Use Medicines Wisely
BY AWAKE! CORRESPONDENT IN NIGERIA
THE woman complained that she had a headache and a pain in her stomach. The doctor spoke with her briefly. He then prescribed a three-day course of injections for malaria, paracetamol (acetaminophen) to stop the headache, two drugs to ease what may have been a stomach ulcer, tranquilizers for her anxiety, and finally, for good measure, a course of multivitamins. The bill was expensive, but the woman did not object. She left happy, confident that the drugs would solve her problems.
Such consultations are not unusual in West Africa. A survey in one large nation there showed that health-care workers in public health centers prescribe an average of 3.8 different drugs per patient per visit. To many people, in fact, a good doctor is one who prescribes plenty of medicine.
Perhaps the West African confidence in medicine is understandable when you consider what the health situation used to be. Over 40 years ago, author John Gunther wrote about earlier times: “This Slave Coast not only . . . killed blacks; it killed whites too, and is the part of Africa known to legend as the ‘White Man’s Grave.’ The undisputed king of the Guinea Coast was, for centuries, the mosquito. Yellow fever, blackwater fever, malaria, were this king’s chosen and malign weapons. The sinister deadliness of the West Coast climate is not a matter of remote record, but a living memory. A favorite anecdote describes the consular officer who, not too long ago, found himself assigned to Nigeria and asked about his pension. ‘Pension?’ his chief in the Colonial Office replied. ‘My dear fellow, nobody who goes to Nigeria ever lives long enough to be retired.’”
Times have changed. Today, there are drugs to combat not just the diseases spread by mosquitoes but many other diseases as well. Vaccines alone have dramatically reduced the death toll from measles, whooping cough, tetanus, and diphtheria. Thanks to vaccines, smallpox has been wiped out. Polio too may soon be a disease of the past.
Little wonder that many Africans today have a profound faith in the value of medicine. Of course, such faith is not limited to West Africa. In the United States, doctors write more than 55 billion prescriptions every year. In France people buy an average of 50 boxes of pills each year. And in Japan the average person spends over $400 (U.S.) annually on medical drugs.
Benefits Versus Risks
Modern drugs have done much to help humanity. When used correctly, they promote good health, but when used incorrectly, they can injure and even kill. In the United States, for example, about 300,000 people are hospitalized each year because of adverse reactions to medical drugs, and 18,000 die.
To use drugs wisely, it is important to recognize that there is always an element of risk. Any drug, even aspirin, can cause harmful side effects. The likelihood of side effects is greater if you take several drugs simultaneously. Food and drink also influence how a drug works in your body and can intensify or neutralize its effect.
There are other risks. You may have an allergic reaction to a certain drug. If you do not take drugs as prescribed—the right dose for the right length of time—they probably will not help you and can even harm you. The same result may occur if your doctor prescribes the wrong drug or unnecessary drugs. You also risk harm if you take expired, substandard, or fake drugs.
To minimize the risks, you should know as much as possible about any drug that you take. You can benefit greatly by knowing the facts.
Antibiotics—Strengths and Weaknesses
Since their development about 50 years ago, antibiotics have saved the lives of millions of people. They have subdued dreadful diseases, such as leprosy, tuberculosis, pneumonia, scarlet fever, and syphilis. They also play a key role in the healing of other infections.
Dr. Stuart Levy, professor of medicine at Tufts University Medical School in the United States, said: “[Antibiotics] have revolutionized medicine. They are the single agent that has most altered medical history.” Says another medical authority: “They are the cornerstone on which modern medicine is built.”
However, before you rush to your doctor and ask for a supply, consider the down side. Antibiotics, when used improperly, can do you more harm than good. This is because antibiotics work by attacking and destroying bacteria in the body. But they do not always destroy all the harmful bacteria; certain strains of bacteria withstand the attack. These resistant strains not only survive but multiply and pass from person to person.
Penicillin, for example, was once highly effective in knocking out infection. Now, partly because of increasingly resistant strains of bacteria, drug companies market several hundred different varieties of penicillin.
What can you do to avoid problems? If you really need antibiotics, make sure they are prescribed by a qualified doctor and are obtained from a legitimate source. Do not pressure your doctor into quickly prescribing antibiotics—he or she may want you to have lab tests to make sure that the one prescribed is the right one for your illness.
It is also important for you to take the right dose for the right length of time. You should take the entire course of antibiotics, even if you feel better before it is finished.
Are Injections Better Than Tablets?
“I want an injection!” These words are heard by many health workers in developing countries. The basis for such a request is the belief that the medication is injected directly into the bloodstream and provides a more powerful cure than do tablets or pills. In some countries it is common to see unlicensed ‘injection doctors’ at markets.
Injections carry risks that pills and tablets do not. If the needle is not clean, the patient can be infected with hepatitis, tetanus, and even AIDS. A dirty needle can also cause a painful abscess. Dangers are increased if the injection is given by an unqualified person.
If you really need an injection, make sure it is administered by someone who is medically qualified. For your protection, always make sure that both needle and syringe are sterile.
Fake Drugs
The global pharmaceutical industry is big business, bringing in about $170 billion (U.S.) each year, according to the World Health Organization (WHO). Eager to exploit the situation, unscrupulous people have produced counterfeit medicine. Counterfeit drugs look like genuine drugs—so do their labels and packages—but they are worthless.
While fake medicines are everywhere, they are particularly common in the developing world, and they bring tragic consequences. In Nigeria, 109 children died of kidney failure after swallowing painkilling syrup containing industrial solvent. In Mexico, burn victims suffered raging skin infections from supposed remedies that contained sawdust, coffee, and dirt. In Burma, scores of villagers may have died of malaria as a result of taking a fake drug that did not fight malarial fever. “The most at risk,” states WHO, “are, once again, the poorest, who sometimes think it is a good bargain when they buy what seems to be an efficient medicine produced by a respectable company.”
How can you protect yourself from fake drugs? Make sure that what you buy is from a reputable source, such as a hospital pharmacy. Do not buy from street peddlers. A pharmacist in Benin City, Nigeria, warns: “To street dealers, selling drugs is just a business. They dispense drugs as though they were sweets or biscuits. The drugs they peddle are often outdated or fake. These people don’t know anything about the drugs they are selling.”
The Problem of Poverty
The medical treatment that a person receives is often determined by how much money he has. To cut costs and save time, people in developing countries may bypass the doctor and go directly to the pharmacy to buy drugs that by law require a prescription. Because they have used the drug before or because friends recommend it, they know what they want for their illness. But what they want may not be what they need.
People try to cut costs in other ways too. A doctor has a lab test done and prescribes a certain medicine. The patient carries the prescription to the pharmacy but finds the cost is high. So rather than looking for extra money, people will often purchase a cheaper drug or buy only some of the medicine prescribed.
Do You Really Need Medication?
If you really need medicine, find out what you are taking. Do not feel embarrassed to ask the doctor or the pharmacist questions about the drug prescribed. You have a right to know. After all, it’s your body that may suffer.
If you do not use your medication correctly, you may not get well. You need to know how much to take, when to take it, and how long to take it. You also need to know what foods, drinks, and other medicines or activities to avoid when taking it. And you need to be aware of possible side effects and what to do if they occur.
Keep in mind, too, that drugs do not provide the answer to every medical problem. You may not need drugs at all. World Health magazine, a WHO publication, states: “Only use a medicine when it is needed. Rest, good food and lots to drink are often enough to help a person get better.”
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“A thousand ills require a thousand cures,” wrote a Roman poet some 2,000 years ago. Today, the poet might have written, ‘A thousand ills require a thousand pills’! Indeed, there seems to be a pill for almost every ill, real or imagined. According to the World Bank, worldwide there are about 100,000 kinds of drugs, made from more than 5,000 active substances.
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The Sensible Use of Medication
1. Do not use outdated drugs.
2. Buy from a reputable source. Do not buy from street peddlers.
3. Make sure you understand and follow the instructions.
4. Don’t use drugs prescribed for another person.
5. Don’t insist on injections. Drugs taken by mouth often work just as well.
6. Keep medicines in a cool place, out of the reach of children.