Health

Call the Doctor

Farhana Urmee

Extending her left hand over the counter Sheuly gives the salesman a shabby 500 taka note, perhaps all that she had, and insists that the salesman gives her the medicine she needs to heal the wound on her right hand. A needle has pierced her finger and she needs three stitches. Sheuly, a garment worker, is in a hurry to get better, as she says, "Her hands are what bring home the money." She tells the man at the counter to look at her wound closely. She needs a powerful medicine, she says.

Sheuly does not seem to feel the necessity to see a doctor before having a powerful (an antibiotic of 500mg instead of 250mg) medicine. Without further ado, she swallows the pill, and the people at the drugstore do not care much about checking prescription while selling medicines. While dealing with people like Sheuly, poor and deprived of health-care-service, employees in drugstores often play at being doctors.

Druggists at the counter, often without proper training and education on the specific field, mess up with different types of medicines; some of them might not have any idea about the right dose or, worst still, they do not know the consequences of selling the wrong medicine to their clients.

It has become a common practice nowadays for people with a physical problem to go to a drugstore and a get medicine without even seeing any doctor. Photo: zahedul i khan

It has become a common practice nowadays for people with a physical problem to go to a drugstore and a get medicine without even seeing any doctor. From the drugstores' end as well, they do not mind selling medicines just like any other commodity. “But in developed countries, every drugstore has A-grade pharmacists at work. Whereas, in our country it is difficult to ensure the presence of a C-grade pharmacist in all the drug stores,” says Prof Dr Abul Hasnat, Department of Clinical Pharmacy and Pharmacology, Dhaka University. He also says that 85-88 percent drugs are sold and consumed in our country without prescription. Only over the counter drugs, drugs having fewer side effects, can be sold without a proper prescription, and, that too, after consulting with a trained pharmacist, he observes.

Drugs (Control) Ordinance, 1982 makes it mandatory for every drugstore to get a licence from the government. Again, the drug stores must have a trained pharmacist registered with the Pharmacy Council of Bangladesh. “But many of the drugstores have hardly any trained pharmacist to provide medicines. In some cases, most of the employees who work at drugstores are selling drugs on the basis of mere assumptions,” says Md Emrul Hossain, Assistant Registrar, National Institute of Kidney Diseases and Urology.

The statistics is both surprising and scary: according to a study done by Department of Pharmaceutical Technology of Dhaka University, in 2008 only 82,000 of total 25 lakh drug stores in the country have a licence. Again, only 56,000 registered pharmacists are working in the licensed stores, says the Directorate General of Drug Administration.

Only a doctor can detect a disease and is authorised to prescribe a particular medicine, observes Emrul Hossain, adding that there are tendencies among common people to try to solve their problems-- even for diseases like headache, joint pain, gastric, in many case, bacterial infection as well-- by selecting random medicines, and seek suggestions from friends or relatives or just drop by a drug store and get some pills with the help of 'pseudo-pharmacists'. “I might prescribe an antibiotic for an 18-year-old boy and the same medicine might not be effective for his friend as every person's body function, immune system, and of course the intensity of infection will not be the some. Then how can any one decide his/her own medicine without seeing a doctor?” Emrul says.

He says that after randomly selecting a medicine, some people also skip another essential thing: "When people are picking their antibiotic without a doctor's prescription, they tend to carry on taking the medicine till a wound is healed. The moment they discover that the wound is healed, they just stop taking the antibiotic. Such practice is utterly harmful for health. Stopping an antibiotic in the middle of the course makes one's body loose its resistance power and the antibiotic may not work anymore. Again, frequent taking of pain-killers harm one's liver, kidney and digestive system in the long run"

For people like Sheuly, who will go to any roadside drugstore and get a pill to cure the malaise, it is merely because the country's healthcare service has still remained expensive. The government can take the initiative of regulating the drugstores who sell drugs without a prescription, observes Dr Abul Hasnat. So, be it sleeping pills, stimulants, pain killers, or even cough syrup, see a doctor before you take any medicine, for doing otherwise might kill you.