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Dilip Mahalanabis | |
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| Born | (1934-11-12)12 November 1934 |
| Died | 16 October 2022(2022-10-16) (aged 87) Kolkata,West Bengal, India |
| Education | MBBS,DCH,MRCP (Edinburgh) |
| Alma mater | Medical College and Hospital, Kolkata |
| Known for | Development oforal rehydration solution |
| Awards | Pollin Prize (2002) Prince Mahidol Award (2006) Padma Vibhushan (posthumous, 2023) |
Dilip Mahalanabis (12 November 1934 – 16 October 2022)[1] was an Indianpaediatrician known for pioneering the use oforal rehydration therapy to treatdiarrhoeal diseases.[2] Mahalanabis had begun researching oral rehydration therapy in 1966 as a research investigator for theJohns Hopkins University International Center for Medical Research and Training inCalcutta,India. During theBangladeshi war for independence, he led the effort by the Johns Hopkins Center that demonstrated the dramatic life-saving effectiveness of oral rehydration therapy whencholera broke out in 1971 among refugees from East Bengal (nowBangladesh) who had sought asylum inWest Bengal.[3][4][5][6][7] The simple, inexpensive Oral Rehydration Solution (ORS) gained acceptance, and was later hailed as one of the most important medical advances of the 20th century.[3][5][8]
From 1975 to 1979, Mahalanabis worked in cholera control for theWorld Health Organization (WHO) inAfghanistan,Egypt andYemen. During the 1980s, he worked as a WHO consultant on research on the management ofbacterial diseases.[5] In 1983, Mahalanabis was made a member of the WHO's Diarrhoeal Diseases Control Programme. He remained in that role for over five years.[4] He was also associated withKolkata'sNational Institute of Cholera and Enteric Diseases (NICED) and theInstitute of Child Health.[3][6]
Dilip Mahalanabis was born on November 12, 1934 inKishoreganj district ofBengal Province of British India. He graduated from theCalcutta Medical College as a paediatrician in 1958 after working there as an intern. The establishment of theNHS in UK provided him an opportunity to pursue medicine in the UK, he obtained degrees from London and Edinburgh.[9]
While he was in the UK he became the first Indian to be selected as the registrar for theQueen Elizabeth Hospital for Children. In the 1960s he joined the Johns Hopkins University International Centre for Medical Research and Training (JH-CMRT) in Kolkata, where he began his research into oral rehydration therapy.[10]
The outbreak of theBangladesh Liberation War led to a massive refugee crisis, with most of the refugees ending up in India. Cholera quickly became a major cause of death among the starving and exhausted refugees, with acase fatality rate (CFR) of 30%.[11] To help the government and non-governmental organisations deal with this situation, JH-CMRT sent its professional and paramedical personnel to the refugee camps. Dr. Mahalanabis and his team worked along the border of India andEast Pakistan, with their treatment center being located inBongaon. The 16 beds available to them in two cottages which served as cholera wards were completely insufficient to serve the 350,000 refugees living in the vicinity of the town, cholera wards quickly ran out of space with even floors being completely occupied by sick patients, this necessitated the setting up of a large separate tent with 100 cots. They also suffered from a shortage of intravenous fluids and had no way of obtaining them in the required quantities and trained personnel to administer them. Based on research available at the time, Mahalanabis and his team were confident that oral rehydration alone would be enough to prevent fatal dehydration in the early stages, with intravenous fluid being required only for severe cases after the onset ofhypovolemic shock and severeacidosis.
He used an oral rehydration solution (ORS) using locally available ingredients and with minimum number of ingredients consisting of 22gglucose, 3.5gsodium chloride, 2.5gsodium hydrogencarbonate per litre of water. The glucose was prepared by JH-CMRT and the ingredients were weighed and packed in sealed and labeled polyethylene bags. This powdered mixture was added to drums containing potable water and given to patients in cups. Due to local sourcing of all the materials, the cost was just 11 paise (1.5 cents) per litre of the solution. The family members of the patients were instructed to provide the patients with the ORS due to the simplicity of the therapy. Potassium was also orally administered for children, and coconut water was provided whenever possible due to its high potassium content along with a small dose oftetracycline for both adults and children. During a 8 week period in which he and his team administered this therapy to 3700 patients, only 135 cases were fatal translating to a CFR of 3.6% which was a massive decrease from 30% fatality observed earlier, in the separate tent the CFR was even lower at 1%, however the conditions were so poor that half the patients died before any oral rehydration therapy could be even administered.[12]
During this time Dr. Dhiman Barua who was the head of the bacterial diseases unit of theWHO visited the camp managed by Mahalanabis, and began boldly promoting the treatment in the WHO andUNICEF. Despite this Mahalanabis's treatment was met with skepticism from the scientific community with many journals refusing to publish his original paper, it would take 7 more years for oral rehydration therapy to be accepted as a good treatment for dehydration from diarrhea and other diseases.[13] He never patented his ORS formula.
He worked in the cholera control unit of the WHO from 1975-79, serving in Afghanistan, Egypt, and Yemen. He worked as a consultant on bacterial diseases for the WHO during the 1980s.[14]
In the mid-1980s and early 1990s, he was a medical officer in the Diarrheal Disease Control Programme of the WHO.
In 1990 he was appointed as a clinical research officer at theInternational Centre for Diarrhoeal Disease Research (ICDDR,B), Bangladesh. Later going on to become the Director of Clinical Research there.[9] In 2004, he and Dr. Nathaniel Pierce were working on an improved version of the ORS which would be more effective at preventing dehydration from all forms diarrhoea and confer addition benefits like reduced stool output.[13]
In 1994, Mahalanabis was elected a foreign member of theRoyal Swedish Academy of Sciences. In 2002 Dr. Mahalanabis, Dr. Nathaniel Pierce,Dr. David Nalin andDr. Norbert Hirschhorn, were awarded the firstPollin Prize in Pediatric Research for their contributions to the discovery and implementation of oral rehydration therapy. In 2006 Dr. Mahalanabis, Dr.Richard A. Cash and Dr.David Nalin were awarded thePrince Mahidol Award, also for their role in the development and application of oral rehydration therapy.[15][16] In 2023, he was posthumously awarded thePadma Vibhushan.[17]
Mahalanabis was married to Jayanti Mahalanabis.[citation needed] He died at a private hospital inWest Bengal,Kolkata on 16 October 2022, at the age of 87.[18] He was suffering from lung infection and other old age related ailments.[19]
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