CASE STUDY: Combating Diarrheal Disease in Bangladesh

Background Diarrheal disease is the world's second-leading cause of death in children five years and younger. It is the major cause of death in three out of five infants in Bangladesh who die from the first month of life. Diarrhea is the passage of three or more loose or liquid stools per day. Most casualties from diarrhea stem from severe dehydration and fluid loss.

Community Approach The Bangladesh Rural Advancement Committee (BRAC) was the first nongovernmental organization to implement a large-scale diarrheal intervention and made oral rehydration therapy widely available to the country. Through its Oral Rehydration Teaching Program, they female health workers taught nonprofessionals (especially mothers) how to administer oral rehydration solution (ORS). This solution was simple but life-saving drink of water, salt and sugar formulated in the late 1960s by American and Bengali researchers working in Bangladesh. ​ORS was inexpensive, did not require special medical equipment, and its ingredients were readily available. The trainers made sure that mothers of a visited town accurately measured the right amount of water before moving on to the next village/town. Along with their own funds, BRAC received financial aid from Oxfam, UK government, and UNICEF, totaling up to $9.3 million used in this intervention program. Lessons Learned Throughout three decades, ORS has been implemented in other countries and has saved an estimated 50 million lives worldwide. Last year, Bangladesh become one of eight countries to have reduced mortality rates of children under five by at least two-thirds since 1990 (meeting the MDG). This community approach worked because the training provided to women was built on their existing knowledge and skills (cooking and feeding children). Training was done in familiar surroundings in a group environment. Known home ingredients were used, and the practices were culturally acceptable. The program was widespread, but organization was managed efficiently through rigorous supervision. The success of BRAC's program and simple solution sets an example for other impoverished countries suffering from high mortality rates due to diarrheal disease.

Additional Links http://opinionator.blogs.nytimes.com/2014/08/14/the-power-and-process-of-a-simple-solution/?_r=0 (Photo: Amy Yee) Video: http://www.pbs.org/wgbh/rxforsurvival/series/video/d_dia1_dis_oralretherapy.html