August 3, 2014
AN EFFECTIVE USE FOR FOREIGN AID:
The man who helped save 50 million lives (Lin Lin Ginzberg, 8/03/14, BBC)
Posted by Orrin Judd at August 3, 2014 8:51 AMHirschhorn's work built on both what Dr Phillips had done, and the work of another colleague David Sachar.Sachar had shown that the body could still transport sodium when glucose was added - something key in fighting dehydration.Proportions were key - too much or too little of any of the ingredients and not only might the solution not work, but it could also cause severe harm.Dr Hirschhorn said: "The proof of concept was that they would absorb the fluid and diminish the amount of diarrhoeal fluid coming out."The proportions are crucial. In order to get the optimal absorption of water you need the same amount of glucose and sodium."Moreover the proportions of electrolytes need to be close enough to the body's own fluid composition so that it can adjust and keep balance."It was a small study, of just eight patients in which the rehydration therapy was given straight into the intestine using naso-gastric tubes - but it proved that specific combination worked.However the introduction of the therapy wasn't simple, even then.Dr Hirschhorn says there was disbelief something so simply could be so effective and outperform the carefully-dosed, hospital-administered IV therapy"Its simplicity was its own enemy. But it took a long time; it took a very long time to convince paediatricians that this was safe, to convince them that you could get out there and reach mothers, reach the community directly."The Lancet has described oral rehydration therapy as "potentially the most important medical advance" of the 20th century with UNICEF adding that no other medical innovation of the century "has had the potential to prevent so many deaths over such a short period of time and at so little cost".Now the effectiveness is well known and it is used around the world administered by doctors in clinics as well as at home by parents of children.But the World Health Organization (WHO) warns diarrhoeal disease is the second leading cause of death in children under five, and is responsible for killing around 760 000 children every year.