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Nutritional antropology

Knowledge, attitudes, and practices of people in Ulaanbaatar, Mongolia, with regard to iodine-deficiency disorders and iodized salt
Indigenous knowledge of wild food hunting and gathering in north-east Thailand

Knowledge, attitudes, and practices of people in Ulaanbaatar, Mongolia, with regard to iodine-deficiency disorders and iodized salt

Methods
Results
References

C. Yamada, D. Oyunchimeg, T. Igari, D. Buttumur, M. Oyunbileg, and T. Umenai

The authors are affiliated with the Maternal and Child Health Project in Ulaanbaatar, Mongolia.

Abstract

In 1995 Mongolia introduced a national programme of salt iodization to eliminate iodine-deficiency disorders. To investigate the extent of acceptability and utilization of iodized salt, a study of people’s knowledge, attitudes, and practice (KAP) was carried out in ‘the capital city, Ulaanbaatar, in 1996 and 1997. A total of 838 people (housewives, parents of schoolchildren, post-partum women, and pregnant women) were interviewed about their KAP regarding iodine-deficiency disorders and iodized salt. In addition, the amount of salt consumption at the household level was examined. Over 95% of the study population knew about iodine- deficiency disorders and iodized salt, and most of them received the information from television and radio. About 90% of them had already used iodized salt. The price of iodized salt is a little higher than that of common salt, but it is still affordable for most people. This study demonstrates the possibility of the expansion of the programme nationwide.

Introduction

Iodine-deficiency disorders have been recognized as a public health problem in 118 countries worldwide, and there are approximately 1.5 billion people at risk [1, 2]. Iodine deficiency particularly affects pregnant women, foetuses, neonates, and children and causes mental and physical disorders [1-4]. Iodine deficiency is a preventable health problem, and its impact on socio-economic development has also been recognized globally during the last decade.

As an intervention, salt iodization is the most effective public health approach for the elimination of iodine-deficiency disorders without side effects [5-9]. In fact, a dramatic decrease in the prevalence of goitre from the use of iodized salt was reported in Pakistan, Finland, and Austria [10-12]. The effectiveness of salt iodization was also confirmed biochemically by the examination of urinary iodine excretion in Finland [11].

Mongolia, a landlocked country in the northern part of Central Asia, has severe endemic iodine- deficiency disorders. A nationwide survey of goitre prevalence conducted from 1992 to 1994 indicated a high goitre rate of approximately 30% in both mothers and children [13-15]. In 1992 the Mongolian government pledged the elimination of iodine- deficiency disorders by the year 2000. A limited salt-iodization programme was initiated in 1995. By 1996 domestically produced iodized salt made up approximately 42% of the total salt consumption in Mongolia [15]. In a report issued by UNICEF in 1994, daily salt consumption was estimated to be 5 g per capita [16].

Although salt iodization is progressing well, it is important to know how much iodized salt is consumed by Mongolians and to assess their knowledge about iodized salt consumption and iodine- deficiency disorders. Therefore, a study estimating salt consumption and evaluating people’s knowledge, attitudes, and practices (KAP) was conducted in 1996 and 1997.

Methods

The study was conducted in two phases during November 1996 and April 1997. During the first period, KAP and salt intake were examined in three groups: parents of schoolchildren, post-partum women, and households. During the second period, the same study was conducted with pregnant women.

Study participants

Parent group

The parents of 300 randomly selected children (189 mothers and 95 fathers) from 30 randomly selected schools in Ulaanbaatar were requested to answer a self-administered questionnaire regarding their KAP on iodine- deficiency disorders and iodized salt, and the price and kind of salt that they used. Samples of salt used in the home were collected and analysed for iodine by the titrimetric method. The mean age of the mothers was 38 ± 5.4 years (range, 28-58), and the mean age of the fathers was 41.0 ± 6.8 years (range, 28-67). There were no significant differences between the responses of the mothers and the fathers.

Post-partum group

One hundred forty-three women admitted to four public maternity hospitals, which handle almost all deliveries in Ulaanbaatar, were interviewed by trained staff on the third day after delivery using the same questionnaire that was used with the parent group. The mean age of the women was 25.0 ± 5.2 years (range, 15-40). Two women refused to participate in the study.

Pregnant group

The second phase of the KAP and salt intake measurement study was carried out with 144 pregnant women who attended three Public Health Units in Ulaanbaatar. Their mean age was 26 ± 5.6 years (range, 17-41). Thirteen (9%), 54 (37%), and 80 (54%) were in their first, second, and third trimesters, respectively. They responded to the same questionnaire used during the first phase of the study but were also asked some additional questions regarding the possession of a television set and radio in their homes. No women refused to participate. From this group, 64 women were randomly selected to participate in a salt- consumption study.

Household group

To measure salt consumption, 264 households were randomly selected from six central districts in the city. One woman of reproductive age, with children, from each household was selected to participate in the study. The mean age of the women was 33.1 ± 5.4 years (range, 20-54). Only six households refused to participate.

Estimation of salt intake

The household participants and the 64 randomly chosen pregnant women agreed to use iodized salt, provided by the study investigators, for two weeks. The weight of salt remaining after two weeks was used to determine consumption. The female head of the household provided data on sex, age, number of meals consumed, and the estimated food intake at home for each family member. To estimate the relative amounts of food intake within the family, a score of 1.0 was assigned to the person who ate the most. Each family member was then given a score relative to 1.0 based roughly on his or her food intake; e.g., the housewife score was 0.8. Family members were categorized into four age groups: I to 4, 5 to 9, 10 to 14, and 15+ years. It was assumed that salt intake correlated with food intake and that people ate equal portions at each meal. The women recorded the meal frequency of each member and house guests during the study period. The salt intake was calculated from these data. This study did not take into account salt consumed outside the home or contained in processed foods.

Market study

The study staff visited 57 randomly selected retailers in the six central districts of Ulaanbaatar. They obtained information about the kind of salt sold, its price, and the prices of several foods. The retailers surveyed were chosen to represent the different types of sellers throughout the city.

Statistical analysis

Student’s t test was used to test the difference between two means, and the chi-square test was used to test the difference between population proportions.

Results

Knowledge

The parent group and the post-partum group were asked if they had heard of iodine-deficiency disorders and iodized salt, and the consequences of iodine-deficiency disorders. All participants had completed elementary school and most had completed high school.

Of 284 parents, 273 (96%) were aware of iodine-deficiency disorders and 260 (92%) knew about iodized salt, whereas of 143 post-partum women, 139 (97%) knew about iodine-deficiency disorders and 140 (98%) knew about iodized salt. When they were questioned about their knowledge of the consequences of iodine-deficiency disorders, more participants knew about goitre than any other consequence (96% of the parents and 99% of the post-partum women). Mental retardation was the least well known consequence, although more than 80% of both groups responded that it was one of the consequences of iodine-deficiency disorders. Growth failure was recognized by 96% of the postpartum women and 89% of the parents as a consequence of iodine -deficiency disorders; however, the difference was not significant. The sources of the information about iodine-deficiency disorders and iodized salt available to these populations were examined. More than 90% of the respondents obtained information about iodine -deficiency disorders from television, followed by radio, articles in the newspaper and other written material, and medical personnel (table 1). Similarly, more than 80% of both groups received information about iodized salt from television, followed by radio and newspapers (table 2). In the group of pregnant women, 97% owned a television set and 87% owned a radio. The mass media campaign was conducted with the collaboration of the UNICEF Mongolia office and the Mongolian government. Throughout 1996, nine 20-minute radio programmes on iodine-deficiency disorders and iodized salt were broadcast every week, for a total of 150 hours, and two 30-minute television programmes were each broadcast twice. In addition, when the people were asked when they watched television at home, many of them responded that they kept television on continuously during broadcasting hours (7 a.m. to 8 a.m. and 6 p.m. to midnight). Moreover, many offices (governmental and private) keep radios turned on all day.

Table 1. Sources of information about iodine-deficiency disorders among parents and post-partum women (percentages, multiple responses)

Source	Parents	Post-partum women
Television	91	97
Radio	52	73
Newspapers	52	43
Written materials	23	43
Medical personnel	26	22
Family members	15	6
Teachers	13	1
Friends	11	3
Others	2	0

Table 2. Sources of information about iodized salt among parents and post-partum women (percentages, multiple responses)

Source	Parents	Post-partum women
Television	81	94
Radio	46	72
Newspapers	45	41
Written materials	22	43
Medical personnel	35	14
Family members	14	3
Teachers	10	2
Friends	1	0
Others	1	2

Attitudes

Four questions on iodine -deficiency disorders and iodized salt were asked only of pregnant women: “Are iodine -deficiency disorders a health problem?” “Does iodized salt prevent iodine- deficiency disorders?” “Is iodized salt good for your baby?” “Is iodized salt good for you?” Over 95% of the women answered in the affirmative to each of these questions.

A question about the taste of salt was asked of the household and the pregnant groups. More than 40% responded that iodized salt tasted different from common salt (table 3). Of the 66 pregnant women who answered yes, 57 (86%) said that iodized salt was less salty and 6 said it was bitter. A sub-study, testing for difference of “saltiness” between the two salts, was carried out among pregnant women, using a double-masking procedure. Sixteen (36%) of 44 respondents answered correctly, 22 (50%) answered incorrectly, and six could not distinguish between the salts.

The household and pregnant groups were asked if they used more or less salt when they used iodized salt. More than 57% of the participants said that they used more (table 3). Of the 99 pregnant women who said they used more salt when they used iodized salt, 82 (82%) said they thought they needed more salt to prevent iodine-deficiency disorders, and 17 (17%) said it was because iodized salt tasted less salty.

Table 3. Attitudes towards the taste and use of salt in households and among pregnant women-no.(%)

Question	Households (n=234)		Pregnant women (n=144)
	Yes	No	Yes	No
1. Is the taste of iodized salt different from that of common salt (less salty, bitter, other)?	100(43)	134(57)	66(46)	78(54)
2. 1 use a larger amount of salt when 1 use iodized salt than when 1 use common salt	133 (57)	101 (43)	99(69)	45 (31)
3. 1 use a larger amount of salt when 1 use iodized salt because it is less saltya	-	-	17(17)	-
4. 1 use a larger amount of salt when 1 use iodized salt because I should consume more to prevent iodine -deficiency disordersa	-	-	82 (83)	-

a. Questions 3 and 4 were only asked of pregnant women who answered yes to question 2.

The three groups were asked about purchasing iodized salt. Eighty-four percent of the parent group, 94% of the post-partum group, and 99% of the pregnant group said they were willing to purchase iodized salt. The post-partum and pregnant groups were significantly more likely than the parent group to be willing iodized salt (p <.01).

Practices

All four groups were asked if they used iodized salt, and more than 83% of the respondents answered affirmatively (table 4). In the household and pregnant groups, a further question was asked about whether they used iodized salt exclusively or used both iodized salt and common salt. Sixty-nine percent of the household group and 60% of the pregnant group said they used iodized salt exclusively.

The parent and the post-partum groups were asked about household salt consumption for a month. Most people said they purchased 2 to 3 kg per month per household. Furthermore, of 288 salt samples collected from the parent group, 210 (73%) contained more than the recommended level for households of 20 ppm iodine.

Measurement of salt consumption

Daily salt consumption at home was estimated in the household and the pregnant groups. In the household study, the mean individual daily salt consumption was 12.4 g for adult males and 8.3 g for adult females (table 5). The mean salt consumptions of the adult male and of the adult female in families with pregnant women were 14.3 g and 10. 1 g, respectively (table 5). The mean salt intakes for both males and females in the families of the pregnant group were significantly higher than those of the household group (male, p <.05; female, p <.01).

Table 4. Participants using iodized salt, according to study group-no. (%)

Group		Using	Not using
Parents		238(84)	46(16)
Post-partum		132(92)	11 (8)
Household		182 (69)	30(11)
	Only iodized salt
	Iodized salt and common salt	51 (19)
	Total	234(89)
Pregnant		88 (60)	3 (2)
	Only iodized salt
	Iodized salt and common salt	56(38)
	Total	144(98)

Iodized salt sales and price in the market

Of 57 retailers, 40 (70%) sold only iodized salt, 6 (11%) sold only common salt, and 11 (19%) sold both kinds of salt. The price of iodized salt ranged from US$0.32 to $0.50 per kilogram. Similarly, prices of common salt ranged from US$0.13 to $0.35 per kilogram. The cost difference between the two kinds of salts (US$0.15) was equal to the price of an egg, a half-loaf of bread, or a glass of milk.

Discussion

From a public health perspective, it is encouraging that almost 90% of the study population already used iodized salt within one year of the introduction of the salt-iodization programme. It is also important to note that more than 90% of the people knew about the relationship between iodine-deficiency disorders and iodized salt. The study population recognized iodine-deficiency disorders as an important health problem, and they accepted iodized salt as a good tool to prevent iodine- deficiency disorders. Although it is possible that the participants tried to give the answers to the interviewers they thought might be most favourable, there is no evidence that they had been exposed to surveys of this type, and they seemed to appreciate being asked to participate.

Although 83% of the parent group said they had ever used iodized salt, only 73% of salt samples taken from their homes were iodized. This is probably because there are three types of iodized salt users: exclusive users, occasional users, and users of both iodized and non-iodized salt. Although it has not been clearly examined how much occasional use of iodized salt or simultaneous use of it with common salt prevents iodine- deficiency disorders, it is important to increase the number of people who use only iodized salt.

Table 5. Salt consumption (g) among household members and pregnant women according to age and sex-mean ± SD

Category	Households (n=264)	Pregnant women (n=64)
Adult males	12.4 ± 5.4**	14.3 ± 6.1**
Adult females	8.3 ± 3.7*	10.1 ± 3.9*
Children 10-14 yr	8.4 ± 4.0	10.5± 5.1
Children 5-9 yr	6.0±2.9	7.0 ± 3.1
Children 1-4 yr	4.3±2.7	4.1±2.6

* p <.05.
** p <.01.

In Ulaanbaatar television was found to be the most popular and effective source of information, and almost all households of the pregnant women surveyed owned a television. Radio was identified as the second most effective mass media source for public health education. More people in rural areas of Mongolia have access to radio than to television. In a report from Peru, the investigators found that interpersonal communication was the most effective means to disseminate health information in rural areas [17]. Although this has not been studied in Mongolia, we suggest that television and radio programmes, with the addition of trained health educators, should be the focus of a nationwide programme to promote the elimination of iodine-deficiency disorders through increased consumption of iodized salt.

In general, iodized salt costs more than common salt because of its additional processing cost. In Ulaanbaatar, however, people had no difficulty purchasing iodized salt. In fact, the difference in monthly expenditure for iodized salt and common salt for a household was approximately US$0.30, equivalent to the cost of a loaf of bread or two eggs. The current cost of iodized salt may not be acceptable in some rural areas. Rock salt is commonly used in rural areas, and it is much cheaper than in Ulaanbaatar (about US$0.04-0.13 per kilogram). In general, purchasing power is lower in rural areas. Therefore, some intervention strategies may need to be considered. One strategy might be to add iodine to salt in the home or in a community centre or to provide the iodine capsule to individuals.

Although information on iodine-deficiency disorders and iodized salt was well disseminated to people in Ulaanbaatar, caution should be taken about the content and correctness of the information. For instance, about half of the pregnant and household groups said the taste of iodized salt was not the same as that of common salt; however, in a double-blind study they could not distinguish this difference. Nearly 60% of the household and pregnant groups incorrectly believed that they should use more salt when they used iodized salt. Increased salt intake may cause some physical problems, especially in pregnant women and people with cardiovascular diseases. Health information messages should incorporate these findings.

Salt iodization was recommended by the World Health Organization/UNICEF/International Council for the Control of Iodine -Deficiency Disorders as the means of eliminating iodine- deficiency disorders [1]. The reasons that many countries are not able to achieve 90% usage include political factors and logistical problems in production and distribution [18-20]. Moreover, a country with numerous small-scale salt producers and scattered local markets may take many years to achieve universal salt iodization.

In contrast, Mongolia seems to likely to achieve a sufficient level of salt iodization within a few years. There are several reasons for this. All nine domestic salt factories were able to produce iodized salt from 1996. The government allowed the importation only of iodized salt from May 1997. People in Ulaanbaatar became highly aware of iodine-deficiency disorders through an extensive media campaign. Finally, Mongolia has a high rate of literacy (83%) [21] and level of education, which allowed the public to understand and act upon information regarding iodine-deficiency disorders and iodized salt. These encouraging results will provide a strong incentive for a national expansion of the iodine-deficiency disorders programme throughout the country. The success of a national programme will be enhanced by the recent interest of some international donor agencies in collaborating with this programme, such as the Japan International Cooperation Agency. Therefore, we believe that iodine-deficiency disorders will be controlled by the year 2000 in Mongolia.

Acknowledgments

We thank Dr. M. Irie, representative of the Japanese Branch of the International Council for the Control of Iodine-Deficiency Disorders, the UNICEF Mongolia Office, and the Japan International Cooperation Agency for their technical and financial support to this study. A special acknowledgement goes to Dr. K. Enkhjargal, Director of the Public Health Department, Mongolian Ministry of Health and Social Welfare, for her technical and administrative contribution to this study.

References

1. World Health Organization/UNICEF/international Council for the Control of Iodine-Deficiency Disorders. Indicators for assessing iodine deficiency disorders and their control through salt iodization. Geneva: World Health Organization, 1994.

2. Hetzel BS, Pandav CS. SOS for a billion. 2nd edn. Oxford: Oxford University Press, 1997.

3. Gaitan E, Dunn, JT. Epidemiology of iodine deficiency. Trends Endocrinol Metab 1992;3:170-5.

4. Maberly GF. Iodine deficiency disorders: contemporary scientific issues. J Nutr 1994; 124:1473S-8S.

5. Ranganathan S. Iodised salt is safe. Indian J Publ Health 1995;39:164-71.

6. Ranganathan S, Reddy V. Human requirements of iodine and safe use of iodised salt. Indian J Med Res 1995;102:227-32.

7. Demaeyer EM, Lowenstein FW, Thilly CH. The control of endemic goiter. Geneva: World Health Organization, 1979.

8. Mannar MGV. Global control of iodine deficiency disorders through the iodination of salt. In: Kakihana HR Jr, Oshi T, Toyokura, ed. The seventh symposium on salt. Amsterdam: Elsevier, 1993, vol 2:415-20.

9. Matovinovic J. Recent results in goiter prophylaxis. In: Stanbury JB, Hetzel BS, eds. Endemic goiter and endemic cretinism. New York: John Wiley, 1980:589-96.

10. Ali A, Khan MM, Malik ZU, Charania BA, Bhojani FA, Baig SM. Impact of the long term supply of iodized salt to the endemic area. J Pakistan Med Assoc 1992;42:138-40.

11. Lamberg, BA, Haikonen M, Mäkelä M, Jukkara A, Axelson E, Weilin MG. Further decrease in thyroidal uptake and disappearance of endemic goitre in children after 30 years of iodine prophylaxis in the east of Finland. Acta Endocrinol 1981;98:205-9.

12. Gollowitsch HJ, Mikosch P, Kresnik E, Gomez I, Plob J, Pipam With, Lind P. Thyroid volume and iodine supply of 6 to 17 year old students. Results 3 years after the introduction of increased iodized salt. Nuklearmedizin 1994;33:235-8.

13. Kachondham Y, Dhanamitta S, Oyunbileg M, Brown L. Child health and nutritional status in Ulaanbaatar, Mongolia: a preliminary assessment. Asia Pacific J Publ Health 1993;6:226-32.

14. UNICEF, Ministry of Health, Mongolia: Child Nutrition Survey. Ulaanbaatar: UNICEF Ulaanbaatar Sub-Office, East Asia and Pacific Regional Office, Ministry of Health, Mongolia, 1993.

15. UNICEF. Programme of Co-operation between the Government of Mongolia and the United Nations Children’s Fund, 1996 Annual Review. Ulaanbaatar: UNICEF, 1996.

16. UNICEF Nutrition Section. Progress towards universal salt iodization. New York: UNICEF, 1994.

17. Quick RE, Gerver ML, Palacios AM, Beingolea L, Vargas R, Mujica O, Moreno D, Seminario L, Smithwick EB, Tauxe RV. Using a knowledge, attitudes and practices survey to supplement findings of an outbreak investigation: cholera prevention measures during the 1991 epidemic in Peru. Int J Epidemiol 1996;25:872-78.

18. Dunn, JT. Seven deadly sins in confronting endemic iodine deficiency, and how to avoid them. J Clin Endocrinol Metab 1996;81:1332-5.

19. Thilly CH, Hetzel BS. An assessment of prophylactic programs: social, political, cultural, and economic issues. In: Stanbury JB, Hetzel BS, eds. Endemic goiter and endemic cretinism. New York: John Wiley, 1980:475-90.

20. Medeiros-Neto GA. Towards the eradication of iodine-deficiency disorders in Brazil through a salt iodination programme. Bull WHO 1988;66:637-42.

21. UNICEF. The state of the world’s children 1998. Oxford and New York: Oxford University Press, 1998.

Indigenous knowledge of wild food hunting and gathering in north-east Thailand

Methods
Discussion and conclusions
References

Prapimporn Somnasang, Geraldine Moreno, and Kusuma Chusil

Prapimporn Somnasang is affiliated with the Department of Community Medicine, Faculty of Medicine, in Khon Kaen University in Khon Kaen, Thailand. Geraldine Moreno is affiliated with the Department of Anthropology in the University of Oregon in Eugene, Oregon, USA. Kusuma Chusil is affiliated with the Department of Pediatrics, Faculty of Medicine in Khon Kaen University.

Abstract

Rural people in north-east Thailand depend on locally gathered or hunted wild food, such as fish, crabs, snails, shrimps, birds, red ants’ eggs, frogs, toads, rabbits, rats, insects, and many kinds of plants. Twenty rural villages in north-east Thailand were surveyed, and one village was studied in depth. The objective was to identify knowledge about hunting and gathering of wild food and gender-based differentiation associated with this knowledge. The study showed that the knowledge related to hunting and gathering wild food was different for women and men. Men had more knowledge of fishing and hunting; women had more knowledge of gathering plants and insects and of scooping for shrimp. These findings should be used in developing appropriate programmes to help the local people.

Introduction

Many societies throughout the world rely heavily on wild plants and animals [1] that provide a rich source of nutrients [2]. Wild plants also supply material for housing, shelter, and crafts; plants and animals provide items for religious observances; and both are important sources of income that can be vital for women, children, and the poor.

Moreno-Black and Price [3] have shown that wild food plays an important economic role among the rural poor in north-east Thailand (Isan). The north-east is the poorest part of the country and includes about one-third of its area and population. Poor rural agricultural families depend on wild plants and animals, which they also sell in local markets [3-7]. Indigenous knowledge of wild food and techniques for obtaining it is crucial for their survival [8-10].

The collection and use of wild food is differentiated according to economic level, social class, and gender. The poor rely on wild food because they cannot afford to buy food, and women and men frequently obtain different kinds of foods. Knowledge of what kinds of wild food to obtain and of where, when, and how to obtain them generally differs between men and women. However, we need to be careful not to allow preconception to influence our expectation as to who is knowledgeable in different societies. For example, Browner [11] found that, contrary to expectations, many men in a Mexican village were more knowledgeable than women about medicinal plants used for women’s reproduction and about women’s reproductive health problems. We should take gender-based distribution of power into account in analyses of intracultural variation.

The objective of this study was to identify knowledge about hunting and gathering of wild food and gender-based differentiation associated with this knowledge in north-east Thailand.

Methods

The study was done in two phases. First, a survey of 20 rural villages in Surin, Roiet, and Mahasarakam Provinces was conducted between January and March 1995. This survey provided general information about how the people hunted or gathered indigenous food and how they obtained their knowledge of such food. This information was used to determine what specific wild-food gathering and hunting activities to study in depth in one typical village in the second phase of the study. The indepth study of Ban Fang village in Khon Kaen Province was conducted between January and September 1995.

The survey of the 20 villages was conducted by the rapid rural appraisal (RRA) method [12-14]. Researchers in nutrition, social science, and agriculture were involved in this multidisciplinary study. The headman in each village was interviewed to determine the social status of the people in the village, and the team of researchers interviewed both men and women in three to six households that were categorized as poor, middle-class, or rich. This permitted a triangulation of differences with economic status.

The guideline open-ended questions for the RRA were as follows:

· Do you consume wild food (products of wild plants and animals)?
· What wild plants and animals do you and your family consume in each season?
· How do you gather or hunt those foods? What methods, tools, or special equipment are used?
· Do men, women, children, or old people gather or hunt those foods?
· Who makes the tools? How do you know about the tools?
· From whom or where did you learn about this?
· Who gathers or hunts with you?
· When do you gather or hunt those foods (any time of the day, daytime, nighttime)?
· Where do you gather or hunt those foods?

The qualitative methods included guided but open-ended interviewing, participant observation, and focus groups. After a period of extensive participant observation, six focus-group sessions were held in the village. These groups contained from four to eight persons, and group composition was determined by gender criteria (table 1). Groups 1 to 4 were asked to talk about the role of women and men in the family, decisions made concerning what to eat, who obtained food for the family, and who cooked food. Groups 5 and 6 were asked to talk about their indigenous knowledge about hunting and gathering wild food, from whom they learned it, and how they did it.

The participant observation included activities with men and women, such as hunting and gathering fish, crabs, snails, shrimp, birds, red ants’eggs, frogs, toads, rabbits, and rats. All the methods, tools, and equipment were recorded and photographed.

Study site

The 20 villages were surveyed by the RRA method at the same time as a health assessment team from the Khong Chee Moon Project was evaluating the impact of proposed irrigation canals on this area of the northeast. Men and women in three to six households in each village were interviewed.

Table 1. Composition of focus groups

Group	No. of people	Sex	Mean age (yr)	Age range (yr)
1	8	F	40	27-54
2	5	M	54	42-68
3	6	F	43	30-50
4	4	M	49	37-56
5	5	F	39	26-52
6	5	M	42	25-50
Total	3	19 F 14 M	30 F 33M	25-68

The village studied in depth is in a remote area near both mountains and forest about 48 km from Khon Kaen. Villagers still depend largely on wild food and other items in the forest and aquatic animals in a natural reservoir. There were 112 houses in the village with a total population of 583 people (309 males and 274 females). The most important agricultural crop was rice. Only one crop of rice could be grown per year because of the lack of water. if the rainfall was not good, rice production suffered. Other crops grown in the village were cucumbers, corn, betel nut leaves, asparagus, and other green vegetables. The average yearly household cash income was US$1,581.

Gender-based patterns of knowledge

Data from the 20 villages showed that most people still consumed both wild and cultivated food daily. Wild foods were available in paddy fields, ponds, reservoirs, forests, and mountainous areas. The availability of wild food depended on the season. During rainy years, wild food was usually abundant. If the agricultural yield was poor, people depended more on wild foods rather than buying food. Most people, both rich and poor, preferred wild food to cultivated food. Therefore, wild foods were not only for the poor. People who did not hunt or gather wild foods purchased them from those who did. Some villagers also sold wild foods in a market in the town. Examples of wild food eaten daily are wild plants with jeaw or pon (spicy dips), fish (usually boiled with vegetables, curried, or roasted), frog spicy soup or dip, mushroom soup, and roasted insects.

In the 20 villages studied, women did most of the gathering of plants, including mushrooms and bamboo shoots. They also scooped for shrimp, fish, and small insects; gathered snails and crabs; dug for insects; and gathered red ants’ eggs. Normally men did most of the deep-water fishing and most hunting of birds, rats, rabbits, frogs, toads, and geckos.

Women in the focus groups claimed that they obtained more wild food for family use than men did. For example, they stated:

· Women gather wild food and animals more than men.

· Women bring food to the family more than men.

· Men do not gather food because they have other work to do, such as working in paddies, growing plants, preparing plots, cutting wood, constructing houses, or working in cities.

· We gather plants in the paddies, uplands, swamps, and forests almost every day. We also scoop for fish and small shrimp and gather snails and crabs.

· Men catch fish in deep water and use guns to hunt for birds and wild animals.

· Women do not hunt birds and animals because we do not know how to use a gun and we cannot go into the deep forest (48-year-old woman).

· When I was young my mother took me to gather wild plants and animals with her. She taught me how to recognize and gather them, and when to find them in each season. I remembered helping her gather dork grajaew and mushrooms in the forest. It’s fun. We would dig for crabs in the paddy in the hot season. We went to gather red ants’eggs together. I also helped her scoop for shrimp and water insects (maeng langum). I watched my mom make nets for scooping and my grandfather make and mend fishing nets. He also made khong from bamboo to put fish in (50-year-old woman).

· My father taught me how to use a net to fish, a gun to shoot birds, rubber bands and a stick to hit birds, and many kinds of bamboo traps to catch rats and ground lizards (56-year-old man).

Women are experts in scooping for small fish, shrimp, insects, and water animals in swamps or shallow water, using a home-made round net. The insects they catch include maeng neal, maneng langum, maeng grachon, and maengda. They take their children with them, since they have to take care of them. Women and children gather crabs and snails more frequently than men. They scoop the animals from the swamp or pick them out of the water or mud. In the dry season, they dig the animals from the paddy or from buffalo dung with a spade, using a bamboo container (khong), basket, or bucket to carry their catch back home. Sometimes men also collect crabs and snails if they happen to find them on the way home.

Red ants’ eggs are considered delicious. They are eaten only at the end of the cool season and the beginning or middle of the hot season. Women are the primary gatherers, but men also participate if they go in a group to gather them to sell. Some villagers earn quite a lot of money by selling red ants’ eggs.

Men, on the other hand, are expert in fishing and hunting for wild animals such as ground lizards, birds, rats, rabbits, snakes, wild chickens, wild pigs, geckos, frogs, and toads. Men usually are responsible for providing fish for the family. They use many kinds of tools to catch fish, depending on the level of water and the season. They know how to use different kinds of fishing nets, such as haa, auan, yor, and dang. They also use homemade fishing rods. Sometimes they catch fish with a pu blowpipe, which consists of a long bamboo stick with an arrow made of a thin sharp stick wrapped with cotton. They use many kinds of bamboo traps to catch fish and other aquatic animals such as shrimp.

Only men and boys hunt and trap birds. The method depends on the kind of bird. For example, grata birds are caught by using a decoy bird in a cage; the bird’s singing attracts other birds, which are caught in a net around the decoy. Another method uses a large net held between two long poles in a sugarcane plantation. When a flock of birds comes to rest on the sugarcane, five to seven men chase them in the direction of the net, where they are caught. This is a popular way to catch omsael birds in the cool season. The men divide the birds to cat or to sell. They also hunt birds with the pu blowpipe.

The rat that is most popular for food is the white rat (noo khao), which lives in paddies. The villagers do not eat house rats because they are considered dirty. Men and boys hunt white rats with slingshots. They also use a net (sing) to catch rabbits as well as rats. The sing is placed on the ground with bait on it; when the rat or rabbit comes to eat the bait, it is caught in the net.

Frogs and toads can be gathered only from the rainy season until the beginning of winter. immediately after a rain, men and older boys go in groups of at least two to a paddy or swamp to catch frogs. The best time to catch them is at night, using lights. Men also hunt frogs and toads during the day using the pu. Frogs, toads, and tadpoles are considered delicious protein foods that can also be sold for a good price in the market.

Insects, red ants’ eggs, and bamboo shoots are gathered by both men and women. Many insects are available in different seasons, and they are also a good source of protein. Women and children scoop or dig insects (maeng kutgee) from the ground in the dry season. At night men and boys use long neon lights to attract insects, which then fall into a bucket of water.

Discussion and conclusions

Rural people in north-east Thailand pass knowledge of how to hunt and gather wild plants and animals from generation to generation. They learn how to survive in the driest part of the country on wild foods and supplement the main staple of rice, which they consume in large quantities at each meal. Wild plants are an important source of vitamins and minerals (table 2). Fish, small shrimp, snails, frogs, birds, and insects are all good sources of protein and energy (table 3; see table 4 for local, English, and scientific names of food plants and animals). The availability of these wild foods varies with the season, and they usually are important components of the diet when they are available.

Villagers have experienced a decrease in the availability of wild foods as a result of the massive deforestation that has been going on for years in Thailand. Some species of plants and animals have disappeared completely. Ecological changes have affected the remaining species also. Even though women have transplanted some species close to their homes, many do not survive outside their natural setting. In some areas insects and plants are no longer safe to eat because of chemicals that have been introduced into the environment.

Indigenous knowledge of how to gather wild food is most critical to the poor. The knowledge is passed down in the family. Children learn the varieties of plants and animals when they go hunting and gathering for food with their parents or relatives.

Rocheleau. et al. [8] pointed out that local knowledge of native plants is very important. We also emphasize that rural people have an impressive knowledge about how to hunt and gather wild food. Chambers and Leach [10] discussed how the forest is a vital source of security for the poor and how much they depend on it. We found that the Isan villagers relied on wild food both as a rich and varied source of nutrition and as a supplement to their income from sales in town markets.

Table 2. Nutritional value of wild plants per 100 g

Planta	Moisture (g)	Protein (g)	Fat (g)	Carbo-hydrate (g)	Fibre (g)	Ash (g)	Energy (kcal)	Ca (mg)	P (mg)	Fe (mg)	Na (mg)	K (mg)	Vitamin B1 (mg)	Vitamin B2 (mg)	Niacin (mg)	Vitamin C (mg)
Pak kadon	73.5	2.9	0.5	17.8	3.9	1.4	87.3	57.5	48	2.5	77.9	267	0.12	0.15	NAb	7.75
Pak khom	88.3	3.9	0.6	2.9	1.0	3.2	32.8	318	69	NA	49.2	475	0.03	0.26	1.01	22.9
Lin pak kee lek	70.6	5.8	0.7	18.1	3.6	1.9	103.4	125.8	160.7	3.7	28	516.5	0.55	0.42	2.94	21.7
Teaw	76.3	2.7	1.1	18.0	2.3	1.3	90.6	47.8	53.3	2.5	35.6	365	0.12	0.33	1.21	14.5
Pak bung	93.1	1.6	0.5	2.3	1	1.3	20.4	43.1	49.3	2.2	89.9	268	NA	NA	NA	NA
Waan	91.6	2.0	0.1	3.2	1.7	1.4	21.3	33.3	53.8	NA	79.0	369	NA	0.2	1.36	0.5

Source: ref. 15.
a. Available local, English, and scientific names can be found in table 4.
b. Not yet analysed.

Table 3. Nutritional value offish and other animals per 100 g

Animala	Energy (kcal)	Moisture (g)	Protein (g)	Fat (g)	Carbo-hydrate (g)	Ash (g)	Ca (mg)	P (mg)	Fe (mg)
Dried zew (fish)	404.7	4.9	58.9	18.7	0.3	17.3	4,257	2,634	9.66
Dried khow (fish)	397.0	4.8	62.7	16.2	0.1	16.2	4,721	2,523	7.36
Fermented fish	88.0	52.0	13.0	4.0	0	31.0	1,857	1,276	5.1
Frog	351.7	5.4	75.1	5.7	0	13.8	3,564	2,045	10.8
Cricket	125.1	71.2	15.4	6.3	1.7	2.7	75.7	254	41.7
Red ant eggs	82.8	81.9	7.0	3.2	6.5	0.6	8.4	113	4.1

Source: refs. 15 and 16.
a. Available local, English, and scientific names can be found in table 4.

Table 4. Examples of wild foods eaten in north-cast Thailand

Local name	English name	Scientific name
Plants
Wean		Marsilea crenata
Pak khom (khen khom)	Chinese spinach	Amoranthus gangeticus Linn
Lin pak kee lek		Cassia siamea Britt
Kanjong		Limnocharis flava
Nork		Centella asiatica
Yopae		Hydrocharis morsus-ranae
Ehin		Monochoria vaginalis
Kayang		Limnophila aromatica Merr
Pinoy		Tenagocharis latifolia
Kipum		Wolffia globosa
Sommong		Garcinia cowa
Ob-ab		Embelia subcoriacea Mez
Erok		Amorphophallus brevispathus Gagnep
Kruamanoi		Cyclea peltata
Dork grajeaw (flower)		Curcuma parviflora
Teaw		Cratoxylon formosum Dyer
Linpi		Emilia sonchifolia
Linfa (pod)		Oroxylum indicum
Mark kheng		Solanum trilobatum
Markmao		Antidesma acidum
Kloy (tuber)		Dioscorea hispida Dennst
Monliam (tuber)		Dioscorea alanta Linn
Kha-pa	Wild galangal	Languas sp
Normai huak	Bamboo shoots	Thyrsostachys siamensis
Hed phungtam (mushroom)		Careya sphaerica
Whai	Rattan	Calamus spp
Bakbok (fruit)		Iruingia malayana
Kantong		Sauropus androgynus
Paew		Polygonum odoratum
Waan		Melientha suavis Pierre
Tamnin	Ivy gourd	Coccinia grandis
Paksienedit	Bratard mustard	Cleome gynandra Linn
Yaanang		Tiliacora triandra Diels
Bak-kheng		Solanum torvum Sv
Bak-wa		Lepisanthes rubignosa Leenh
Khawtonmak		Paederia linearis Hook
Pak bung	Morning glory	Ipomoia aquatica Forsk
Pak-sai	Bitter cucumber	Momordica charantia Linn
Pak-pan	Chinese chive	Allium tuberosum Roxb
Bak-khaeg		Solanum torvum Sv
Bak-tan	Common jujube	Zizyphus rotundifolia Lamk
Dokpaksarp		Adenia viridiflora
Pak-kradon		Careya spaerica Roxb
Hed-kra-darng		Lentinus praeriqidus Berk
Ma-muangpa	Wild mango	Chibula retz
Rarg-bua	Lotus root	Nelumbo nucifera Linn
Nhaam		Lasia spinosa
Mak-ngaew		Lipisanthes rubiqnosa Leenh
Kradon		Careya herbacea Roxb
Tuew		Cratoxylon formosum Dyer
Jik		Barrintonia racemosa
Bak-wah		Lepisanthes rubignosa Leenh
Sarb		Adenia viridiflora Craib
Som		Rumba crisps Inn
Bak-ngaew		Nephelium hypoleucum Kurz
Bak-waa		Lepisathes rubignosa Leenh
Mum koa gum	Yam	Dioscorea spp
Ma-duea	Fig	Ficus sp
Kii lec waan		Cassia surattensis Burmf
Ma-muangnoi	Mango	Mangifera spp
Dokbuahdang	Lotus	Nympheae lotus Linn
Dok-kajiew		Curcuma aeruginosa Roxb
Maipaipa	Bamboo	Babusa spp
Mun muasua	Lesser yam	Dioscorea esculenta Burk
Mun kaogum	Yam	Dioscorea sp
Bon	Caladium	Caladium gigantea Hookf
Fresh-water fish
Pla khona		Cirrhinus jullieni
Zew	Rasbora
Khow	Julien’s mud carp	Cirrhinus jullieni
Frog	Tiger frog	Rana tigrinia
Insects
Maeng kinoon		Microtricia sp
Maeng kizorn (krachorn)		Gryllotalpa africana
Tuckatan	Locust	Locusta sp
Maeng kutgee	Dung beetle	Heliocopris bucephalus
Jing reed (jilaw)	House cricket	Acheta tetacea
Jipome	Short-tailed cricket	Bachytropes portentosus

Unfortunately, the natural resource habitats-forests, mountains, paddies, and ponds-are under constant and increasing assault from many agents, both mechanical and chemical. These need to be considered in rural development projects in Thailand, as has been done in Africa and in some other countries. The kinds of wild foods that should be encouraged are wild plants eaten as vegetables and all fish and other aquatic animals, because they are important sources of nutrients in the daily diet. Thailand should promote reforestation and enforce the existing ban on deforestation. It must also preserve its natural water resources so there will be more aquatic species, including wild fish and plants.

We found that young villagers had less knowledge of hunting and gathering methods and could not identify the items as well or as accurately as the older villagers. The young people had other interests and pursuits, including working for wages outside the village. Therefore, their time in the village was limited and they had less chance to learn from the elders. They might also lose their interest in the traditional gathering of subsistence wild food from the environment. This loss of knowledge in one generation is significant, since it means that they will depend more on market food in the future. Moreno-Black and Price [3] pointed out that women earned cash from selling wild food in the markets, which they used to purchase cultivated and processed foods as well as other wild foods.

We also found major gender differences in knowledge of wild food and methods of procurement. Women will be vital in identifying threatened wild species and conservation efforts, because they realize that forests and other natural resources are critical to their survival and the survival of future generations. However, we also found that men can recognize wild plants and often know how to prepare them, even though they usually do not gather them. They may bring plants that they happen to find on their way home, but they do not consider it their responsibility and consider plant gathering to be a woman’s task.

Acknowledgements

This work was supported by the Margaret McNamara Memorial Fund from the World Bank in 1994.

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