posts: 26811

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    "id": "wp-26811",
    "slug": "untitled-reusable-block-108",
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                "text": [
                    {
                        "text": "How was ORT developed?",
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                        "text": "When it comes to \u201cthe most important medical advances\u201d and life-saving interventions, we often think about expensive drugs and complicated surgeries that were discovered and perfected in sophisticated laboratories. ORT defies these expectations. Not only is it low-tech and cheap (only ",
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                        "url": "https://docs.google.com/document/d/1fE-_uWIw1DGBjc_Gel6dOcqC-7iYH0b3J7ABkpof54o/edit#bookmark=id.gsa2of7kcmpf",
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                                "text": "around 0.50$ per treatment course",
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                        ],
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                    {
                        "text": "), but it was also developed far away from the world\u2019s leading hospitals, under often challenging circumstances.",
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                        "text": "The early hospital trials for ORT in the late 1960s were performed by Drs Richard Cash and David Nalin in Dacca, in today\u2019s Bangladesh. The most common treatment for diarrhea at the time was the much more expensive ",
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                        "children": [
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                                "text": "intravenous rehydration therapy",
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                        "text": " (IVT), which involved the administration of saline solution intravenously in hospital settings. While IVT was an effective treatment, Cash and Nalin recognized the need for an alternative treatment because the people most affected by diarrheal disease were those who did not have access to clinical centers where IVT was available. In addition, the possibilities of scaling-up IVT use during large outbreaks of diseases \u2013 such as cholera epidemics \u2013 were limited.",
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                        "text": "In the late 1960s Cash and Nalin conducted a number of small clinical trials during cholera epidemics in the region, which showed the promise of ORT.{ref}Nalin, David, et al.",
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                    },
                    {
                        "url": "https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(68)90591-6/fulltext",
                        "children": [
                            {
                                "text": " \"Oral maintenance therapy for cholera in adults.\"",
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                        ],
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                        "text": " The Lancet 292.7564 (1968): 370-372.{/ref} However, the most significant proof of ORT effectiveness came from desperate circumstances during the Indo-Pakistani War in 1971.{ref}Fontaine, Olivier, Paul Garner, and M. K. Bhan. ",
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                    {
                        "url": "https://www.bmj.com/content/334/suppl_1/s14",
                        "children": [
                            {
                                "text": "Oral rehydration therapy: the simple solution for saving lives.",
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                        ],
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                        "text": " BMJ 334.suppl 1 (2007): s14-s14.{/ref} The conditions of war, complicated by the monsoon season, displaced millions of people into refugee camps, which ultimately led to a disastrous cholera outbreak. Early during the outbreak almost 30% of the afflicted patients died due to the shortage of the IVT therapy. Pressed by the disastrous circumstances, Dr Dilip Mahalanabis decided to start providing bags of salt and sugar dissolved in water to the people in the camp. The decision by Dr Mahalanabis proved to be the right one: in just a few months the case-fatality ratio from cholera and cholera-like diarrheal diseases fell below 4% among the people treated with ORT, as compared with the 30% ratio observed previously. This success was a major stepping stone for wider adoption of ORT.{ref}Mahalanabis, Dilip, et al. ",
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                    {
                        "url": "https://apps.who.int/iris/handle/10665/74857",
                        "children": [
                            {
                                "text": "Oral fluid therapy of cholera among Bangladesh refugees.",
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                        "children": [
                            {
                                "text": " Johns Hopkins medical journal",
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                        ],
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                    },
                    {
                        "text": ". 1973. 197-205.{/ref}",
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                        "text": "While ORT is a simple, low-tech solution for the treatment of diarrhea \u2013 a major public health issue \u2013 it took many years for its use to be accepted. It wasn\u2019t until 1978 that the World Health Organization (WHO) created the diarrheal disease control program that has helped to popularise the use of ORT worldwide.{ref}World Health Assembly, 31. (\u200e1978)\u200e. ",
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                    },
                    {
                        "url": "http://www.who.int/iris/handle/10665/86044",
                        "children": [
                            {
                                "text": "Thirty-first World Health Assembly, Geneva, 8-24 May 1978: part II: verbatim records of plenary meetings: summary records and reports of committees.",
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                            }
                        ],
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                    },
                    {
                        "text": " World Health Organization.{/ref} To put this into perspective \u2013 we only adopted the use of ORT more than a decade after we landed on the Moon.",
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                        "text": "There are many reasons why the uptake and recognition of ORT by richer countries was slow. Western doctors were skeptical of adopting treatments tested in developing countries and considered these to be of a lower standard.{ref}Ruxin, Joshua Nalibow. ",
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                    },
                    {
                        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1036912/",
                        "children": [
                            {
                                "text": "Magic bullet: the history of oral rehydration therapy.",
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                    {
                        "children": [
                            {
                                "text": " Medical History",
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                        "text": " 38.4 (1994): 363-397.{/ref} The idea that drinking a simple water, sugar, and salt solution, was just as good of a treatment as a \"sophisticated\" intravenous drip seemed radical at the time. And, even today, ORT treatment seems counterintuitive, because, while it reduces the likelihood of death and speeds up recovery, it does not actually prevent or stop diarrhea.",
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                "text": [
                    {
                        "text": "ORT saves lives",
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                    }
                ],
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                        "text": "How many lives has ORT saved? The exact number is in some ways impossible to know because many other interventions and treatments have contributed to the ",
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                    },
                    {
                        "url": "https://ourworldindata.org/grapher/deaths-from-diarrheal-diseases-by-age",
                        "children": [
                            {
                                "text": "decreasing number of deaths from diarrheal diseases",
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                        "text": ". However, the incredible decline in deaths from diarrheal diseases in children in the last two decades of the 20th century (from around 4.8 million annual deaths in 1980 to 1.2 million deaths in 2000) has coincided with an expanded global use of ORT. A number of researchers have suggested that the dramatic decline was not just a coincidence but directly caused by the increased ORT use.{ref}Pierce, Nathaniel F. ",
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                    {
                        "url": "https://pdfs.semanticscholar.org/aa0c/ac1093dc50c362396548b0b312ed1e79e6ac.pdf",
                        "children": [
                            {
                                "text": "How much has ORT reduced child mortality?.",
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                        ],
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                    {
                        "children": [
                            {
                                "text": "Journal of Health, Population and Nutrition",
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                            }
                        ],
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                    },
                    {
                        "text": " (2001): 1-3.",
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                        "text": "Victora, Cesar G., Jennifer Bryce, Olivier Fontaine, and Roeland Monasch. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2560623/",
                        "children": [
                            {
                                "text": "Reducing deaths from diarrhoea through oral rehydration therapy.",
                                "spanType": "span-simple-text"
                            }
                        ],
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                    },
                    {
                        "children": [
                            {
                                "text": "Bulletin of the World Health Organization",
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                        "text": " 78 (2000): 1246-1255.{/ref} Twelve years ago Fontaine, Garner, and Bhan estimated that more than 50 million children have been saved by ORT between 1982 and 2007 \u2013 that is on average of 2 million lives a year.{ref}It should be noted that the exact estimates for the number of lives saved annually by ORT vary by source. Nathaniel F. Pierce, another researcher involved in ORT discovery, ",
                        "spanType": "span-simple-text"
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                    {
                        "url": "https://pdfs.semanticscholar.org/aa0c/ac1093dc50c362396548b0b312ed1e79e6ac.pdf",
                        "children": [
                            {
                                "text": "suggested that",
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                        ],
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                    },
                    {
                        "text": " the annual decline in childhood diarrhea could be anywhere between 1.5 and 3.3 million per year, depending on the period one looks at. ",
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                    },
                    {
                        "url": "https://www.scienceheroes.com/index.php?option=com_content&view=article&id=65&Itemid=113",
                        "children": [
                            {
                                "text": "All estimates",
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                            }
                        ],
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                    },
                    {
                        "text": ", though, suggest that millions of lives are saved by ORT each year. ",
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                "value": [
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                        "text": "Fontaine, Olivier, Paul Garner, and M. K. Bhan. ",
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                    },
                    {
                        "url": "https://www.bmj.com/content/334/suppl_1/s14",
                        "children": [
                            {
                                "text": "Oral rehydration therapy: the simple solution for saving lives.",
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                    {
                        "text": " BMJ 334.suppl 1 (2007): s14-s14.{/ref} Based on these estimates the number of children saved from 1982 until 2019 by ORT could be more than 70 million. Whatever the exact number of lives saved is, it would not be an overstatement to say that many adults would not be alive today if not for the discovery of ORT.",
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        ],
        "type": "article",
        "title": "Oral rehydration therapy: a low-tech solution that has saved millions of lives",
        "authors": [
            null
        ],
        "dateline": "November 1, 2019",
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    "createdAt": "2019-11-01T14:51:07.000Z",
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    "updatedAt": "2023-06-30T16:36:52.000Z",
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    "publishedAt": "2019-11-01T14:51:04.000Z",
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