responses and attracted more
vaccine makers, lowering costs.
“More cholera vaccines have
been deployed over the last two
years than in the previous 15
years combined,” Chan said.
A Revolution in Recovery
The treatment advances relied
heavily on research and testing
done at the International Center
for Diarrheal Disease Research,
known as the ICDDR,B, in Dhaka.
Although Dhaka may not be
the first place one might look to
find a public health revolution,
the center is famous among
experts in gut diseases.
While its upper levels are
quiet and scholarly, the center’s
ground floor is the world’s
largest diarrhea hospital. Its vast
wards treat 220,000 patients a
year, almost all of whom recover
within 36 hours. Doctors there
save hundreds of lives a day.
The ICDDR,B was originally
the Cholera Research Laboratory,
founded in 1960 by the United
States as part of that era’s “soft
diplomacy.” Research hospitals
were built in friendly countries
both to save lives locally and to
act as sentinels for diseases that
might threaten America.
The wards, which in the rainy
season extend into circus-size
tents in the parking lot, contain
long rows of “cholera cots.” On
each iron or wood frame is a plastic sheet with a hole in the middle. A bucket beneath the hole
catches diarrhea, while another
beside the cot fills with vomit.
An IV pole completes the setup.
Defying expectations, the
ward smells only of the antiseptic that the floors are constantly
Patients with severe watery
diarrhea arrive around the clock,
many of them carried in — limp,
dehydrated and barely conscious
— by friends or family. A nurse
sees each one immediately, and
those close to death get an IV line
inserted within 30 seconds.
It contains a blend of glucose,
electrolytes and water. Cholera
spurs the intestines to violently
flush themselves, but it does not
actually damage the gut cells. If
the fluid is replaced and the bacteria flushed out or killed by
antibiotics, the patient is usually
Within hours, patients start to
revive. As soon as they can swallow, they get an antibiotic and
start drinking a rehydration solution. Most walk out within a day.
The techniques perfected here
are so effective that the ICDDR,B
has sent training teams to 17
cholera outbreaks in the past
Usually, the only patients who
stay long in the hospital are
infants so malnourished that
another bout of diarrhea would
kill them. They live for up to a
month in a separate ward with
their mothers, who are taught
how to cook nutritious porridges
INDIA ABROAD March 3, 2017 25 SOUTH ASIA
Above, People collect water from
various pipes for use in cooking,
drinking and bathing, in the Korail
slum in Dhaka, Bangladesh, Aug. 19,
2016. Far left, a child cholera patient
in the general ward of the
International Center for Diarrheal
Disease Research in Dhaka,
Bangladesh, Aug. 17, 2016. Left, Dr.
John Clemens, the executive director
of the International Center for
Diarrheal Disease Research, in
Dhaka, Bangladesh, Aug. 17, 2016.
Korail, one of the biggest slums in
Dhaka, Bangladesh, Aug. 15, 2016.
Continued from page 24
Ismail Ferdous/The New York Times
Continued on page 26