Appetite for money increased. Its all about that medical card you carry with you while at it.

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.

As Doc Rankaz13 said up there, most citizens are casual about their health. So when you bring your child to hospital, this is the time to slip them a vitamin D supplement to prevent against rickets, an albendazole syrup to flush those worms out, some multivitamins to take care of any deficiencies, etcetera etcetera.

Docs in private hospitals have targets to meet. Say KES 100,000 a day. If they don't, they are declared redundant. So they have to send you to the Labs or Radiography for unnecessary tests or the Pharmacy for meds you do not actually need.

Let food be thy medicine. Otherwise you are just helping a doctor meet their targets and/or sating an assumption (ati patients don't value cheap medicine) ABK

Woe? it was my biggest joy esp if it was the only tab.

In my whole life,I have never finished a 'dose'.
Injection fine,tabs are a NO NO. Even if you prescribe tabs they will end up expiring.

Haki those were the days.
injuries gotten from playing football were treated by a heavy beating and a strong dose of hot salted water.

Later we graduated to gee vee (hated that stuff it made your scar crack)

halafu baadaye kumwaga antibiotic capsule powder on the wound haki ya mama.

I remember it resulted in us hiding our injuries from our mum to avoid the beating and salted water.

But the colds and coughs were the ones
we dreaded going to the local dispensary for treatment.
Shindano to us little kids was a thing to be feared.
In those days the prefered method of treatment was injection straight to the buttocks.

you should have seen us.
walking to the dispensary playful while at the same fearful of the injection.
Long queues of sick children surprising running around, playing with each other.
As far as i could tell grown ups never seemed to get sick.
Then the roll call to know your ultimate destination this was after seeing the doctor.

Roll call
Mwangi, otieno, koech, Amina, kwa dawa shouts the nurse.
- unakuja na chupa
- pimiwa dawa.
- go
that was a relief.

roll call ojwang,ngilu,zuleka kwa injection the nurse announces remorselessly.
knees begin to shake
voices break
we plea for mercy,
we enter the room and watch as those huge brass/copper syringes boil in water.
They were a sight to behold.
I wish i could get pictures of them.
we used to think that the dispensary were using syringes made for injecting cows or donkeys not humans
we could not believe humans had created such cruel instruments to torture us.

Then the struggle begins.
pulling by the shirt collar and ears by our mother as we enter the injection room,
slap behind the head,
bend over
strip the short
PAP! SHINDANO
Ndiyo hiyo nduuuuuuuru!!!!!
uuuuuuwwwweeeeeeiiiiii


up today i have hated hospitals and i do not understated how drug addicts stick needles in their bodies and eat pills for breakfast.

I even fight for my kids right to acquire natural immunity for common ailments,
but that is a battle i lost compliments of the mother.
MUTOTO KOHOA- MUTOTO HOSIPITAL
MUTOTO GONGWA MUTOTO HOSIPITAL

Now we have a cabinet full of drugs.
we call it the chemist.

Maybe the symptoms changed

Food is the best medicine. A good meal, well balanced and cooked, and a healthy lifestyle should keep the doctor away. Problem is, most of our meals are poisonous.

What do you mean? Let's start at http://mobile.nytimes.co...-years.html?from=science