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close this bookScurvy and its Prevention and Control in Major Emergencies (WHO; 1999; 70 pages)
View the documentAcknowledgements
View the documentScurvy: definition
open this folder and view contentsIntroduction
open this folder and view contentsScurvy
open this folder and view contentsVitamin C
open this folder and view contentsRecommended Daily Allowance (RDA)
open this folder and view contentsSources of vitamin C
close this folderStrategies to prevent scurvy in large refugee populations
View the documentBackground
open this folder and view contentsMain approaches
close this folderOther options
View the documentFortification of oil
View the documentFortification of water
View the documentFortification of dried skimmed milk (DSM)
View the documentGermination
View the documentOther interventions
View the documentCosts
open this folder and view contentsConclusions and recommendations
View the documentReferences
View the documentAnnex 1
View the documentAnnex 2
View the documentAnnex 3
View the documentBack Cover

Other interventions

Another option for increasing the vitamin C intake of refugees would be to improve their diet by adding commodities to the basic ration. Tomato paste is readily accepted by many refugee populations in Africa, tomato sauce being a regular item of the usual diet. However, the stability of vitamin C in canned tomato paste is questionable. Due to the high acidity of tomatoes the metal can usually starts to corrode. Metal ions could react with the vitamin and destroy (oxidise) it (Roche, personal communication). The stability of the vitamin would therefore depend on the material used to pack the tomato paste. Vitamin C losses during cooking would have to be looked into, as well as the feasibility of timely delivery, distribution, availability and cost.

Herbs and spices are good sources of vitamin C and significantly increase nutrient intake by enhancing the flavour of prepared foods. Dried peppers can have a vitamin C content as high as 180 mg per 100 g, dried sweet peppers 90 mg per 100 g, and dried red peppers 12 mg per 100 g (FAO/WHO, 1970). Once again, losses prior to consumption have to be investigated and problems regarding logistics, availability and cost taken into consideration.

Various fortified "new food" options for use by all members of a household as part of the total diet include chocolate and candy bars, sweets, dry instant-soup mixes, and condiments. Their cultural acceptability by all age groups, costs and related logistics should be determined in advance. Since most of the items suggested as alternative sources of vitamin C are products of fairly sophisticated markets, they may well not be consumed by target populations. A strong educational component emphasizing the importance of their consumption would thus be required to help ensure the success of any such intervention.

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