Eating Clays and Other Soils
Pregnant women can eat some unusual things to satisfy their urges (end of previous blog here). There are multiple terms that can be used to describe this phenomenon.
Pica is a medical disorder characterized by an appetite for largely non-nutritive substances (e.g., coal, soil, feces, chalk, paper, etc.) or an abnormal appetite for some things that may be considered food, such as food ingredients (e.g., flour, raw potato, starch, ice cubes). In order for these actions to be considered pica, they must persist for more than one month, at an age where eating such objects is considered developmentally inappropriate.
The following article is about another.
"I know it is bad but I wanted to sustain the baby, so I eat it," she says, looking at her newborn daughter. While she was pregnant she would eat between 10 and 15 balls of clay each day. Sometimes she roasted them, sometimes she ate them plain. The old women in her community told her the clay would make her baby strong and remove "bad water" from her stomach.
"When I ate it, the vomiting stopped," she says. She understands the idea of gnawing on a rock-hard piece of clay may seem bizarre, but it's surprisingly common among her friends and family in rural Sierra Leone. Most mothers waiting with her at the maternity clinic admitted they also ate clay.
"It's cultural, it's traditional," said Ms. Jalloh's doctor, James Smith. "We have been telling them to stop taking these things."
The ingestion of earth or clay, known as geophagy, is a little-known but relatively widespread phenomenon in parts of Africa and Asia. It's usually consumed by pregnant or lactating women in order to reduce nausea and supplement a mineral-deficient diet. Some researchers suspect the clay coats the gastrointestinal tract and absorbs toxins, which is why a substance commonly found in the clay is used in some Western anti-diarrheal medicines. But it can also contain harmful parasites and cause lead poisoning, intestinal obstruction and colon rupture.
FYI, some Native Americans in California used to practice geophagy, and slaves brought the practice to the Southeast, where it still persists, mostly in rural areas.
Kaolin (also called kaolinite) used to be in and gave part of its name to kaopectate. Attapulgite (named after Attapulgus, Georgia) is a common clay in the Southeast that's also been used in kaopectate. Neither is in the current U.S. formulation, but attapulgite is still in the Canadian version...plus a number of other American diarrhea medications.
Hunger is obviously a sad reason for eating clay, and there's no question that parasites can be an issue if the soil is contaminated with bodily wastes. However, the article dwelled upon speculation that the practice itself is unhealthy...until it finally got to a very key point.
Dr. Smith said he's not aware of any medical studies about the effects of geophagy on pregnant women and insists more research is desperately needed.
"I don't even know the ingredients of this clay, so we need to do further studies."
If you're going to condemn traditional medicines, it would be great to have proof and to offer alternatives that are affordable and readily available. Smith offers neither. Nevertheless, some are trying to restrict supply rather than addressing the demand.
Not far from the hospital, an entire community labours in the midday sun, knee-deep in mud. The men dig the pits and sieve the clay. The children haul off the buckets, and add salt and herbs. The women break the clay into pieces and roll them into balls. The balls are then sold in bags of 12 at markets across the country. One bag sells for 100 leones, the equivalent of three cents.
"We are not happy doing it," said John Kamara as he wades back into the pit and pours out a bucketful of clay. In a good month he will earn about $60. "I hope after my children are educated they will take me out of this filth," he said.
Some community groups are hoping to curb clay-eating by giving the miners a way out.
"If they're going to stop, they need a substitute," said Ramatu Fornah of the Women's Action for Human Dignity, a community-based organization in the heart of Sierra Leone's clay-mining district. "We've targeted about 30 of them and are teaching them agriculture."
Recently war-torn Sierra Leone is one of the poorest nations in the world, with a GDP per capita of about $700 per year. It ranks dead last in the human development index. Two-thirds of the population is already dependent upon subsistence agriculture...which is better than blood diamonds. Life expectancy there is just 41.8 years.
Meanwhile, how hard is it for consumers to find other sources of clay, especially when most can't afford a substitute that they may or may not believe is better?
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