Dr Ravinder K Gupta and Dr Anuj Gupta
July 29th marks a significant day in India’s public health calendar – Oral Rehydration Solution (ORS) Day. This day serves as a reminder of the crucial role ORS plays in saving lives and resonates deeply with the mission to combat dehydration related fatalities particularly among children suffering from diarrheal diseases, a leading cause of mortality in India and many developing nations.In a country like India, where access to clean water and sanitation facilities remains a challenge in many regions, ORS emerges as a low-cost, easily accessible tool that can be administered at home or in healthcare settings. Initiated by the Indian Academy of Paediatrics (IAP) in 2001, ORS Day aims to raise awareness about the importance of this simple yet effective solution.
Oral Rehydration Solution (ORS), a humble yet powerful mixture of salts and sugars dissolved in water, has been a game-changer since its inception. Diarrhoea, often caused by contaminated food or water, leads to rapid loss of fluids and electrolytes. ORS works by replenishing these essential elements, helping the body recover and preventing severe dehydration, particularly in resource-limited settings.
Rral Rehydration Solution Day
The history of ORS is intertwined with groundbreaking research and humanitarian efforts. Developed in the 1960s by researchers from the Indian Council of Medical Research (ICMR) and the Government of India, led by Dr. Dilip Mahalanabis, ORS was a revolutionary breakthrough in global health.Researchers discovered that glucose could significantly enhance the absorption of sodium and water in the intestines, a breakthrough that proved crucial in treating cholera. Its effectiveness was dramatically demonstrated during the 1971. Indo-Pakistani War, where it significantly reduced mortality rates in refugee camps. In 1978, the World Health Organization (WHO) recognized ORS as a critical tool in combating dehydration. It was included in the WHO’s List of Essential Medicines, highlighting its importance in global health. Since then, ORS has been hailed as one of the most significant medical advancements of the 20th century.
The introduction of ORS has had a profound impact on global health. It is estimated that ORS has saved around 70 million lives since its introduction. The simplicity and cost-effectiveness of ORS make it accessible even in the most resource-limited settings. It’s easy to use, doesn’t require sophisticated medical training, and has been proven effective in preventing dehydration-related deaths.
Over the decades, ORS has evolved through continuous research and innovation. Initially administered as a liquid solution, it has been adapted into various forms, including powdered formulations and pre-packaged sachets.These innovations related to Oral Rehydration Solution (ORS) have focused on improving its effectiveness, accessibility, and ease of use, especially in low-resource settings where diarrheal diseases are prevalent. Some of the examples are flavoured ORS to improve compliance specially among children, pre-measured ready-to-use ORS sachets, zinc-ORS Combination and ORS Plus(ORSwith probiotics).These adaptations have made ORS easier to transport, store, and administer, especially in remote and resource-limited areas. Also educating caregivers on preparing ORS at home using locally available ingredients have been crucial in making ORS easily accessible and effective. Home Based ORS can be made by dissolving Half (1/2) level teaspoon of Salt with Six (6) level teaspoons of Sugar into One (1) liter of clean drinking or boiled water and then cooled. A lemon can be added to the home-based ORS to make it more palatable. Rice water can also be used instead of regular water to prepare ORS and carrot soup or a smashed banana can be added to make it more acceptable. There are two types of commercially available ORS packets. The larger one can be dissolved in 1L and the smaller sachet can be dissolved in 200ml of clean boiled water stirred till all contents are dissolved and thereafter used to replenish ongoing stool losses as well as vomiting.
Despite its effectiveness, there is still work to be done.ORS remains underutilized in many communities across India.There is a misconception that traditional home remedies like rice water or herbal concoctions are better than ORS. While these remedies may have some benefits, they often lack the precise electrolyte balance provided by ORS. Some believe ORS is expensive or not worth the cost compared to homemade remedies or other beverages. Some people may think ORS is only necessary for severe dehydration or that it can be harmful if used incorrectly. People sometimes believe that other drinks like sugary and carbonated drinks or fruit juices are just as effective as ORS for hydration. Misconceptions about its use, coupled with limited awareness, hinder its widespread adoption.
ORS Day aims to dispel these myths, educate caregivers about its proper administration, and highlight its role as a frontline treatment for diarrheal diseases.Moreover,ORS Day serves as a platform to acknowledge the concerted efforts of healthcare workers, policymakers, and organizations committed to improving child health.
India, where access to clean water and sanitation remains a challenge in many regions, ORS continues to play a crucial role in public health strategies. National programs and initiatives have been instrumental in promoting ORS use, ORS distribution, training healthcare providers, and educating communities about its benefits and proper administration.
Slogans such as “ORS Saves Lives, One Drink at a Time” and “A Spoonful of ORS, A World of Difference” resonate with the simplicity and not only raise awareness but also emphasize the urgency of making ORS universally accessible and understood. The goal is cleari.e.to reduce child mortality rates caused by diarrheal diseases and improve overall child health outcomes.
The Union Health Minister of India JP Nadda has launched National STOP Diarrhoea Campaign 2024. The campaign aims at reducing the child deaths due to diarrhoea, with a two-month drive and co-packaging of ORS and zinc for children under five years of age. The campaign also includes extensive information, education and communication through different platforms and collaboration across multiple sectors.
As we celebrate ORS Day on July 29th, let us renew our commitment to promoting child health and well-being. Let us advocate for policies that prioritize access to clean water and sanitation, essential companions to ORS in preventing diarrheal diseases. By recognizing the critical importance of ORS in preventing childhood deaths due to dehydration, we take a significant step towards achieving the Sustainable Development Goal of reducing child mortality rates. This day serves as a call to educate, distribute, and advocate for the widespread use of ORS in communities across India. Together, we can ensure that every child receives the lifesaving treatment they deserve because when we hydrate our children, we empower our future. Let’s raise a glass or a spoonful to ORS, a simple solution with profound implications for global health.
Slogan for the year 2024 is, “Diarrhoea ki Roktham, Safai aur ORS se rakhenapnadhyaan”.
(The authors are from Department of Paediatrics, Acharya Shri Chander College of Medical Sciences (ASCOMS), Jammu)