Bitter Pills:Medicines & The Third World Poor | Page 24

As the flood water recedes, hookworm and roundworm thrive in the moist soil
where people must squat to defecate. The skies are beginning to clear as the
monsoon is nearly over. But every so often a sudden downpour leaves the villagers
soaked to the skin as they work on, rebuildi ng the mud walls of their homes.
Adults and children look thin and weak from intestinal parasites and repeated
bouts of diarrhoea. Many of the youngest children have pot bellies from the
combined effects of malnutrition and heavy worm infestations. The eyes of those
worst affected are dull and dry-looking. At night they stumble in the dark, showing
the first obvious signs of nutritional blindness. Those who survive may have their
eyesight damaged for life. Respiratory illnesses are common, and there are serious
pneumonia and TB cases.
What both children and adults obviously need is more food and a healthy
environment. The prospects of any far-reaching changes are remote. Even with
the necessary resources and the political will, the process of improving health will
take time. But the islanders could benefit from preventive health measures and
a few key drugs could make the difference between life and death for some.
Antibacterial and antituberculous drugs, deworming pills and some vaccines could
all make an immediate impact on the islanders' health.
There are four government-paid health workers on the island. But people see little
point in going to find them. They have no drugs. There is also a small drug
dispensary, but its annual drugs allocation, worth Taka 5,000 (about £138), is
hopelessly inadequate to cater for the needs of 12,000 people. Not only is the
allocation meagre at little more than lp a head, but supplies are so erratic that
the dispensary only has stocks for a few months of the year. Most of the time
its shelves are empty and the doors locked.
The island has no private pharmacy, but some traders do sell high-priced drugs
to those who can spare the cash to buy them. Medicines are an impossible luxury
for the poorest families,who spend about three-quarters of their income on food.'''
Across the water, there is a government health centre where medicines are
distributed free. But the poor have neither the time nor the money to pay for the
crossing and then make the 6-mile trek to the centre. They might queue for hours
only to find that the dispensary has run out of the drug they require. So the poor
are forced to treat illness as a fact of life and carry on regardless. They may not
go for help until the problem is serious. All too often, by the time they go for
treatment, it is too late.
The situation of the islanders is not unique. Throughout Asia, Africa and Latin
America, millions of the world's poor have no means of obtaining medicines to
help relieve suffering, or cure illness.(2) This is because the world distribution of
medicines is like that of most commodities. It is dependent on purchasing power,
not need. The rich take a disproportionate slice of the pharmaceutical cake, leaving
the poor with the crumbs.
Nineteen of the world's richest industrialised countries (with a combined
population of 684 millions) consumed 58% of drugs on the world market in 1976.
17