Padma Awards 2023: Who was Dilip Mahalanabis, and why is ORS such a game-changer?

Dr Dilip Mahalanabis died on October 15, 2022. The Padma Vibhushan (Medicine) was conferred on him posthumously in 2023. (Image source: Twitter/@kvijayraghavan)

Dr Dilip Mahalanabis, a paediatrician, was among many doctors who selflessly served the country and saved millions of lives when there was an outbreak of cholera—a deadly diarrhoeal disease back in 1971—during the Liberation War of Bangladesh. The country lost this legendary doctor at 87 on October 15, 2022. On our 74th Republic Day, the government of India posthumously awarded him the Padma Vibhushan—the second-highest civilian award for his selfless service to humanity.

What was Dr Dilip’s story?

In 1971, Dr Dilip Mahalanabis was called to serve at a refugee camp in West Bengal where the death toll due to cholera was rising day by day. The only solution was to put a drip (IV or intravenous line) to rehydrate the severely dehydrated people who were at a high risk of dying. However, only two healthcare workers among his staff were trained in putting an IV line. An alternative had to be found to help the endless number of people who kept coming in with diarrhoea. In such dire circumstances, when he realized that they were losing the battle, Dr Dilip allowed people to give the rehydration therapy orally.

How was ORS a game-changer?

Despite continuous criticism and resistance from clinicians, Dr Dilip believed that oral rehydration therapy could be given by even untrained relatives of the patients. He kept several drums of the oral rehydration solution (ORS) by his side and asked the family and relatives to keep giving the solution to the patient. The medical fraternity witnessed the miracle of ORS when the death toll among cholera patients dropped from 30 percent to less than 4 percent! Patients were getting better soon and returning home.

Worldwide acceptance of ORS

The news from West Bengal soon spread across the world. Another doctor, Dr Dhiman Barua, who was witnessing a similar outbreak in South Africa, got convinced that the decision to allow untrained people to administer ORS was right. More and more physicians started prescribing ORS to dehydrated patients; Dr Mahalanabis had converted a treatment that could only be given by trained professionals into a household medicine worldwide. In fact, The Lancet called it “potentially the most important medical advance” of the 20th century.

Dilip Mahalanabis
‘India’s gift to the World’!

Padma Vibhushan - (Posthumous) - Medicine

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West Bengal

Pioneered ORS, a path-breaking medical discovery estimated to have saved over 5 crore lives globally.#PadmaAwards2023#PeoplesPadma pic.twitter.com/NOPQzYhyFA

— Ministry of Information and Broadcasting (@MIB_India) January 26, 2023

One formula for any type of diarrhoea

The success of ORS in Kolkata led to the acceptance of ORS as an important treatment for diarrhoea. After years of research in Kolkata and Dhaka, many training activities and seminars were held by the World Health Organization (WHO) to decide on a single formula of ORS for all types of diarrhoea in patients of all ages. Ever since, ORS has been available in every corner of the world to win the fight against diarrhoeal diseases. Although ORS is not the only solution to treat diarrhoea, its role in rehydrating affected patients has been significant.

How to use ORS at home?

ORS is available over the counter at pharmacies. If the patient can’t see a doctor soon, ORS can be given to a baby or adult with diarrhoea and vomiting. It mostly comes in a powdered form in a sachet. Follow these steps to make the solution at home:

1. Wash your hands with soap and clean or treated water.

2. Clean the utensil in which you will be preparing the solution with soap and water.

3. Boil 1 litre of drinking water and let it cool to room temperature.

4. Add the ORS powder to it and stir until it dissolves.

5. Put the solution in a clean bottle.

6. For babies, feed half a litre of the solution every day; for toddlers, give one litre of ORS each day; and for adults, three litres of the ORS solution should be given in a day to help them feel better.

7. Consult a doctor as soon as you can for further check-ups and diagnosis.

A person with diarrhoea and vomiting should ideally feel better after drinking ORS solution. However, one should always see a doctor to confirm the diagnosis and receive further treatment if necessary.

A decision made by a paediatrician in a difficult situation has served humanity tremendously. Not only did it help the refugees in 1971, but it has saved millions of lives across the world since then, without letting it burden the healthcare systems even in countries with scarce resources.