherian said.

"IMA strongly feels that IDDs, simply because they are easily preventable, should not be occurring at all, moreso when preventive interventions come cheap and are accessible to all.

"The cost difference between the use of iodised and non-iodised salt works out to less than Rs 50 per person for a whole lifetime.''

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