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“But you must consider safety!” argue the packeteers. “If people
make their own rehydration drink, they may put in too much salt!
That can be dangerous!”
“True,” say the home mixers. “But if people mix a standard
packet with too little water, the result can be equally dangerous!”
And it does happen. John Rohde and others conducted a study
with two groups of mothers in Indonesia. One group made
Rehydration Drink using packets. Another group mixed salt, sugar,
and water, using plastic measuring spoons The study showed
a slightly higher number of mothers prepared dangerously
salty drinks when using the packets.
Another argument often given by those favoring packets is that the packets
seem more like medicines, and therefore people accept them more readily than
homemade mixes. This may be true. But, surely, to promote a simple drink by
giving it the magic of a medicine is shortsighted. It makes far more sense to help
people understand oral rehydration and why it works. Many health workers feel it
is important to look at Rehydration Drink as a FOOD, not a MEDICINE! Strict
medical controls for this basic food supplement are an obstacle, not a help.
The underlying issue in the argument about packets and home mixes is political.
Do health planners want to use technology that will make poor families more self-
reliant and independent? Or do they want to use outside technologies that make
people more dependent on institutions and central control?
We think that, in most circumstances, the arguments in favor of the homemade
drink strongly outweigh those in favor of packets. An exception might be in remote
areas where sugar or salt is sometimes scarce or unavailable.
What about packets for use in clinics?
Some health program planners suggest that Special Drink should be prepared
by families in their homes, but that packets or more complex mixes might be
more appropriate in health posts and clinics. We disagree. The health post or clinic
should be a center for parent education. So it is important that, even in the clinic,
the parents learn to prepare the Rehydration Drink and give it to their children
themselves.
In the health post or clinic, use the same rehydration
methods you want families to use in their homes.
On the following page is a diagram showing many different methods of
rehydration. They range from those that are completely dependent on outside
resources (I.V. solution) to those that permit the greatest self-reliance on the part of
the family.
Discuss these choices with the health workers in your training course, and decide
together which approach will best serve the needs of people in your area.