Context: In the demise of Dilip Mahalabnis on October 16 we lost a pioneering public health physician the ORS pioneer who helped save millions of lives. In 1978, a Lancet editorial termed ORS the most important medical advance in this century.

About Oral Rehydration therapy

• Oral Rehydration Therapy involves providing drinking water with modest amounts of sugar and salts, specifically sodium and potassium. It treats dehydration due to fluid losses from diarrhoea.

• Earlier fluids were administered through an intravenous route for the management of cholera. Only sips of water without food were provided. It worsened the underlying malnutrition problems.

How ORT proved to be beneficial for the world?

• An estimated 54 million diarrhoeal deaths were averted by ORT alone between 1978 and 2000.

• A Lancet editorial in 1978 termed it as potentially the most important medical advance in India.

• As per the Current Science article in 2019, “ORT remains the greatest contribution from the Indian subcontinent towards achieving Sustainable Development Goals”.

How did ORT get recognition across the world? 

• ORT for the management of severe diarrhoea was developed in the latter half 1960s.

• There was belief among professionals that ORT should be supervised by doctors.

• Seventh cholera pandemic started in Indonesia in 1961 and spread to East Pakistan (Bangladesh) by 1963 and to India in 1964.

• It spread to refugee camps of Bangladeshis in India during the 1971 war. Mahalanabis’ team was treating cases of the cholera epidemic in a refugee camp in West Bengal.

• He decided to use ORS. He mixed salt and sugar solution (ORS) in drums and administered it to the cholera patients in the camps. It was evident after some time that therapy was working and it was possible to administer it through volunteers. ORS reduced mortality due to cholera or acute diarrhoeal diseases in these camps from 40 per cent to 5 per cent.

• It was then recognised by WHO. It launched a worldwide campaign in 1978 to reduce mortality related to diarrhoea, with ORT as one of the key elements.

What were the other contributions of Dilip Mahalanabis?

• He served in the Diarrhoeal Disease Control Programme at the WHO.

• In 1990, he established the Society for Applied Studies (SAS) in West Bengal with a vision of “Improved Health and Quality of Life” in India and other developing countries, especially for children and women.

About Disease Cholera

• Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae that can kill within hours if left untreated.

• Most of those infected will have no or mild symptoms and can be successfully treated with oral rehydration solution. Cholera affects both children and adults.

• Provision of safe water and sanitation is critical to prevent and control the transmission of cholera and other waterborne diseases.

• Cholera remains a global threat to public health and an indicator of inequity and lack of social development.

Conclusion

• Dilip Mahalanabis pioneered a simple and effective solution for diarrhoea that saves millions of lives which can be considered as one of the greatest contributions of Indian in medical sciences. To carry the carry legacy forward young scientists should step in.