Thinking Citizen Blog — Bangladesh IV — The Most Amazing Under-Appreciated Story of the 20th Century — ORT
Thinking Citizen Blog — Monday is Foreign Policy Day
Today’s Topic: Bangladesh IV — The Most Amazing Under-Appreciated Story of the 20th Century — ORT
ORT stands for Oral Rehydration Therapy. “Since the adoption of this inexpensive and easily applied intervention, the worldwide mortality rate for children with acute infectious diarrhea has plummeted from 5 million to about 1.3 million deaths per year.” (sixth link below) Would you think a simple discovery that saved the lives of 50 million children would deserve a prominent place in a standard K-12 curriculum anywhere in the world? I do. But I did not learn the story until this week. Thank you to John Haaga for enlightening me and inspiring me to do the research behind this post. You have probably heard of “Pediayite” but do you know that Bangladesh played an important role in its development? It turns out that something very positive came out of the nightmare of Bangladesh in the early 1970s. Experts — please chime in. Correct, elaborate, elucidate.
BRAC — Bangladesh Rural Advancement Committee — largest NGO you have never heard of
1. “In 1980 the Bangladeshi nonprofit BRAC created a door-to-door and person-to-person sales force to teach ORT for use by mothers at home. A task force of fourteen women, one cook and one male supervisor traveled from village to village.”
2. “After visiting with women in several villages, they hit upon the idea of encouraging the women in the village to make their own oral rehydration fluid. They used available household equipment, starting with a “half a seer” (half a quart) of water and adding a fistful of sugar and a three-finger pinch of salt.”
3. Later on, the approach was broadcast over television and radio and a market for oral rehydration salts packets developed. Three decades later, national surveys have found that almost 90% of children with severe diarrhea in Bangladesh are given oral rehydration fluids at home or in a health facility.”
NB: BRAC may be the largest NGO in the world in terms of employees — 90,000, 70% women, serving 126 million people. Its name has changed over time: from Building Resources Across Communities to Bangladeshi Rehabilitation Assistance Committee to the present incarnation.
HEROES LIST: Sir Fazle Hasan Abed (1936–2019) , Rafiqi Islam (1936–2018), Dilip Mahalanabis (1934 — )
1. Fazle Hasan Abed (1936–2019) founder of BRAC. First photo above.
2. Rafiqui Islam (1936–2018), Bangladeshi pediatrician, one of the developers of Orsaline, the oral rehydration solution, during the Bangladeshi war of liberation of 1971. Second photo above.
3. Dilip Mahalanabis (1934 — ) was an Indian pediatrician and pioneer researcher into ORT based at the Johns Hopkins Center for Medical Research and Training in Calcutta, India. Photo below.
NB: How many other heroes? Plenty, but I’m not qualified to assess their relative contributions: Norbert Hirschorn (1938 — ), David Nalin (1941 — ), Richard Cash (1941 — ).
QUOTES ABOUT ORT — UNICEF, THE LANCET, AND OTHERS
1. “No other single medical breakthrough of the 20th century has had the potential to prevent so many deaths over such a short period of time and at so little cost” — UNICEF 1987
2.“Potentially the most important medical advance of this century.” — The Lancet
3. “Which medicine has saved more lives than any other and can be made by anyone in their kitchen, back bedroom, shantytown hut or dwelling built of sticks — as long as they have access to clean water? The answer is: eight teaspoons of sugar, half a teaspoon of salt and one litre of water. Mix. Drink…… It requires no specialized equipment; uses ingredients that are ubiquitous and have a long shelf life; has few side effects; and can be made up in any quantity — the perfect medicine.” — Jeremy Laurance, British Journalist.
NB: “In October 2006, The Independent, A British newspaper, reported on the greatest achievements in medical science in 150 years. The second on their list was oral rehydration therapy (first was oral contraception).”
FOOTNOTE — A little basic physiology
1. “ Fluid from the body enters the intestinal lumen during digestion. This fluid is isosmotic with the blood and contains a high quantity, about 142 mEq/L, of sodium. A healthy individual secretes 2000–3000 milligrams of sodium per day into the intestinal lumen. Nearly all of this is reabsorbed so that sodium levels in the body remain constant. In a diarrheal illness, sodium-rich intestinal secretions are lost before they can be reabsorbed.”
3. “This can lead to life-threatening dehydration or electrolyte imbalances within hours when fluid loss is severe. The objective of therapy is the replenishment of sodium and water losses by ORT or intravenous infusion.”
Here is a link to the last four years of posts organized by theme:
Please share the coolest or most important thing you learned in the last week, month, or year related to foreign policy. Or, even better, the coolest or most important thing you learned in our life related to foreign policy.
This is your chance to make someone else’s day. And to consolidate in your memory something important you might otherwise forget. Or to think more deeply than otherwise about something dear to your heart. Continuity is the key to depth of thought. The prospect of imminent publication, like hanging and final exams, concentrates the mind. A useful life long habit.