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There is much debate among health planners about how a rehydration drink
should be prepared. The main disagreements center around 3 issues:
• Whether to use mass-produced ‘packets’ or homemade rehydration mixes.
• What amount of salt to use.
• Whether methods should be standardized or locally adapted.
Instructors of health workers should be familiar with the different points of view
so that they can prepare health workers to make appropriate decisions and advise
people well.
1. ‘Packets’ or homemade mix?
• Which can
save more lives?
• Which is
more reliable m
terms of safety?
In terms of being
available when
needed?
• Which puts
more control and
responsibility in the
hands of the local
people?
Many large organizations, including the World Health Organization, favor teaching
people to use factory-produced ‘rehydration salts’. Millions of standard packets have
been produced by large drug companies and are now being distributed in many
countries by UNICEF and other groups. Each UNICEF packet can be used to make 1
liter of Rehydration Drink.
Smaller, community-based programs often favor teaching families to make their
own Special Drink, using water, sugar, and salt that they have in their homes or can
buy at the local market.
Those in favor of the packets argue that these are safer and
work better. “After all,” they say, “the contents of each packet are
accurately measured. Baking soda and potassium are included. And
the special sugar (glucose) may, in some cases, be more easily
absorbed by children with severe diarrhea.” (However, studies
indicate that ordinary sugar works as well.)
Those in favor of the homemade Special Drink argue That this
approach allows more children with diarrhea to be treated, right
away, and in their own homes. If packets are used, then for each
case of diarrhea families will have to depend on a supply system
that involves foreign manufacturers, international organizations,
health ministries, transportation networks, and health posts. But in
most parts of the world, the sugar and salt needed for homemade
mix are common household items. Once they learn how, families
can make and use the drink right away whenever it is needed—
without having to depend on outsiders.