Bitter Pills:Medicines & The Third World Poor | Page 8

INTRODUCTION
AS THE BOAT drew into the shore we heard a strange sound from the bank.
A woman was crying. We found her with a dead baby in her arms and a collection
of medicine bottles beside her. She had spent all her money on these expensive
drugs. She could not understand why they had not saved her baby. This
Bangladeshi woman had never been told what was obvious to the doctor who found
her. The baby had become severely dehydrated from diarrhoea. Her death could
have been prevented with a simple home-made solution of water, salt and sugar.
No amount of medicine could have kept her alive.
People in remote mountain villages in North Yemen are cut off from the country's
very limited health services concentrated in the towns. Drug pedlars, known locally
as 'health men', have a ready market. They sell a wide range of sophisticated drugs
which can have harmful side-effects. Most of these medicines can only be obtained
on a doctor's prescription in Europe and North America. Some have even been
taken off the market in rich countries because the possible risks outweigh their
benefits. But in Yemen the drug sellers are unaware of the hazards or how the
drugs should be used. Most have acquired their training working as hospital
cleaners, or behind the counter in a drug store.
On open market stalls in Upper Volta red and yellow capsules of antibiotics are
displayed for sale alongside equally colourful sweets. Poor people buy just one
or two capsules at a time to treat themselves. They have no idea that antibiotics
are not fully effective unless you take a complete course, or that tetracycline, left
out in the heat and humidity, can become toxic. But the main hazard from the
uncontrolled use of antibiotics is that bacteria build up resistance to drugs. A poor
community can find itself with no alternatives to the drugs that no longer work.
In 1980 governments and aid agencies allover the world responded to the plight
of the Kampuchean people by rushing in a mass of drugs they had well-meaningly
scrambled together. But this jumble of medicines, labelled in dozens of different
languages, created chaos. In the absence of a team of multilingual pharmacists
to sift through them, many potentially useful and useless drugs alike had to be
discarded.
Throughout Asia, Africa and Latin America millions of the poorest have no access
to life-saving drugs. But drugs are wasted and misused worldwide. In poor
countries those that are most needed are often the hardest to obtain, at least at
prices the poor can afford. Where the need is for a limited selection of priority
drugs at low prices, manufacturers and retailers come under commercial pressure
to sell a mass of