For millions of people living in the poorer corners of the world, endemic cretinism, an iodine deficiency disease, is a tragic part of everyday existence. In frequently flooded or mountainous regions-where iodine is leached from the soil-thousands of children are born with the illness each year. These babies are afflicted with thyroid and growth disorders, along with permanent neurological conditions such as retardation and deafness.
Dr. Robert Delong, a professor of pediatrics, has devoted his career to combating this problem with his revolutionary method of delivering iodine to impoverished areas: putting the substance into irrigation water.
Back in 1980, he was recruited as the neurological consultant to a small team of doctors traveling to Ecuador and visited tiny Andean villages to learn more about iodine deficiency disorders. "While I was there, I saw 120 cases of a disease I had never seen before," Delong explained, "and I was hooked."
Since then, Delong has become "the world's foremost authority on the clinical effects of iodine deficiency on the developing brain," said Dr. John Dunn, a professor of medicine at the University of Virginia and secretary of the International Council for the Control of Iodine Deficiency Diseases. "He has personally examined and described the clinical features in most of the major endemias in the world."
On his visits to South America, Delong saw the amazing difference providing iodine to pregnant women could make. He quickly recognized the need to initiate preventive programs in other nations. After spending time in Zaire and Bhutan, he headed to China to start work in a cluster of villages in the province of XinJiang.
Upon his arrival, Delong was met by government officials who prevented him from reaching his intended destination and firmly explained that he would be working in the county of Hotien instead.
After that experience, Delong said, "I learned to be flexible. In China, you never know where you're going to eat or where you're going to lay your head, and you learn to go with the flow."
After treating many people in Hotien individually, Delong began looking for ways to integrate iodine into the diet of the general population. Iodized salt, the technique used in most developed nations, had been unsuccessful because processed salt was incompatible with the cultural traditions of the local people. A more creative technique was desperately needed.
While looking at Hotien's agricultural canal system, Delong came up with the idea of iodizing the irrigation water. Nobody had ever attempted this strategy before, but if the iodine could be dripped into the water to reach the soil, and then the crops, it would become an integral part of the traditional diet. The plan was attempted in a trial area; during the first year, four villages and 3,600 people were provided with iodized irrigation water.
The improvement was notable, and the program quickly expanded. In the second year, 15,000 people were treated, the third year, 24,000 and by the fourth year, more than 45,000 people were being helped.
After that, Kiwanis International began funding the treatment, and today more than 3 million people in western China are being treated based on Delong's technique.
The positive impact of the iodinization has gone beyond preventing cretinism. Recent statistics have shown a significant drop in infant mortality, an increase in mean IQ scores and average height among the children of the area and even an improvement in agricultural production levels, a result completely unanticipated by scientists.
Delong's work has received international recognition for its creativity and scope. Dr. John Stanbury, retired chair of the international council, worked with Delong in his earlier years. He praised Delong's method, explaining that it has "made a substantial impact on China and corrected a deficiency for millions of people."
With possible expansion into North Pakistan, Mali, Peru or Tashkent, the technique Delong developed may one day save millions more.
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