Bitter Pills:Medicines & The Third World Poor | Page 118

There are contrasting views on why injections are so popular. An OXFAM researcher
writes from Upper Volta that injections are widely used. "This is a characteristic
feature of Voltaique medical practice and the reasons seem complex. Originally
injections were introduced by French doctors and probably became entirely
associated with the new Western medicine. Pills, liquid, or ointments were similar
to traditional medicine, while the needle was a complete novelty..." (IOI) In Africa
as a whole from the 1950s the eradication of yaws by the use of injectable penicillin
is reported to have made a deep and lasting impression. (l02)
By contrast, Dr. Hassani in North Yemen attributes the popularity of injections
to the traditional belief, common to most societies, that anything that makes you
better must hurt. In Yemen treatments administered by traditional cuppers and
burners can be very painful. Dr. Hassani explains that many of his patients insist
on having injections of calcium gluconate. These can, and should, be given slowly
and painlessly. But if he gives the injection correctly the patients complain that they
have been cheated because they could not feel the 'difference'. So in Yemen doctors
and drug sellers inject calcium fast. As another doctor points out - this practice
can kill.<103)
The Yemenis' addiction to injections carries other unsuspected dangers, as a doctor
working in a remote, mountainous area explains: "Many hormone injections and
vitamin injections are given for 'gawi' (strength). These drugs are not known to
be effective and in some cases are positively dangerous. Many a time we have seen
a hormone preparation given to a woman because of a delayed period. The doctor
had not examined her and in fact, often it was a brother, father or husband who
had brought it to her. No one could read to see that one of the contra-indications
was early pregnancy!" (KM)
A recent report by the Institute of Development Studies in Britain on health services
in rural Ghana showed that some health centres give injections to over 80% of
patients. The over-use of chloroquine injections in particular was rampant. They
were routinely given to adults who complained of fever but were not in a serious
condition. These patients could have been treated with antimalarial tablets for a
fraction the cost of the injections. Unnecessary injections can cost more than money.
Young children routinely injected with chloroquine were needlessly exposed to the
risk of sudden death from absorbing the drug too fast. "05)
Because the Ghanaian clinics gave so many injections, they were always short of
syringes. So disposable syringes had to be rinsed out and reused. In some health
units one needle was used for more than 20 patients.(106) Few untrained injection
givers have any notion that if they hit the sciatic nerve, they can paralyse their patient's
leg, or that an unsterile needle can cause painful abcesses or serum heptatitis. They
are not aware that a dirty syringe can kill.
Manufacturers must be aware of the dangers, for back-room injections are routine
and in some Third World countries it is a common sight for ordinary people to
be buying syringes and vials for home injections. In Bangladesh Fisons' subsidiary
has produced an instruction leaflet in Bengali on how to give an injection safely
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