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In the village of Liyari located in Balochistan, Pakistan, three-year-old Sobia lives with her parents and her brother. When extreme monsoon rains triggered floods and landslides across Pakistan in 2022, their family faced a critical health situation. Even before the floods, diarrhoea accounted for 8% of deaths in children under five in Pakistan. Following the disaster, local health workers observed an increase of 15–20% in diarrhoea cases, especially among children under five. One of those children was Sobia.

As Sobia’s condition deteriorated, her mother brought her to their local basic health unit. Instead of the conventional treatment with oral rehydration salts, Sobia received a co-package of zinc and low-osmolarity oral rehydration salts (LO-ORS).

A health care worker provides counselling and treatment of a co-package of zinc and LO-ORS to a mom holding a three-year-old for diarrhoea.
A health workers treats three-year-old Sobia with a co-pack of zinc and LO-ORS. The health worker also counsels her mother on diarrhoea prevention.

The combination of zinc and LO-ORS significantly improves recovery rates, reducing the duration and severity of diarrhoea episodes. Her treatment was provided through a rapid-response project launched by Nutrition International, with funding from Comic Relief US, in partnership with the Balochistan Rural Support Program, coordinating with the Sindh Rural Support Program and local and district governments.

The project was executed in six target districts of Balochistan and Sindh provinces following the floods with the objective to reduce diarrhoea-related deaths among children under five by training healthcare providers in diarrhoea management and distributing zinc and LO-ORS doses through health facilities. The cost-effective solution can prevent up to 93% of diarrhoea-related deaths.

“Previously, children under five were exclusively treated with oral rehydration solutions sachets containing antibiotics at health facilities,” explains Dr. Abdul Hameed, District Health Officer of Lasbela. “However, this training proved to be highly advantageous for our healthcare providers, as it enlightened them about the importance of incorporating LO-ORS along with zinc in the treatment, resulting in a quicker recovery for children as compared to the previous approach.”

A group of health workers listen during a training on the use of zinc and LO-ORS to treat childhood diarrhoea in Pakistan.
Over 150 health workers received training across six districts to treat childhood diarrhoea with a co-package of zinc and LO-ORS.

Sobia’s recovery is a testament to the project’s impact and is directly related to the training of health workers and the availability of zinc and LO-ORS co-packs. Kulsoom Hassan, a women medical technician based in a basic health unit in Jam Yousafabad, Lasbela participated in one of the trainings. The session covered everything from recognizing danger signs of diarrhoea to the importance of zinc supplementation combined with LO-ORS, exclusive breastfeeding, good nutrition and water, sanitation and hygiene practices.

Kulsoom (left) receives a certificate after participating in training to effectively treat childhood diarrhoea.

Kulsoom serves 20 to 25 patients daily, primarily women and children from the neighbouring areas and says she found the training to be incredibly useful. “Due to this particular project, I have learned about the importance of zinc combined with LO-ORS in diarrhoea management among children under five. I will convey the same key message to peers, patients and other community individuals.”

Nutrition International and the local governments have distributed 214,525 co-packs, containing one zinc syrup, three LO-ORS sachets and a leaflet with critical information for caregivers, to prevent and treat childhood diarrhoea. Over 150 healthcare staff have also received training on diarrhoea management.

“I lack the words to adequately convey my gratitude to all of you for preserving my child’s life,” Sobia’s mom Mah Pari shared after her daughter’s recovery. “The Balochistan Rural Support Program with the support of Nutrition International is doing a very great job to serve children under five in the area.”

Nutrition International, with funding from Comic Relief US, has helped to ensure children impacted by the disaster receive this critical nutrition intervention. By working together, we can ensure that stories like Sobia’s and those of healthcare workers like Kulsoom become the norm and not the exception.

For the last 30 years, Nutrition International has been working together with national and provincial governments to enhance access to essential micronutrients through supplementation and fortification to improve health of women and children in Pakistan and around the world. Learn more about our work to prevent childhood deaths from diarrhoea.