I went to Cambodia for the first time on a medical mission in 2001. I was impressed by the high frequency of enlarged thyroids (goiters) I found, particularly amoung women. Some study taught me that Cambodia is a part of the world that has low levels of iodine in its soil. That is true of many parts of the world, including much of North America, where I have practiced the specialty of endocrinology for nearly forty years. But to my knowledge I had never seen a case of iodine deficiency before.

  The reason we do not see iodine deficiency in Canada and the US is because virtually all of our salt has had iodine added since the 1920's. I have done short term medical missions to Mexico and Equador which are also iodine deficient regions, but found no more goiters amoung the several hundred people I examined than I would find in the US or Canada. That is because even in these relatively poor countries UNICEF, with the help of Kiwanis International, has had a well established iodized salt program for two or three generations.

  Cambodia has not been so fortunate. War and political instability have led to a loss of the country's educated workers and its infrastructure. These are gradually being restored, but in the meantime, the country continues to suffer from iodine deficiency.

  Suffer is the correct word because iodine deficiency results in a number of physical and mental disorders, classified as iodine deficiency disorders (IDD). These include congenital deafness, decreased muscle tone most importantly, congenital impairment of IQ. In fact, IDD is the most common cause of preventable mental retardation in the world. In its most severe form we call it cretanism, but that is only the tip of the iceberg.

  A child born to an iodine deficient mother has a permanently reduced IQ of 10-15 points.

  Some day this will be prevented by a country-wide iodized salt program, just as it is in most of the rest of the world. In the meantime, Cambodian children will be doomed to a lower IQ than they should have.

  Since I was in the country as a Christian doctor, I felt an obligation to do what I could for the population to which I had access, the protestant congregations. While they make up only 1% of the population, we were able to gain the help of their pastors for what we call THE SALT OF THE EARTH PROJECT.

  With the partnership of Cambodian pastor Keat Kove, we have purchased iodized salt locally in Cambodia. THE COST IS ONLY TWENTY-FIVE CENTS PER KILOGRAM.

 The bulk purchases are divided into 1kg sealed plastic baggs by volunteers from pastor Kove's congregations. Each 1kg bag has printed on it in Khmer the quote from John 5:13,"You are the salt of the earth". On the reverse side is an brief explanation of the importance of iodized salt, ending with the statement, "It makes kids stronger and smarter".

  Pastor Kove then gives the bags of salt to pastors throughout the country. This effective distribution system has the added advantage of instilling trust in the recipients. Their pastors are respected members of their communities and are much more likely than outsiders to convince the people to use our refined salt. This is an important step in the project because the refined, iodized salt looks quiet different from the gravel-like rock salt that they traditionally use.

  We provide each family in a congregation with two of the 1kg bags, on for themselve and one for a non-believing neighbor. One kg lasts a family for a year.

  Iodine cannot be stored in the body for the long term so we must renew the supply of iodized salt each year. Therefore, my main function has been to put on fundraising projects every year to cover the cost of the salt. Happily, this is the only cost we have to meet. There is virtually no other overhead in the project.

  We look forward to the day that all Camboians will use iodized salt, but until then we will continue to provide for as many of the as we can.

  Pastor Kove and I greatly appreciate the financial support we have received. Although we cannot pinpoint the numbers, we know that there are many children in Cambodia who are stronger and smarter than they would have been without this effort.