The magic formula: How Dr Dilip Mahalanabis’ ORS saves lives globally

In 1971, Kolkata-based pediatrician Dr Dilip Mahalanabis concocted a simple formula of salt, sugar, and clean water as a treatment to cure diarrhea during the devastating cholera outbreak amid the Bangladesh War of Independence.
While there was a deficiency of saline solution, a common treatment for diarrhea in those days which was given as an IV solution, Dr Mahalanabis implemented his formula to treat cholera.
This simple solution which increases water absorption in the body saved millions of lives, especially since cholera causes severe diarrhea.
During this time, he also carried out studies in Oral Rehydration Therapy at the John Hopkins University International Centre for Medical Research and Training in Kolkata.
This therapy provides fluid through the mouth to prevent or correct dehydration caused by diarrhea. In Bangladesh, Dr Mahalanabis gave out a mixture of table salt, baking soda and glucose with clean drinking water, reducing the number of cholera deaths.

ORS contains a formula of sodium chloride, glucose, potassium, and citrate in specific doses.

According to a report in the Lancet, many people in refugee camps recovered with this treatment. “Subsequently, his approach of diarrhea management has been adopted and implemented by WHO globally,” Shanta Dutta, ICMR-National Institute of Cholera and Enteric Diseases told The Lancet Infectious Diseases.
In a span of three decades, Dr Mahalanabis’ Oral Rehydration Solution saved nearly 54 million lives particularly children.
This breakthrough became the foundation for the WHO’s Diarrheal Diseases Control program, launched in 1978, with an emphasis on children under five.
The WHO released guidelines recommending ORS for all forms of diarrhea, along with continued feeding and restrained antibiotic use.
Working with UNICEF and other aid organisations, WHO helped establish national programs for diarrheal disease control, resulting in the widespread adoption and local production of ORS.
In 2023, after his death on October 16, 2022, the government posthumously awarded Dr Mahalanabis the Padma Vibhushan, India’s second-highest civilian award.
HOW DOES ORS WORK?
ORS contains a formula of sodium chloride, glucose, potassium, and citrate in specific doses. This combination of electrolytes and carbohydrates with clean water (mostly boiled or disinfected) helps the body retain water and electrolytes essential for it to function.

The WHO released guidelines recommending ORS for all forms of diarrhea, along with continued feeding and restrained antibiotic use. (Photo: Getty Images)

Dehydration caused by diarrhea and vomiting can become detrimental and devastating, in severe cases. ORS provides the most perfect, cost-effective solution to this.
According to Science Direct, ORS should be consumed with water only and should be mixed with milk or juice. Extra sugar should not be added to the solution.
HOW CAN ORS SAVE LIVES?
In India, diarrhea is the third leading cause of child mortality. According to the National Family Health Survey-5, only 60.6% of children receive oral rehydration salts for treatment.
Doctors have been advising that ORS proves even more effective than homemade mixtures of salt and sugar with water.
Dr Mohsin Wali, Consultant Physician at Sir Ganga Ram Hospital, earlier spoke to IndiaToday.in about consuming the correct ORS formula.
“Choosing the right ORS is crucial for effectively managing diarrhea and dehydration. It’s vital to differentiate between ORS and commercially available sugary drinks. While these beverages may offer some electrolytes and fluids, they lack the crucial glucose-sodium and potassium balance necessary for rapid and effective rehydration,” said Dr Wali.
With this, Dr Mahalanabis’ groundbreaking discovery of ORS not only transformed the management of diarrhea but also became a global standard for preventing dehydration in life-threatening situations.