Richard Cash: public health doctor whose salt and sugar solution for cholera patients is estimated to have saved 70 million lives

Abstract

BRAC In 1967 newly qualified doctor Richard Cash was sent to East Pakistan (now Bangladesh) to respond to one of the many cholera epidemics that swept through the region. The treatment at the time was intravenous therapy to replace lost fluids, but such a resource intensive process was inappropriate in a country where funding and trained personnel were not available at anywhere near the scale needed. A simple, inexpensive, and easy to administer treatment did, however, exist: oral rehydration therapy (ORT), just salt and sugar in clean water. This had already been shown to be effective in laboratory studies but Cash and David Nalin, his colleague at the US National Institutes for Health, decided to test it on a much larger scale. They faced objections from colleagues who weren’t sure patients would be able to swallow the fluid or that the treatment would work—but their multiple clinical trials of ORT proved the doubters wrong.1 Cash went on to work closely with the …