An Indian doctor gets recognition for his work towards the greatest medical discovery of the 20th century

Celebrities don’t host concerts to fight diarrhea said an article in TIME magazine last year. In fact, when 29 child-health specialists from major international development agencies were asked the causes of child mortality, guess what they said? That Aids, Tuberculosis and Malaria are the three greatest childhood killers. The truth is that Pneumonia, Diarrhea and Malaria are the real killers. And these deaths occur mostly in poor countries.

Sadly, India has the highest number of deaths of children amongst all countries, and many of these deaths are due to Pneumonia, Diarrhea and Malaria. This does vary from state to state, and Kerala is at the lower end of the spectrum, with less than 19 deaths of under fives’s per thousand while more than a hundred children per thousand die in Madhya Pradesh.

It is fitting then that an Indian doctor was part of a team that invented a remedy for diarrhea. Late last year four medical professionals – three Americans and one Indian – got the Prince Mahidol Award 2006 for doing work that led to the use of ORT (Oral Rehydration Therapy) – “an inexpensive but effective treatment of severe diarrhoea.”

These four men are Dr Dilip Mahalanabis, who is a director of a non-governmental research organisation in Calcutta, Dr David R Nalin, former director at Merck & Co’s Vaccine Division in Pennsylvania, Dr Richard A Cash, senior lecturer at the Harvard University School of Public Health in Boston.
These four pioneers were chosen from among 59 nominees in 29 countries.

ORT is the greatest discovery of the 20th century
The medical Journal The Lancet has called ORT as “the 20th century’s most important medical discovery”, yet strangely, it was a tough task for the award body to find out who actually invented ORT. This was because the treatment had been around for almost 40 years and was so common that the award body took years to narrow down those who had discovered, researched and popularised it.
Dr. Mahalanabis was picked as during the 1971 war he treated more than 3,000 patients in West Bengal refugee camps with ORT. This was considered the first large-scale use of ORS in a disaster situation. The death rate came down dramatically from 30 per cent to 3% by the use of ORT. The story is told by TIME. Here is an excerpt:

When Bangladesh’s war for independence from Pakistan broke out in 1971, 9 million refugees poured into India, bringing cholera with them. Dilip Mahalanabis, an Indian doctor who had participated in the oral rehydration trials at the Johns Hopkins Center in Calcutta, began using IV saline treatment at a border camp, but within weeks his supplies were exhausted. Amid awful scenes in which people walked for days only to die, Mahalanabis and his team drew on their experiences in Calcutta. They formed an assembly line to weigh out correct proportions of rehydration ingredients in plastic bags, sealed the bags with an iron, and mixed the powder with water so patients’ friends and relatives could collect it in mugs. “We converted the library at Johns Hopkins into a factory,” Mahalanabis, now 79, recalls. “We brought in drums with side-taps, filled them up and sent them to the field. We were essentially using people to experiment on. But we were pushed to the wall. We had no choice.”
Still, skepticism about the effectiveness of oral rehydration continued. Several journals refused to publish Mahalanabis’ paper about the outbreak. But Dhiman Barua, then head of WHO’s bacterial diseases unit in Geneva, Switzerland and a survivor of the massive 1932 cholera epidemic in Bangladesh’s southern port city of Chittagong, had visited Mahalanabis’ camp. He was converted and pushed oral rehydration through all the U.N. health agencies. who rolled out its diarrheal-diseases control program in 1978. …today the initiative cut total worldwide diarrhea deaths from about 5 million in 1980 to 3 million today.

Sadly however children in India are still dying in great numbers from diarrhea. ORT is not properly distributed and it’s use not explained:

…but decades later, ORT remains grossly underused…diseases that have high profiles and vocal activists — such as aids, tuberculosis and malaria — attract far more interest and money from big donors and governments, based partly on the mistaken belief that they kill the most children.

Related Reading: The diet of Indian children is inadequate

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