Bitter Pills:Medicines & The Third World Poor | Page 124

CHAPTER 8

TRAIL-BLAZERS
Small-scale Solutions
POOR PEOPLE suffer most ill health, but benefit least from modern health care
and life-saving drugs. The Third World market is flooded with unnecessary and
overpriced medicines which poor people make great sacrifices to buy, unaware
that their uncontrolled use is wasteful and dangerous. That is our diagnosis of
the problems.
Before identifying some of the policy options open to Third World governments
in tackling these problems, we shall focus now on what is being achieved nearer
the grass-roots. Some of the small-scale projects we shall describe are acting as
trail-blazers for programmes now being adopted on a national scale. OXFAM's
involvement with these and many other health projects, has taught us about the
problems the poor confront. Watching the progress of these projects over some
years, and learning from friends and colleagues in the villages, we have seen that
improvements can be achieved with persistence. But we also have been forced
to the realisation that some of the more intractable problems for the Third World
poor cannot be tackled locally. In the case of medicines, action must also be taken
in the rich drug-producing nations, where many of the market pressures originate.

GONOSHASTHAYA KENDRA
One of the most exciting projects in which OXFAM participates is Gonoshasthaya
Kendra (the People's Health Centre) in Savar, a rural district about twenty miles
from the capital of Bangladesh. (l) The project was set up in 1972 by
Dr. Zafrullah Chowdhury and a group of medical colleagues who had worked
together treating casualties and refugees during the country's struggle for
independence in 1971. Their first objective was to set up community-based health
services for the 200,000 people living in the villages of Savar.
From the outset the emphasis was on prevention. The team at Gonoshasthaya
Kendra were committed to stopping their centre from becoming nothing more
than "community disease centre". (2) They became increasingly aware that health
care alone could do little to improve health without an attack on poverty. So the
scope of the project was extended to include schemes for agricultural credit, literacy
and vocational training. Both the wide range of community development work
at Gonoshasthaya Kendra and the project's bold new initiative in establishing
a modern drug factory are important because, by themselves, attempts to improve
the supply of essential drugs could have little impact on health.
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