A simple solution: The history of ORS in Bangladesh

DHAKA, Bangladesh — In the last 30 years, oral rehydration solution (ORS) — a blend of salt, sugar, and clean water — has saved an estimated 50 million lives worldwide, especially children at risk of contracting severely dehydrating, fatal diarrhea. In 1978 the British medical journal The Lancet called ORS potentially the most important medical advance of the 20th century. Diarrheal diseases are one of the world’s largest killers of children under age 5.

A simple electrolyte blend, ORS was formulated to treat cholera by US and Bengali researchers in the late 1960s at the Pakistan-SEATO, the predecessor to the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). The American researchers, a group of young doctors, had opted to go overseas as part of a US government program, in lieu of serving in the Vietnam War. At the time, the United States was more insular, and Third World diseases like diarrhea were not typically discussed in medical schools, said Dr. Richard Cash, one of the researchers.

“You think I ever thought about diarrhea other than it messed up one of my vacations?” Cash said in a recent interview in Dhaka. "I was just in the right place at the right time."

In the 1970s, BRAC (formerly Bangladesh Rural Advancement Committee), the well-known Bangladeshi NGO, collaborated with icddr,b to devise a rigorously monitored process to teach mothers to make the mixture at home. Starting in 1980, more than 12 million Bangladeshi mothers were taught to make ORS, a program that saved countless lives, according to Cash’s book, “A Simple Solution.’’

That knowledge took hold: Since 2007, the 2011 Bangladesh Demographic and Health Survey reports, about 78 percent of children with diarrhea have been treated with ORS, which is readily available at shops and clinics today.

ORS is now a mainstream treatment around the world, with UNICEF distributing 500 million sachets to 60 countries each year. 

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