Bitter Pills:Medicines & The Third World Poor | Page 136

Solutions have been proposed to make the scheme pay for itself and these now
await approval by the Nepalese health authorities. The major change proposed
is that the prescription fee should be replaced by a charge for each item prescribed.
A drug manual has been prepared to help prevent over-prescribing and misuse
of antibiotics. Items on the list considered disproportionately expensive will in
future be available only at cost price. Measures are proposed to stop repeat
prescriptions being given free to patients who are not chronically sick and a daily
charge for in-patients is proposed.
If the Bhojpur Drug Scheme can be made economically viable and remain
acceptable to patients and health workers, it could be more widely adopted
throughout Nepal. But the major concern of all involved is to ensure that the
scheme continues to make treatment accessible the whole population - especially
the poorest. <27)

VILLAGE THEATRE IN MEXICO
Nothing can be done to stop poor people wasting money on medicines that are
arguably useless or potentially harmful, unless they can be convinced that 'wonder
drugs' are not all they may seem. It is all the more necessary to make the poor
aware of the problems in countries where medicines are widely promoted over
the radio, as happens in Mexico.
In the mountainous state of Sinaloa, Project Piaxtla aims to involve the campesinos
(farmworkers) and their families in helping set up their own health care network.
As part of the project's educational work, the village health team in Ajoya found
an imaginative and entertaining way of using health festivals to get their message
across. They helped to organise improvised theatre skits to draw local people into
identifying with 'real life' situations at the same time as stimulating their awareness
of the issues. David Werner, author of Where There is no Doctor and director
of Project Piaxtla, explains: "We have come to believe strongly that education
and awareness- raising is essential to the process of demystification and sensible
use of medications." (28)
The health workers in Ajoya performed one sketch aimed at opening people's
eyes to the overuse and misuse of medicines. The following is David Werner's
translation of the health workers' play, which conveys something of the universal
experience of the Third World poor: (29)
It is nearly dawn. The rooster crows: "Cock-a-doodle-doo."
(The rooster is actually a health worker in costume). The old man
and his wife stir in bed, as they usually wake up early in the
morning. Beside the bed is an enormous 'radio' with a sign that
reads 'Radio Deception'. Hidden inside the radio is an actor.
Old Dona Luisa turns on the radio. There are the sounds of
country music. Then the voice from the radio says: "Good
morning to you all. The last song was dedicated to Juanita Torres
in Ajoya, Sinaloa. And now before we play more country
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