Dehydration caused by severe diarrhoea can be combated by a solution of water, sugar and salt - ingredients available to almost all, anywhere.

The preparation is simple but its effectiveness is miraculous.

"Oral rehydration solutions", or ORS for short, come in many forms these days. They are called anything from "oral glucose-electrolyte solutions" to sports drinks. Whatever the name, they are an effective treatment for fluid and salt loss brought about by acute diarrhoea.

Before ORS, one in every 100 child sufferers worldwide died from the food-and-water-borne disease - that's about five million children a year. This was because doctors could treat patients with intravenous fluids and salt replacement only. That meant hospitalisation - or risking death.

In 1968, a couple of United States medical scholars stumbled upon an effective treatment for cholera.

Dr David Nalin and Dr Richard Cash were working at the Pakistan-South-East Asian Treaty Organisation cholera research laboratory at Dhaka [later to become the capital of Bangladesh].

Instead of hooking cholera patients to a drip they administered an oral glucose-electrolyte solution. They called it oral rehydration therapy and it proved effective.

Previous studies suggested adding glucose - or sugar - to sodium solution - a mixture of water and salt - helped improve the body's absorption of sodium and water. The pair started clinical trials on a limited number of patients.

Their results confirmed the hypothesis and were published in The Lancet in the same year. It was a medical breakthrough.

But, some were not convinced. Because of the small size of the trial sceptical doctors refused to adopt the treatment.

Nevertheless, one of the converted was Dr Dilip Mahalanabis. He conducted a larger study using 3,000 patients at a camp in India where he was working with war refugees.

The Mahalanabis-trial results added weight to what Nalin and Cash had found. Moreover, there was another study conducted separately in the US and released at the same time that helped convince other doubters.

Prof Stanley Schultz demonstrated how glucose facilitated the absorption of sodium and water.

The three studies subsequently led to broad use of ORS and childhood deaths from diarrhoea fell.

World Health Organisation figures show ORS helps prevent more than a million child deaths a year from severe diarrhoea.

Nalin, Cash and Mahalanabis are the joint recipients of the 2006 Prince Mahidol Award for "exemplary contributions in the field of public health". Schultz will receive the accolade for medicine.

They will receive the award from Their Majesties the King and Queen at a ceremony at the Chakri Throne Hall in the Grand Palace compound today. Members of the public can watch the ceremony live on www.nationmultimedia.com. 

Arthit Khwankhom

The Nation