The founder of the Diarrhoeal Diseases Control Programme, Dr Dhiman Barua (1920-2020), who was the pioneer in promoting Oral Rehydration Salt Solution (ORS) for diarrhoea, passed away in September 2020, just two months before his 100th birthday.
Dr Barua’s work on promoting ORS solution has been called “potentially the most important medical advance” of the 20th century by The Lancet, and is continuing to save millions of lives every year.
Barua was born to a family of doctors and traditional medicine practitioners in Rangoon, Burma, which was then a part of undivided India, his family moved to his ancestral village near Chittagong, then a part of undivided India, when he was four years old.
Career
Dr Barua started his early medical education at Chittagong Medical School in 1937—41 upon receiving a scholarship. He held a short-commission posting during World War II and served in Malaysia, India, and Burma with Indian Army Medical Corps.
On his commanding officer’s advice, he joined Calcutta Medical College for a medical degree. Thereafter, he became a Doctor of Medicine Pathology & Bacteriology from King George’s Medical College & the University of Lucknow in 1956. He also studied microbiology at Institut Pasteur, Paris in 1958—59, and at the University of Texas, Galveston in 1971.
Dr Barua started working for WHO in 1965 with the Cholera Control Team based in Manila in the Philippines. In 1966, he moved to WHO head office in Geneva as a medical officer working on cholera and other diarrhoeal diseases. In 1978, he established the Diarrhoeal Diseases Control Programme. Throughout his career at World Health Organization (WHO), he trained health workers in many countries in oral rehydration therapy and other aspects of diarrhoeal diseases, mostly at the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh.
As a child, Dr Barua had seen people in his village dying of cholera in huge numbers. Till the late 60s, intravenous (IV) saline in glass bottles was the standard treatment for cholera and diarrhoeal disease. A one-litre bottle was so heavy that to transport it by air was many times more expensive than the fluid itself.
Such conditions obliged Dr Barua and his team of doctors to think about alternatives to IV fluid in oral rehydration. They had to encounter problems in popularising ORS as oral rehydration therapy was generally regarded by doctors as second-class treatment. Pediatricians in developed countries feared that the sodium concentration in the formula was too high for children, which is why the doctors had to be invited to try it for themselves.
Things changed at the end of 1970, when a Swiss company succeeded in packaging the ingredients in aluminium foil bags to prevent absorption of moisture and caking of the powder. This was an important great discovery, because of long shelf life and easy transportation.