In 1971, Kolkata-based pediatrician Dr. Dilip Mahalanabis devised a simple formula of salt, sugar and clean water as a treatment to cure diarrhea during a devastating cholera outbreak during Bangladesh’s independence struggle.

While there was a shortage of saline solution, a common treatment for diarrhea in those days given as an IV solution, Dr. Mahalanabis applied his formula to treat cholera.

This simple solution of increasing water absorption in the body saved millions of lives, especially since cholera causes severe diarrhea.

During this time, he also studied oral rehydration therapy at the John Hopkins University International Center for Medical Research and Training in Kolkata.

This therapy provides fluids through the mouth to prevent or correct dehydration caused by diarrhea. In Bangladesh, Dr. Mahalanabis introduced a mixture of table salt, baking soda, and glucose into clean drinking water, which reduced the number of cholera deaths.

According to a report in The Lancet, many people in refugee camps recovered from this treatment. “Subsequently, their approach to diarrhea management has been adopted and implemented globally by WHO,” Shanta Dutta of the ICMR-National Institute of Cholera and Enteric Diseases told The Lancet Infectious Diseases.

Over a period of three decades, Dr. Mahalanabis’ oral rehydration solution saved the lives of approximately 54 million people, especially children.

This success became the foundation of WHO’s Diarrhea Disease Control Programme, which was launched in 1978 with an emphasis on children under five years of age.

WHO issued guidelines recommending ORS for all types of diarrhea, as well as consistent feeding and limited antibiotic use.

Working with UNICEF and other aid organizations, WHO helped establish national programs for diarrheal disease control, resulting in widespread adoption and local production of ORS.

In 2023, following his death on October 16, 2022, the government posthumously awarded Dr. Mahalanobis the Padma Vibhushan, India’s second highest civilian award.

How does ORS work?

ORS contains a formula of sodium chloride, glucose, potassium and citrate in specific doses. This combination of electrolytes and carbohydrates with clean water (mostly boiled or disinfected) helps retain the water and electrolytes the body needs to function.

In severe cases, dehydration caused by diarrhea and vomiting can be harmful and devastating. ORS provides the best, cost-effective solution to this.

According to Science Direct, ORS should be consumed only with water and mixed with milk or juice. Extra sugar should not be added to the solution.

How can ORS save lives?

Diarrhea is the third leading cause of child death in India. According to the National Family Health Survey-5, only 60.6% children receive oral rehydration salts for treatment.

Doctors have been advising that ORS proves to be more effective than a homemade mixture of salt and sugar with water.

Dr Mohsin Wali, consultant physician, Sir Ganga Ram Hospital, previously spoke to IndiaToday.in about picking the right ORS formula.

“It is important to select the right ORS to effectively manage diarrhea and dehydration. It is important to distinguish between ORS and commercially available sugary beverages. Although these beverages may provide some electrolytes and fluids, But they lack the critical glucose-sodium and potassium balance needed for rapid and effective rehydration,” Dr. Wali said.

With this, Dr. Mahalanabis’s groundbreaking discovery of ORS not only transformed the management of diarrhea but also became a global standard for preventing dehydration in life-threatening situations.