"SWAZILAND: Devastating impact of nutrient deficiencies", Integrated
Regional Information Networks (IRIN) News, September 3, 2004,

Up to 60 percent of Swazi infants are likely to incur brain damage due
to vitamin deficiencies, while a wide spectrum of the population are
at risk of malnourishment, according to a United Nations Children's
Fund (UNICEF) report released on Thursday.

"The price of the current food shortage crisis is being paid by
children and others, who are suffering stunted growth and diminished
performance at school and on the job," Siddharth Nirupam, UNICEF
Swaziland's programme officer for health and nutrition, told IRIN.

Nirupam said new programmes were already in place to boost vitamin
consumption, but data was not yet available to assess their
effectiveness. One such programme is targeted at vitamin A
distribution among children under five years - the national prevalence
of vitamin A deficiency in children aged under six is 40 percent and
causes the deaths of 600 children annually.

Vitamin A deficiency leads to stunted growth, greater susceptibility
to infection and more frequent ill health. A lack of folic acid (one
of the B vitamins), required for the production of normal red blood
cells, can cause a type of anaemia, severe birth defects in children
and increased heart disease and strokes in adults.

The UNICEF report estimates that 4,000 Swazi babies are born each year
with intellectual impairment caused by a lack of iodine in the
mother's diet during pregnancy.

"In countries where the goiter rate [enlargement of the thyroid gland,
usually caused by too little iodine,] is 10 percent or more, as in
Swaziland, iodine deficiency is estimated to be so widespread as to
lower the average national IQ by as much as 10 to 15 percentage
points," the report said.

Worldwide, iodine deficiency is the leading cause of preventable
mental impairment and diminished work potential.

Lower productivity in the workforce, caused by iron and iodine
deficiencies that lead to illness and general lethargy, has slashed
0.6 percent off the nation's gross domestic product. Given that
Swaziland's GDP growth this year is only 2 percent, the impact of
vitamin deficiencies on the economy is devastating, said health
officials. The finance ministry has noted that the country needs a GDP
growth rate of at least 3.6 percent to maintain present standards of

Two-thirds of Swazis already live in chronic poverty, according to the
UN Development Programme, and HIV/AIDS cuts one percent off GDP growth

"The increased ill health due to vitamin deficiencies, which can be
remedied, is putting further pressure on an overburdened health care
system," Nirupam commented.

Swaziland is not one of the 49 countries in the world that require
flour to be fortified with iron, and was thereby "missing an
opportunity to protect the nation's mental and physical health, and
increase national energy and productivity," said the report. Neither
is Swaziland among the 38 nations that require wheat flour to be
fortified with folic acid.

No data is available on the availability of iron supplements, which
reduce anaemia - around 30 percent of Swazi women and 45 percent of
young children are now anaemic.

However, 60 percent of Swazi children consume household salt fortified
with iodine and health organisations are seeking to raise that figure.
Fortified salt is one of the staples distributed by the UN World Food
Programme, the Baphalali Swaziland Red Cross and other food aid groups
to about a quarter of the population requiring food assistance.

The report recommended the fortification of staple foods like flour,
sugar and salt with vitamins and minerals. "Fortified foods have long
protected people in Europe and North America. It is now time that they
did the same for the developing world," the report remarked.

Programmes to distribute vitamin and mineral supplements in low-cost
capsules and syrups to young children and women of childbearing age
were also recommended, as was community education on the need to
expand the Swazi diet, which typically consists of maize meal,
spinach, cabbage and, occasionally, meat.