After spending my career managing operations and sales at large health care companies, I was interested in giving back to my home community. I had recently retired from my role as president of the Apollo Group of hospitals in India, when a former colleague approached me about working on an NGO project to address diarrhea in Indian children. I was intrigued.
Early in my career, I worked extensively in state of Uttar Pradesh (UP), one of the largest and poorest in India. The diarrhea project I was asked to lead was also in UP, and it struck me that not much had changed there the last 40 years. The poverty, the low employment, the poor health indicators – it was all the same. While India’s GDP has soared over the past two decades, life in the rural communities had not changed much. This frustrated me – but also inspired me. I decided to come out of my brief (just 6 months!) retirement to take on the challenge of the diarrhea project. I hoped my business skills might help turn the tide on one of the greatest drivers of child mortality in India in some small way.
Countless children do die from diarrhea – an estimated 700,000 globally each year – 212,000 of which are in India. Surely, we can do better than this.
No child should ever die from diarrhea. Treatment is simple and effective – and costs less than $0.50. And yet, despite this, countless children do die from diarrhea – an estimated 700,000 globally each year – 212,000 of which are in India. Surely, we can do better than this.
The World Health Organization-recommended treatment for diarrhea in children is zinc and oral rehydration salts (ORS). Together, they can prevent over 90% of deaths from diarrhea, and yet less than 5% of children in India are receiving the recommended treatment. The reason is that many health workers and mothers are not aware that zinc and ORS are the recommended treatment for diarrhea. This is especially a challenge in rural areas where the majority of deaths from diarrhea occur. Most rural communities do not have nearby hospitals or health clinics, and therefore rely on rural health providers in the villages for much of their health care needs. Access to information about recommended treatments and distribution of products is often limited in these rural settings.
In order to dramatically reduce the number of children who die from diarrhea, we’re working with State Ministries of Health and local partners in three states – Uttar Pradesh, Madhya Pradesh, and Gujarat – to help drive rapid, large-scale implementation of zinc and ORS scale up. Specifically, CHAI is supporting two key actions that are critical to success:
- Reaching health providers to ensure they are dispensing zinc-ORS for all pediatric diarrhea cases
- Reinforcing key messages among caregivers and mothers to immediately seek treatment and to use zinc-ORS.
Through partnerships with the Bill & Melinda Gates Foundation, the IKEA Foundation, and the International Zinc Association, we’ve reached more than 230,000 frontline health workers and over 1 million caregivers. Together, we’ve also worked to create an innovative rural distribution network extends beyond the reach of traditional pharmaceutical channels.
We’ve reached more than 230,000 frontline health workers and over 1 million caregivers.
It's been two years into the program, and the early results are promising. The uptake of zinc-ORS has increased significantly, and of the more than 120,000 private rural health providers receiving direct distribution, over two-thirds are now regularly purchasing and dispensing zinc-ORS for pediatric diarrhea cases. The program goal is for at least 35%-50% of all children with diarrhea to be receiving zinc-ORS by 2015 – an admittedly ambitious increase from current levels that are well below 5%. If we achieve this, approximately 50,000 children’s lives would be saved – and tens of thousands more annually thereafter.
If we achieve this, approximately 50,000 children’s lives would be saved – and tens of thousands more annually thereafter.
Today, President Clinton visited a rural village in Lucknow, India, to see our zinc-ORS program in action. He witnessed the engagement of a local village – women, health providers, village leaders, and children – learning about zinc-ORS and taking ownership for changing how diarrhea is treated in their community. Changing the habit of one village at a time – and reaching scale through the cascading influence of these efforts – is how we will ultimately achieve success.
Every day, I am motivated by this aspiration – and the challenge of achieving these results.
As Mahatma Ghandi says, “In a gentle way, you can shake the world.” We are attempting to ‘shake the world’ by proving that no Indian child should die from diarrhea in this day and age. Every day, I am motivated by this aspiration – and the challenge of achieving these results.