When Dr Dilip Mahalanabis passed away in a private hospital in Kolkata on 16th October 2022 very few of us noticed as we were busy watching the T20 World Cup in Australia. And yet as the Financial Times noted “…the distinguished paediatrician deserved a less muted valediction. His pioneering medical work among refugees fleeing war in the 1970s demonstrated that oral rehydration therapy — a simple solution of glucose, salts and water designed to replace vital fluids lost during bouts of infectious disease — could be successfully administered at scale, even during a desperate humanitarian crisis. The Lancet estimates this treatment has helped save 54 million lives over the past half century.”

So, who was Dilip Mahalanabis and how did he hit upon this gamechanging innovation which saved 54 million lives? “…Mahalanabis was born in East Bengal, now Bangladesh, in 1934 and educated at a medical school in Kolkata. After a spell working for the NHS in London, he eventually returned to the city in 1966 to begin research into oral rehydration treatments at Kolkata’s Johns Hopkins University International Centre for Medical Research and Training. But in 1971, the Bangladesh war of independence broke out: thousands fled to refugee camps on the country’s border with India. Infectious disease spread rapidly in these close confines, and Mahalanabis decided to put his theory into practice.

In an interview published in a 2009 bulletin of the World Health Organization, he painted a graphic picture of the conditions he encountered while attempting to use traditional intravenous methods. “There were two rooms in the hospital in Bangaon that were filled with severely ill cholera patients lying on the floor. In order to treat these people with IV saline, you literally had to kneel down in their faeces and their vomit”.
Within 48 hours he realised he was fighting a losing battle “because there was not enough IV and only two members of my team were trained to give IV fluids”. 
He decided to deploy a simple, low-cost solution and to allow people without medical training, including family members, to administer it….The no-frills approach quickly proved highly effective. Ghosh recalled Mahalanabis telling him that a member of the army had asked about the length of time the oral solution should be administered for. “He told him they can keep on taking it as long as they are thirsty and when they are no longer thirsty that means they have become well and they can stop.””

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