It is through salt that the iodine deficiency endemic to the Himalaya -causing goitre and cretinism – can be tackled. If a permanent system of salt iodization and distribution were set up, the Himalaya would be rid of cretinism and other associated disorders. Yet salt, the all-important commodity, is hardly ever discussed at the national policy level.
Iodine is a trace element found in the soil. Through time, iodine has "leached" from mountains to plains and then to the sea. This leaching has given the soil of many highlands and flood-prone areas, including that of Bhutan, India, Nepal and Bangladesh, very low iodine content. As a result the quantity of iodine in food crops is very low. Being an essential micronutrient, a lack of iodine in the diet leads to Iodine Deficiency Disorders (IDD) even if the diet is otherwise well-balanced.
Experts say some degree of goitre is present in more than one half of the population of Bhutan and Nepal — its prevalence surpassing that of India and other neighbouring countries. Cretinism is characterized by mental retardation, deaf-mutism, and lack of muscular coordination, and it also occurs in perhaps one out of every 50 persons.
The eradication of goitre and cretinism today ranks as one of the most important public health in the Himalaya. In Nepal, the iodine supplement has normally been through salt. Iodized oil injection, another method, is used in high risk areas where iodized salt has not penetrated. While oil injections are undoubtedly effective, especially in preventing cretinism in newborns, the method is more of an interim measure. At the present level of technology, iodized salt remains the chosen vehicle to overcome IDD because of the country's transportation problems, consumer resistance, finance, and the dependence on ad-hoc foreign assistance programmes.