2012 wrote:I remember when we were kids one packet of medicine syrup or tablet is what we got. Now when I take my kid or I go to hospital myself, I leave with a manila paperbag full. Kenchic uses a smaller paper to pack a meal. What happened? Did immunity increase or medicine got weaker or more money is made this way?
Misuse is the problem. My dad tells me that when piriton tablets first appeared in the market, adults would get a dose of only half a tablet and even then, staying awake was an uphill problem. Today, I've seen fellows who claim even two aren't enough to knock them down.
Secondly, some of what you get is actually just placebos that you can comfortably do without, a good example being cough syrups. Do a small experiment: note some of the contents of these cough syrups and look them up. You'll be shocked to find some that combine antitussives and expectorants in the same formulation, which sort of beats the purpose.
Thirdly, as someone has alluded up there, the financial motive has, unfortunately, infiltrated the sector. A couple of factors and examples here:
- patient insistence. How often have you heard of cases of patients insisting to the clinician to give them a certain medication? Happens quite commonly actually. To this day, we still have folks who believe that kama hawajadungwa sindano basi hawajatibiwa. I tell you, it's an uphill task trying to convince such a person that injections are only reserved for emergencies or for medicines that only come in injectable form.
- I have a pal who used to locum in one of the top pediatric hospitals in Nbi. He once told me a story of a young kid who happened to fall down in their house while playing with siblings and sprained his arm. Kid was literally escorted to hospital by the entire clan including grandparents. The minute they got to hospital, they demanded all sorts of tests including an MRI, yet clinician could clearly see this was a simple sprain deserving of just a crepe bandage and some rest. And you know what? If you hesitate, you're threatened with all sorts of consequences.
- another clinician tells me of a story he experienced today. Due to the anthrax scare that happened in Embu county, he happened to receive a patient who apparently claimed to have bought meat from one of them guys. Upon examination and lab tests, she seemed ok and in no need of medication. It proved so difficult to convince her of that fact that eventually he caved in and prescribed a totally unnecessary antibiotic.
reminds me of the numerous times it has proved nigh impossible to convince patients that they do not need any medication.
- another aspect that comes in here is the issue of cost. Back in the day when doing my internship, I recall this guy who walked in and obviously needed a simple antibiotic for his chest infection. At the time, a 5-day course of Cotrimoxazole (what you know as Septrin, a cheap but effective antibiotic) would cost about 50 - 100 bob depending on brand. But the clinician at the time ended up prescribing a rather expensive antibiotic (I forget which one exactly) that cost the patient about 500/=. Upon enquiry, it turned out that most patients didn't value cheap drugs and that most tended to associate cheap drugs with poor quality. I was dumbfounded!!
Fourthly, I have observed over time that a significant number of Kenyans have a very casual approach towards their health. Often times, you see a guy with a simple, treatable ailment who delays in seeking medical attention in good time and by the time they finally make their way to hospital, a simple thing that'd have been treated easily has complicated into something else requiring multiple drug therapy over a long period. A good example is a simple URTI which if left unattended morphs into a LRTI.
And finally, I've recently followed up n some cases brought to light of how some HMOs huko kwa kina @Kiash that apparently deny patients essential care and treatment ostensibly to save the company cash, some even rewarding employees who issue or authorize such denials.
Life is like playing a violin solo in public and learning the instrument as one goes on.