Photos and Drawings:
UNICEF, Ministry of Health, Sultanate of Oman, Hector Cattolica

Reduced osmolarity ORS

grams
/litre

Reduced osmolarity ORS

mmol/
litre

Sodium chloride

2.6

Sodium

75

Glucose, anhydrous

13.5

Chloride

65

Potassium chloride

1.5

Glucose, anhydrous

75

Trisodium citrate, dihydrate

2.9

Potassium

20

Citrate

10

Total Osmolarity

245

The above ingredients are to be dissolved in one litre of clean water.

WHO said the new formula would reduce the severity of diarrhoea and vomiting, the number of hospitalisations, the need for costly intravenous fluid treatment and the length of illness. This formula also gives the packets a longer shelf life and is at least as effective in correcting acidosis and reducing stool volume as the old formula. Packets containing sodium bicarbonate are still safe and effective.
How do I make the solution?

• Dissolve the contents of the packet in the amount of drinking water indicated on the packet, usually 1 litre.
• If drinking water is not available, or if you are not sure the water is drinkable, boil the water for at least 10 minutes and then let cool.
• Stir well, and give to the child to drink in a cup or spoon feed.

Be careful to mix the right amount of water. If you use too little water, the drink could make the diarrhoea worse. If you use too much water, the drink will be less effective. Do not add liquids such as milk, soup, fruit juice or soft drinks to this ORS solution.

10 Things you should know about Rehydrating a child.

1. Wash your hands with soap and water before preparing solution.
   
2. Prepare a solution, in a clean pot, by mixing
   
   - eight level teaspoons of sugar and
   - one level teaspoon of salt
   - in one litre of clean water
   or
   - 1 packet of Oral Rehydration Salts (ORS)
   - with one litre of clean drinking or boiled water (after cooled)
   
   Stir the mixture till all the contents dissolve.
   
3. Wash your hands and the baby's hands with soap and water before feeding solution.
   
4. Give the sick child as much of the solution as it needs, in small amounts frequently.
   
5. Give child alternately other fluids - such as breast milk and juices.
   
6. Continue to give solids if child is four months or older.
   
7. If the child still needs ORS after 24 hours, make a fresh solution.
   
8. ORS does not stop diarrhoea. It prevents the body from drying up. The diarrhoea will stop by itself.
   
9. If child vomits, wait ten minutes and give it ORS again. Usually vomiting will stop.
   
10. If diarrhoea increases and /or vomiting persists, take child over to a health clinic.

Selling Survival - a UNICEF poster

Dehydration caused by diarrhoea is the biggest single killer of children in the modern world and diarrhoea itself is one of the major causes of nutritional loss and poor growth. Now, dehydration can be prevented and nutritional losses minimized by a revolutionary new technique called Oral Rehydration therapy (ORT). To prevent dehydration, oral rehydration salts can be made at home from ordinary household ingredients. To prevent - or treat - dehydration, sachets of the salts made up to precise WHO/UNICEF formula now cost only a few cents each. But the problem is how to make them available to millions of parents through out the world.

The sachets, says UNICEF, should be household items - available from every corner shop like soap, batteries, razor-blades or Coca-Cola. The State of the World's Children (UNICEF).

Orange Flavoured ORS
Marketed by Population Services International - PSI in India