“It wasn’t a single moment,” she recalls. “It was years of seeing children with diarrhea getting worse instead of better. Parents would proudly say they’d given ORS — but when I checked, it was a high-sugar drink called ORSL. That’s when I realized something was dangerously wrong.”
Connecting the dots between misleading labels and worsening cases, she began collecting samples and evidence. “I asked parents to bring what they had used. Seeing the bottles and reading the labels — that’s how I understood the depth of the problem.”
Her journey from observation to action was steeped in resistance. “At first, I just spoke to parents. Later, I started creating awareness on social media,” she says. “One company rep once told me they’d ‘give me a chance to speak’ at a conference — after that, silence. I kept writing to regulators. The CDSCO told me they hadn’t approved such products and directed me to the FSSAI. So I wrote to the Health Ministry too.”
In April 2022, her persistence paid off — the FSSAI ordered that non-compliant products must remove “ORS” from their labels. “It felt like a victory,” she says. “But in July, the order was revised — companies with valid trademarks could keep using the term, provided they added a disclaimer saying, ‘This is not an ORS as per WHO formula.’ It was frustrating, but still a step forward.”
The lack of institutional support made the journey lonelier. “Some doctors supported me quietly, but most were indifferent. The association I belonged to didn’t back me — some even accepted sponsorships from the very companies I was questioning,” she says. “There were times I felt crushed. But giving up wasn’t an option — I owed it to the children.”
Her fight continues, now focused on public education. “People think anything labeled ORS is safe — it’s not. Only WHO-recommended formula qualifies,” she stresses. “A 4-gram sachet must be mixed with 200 ml water, and a 20-gram one with 1 liter, used within 24 hours. Even a small mistake can harm.”
For Dr Sivaranjini, this victory is deeply personal. “After all these years,” she says, “it feels gratifying to know that truth, persistence, and purpose can still make a difference — one label at a time.
After an eight-year struggle, pediatrician Dr Sivaranjini finally saw justice when the FSSAI ruled that no brand can use the term “Oral Rehydration Salts (ORS)” unless it strictly follows WHO standards. Her quiet crusade began in hospital wards — and ended up changing national health policy
