Lumps in the mountains; Goiter.

About 740 million people have goiters, but the percentage varies greatly by region (eastern Mediterranean: 32%; Africa: 20%: Europe: 15%; Southeast Asia: 12%; western Pacific: 8%; the Americas: 5%).
A goiter is a noncancerous enlargement of the thyroid gland in the front of the neck. Many conditions can cause goiter, but the most common is a lack of sufficient iodine in the diet, which is usually a result of the soil in which food is grown being iodine-poor—a condition that occurs in many mountainous regions away from the sea. Iodine is required for the production of thyroid hormones, which regulate the body's metabolism.
Iodine deficiency or a lack of iodine causes a swelling called a goiter. People who don't get enough iodine in their diet can develop other problems too. They have less energy. They have difficulty learning and working. They might also be partly paralyzed, deaf or mentally or physically challenged. Iodine deficiency has been called the silent hunger because one does not crave it although our bodies must have it.

When goiters develop, they can range in size from a lump you feel but can't see, to swellings that are as big as a fist. Many goiters are as big as a chicken egg. Sometimes they can make it difficult to swallow or breathe. Some people who lack iodine don't develop goiters, but they have other symptoms instead. These people act sluggish and sleepy, their skin is dry, they get cold easily, and they are constipated.
One of the worst things lack of iodine does is to slow the development of a baby's brain even before the baby is born. Iodine deficiency is the world's leading cause of mental defects.

If a pregnant woman doesn't have enough iodine, her baby could die or be born with a stunted body and without the ability to hear or speak. Sometimes the effects of iodine deficiency are not so serious, but children are still affected, both in their minds and bodies. Such children get sick more often.

Women who suffer from a lack of iodine have a harder time getting pregnant, and when they do get pregnant they suffer more miscarriages, stillbirths and other problems. About five to ten babies out of every thousand pregnancies worldwide die because of iodine deficiency.
Iodine is naturally a part of soil and water, which means it is present in most food. But in an areas where there are frequent floods, or lands away from oceans, there is likely very little or no iodine in the soil and water. So food grown in these areas lacks iodine too.
Recently in Kenya, there has been a prevalence of goiter, most recent cases being reported in Mt Elgon areas, with the Sabot communities. This only compounds the social issues in the region which has been adversely affected by land disputes which suppresses further, food production in the area.
Pregnant women here are lacking in iodine,increasing the risk of child mortality.
it is therefore of critical importance that the government, through relevant ministries,looks into soil treatment and supplementary medication for this population.
In the efforts to fight iodine deficiency,the government of Kenya provided a policy,which dictates that salt be iodized and made available, the average retail cost of salt is ~15 Kenyan shillings per kilo.
The Ministry of Health with support from UNICEF has trained salt monitors for district level monitoring to ensure retailers and households understand the importance of Iodine Deficiency Disorders control through salt iodization. The monitors use rapid testing kits in the field and make reports to head office for follow-up if non-iodized salt is found. Advocacy messages on the importance of consuming iodized salt and storing it properly once purchased are communicated through mobile cinemas in rural communities.
Community health initiatives, are continuously needed among communities such as these, so as to facilitate sustainable prevention measures that significantly foster development in regard to the Millennium Development Goals.

Nyambura Mundia