'Use of ORS' in diarrhoea needs push in MP

Bhopal, July 29: Sharda, a three year old girl lost her life just few days back in a village in Sehore, about 40 kilometers away from Bhopal, capital city of the state of Madhya Pradesh. She was suffering with acute diarrhoea, and died of dehydration. She is not the only an isolated case, thousands of children die due to dehydration in diarrhoea in Madhya Pradesh and may be millions in India. Bhopal recently lost four lives due to cholera. Oral Rehydration salt solution can save many like Sharda. Every year on July 29: we observe ORS Day with aim to promote the use of Oral Rehydration salt and to educate the people about its use.

Oral Rehydration Salt is a dry mixture of powder containing Sodium Chloride, Trisodium Citrate dehydrate, Potassium Chloride and anhydrous glucose. It is used for prevention and treatment of dehydration due to diarrhoea including maintenance therapy. Acute diarrhoeal diseases are among the leading causes of mortality in infants and young children in India. In most cases, death is caused by dehydration. Dehydration from diarrhoea can be prevented by giving extra fluids at home, or it can be treated simply, effectively, and cheaply in all age-groups and in all but the most severe cases by giving patients by mouth an adequate glucose-electrolyte solution called Oral Rehydration Salts (ORS) solution. Oral Rehydration Therapy was first researched in the 1940s but it was twenty years later before the idea was developed by research institutions in Bangladesh and India for the management of severe cholera. It was adopted in 1978 as primary tool to fight diarrhoea and since then has saved million of deaths of children, but still there is grave need to promotes its use and enhance its access.

National family Health Survey III reveals that in the developing State like Madhya Pradesh only 28.6 % children with diarrhoea in last two weeks had received the ORS. Madhya Pradesh has the highest infant mortality rate in India. 76 children die out of the thousand born within the first year of their life; diarrhoea is one of the contributors to the same. State also has high incidence of malnutrition among children especially under three years of age, when malnourished child suffers with diarrhoea it aggravates the situation and increase chances of his or her mortality.

It is an indication that there is an urgent need to expand awareness among communities on its importance, its use and enhance its accessibility for communities not only on ORS day but throughout the year. Though officially State has many stocking points of ORS like Anganwadi centre's, sub health centre's and primary health care centre's but more important is its accessibility at time when it is needed and knowledge its right usage by the communities and parents of the children when they need the most. Department of Health & Family Welfare, Government of Madhya Pradesh's medium term strategy document states that diarrhoeal disease episodes per year is 760 per one lakh population and it projects that by year 2015 it will increase to 880 episodes per lakh.

This means that we not only need to expand usage of this inexpensive and readily available intervention in the state which can help reduce death and suffering from dehydration caused by diarrhoea. It will also help to reduce number of days of hospitalization, length of treatment and costly intravenous treatment. The tragedy is that inspite of the medical fraternity and many of us working in social sector know about its advantage as life saviour for children. Experience, research has validated the same and it was hailed by the prestigious British Journal, the Lancet as "...potentially the most important medical advance of the century..." children still die for want of this simple intervention. May be we need to go beyond our present efforts and need to rework out strategies and bridge the existing gap between information and knowledge and action by communities at ground or else we will continue to let children die...

by anil gulati