Oral Rehydration Therapy
Every parent knows that diarrhea is one of the commonest ailments of childhood. It affects hundreds of millions of 
children around the world an average of three times a year. And especially in areas where water and sanitation are
poor, it can be a problem for adults also.
But children are most vulnerable to the problems caused by diarrhea, especially children who are poorly nourished 
and in poor health to start with. UNICEF and the World Health Organization estimate that more than three million 
children in developing countries die each year from serious bouts of diarrhea--the most important single cause of 
death and malnutrition among young children.
DEHYDRATION--A LIFE-THREATENING CONDITION
Most of the children who die from diarrhea die because their bodies have become dehydrated. That is, they have 
lost more fluid than they have taken in. As body fluids are lost, essential salts, minerals, and other nutrients are 
also lost and the body is no longer able to function properly. Severe dehydration may cause rapid weak pulse; 
fever; fast, deep breathing; or convulsions. Untreated, it is fatal.
The diarrhea that causes the dehydration can and should be treated before the problem becomes so serious. The 
idea is to give the child (or adult) as much fluid as possible and to restore the balance of salts and other nutrients. 
The treatment is called oral rehydration therapy (ORT). It works almost as fast as an intravenous (IV) feeding and 
is safer, simpler, and cheaper. Any mother can treat her child at home for just a few cents, versus the high cost of 
an IV or other medications. WHO estimates that use of ORT saved over 200,000 lives in 1984.
Use of ORT is so effective that as of January 1988 some 90 countries around the world had national programs to 
promote its use and it is becoming the treatment of choice in many hospitals in industrialized countries. Many 
organizations have programs to teach medical workers as well as parents about the treatment and to train them in 
its use.
TREATING OR PREVENTING DEHYDRATION
A mixture--called rehydration salts--of salt, sugar, sodium, potassium (and perhaps other nutrients), and water is 
fed to the child frequently throughout the day and night. The salt-sugar mix is usually available in packets or tablets
to be mixed with clean water. in some places, the bottled mixture may also be available. If the salt-sugar mixture is 
not available, you can make your own rehydration drink at home (see box).

Mix up the drink at the first signs of diarrhea. Give the person sips of the drink every few minutes, day and night, 
that they are awake--even if they don't feel like drinking it and even if they vomit. An adult should drink three or 
more liters a day and a small child should have at least one liter a day or one glass for each watery stool.
Diarrhea is often caused by malnutrition, but if it goes on long enough the diarrhea itself contributes to the 
malnutrition. Be sure that the person who has diarrhea eats good, easily digestible food along with the rehydration 
drink. This is especially important for children, but anyone who is thin and weak should get plenty of protein and 
energy foods all the time that they have diarrhea. If they are too sick to eat much, they should take broth, porridge, 
rice water, and/or cooked and mashed beans or fruit, in addition to the rehydration drink. Babies should continue to
be fed breast milk. As soon as they can, the sick persons should begin eating well again.
(It should be noted that doctors often have different ideas about how to treat people with diarrhea, especially 
regarding the types and quantities of food the sick person should eat. Many doctors feel that people with diarrhea 
should not eat anything but thin soups or cereals. Other doctors say that the sick person should be allowed to eat 
almost any good healthful food they feel like eating. You should be prepared to follow the advice of your doctor or 
health worker.)
Unless the diarrhea is caused by some other disease, such as amoebic dysentery, the person should respond 
quickly to the treatment. If the diarrhea gets worse, or if there are other disease symptoms such as fever, and the 
person seems to be dehydrating, get help from a doctor or health worker immediately. Remember that children are 
affected more quickly than adults, and dehydration is very dangerous for babies.
Look for these signs of dehydration:
		o  dry, tearless, sunken eyes 
		o  sudden weight loss 
		o  dry skin, mouth, and tongue 
		o  sudden weight loss 
		o  sunken "soft spot" on a baby's head 
		o  little or no urine, and what there is is dark yellow
Dehydration also causes the skin to lose its elasticity. a pinch of skin does not fall back to normal, but stays up in a 
lump. Dehydration may also cause rapid, deep breathing; a fast but weak pulse; fever; and/or convulsions.
Source: 
Werner, David. Where There Is No Doctor. Palo Alto, California: Hesperian Foundation, 1980. First published in 
Spanish as Donde No Hay Doctor. Now available in English, Spanish, French, Portuguese, and Swahili. Available 
through VITA in English, Spanish, and French.
 
The Project for Appropriate Technology for Health, Seattle, Washington USA.
 
Grant, James F. State of the World's Children 1988. New York: Oxford University Press, for UNICEF (United Nations 
Children's Fund), 1988.

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