Richard Cash: my friend and mentor

Richard Alan Cash, a senior faculty of the Harvard School of Public Health has just passed away in Boston, USA. He and I have been friends for over four decades and have worked together in Bangladesh and many other parts of the world. I was fortunate to co-author with him many books and articles on global development, particularly those related to public health. Richard had an eternal tie with Bangladesh. In him we lost a selfless ambassador. In 1971, he mobilized international support and advocated for US support for our independence. As a recognition of his contributions, he was given the 'Friends of Liberation War' medal by the Bangladesh government. I felt deeply honoured when I received the award on his behalf from the then Prime Minister.

Richard was born in 1941 in the state of Wisconsin in USA where he had his early education. He studied medicine at the New York University School of Medicine and completed a higher degree in public health from Johns Hopkins University. His first assignment as a doctor was in Dhaka where he worked as a medical officer at the erstwhile Cholera Research Laboratory (now icddrb) in 1966-69. His Dhaka assignment was monumental in pursuing his own excellence and contributing to the world of medical science. Working closely with David Nalin, Majid Molla, Rafiqul Islam and others, he carried out multiple research studies both in Dhaka and Matlab in the late 1960s that led to the perfection of oral rehydration therapy (ORT) as the treatment of choice for diarrhoeal dehydration. The discovery of ORT had a tremendous impact on child survival globally. Lancet, the prestigious medical journal, called it the 'most significant medical advance of the century'.  Although its background work was carried out in Bangladesh, the fruits of ORT were not made available to the common citizens until BRAC took the onerous task of teaching every mother in the country on how to prepare ORT at home with salt and sugar – the lobon-gur solution. Because of this daunting work and the subsequent marketing of the solution by various agencies and companies, Bangladesh now has the highest use rate of ORT in the world – over 80% of diarrhoea episodes are now treated with some forms of ORT! Richard and his colleagues will be remembered for saving millions of lives every year around the world through the use of the magic solution. As a recognition of this contribution, he received many awards including the prestigious Prince Mahidol Award in Thailand in 2006.

I first met Richard in late 1979. He was conducting a course at icddrb. I just had returned after my MSc in demography at the London School of Economics. At that time BRAC had started a pilot programme to develop a model for teaching ORT at household level. We at BRAC decided to expose him to the pilot project in Habiganj and solicit his advice on going forward. Abed bhai (Sir Fazle Hasan Abed) asked me to accompany him. For me, it was a golden opportunity to meet and get acquainted with a Harvard professor, a kind of a dream for a young professional. We spent three days in the field together visiting different villages. He was impressed with both the way the project was being implemented and my own engagement with it in improving the delivery of the intervention. Afterwards we became good friends and remained so until his last days. The last time I met him was in June of this year when Sadia Chowdhury (formerly of BRAC and World Bank) and I visited him in a rehab centre in Boston. He was so happy to see us and reminisced many memories of us together. We were not surprised to see the Dean of the Harvard School of Public Health in her visit feeding soup to Richard as a show of care and respect for her senior faculty.

He was a great friend of BRAC and of its founder Sir Abed. When we decided to launch a School of Public Health, he was there to help us take it forward. I remember our preparatory trip to Hanoi to study how their School of Public Health was practicing 'problem-based learning' which we wanted to imitate. Hanoi was one of the few schools of public health in the world where the Rockefeller Foundation-supported 'schools of public health without walls' model was being tried. We learned how the concept was being implemented in the Vietnamese context and the challenges it was facing. We came up with the conclusion that we needed to do much more in getting the community involved in the teaching than the Hanoi experience was able to do. Such learning helped in the development of the James P Grant School of Public Health develop as an effective model practicing community-based problem-based learning. We couldn't perhaps do it without Richard and several of our other friends. Until his last day he was an adjunct professor teaching at least two courses including the Epidemiology of Infectious Diseases. He was one of the most popular and successful teachers in our School. Everyone at the School is at a shock learning of his passing away.

In my year at Harvard in early nineties as a McArthur fellow, Richard was a daily friend for me and my family. He used to invite us frequently for a meal or for a trip to a tourist spot. He would also visit us when I was doing my doctoral work in London in mid-1980s. We have saved a picture where he was holding my son Wameq in his lap, trying to teach him the alphabet. While at Harvard, Richard and I started writing the book, "A Simple Solution" (published by University Press in 1996), which documented the decade-long experience of the BRAC ORT programme. The book, which has been reprinted several times, has earned world-wide attention and appreciation, and is taught in many universities globally. I have had the good fortune to co-author with him numerous articles and books. He was a great copy-editor too. I would send many of my writings for him to edit which he always did with deep interest.

He was a great support throughout my professional career. In the 1980s, Richard was the Director of a large USAID-funded project titled ADDR (Applied Diarrheal Disease Research), based at Harvard. Through this, academics in low-income countries received grants to do research on practical aspects related to diarrhoeal diseases. Richard asked me to oversee one of such researches which was awarded to a group of academics at Thailand's Khon Kaen University. I spent several days at Khon Kaen working with the researchers on its implementation. We worked collegially and the researchers were very happy. They wrote to Richard commending me and my assistance. This made Richard very happy too. He would mention this story many times to many people as an example of South-to-South learning.

One of his unfulfilled desires was to read my memoir. As it was in Bangla he wanted me to translate it but I feel bad that the English version couldn't be completed before he left us forever. Richard has left us and I feel a great void around me. My heartfelt sympathy to his lovely wife Stella Dupuis, sisters Kathy and Ellen and to numerous friends and well-wishers who are spread all over the world who, I am sure, are equally saddened. The world has lost a great human being; it will never be the same again. May his soul rests in eternal peace.

The author is former Vice Chair of BRAC and founding Dean of the Brac University James P Grant School of Public Health.