After living in Lesotho for almost a year, I have experienced two cases of overprescribed medication and agree with the results of a new study that shows that:
“Doctors in sub-Sahara Africa generally prescribe more drugs than the number recommended by the World Health Organization.” published in the BMC Public Health Journal,
I have experienced two cases of individuals who were given 4-5 medications, and one injection for:
1). A cold
The seventeen-year-old daughter of my host family during Peace Corps training woke up with a cough, and what appeared to me to be the common cold. She did not want to miss school so on her way, she stopped at one of the new clinics built by American donor funding, and was given five plastic bags of different medications, including an antibiotic, plus one injection.
The following day, I asked her if she felt better, and she said, “No.”
I asked her if she saw a doctor, and she replied, “There are no doctors at the clinic.”
2). Allergies/Hay fever
A fourteen-year-old girl at my school could not keep her eyes open during my English class. She said she had allergies and both eyes were swollen with tears streaming down her cheeks. She used her sleeve to wipe them away.
I could tell she was in pain, and asked if she had medicine to take.
“Yes, teacher,” she said. “The clinic gave me an injection and four medicines.”
“Aren’t they helping?”
“No teacher.”
“Come with me and I’ll give you some drops to clean your eyes.”
“Thank you teacher.”
She told me she lived with her grandma, and as I held onto her elbow so she wouldn’t trip over the rocks, I wondered if she was an orphan.
“Here put on my sunglasses.”
She could barely open her eyes, and I wasn’t sure whether to speak to her, or to remain quiet during our fifteen-minute walk home.
Inside my rondavel, I told her to lean back on my pillows so I could place a few drops of “Refresh tears” into her eyes, to flush out any pollen, or other irritant.
She didn’t seem to feel better, so I gave the special Milky Way bar I’d been saving for when I needed to give someone a treat. As with all children at my school, they rarely get candy, so she nibbled it so it would last.
She sat on my couch looking miserable. I found my Peace Corps medical kit wondering if I had any medication for allergies. I’d forgotten I had antihistamines, and was so happy to give her a few pills. She took one, trusting me completely, and after twenty minutes or so, her eyes were dry. They still hurt, but she wanted me to show her my photos on my laptop. I was so happy to make her feel better.
3). High blood pressure
I visited a beautiful clinic built with American donor funding. I was invited to speak to the nurses, even while they were attending to patients.
A woman needed her blood pressure checked to renew her medication, and the nurse told me:
“The blood pressure cuff doesn’t work; the batteries are dead.”
“Don’t you have a manual one?” I asked.
“No.”
At least fifteen patients lined up for their small plastic bags of pills, which are then put into a brown paper bag. When I asked my host mother if the person counting the pills was a pharmacist, she replied,
“No. She just helps.”
I listen to BBC World News daily, and on August 22nd, 2016, (Scroll down) they talked about the study published in the BMC Public Health Journal, which stated:
“A new study has found that doctors in sub-Sahara Africa generally prescribe more drugs than the number recommended by the World Health Organization.
The study, published in the BMC Public Health Journal, reveals that a patient seeking treatment in the region is likely to be asked to take more medicine than they should ideally be given leading to misuse or overuse of drugs.
The researchers also found that half the time, one is likely to be given an antibiotic, often, without being tested.”
From the three examples I’ve come across, this is happening in Lesotho, and as far as the clinics I’ve visited, there are no doctors, only nurses, and the one time I saw the woman dispensing medication, she was not a qualified pharmacist.
This is a huge problem as far as I can see, not only in terms of a waste of “free” medication, but also dangerous to the patients, in terms of adverse effects.
Carol says
September 19, 2016 at 8:01 amThe medical situation you’ve described must be very hard to bear, I wonder how you find the strength to live with it. Did the Peace Corps training prepare you for all this?
Sonia Marsh says
September 19, 2016 at 11:12 amNo, but the Peace Corps takes care of our health so we don’t have to worry about too many prescriptions. It just seems like a waste of medicine provided by WHO for free, plus there are adverse effects when combining all these drugs.
Carol says
September 19, 2016 at 12:31 pmFortunately for you, but to see those children getting such bad medical treatment must be unbearable…
Khethang says
September 20, 2016 at 11:45 amThere is a big problem in LESOTHO, me and my colleague went to a Doctor last week I had flu. He gave me four packets of pills one of them antibiotic and an injection, after three days of taking the medication, I had dizziness in my head I returned to the Doctor., He said its not caused by medicine but by high blood pressure, he gave me other medication but still no change. My colleague has the same problem of dizziness also, Iam now confused! May someone help please!
Florina says
September 20, 2016 at 3:57 pmIt is a serious problem,
Ian Mathie says
September 20, 2016 at 3:22 amAll over Africa one can buy prescription medicines over the counter, often in bulk. It has ever been thus. Now, with the evil trade in fake medicines that has proliferated because of the internet, this problem has become far worse.
In many African countries, health care assistants used to be trained t deal with just a few specific problems. The idea was drawn from the Chinese ‘barefoot doctors’ programme and, within its original scope, worked vquite well at managing the most common complaints Anything more serious was supposed to be referred to a fully qualified medical professional.
Sadly, over time, individual health care assistants have tried to do more than they were qualified for – usually under pressure from sick relatives demanding help for their families and exploiting the cultural pressures that African society imposes. Others, less scrupulous, and probably motivated by personal gain or prestige, just reached a little bit further, extending the envelope of what the drugs they were permitted to use could deal with, ascribing properties that were untrue to some medicines, and so defeating the real benefits of the basic system.
So now you find this system of indiscriminate doling out of drugs, often for problems for which they are unsuited or even dangerous. The donor agencies who provide the drugs do little or nothing to check how they are being used, trusting the local authorities to do this reliably and consistently when they are incapable of doing so.
It all comes down to the total mismanagement of foreign aid. Private donors need to be far more careful about what they provide and how it is distributed, particularly when it involved medicine.
Suellen Zima says
September 24, 2016 at 11:47 pmThe over-prescribing is also true in the U.S. And people everywhere are all too ready to pop any medication into their mouths. It’s a world-wide problem. Very depressing.