08. Community oral rehydration points
- Early access to oral rehydration solution (ORS) saves lives.
- When a cholera epidemic occurs (or large numbers of people need rehydration, for example after displacement), the National Society should set up community oral rehydration points (ORP).
- ORPs provide rehydration solution quickly, provide screening and referral for sick people, and can act as a central information hub.
|What you need to know|
|An ORP provides the first level of treatment of cholera and improves access to ORS at community level. ORPs are extremely important in areas where access to health facilities is difficult or where the high number of cases is overwhelming health services. As the first level of care, ORPs should be planned elements of a comprehensive clinical pathway that includes cholera treatment units (CTUs) and cholera treatment centres (CTCs).|
Key points for volunteers to remember if they look after a community ORP
- Use only boiled or purified water. If the water is unsafe, treat it first with water purification tablets.
- Do not put more ORS than recommended in boiled or purified water.
- Keep buckets covered to protect the mixture against contamination by flies, etc.
- If you still have some ORS mixture left at the end of the day, dispose of it safely!
- Distribute ORS to patients but also arrange referrals or visits to the patients by a health professional. This should be done urgently if the person shows any evidence of dehydration.
- Use the latex gloves provided when you are in contact with patients, their stools or vomit.
- Remember: Wash your hands regularly! Early and prompt treatment can prevent death from cholera in most cases! Use a clean latrine! Make sure drinking water is treated and free from germs!
- Initiate early treatment of mild and moderate cases of dehydration by distributing ORS and zinc when appropriate. (See Action tools Preparing oral rehydration solution (ORS), Giving oral rehydration solution (ORS), Zinc supplementation.)
- Distribute key commodities, such as ORS, soap and household water treatment supplies.
- Refer severe or at risk cases to health facilities for treatment. (See Action tool Referral to health facilities.)
- Act as a community-based disease surveillance point, ensuring that all suspected cases are recorded. (See Action tool Community-based surveillance.)
- Are a key reference point for behaviour change and social mobilization activities. (See Action tool Social mobilization and behaviour change.)
- Distribute zinc supplements (if approved). (See Action tool Zinc supplementation.)
A community ORP kit available from IFRC contains the items listed below. (Kits that are procured and made locally should have similar contents.)
ORP kit contents
|1||Container, 20 litres, with two candle water filters|
|1||Notebook, A5 hard cover|
|5||Pen, ball point blue|
|10||Cup, plastic, 200 ml, without handle|
|10||Cup, plastic, 500 ml, without handle|
|20||Spoon, plastic, 20 ml|
|1||Jug, plastic, 1 litre with beak and handle|
|1||Plastic casing, ceramic filter (fairey)|
|1||Bucket, plastic, 14 litres, with clip cover and outlet tap (Oxfam type)|
|2||Jerry can, foldable, 10 litres, food grade plastic, screw cap 50 mm|
|6||Soap, body soap, 100 gr piece|
|12||Chlorine, 40 mg (nadcc 67mg), for 10 litres water, strip of 10 tabs|
|30||Pur ® 4gm sachets (1 sachet for 10 litres of water)|
|3||Syringe, 10 ml, 2 parts, disposable|
|1||Flag, Red Cross Red Crescent, 0.8 x 1.2 metres|
|2||Tabard/bib, Red Cross Red Crescent, 40 x 40 cm|
|1||Gloves, examination, nitryl, non-sterile, medium (7-8), box of 100 pieces|
|2||Gloves, for washing dishes, rubber, pair, size medium|
|1||Spoon, wooden, for stirring, 30 cm|
|1||Rope, nylon, diameter 3 mm, braided, 5 metres|
|1||Brush, hand scrubbing brush|
ORS, zinc and chlorine for disinfection are not included in the kit and need to be added.
Shade, access to water and a latrine are also important and should be included when selecting the location of the ORP point.