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[How can we save two million children per year?]
As a physician, we're trained to absorb, to ask questions
and to always ask ourselves, how can I do better?
We have a way to save 2 million children every year.
That way is through Oral Rehydration Therapy.
It's a simple technology that has existed for over 30 years.
That technology was developed to treat a scourge,
a very miserable condition, called diarrhea.
It's a universal disease
that maybe a nuisance in developed countries.
But in developing countries, in poor countries,
it's life-threatening to many, many children.
Diarrhea will kill more young children
than the combined total of AIDS, Malaria and Tuberculosis.
Yet the funding for diarrhea is disproportionately low.
Other diseases, such as Tuberculosis, Malaria
and AIDS, get far more money.
I wanna look at what happens to lead to the death of a child.
and there's two parts to dying from infectious diarrhea.
The first part is essentially drinking dirty water.
Once you drink the dirty water,
the bacteria, the viruses, develop in your gut
and they lead to losing both water and electrolytes.
Oral Rehydration Therapy is a cure for this.
The prevention is clean water,
but the cure is the right combination of salt, sugar and water.
I'd like to briefly talk about what dehydration is.
Often times we think that it's simply losing fluids, water,
but it's also losing electrolytes.
And the main electrolyte we lose when we have dehydration is salt.
Oral Rehydration Solutions, first were used as salts,
and that's why we use the "S".
The application of Oral Rehydration Salts
is termed Oral Rehydration Therapy: ORT.
Salt is so important in rehydrating you,
that we use it very frequently in medical situations, emergency situations.
And if you are sick from diarrhea or heat exhaustion,
you can be rushed to the emergency room,
and in the emergency room, you'll be given IV solutions.
Those IVs contain very, very high amounts of sodium,
but you never know it, because you're not tasting it.
The normal IV has a 154 mEq (milliequivalents) of sodium.
Oral Rehydration Solutions,
the one the World Health Organization promotes, has 75, or about half.
Pediatrics solutions in the United States use 45 milliequivalents,
and then sport drinks have far fewer levels of sodium.
Coconut water and apple juice have even lower amounts of sodium.
So you can see that if you go to the emergency room,
if you need an IV,
you're getting very high amounts of sodium.
You can also get it through Oral Rehydration Therapy.
[The Sodium Glucose Co-Transport System]
And what happens in the gut is actually quite magical,
because if you get the right amount of water, salt and sugar,
then you activate what's called the Sodium Glucose Co-Transport system.
It's a system that lives in the lining of the gut
where by one Sodium and one Glucose Molecule,
will activate what we call the transport mechanism,
taking the water, salts, and sugar
through the intestinal lining and into your blood stream.
Where the salt goes, the water will follow,
and that's really the key to it.
But the problem with all of this is that we don't like to drink
salty-sugary solutions.
So like Mary Poppins said a long time ago,
a spoon full of sugar makes the medicine go down.
One of the things that when... arrive with sports drinks
is that they put way, way too much sugar in,
and now you have an imbalance of sugars and salt,
way too many sugars, not enough salts.
But there's an important aspect to the Mary Poppins effect,
and that is that taste matters.
It matters so much that TIME magazine, in 2006, asked:
"why aren't using more of this life-saving technology?"
Doctors without Borders believes that after penicillin,
Oral Rehydration Therapy is the most important medical advance.
Full stop.
And the question that keeps coming up, around the world,
and especially in the United States, is:
"Why aren't we using it more often?"
When you use Oral Rehydration Solution,
the chances of you, a small child living are great, greater than 99%.
If you don't have Oral Rehydration Solution,
and you use coconut water, apple juice or sport drinks,
then your death rate climbs, and if you're a little child,
that can climb to above 50%, and sometimes above 90%.
I'd like to be joined by an 8-year-old girl here to demonstrate
just how much fluid and electrolytes she could lose in an hour.
You can go ahead and start pouring.
Cholera is the fastest way to lose fluids and salts in your body.
We've heard of it from Haiti, most recently,
and it's endemic in many parts of the world.
One liter of water and, go ahead,
3 teaspoons of salt can be lost by someone her size.
The wonderful thing, now is that we have a solution.
And that solution is Oral Rehydration Therapy.
And my young assistant will demonstrate how anyone,
in any place in the world, can make Oral Rehydration Therapy.
One liter of water.
A half teaspoon of salt.
And five teaspoons of sugar.
Thank you.
Mix and drink.
So, there you go:
Oral Rehydration Therapy has saved 50 million lives,
50 million children, since it was first introduced to the world in 1980.
It's faster, safer, cheaper, and actually more effective
than IV hydration. Hands down.
IV hydration is slow, it's painful, you need skilled labor to administrate it
and it's far more costly.
Who's recommending and endorsing Oral Dehydration Therapy?
A lot of organizations around the world.
So I wanna ask: Who, then, is teaching Oral Rehydration Therapy?
Well, basically, medical schools around the world, except one country.
And that country is the United States,
where it's not regularly taught.
I wanna change that in my lifetime, and I want to challenge the world
to help in reducing those deaths,
those 2 million deaths of children 5 and under, to zero.
It's possible, and the technology is here today.
Thank you very much.
(Applause)