How a chance encounter in parking lot led Indian doc to revolutionise ORS use


MELBOURNE: For over a decade since he started work at the World Health Organisation’s Geneva office in 1966, Dr Dhiman Barua — who promoted the use of Oral Rehydration Salts (ORS) and saved millions of lives in developing countries — tried hard to convince his peers that oral salts could cut down deaths due to cholera and diarrheal diseases. Then one day in 1978, he accidentally ran into the then director general Dr Halfdan Malher in the parking garage.
Barua — then an ordinary staffer who mostly kept to himself — managed to strike a brief conversation with Malher to explain to him his idea of a special programme to tackle diarrhoea and cholera and handed him an ORS packet which would be the “gamechanger” in this fight.
At that time, expensive intravenous saline treatment was used to counter these diseases and hospital doctors regarded oral rehydration therapy as second-class treatment. In developed countries, there were fears that sodium concentration in the formula was too high for children.
“The duo only talked for a few minutes, but Malher immediately realised the impact this life-saving solution could have. He decided to seek funding for the Diarrhoeal Disease Control Programme (CDD) which would eventually be led by Dr Barua. And the rest is history,” recalled Barua’s colleague and friend Dr Olivier Fontaine as he spoke to TOI ahead of what would have been Barua’s 100th birthday on October 19. Barua passed away in Geneva in August this year.
“Dr Barua never received the recognition he deserved,” said Dr Micheal Merson, Wolfgang Joklik Professor of Global Health at Duke University, who helmed CDD after Barua’s retirement.
“There has been much recognition of researchers who discovered oral rehydration therapy and undertook studies to show its effectiveness but very little recognition of the achievement of the vision that Dr Barua had to extend the treatment around the world,” Merson told TOI.
A 2019 study published in the ‘Journal of Global Health’ had found that the number of diarrheal deaths in children had been reduced by 82% since the start of the CDD program in 1980. “It wouldn’t have happened without Barua’s vision that ORS could be used outside of hospitals by health workers with minimal training to treat not only cholera but also childhood diarrhoea,” said Fontaine.
Fontaine recounted how Barua had once met Mother Teresa and upon learning that she was working in Kolkata with the poor and that diarrhoea was a major problem there, sent her a few hundred packets of ORS. “A few months later, he received a letter from her thanking him for the wonderful treatment he had sent,” said Fontaine.
Disease and death featured in the earliest childhood memories of Barua, who hailed from Chittagong — now in Bangladesh but then a part of undivided India. In an interview to WHO in 2009, Barua recounted how as an 11-year-old he had seen people in his village “drop dead like flies” due to cholera.
“This left an imprint on him,” said Barua’s younger son Kausik, an investment banker in New York. “It makes sense that his life’s work was devoted to making sure the world would have access to ORS,” he said.
Barua was instrumental in promoting the use of ORS not just in Africa, but in Indonesia and Philippines as well. According to Nathaniel Pierce, emeritus professor of Public Health, Johns Hopkins University (US), Barua’s commissioning of workshops in developing countries like Indonesia led to popularisation and adoption of the programme by researchers there.
Barua served in the Army Medical Corps in World War II and later as the head of the department of bacteriology at the Calcutta School of Tropical Medicine in 1961, his research was focused on the cholera epidemic in 1962.
After retiring from the WHO in 1987, Barua spent most of his time learning on a variety of subjects and meticulously taking notes, said his elder son Basab, a retired doctor in the UK. His Melbourne-based niece, Banya, added that education was another issue Barua cared for deeply and donated throughout his life to help underprivileged children complete their education.


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