Maternal and neonatal tetanus is not the first target of a Kiwanis global campaign for children. During the 1990s, members and clubs worldwide helped raise and leverage more than US$100 million to virtually eliminate iodine deficiency disorders (IDD), the world’s leading cause of mental disabilities.
Today, Kiwanis’ Eliminate Project aims to raise US$110 million to virtually eliminate maternal and neonatal tetanus (MNT). So, when six Kiwanis members traveled to Guinea this past September, they were intent on observing that nation’s immunization program.
But while there, their UNICEF and government hosts invited them on a tour of salt plants, warehouses and markets. In a journal of his Guinea trip, Kiwanis International Vice President John Button recorded why he remains optimistic despite concerns about recent declines in the availability of iodized salt for Guinea’s nearly 10 million people. Following are IDD-related excerpts from his journal. You can read his comments about Guinea’s immunization program in the March 2013 issue of Kiwanis magazine.
Day 7, Coyah:
We traveled to Coyah to see the IDD (iodine deficiency disorders) program. Coyah is on the major route into and out of Conakry, ideally located for the salt-distribution center. It is here that the salt warehouses are located. We met with salt producers, surveillance teams and government surveillance officers. We learned that:
- Prior to the IDD campaign, only 12 percent of households had access to iodized salt. This number rose to 68 percent with the campaign.
- Prior to the campaign, the incidence of goiter was 67 percent, which fell to 20 percent with the introduction of iodine.
- Currently, 55 percent of households have access to iodized salt, but there is no iodine or iodized salt in the country.
We expressed our alarm and asked some pointed questions about the decreased availability of iodized salt. I am certain our hosts were taken aback by the vigor with which they were questioned. The producers listed four primary causes:
- No iodine is available
- Rogue salt producers
- Decreased government commitment
- No funding
We toured the warehouses that are full of cement bags of un-iodized salt. A local street vendor was selling this salt also in cement bags.
Day 8, Conakry:
Our day began in a traffic jam. … Our first meeting of the day was a debriefing session at United Nations House with the UN resident coordinator. He took careful note of our IDD concerns and pledged to work with the government to raise its level of commitment and resource availability.
We next met by Skype with Julien Harneis, the UNICEF Guinea representative who spoke with us from Amman, Jordan. He too took careful note of our IDD concerns and indicated that UNICEF has already developed a plan to rectify them.
Afterwards, I spoke privately with Dr. Salvatore Nibitangu, the head of UNICEF’s health programs. Salvatore and I had only known each other for a few days. He accompanied us on all our travels. We had developed a good relationship characterized by collegiality and candour. He stated that he believed that the IDD numbers had bottomed out and that UNICEF will be taking control of the program. My concerns were greatly allayed.
Day 9, Ridgetown, Ontario, Canada:
Impressions: The team was concerned about the decrease in the availability of iodized salt. Our concerns were shared with the UN and UNICEF authorities and assurances were given that they would be addressed. I suppose that a country surrounded by civil strife and war and beset with its own civil unrest might develop a different set of priorities. However, I am convinced that iodized salt availability will return to its previous high levels with the support, advocacy and efforts of UNICEF.
I would be remiss were I not to salute the commitment of the Governor of Middle Guinea and the Prefecture of the Prefect of Mali to the campaign. They were tireless and eloquent in their advocacy of tetanus immunization but also championing their partnership with UNICEF and Kiwanis International.