Oral rehydration therapy — simple administration of basic nutrients

Oral rehydration therapy (ORT) is simply the administration of basic nutrients and water, given by mouth. Various formulations of broths and salt-and-sugar solutions have been used for centuries in medicine. Chicken soup was first recommended as a nourishment for sick patients in the writings of the physician Moses Maimonides in the late 12th century (Rosner, 1971). However, as medicine became more sophisticated, such simple remedies were replaced by more technical solutions. Intravenous (IV) fluid therapy became the mainstay of fluid support, and advanced therapies such as total parenteral nutrition were developed to provide nutrition intravenously.

However, need overwhelmed the availability of IV fluids in the aftermath of war between India and Pakistan in 1971. Thousands of refugee children were dying of diarrhoea because hospitalization facilities were simply not available for them. In desperation, health professionals developed a simple recipe for an oral rehydration liquid consisting mostly of sodium chloride, glucose and sodium citrate. Family members were taught how to give the solution to their children, simply by using a spoon to give the solution frequently and in small amounts (Figure 1). This strategy reduced infant mortality in the refugee camps from 40% to 3% (Mahalanabis et al, 1973). The World Health Organization subsequently adopted the low technology solution and ‘WHO juice’ gained worldwide recognition in the 1990s. WHO estimates that ORT currently has reduced the mortality from diarrhoeal diseases by two-thirds, saving approximately 3 million children’s lives per year (Victora et al, 2000).