One level teaspoon salt

Fig. 8.1. Preparing a simple oral rehydration solution.

tering it to her child. If it tastes salty, then more water should be added.

A naturally available rehydration solution is the fluid from a green coconut. A 7-month coconut has been found to be the most suitable. Rice-water made from a handful of rice boiled in a saucepan of water until it disappears, plus the appropriate amount of salt for the volume of water, makes a simple rehydration solution. Carrot water can also be used.

If mothers are taught how to make up these solutions, then they can treat their children as soon as they start to get diarrhoea. The mother should use a cup and a spoon and sit with her child giving it small quantities of fluid at frequent intervals. Severe dehydration can usually be prevented by primary care from the mother.

There is no need to use an antibiotic or an antispasmodic, both of which are contra-indicated. Lactobacilli, which inhibit E. coli, colonize the gut in the breast-fed infant. In some countries, lactobacilli are administered in yoghurt (curd).

Surveillance In countries with a seasonal rainfall pattern, gastro-enteritis outbreaks often start with the beginning of the rains, so monitoring the weather can provide early warning of an impending outbreak.

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