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A simple healthmessage
A national workshop on oral rehydra-tion was held in Bangladesh last year.One of the programmes discussed camefrom the Bangladesh Rural Advance-ment Committee (BRAC) who areworking in a remote rural area ofSylhet. Their programme is based on asimple health message entitled ‘Tenpoints to remember’. These pointsinclude a description of how diarrhoeabegins, the recipe for an oral rehydra-tion mixture ‘lobon-gur’ (with molassesas a local alternative to sugar), thedangers of giving the wrong quantitiesand when a case should be referred to adoctor. The goal of the programme is toteach oral rehydration therapy to onewoman in every household in theproject area.Oral Replacement Workers (ORW),women between 20 to 50 years old whocan read and write Bengali, visit homesto ensure that the lobon-gur mixture isbeing made properly. In Azmiriganj,Sylhet, BRAC has 30 ORWs workingabout 15 days a month. The pro-gramme staff is composed of a projectmanager, two monitors and two teams.Each team assigned to a specific villagehas a coordinator, ten ORWs and aservice staff.Monitors visiting homes two weeksafter the visit of the ORW found that allthe women were mixing the ORTsolution correctly, although only 34 percent could recall all of the ‘Ten pointsto remember’. The ORWs were paidaccording to the number of motherswho were mixing the solution correctlyand could remember some or all of theten points.
BRAC’s oral rehydration programme1980. Glimpse ~012 (1): 1-2.
Dr Nicholas Cohen, currently workingwith the National Institute of Socialand Preventive Medicine in Dacca, hassent us photographs and a report of anoral rehydration programme in Bangla-desh sponsored by the Save the Child-ren Fund (UK) and assisted by theInternational Centre for Diarrhoea1Disease Research (ICDDR,B). Theprogramme, designed to provide oralrehydration therapy where pre-packedoral rehydration salts are unavailableor inappropriate, is aimed at two maingroups. Firstly children, and secondlyvillagers with a special interest in beingtrained as health workers. Two specialfeatures of this programme are themonthly meetings for all those involvedto discuss results and problems, andregular checking of the concentrationof oral rehydration solution made up byvillagers. Ideally, the programme isseen as part of a package of healthmeasures which should be made avail-able cheaply and regularly in everycommunity.
A training programme for national pro-gramme managers was organized byWHO in Bangkok from 27 October to 7November. Forty participants attendedfrom all over the world. The aim of thecourse was to provide information sothat the participants could return homeand set up and manage nationaldiarrhoea1 disease control programmes.This was done by presenting partici-pants with a fictitious country withinwhich, given appropriate data, theyhad to work out the logistics of settingup an oral rehydration supply systemand identify ways of controllingdiarrhoea1 diseases. Discussions withWHO staff running the course and withother participants helped to link thetheory to the particular problems thateach manager would face at home. It ishoped that those who attended thecourse will teach others in future train-ing programmes within the WHOregions. We would be interested tohear from anyone who took part in thetraining programme.
A Spanish edition of
is now available from the PanAmerican Health Organization 525,Twenty-third Street, N.W., Washing-ton D.C., 20037, U.S.A.
PATH, the Programme for Appropri-ate Technology in Health and itsaffiliate, PIACT de Mexico, haverecently developed an effervescenttablet containing enough oral rehydra-tion salts for 2OOcc (a glass or cup ofwater). The new tablet is now under-going final shelf life and packaging testsbefore it becomes available for evalu-ation within oral rehydration therapyprogrammes. A pink colouring hasbeen added to the tablet to take advan-tage of the association (found in manycountries) between pink colour and“stomach medicine”. Further infor-mation on the tablet can be obtainedfrom PATH, 4000 NE 41 Street, Seattle,Washington 98105, USA.2
Diarrhoea Dialogue, issue 3, November 1980. Produced quarterly by AHRTAG at 85 Marylebone High Street, London Wl M 3DE.