Bitter Pills:Medicines & The Third World Poor | Page 99

YOU GET SICK, YOU BUY MEDICINE
People everywhere share a need to believe in the healing powers of someone or
something. Most of us will readily believe in the power of a drug and in this there
is little difference between an educated Westerner and a poor, illiterate man or
woman. All medicines, whether traditional herbal remedies or modern factoryproduced drugs, have a special mystique.
In the eyes of the poor, modern medicines embody the power and status of the
well-fed, Westernised people who are powerful in their societies. This encourages
the poor to try to emulate the small minority who consume most of the medicines,
in the same way as more and more poor people buy expensive factory goods like
tinned foods and fizzy drinks.
Prevention may be better than cure. But prevention takes time. The poor need
a quick solution to their health problems. Drugs hold out the promise of an instant
cure. They tempt people with the illusion that there is a pill for every ill, provided
you can afford to pay for it. In turning to local drug sellers for help, the poor
may also be swayed by their status in the community. They may be literate and
seem very knowledgeable. All these factors leave the poor and sick extremely
vulnerable to sales pressures and to dangers from the actual drugs that neither
they, nor the medicine sellers suspect.
A doctor working in North Yemen explains how people increasingly depend on
buying medicines to solve ill-health problems: "Yemenis have come to want, indeed
to feel they need what they perceive as Western medicine. This means for most
of them Western medicines, simply because drugs, attractively packaged and
efficiently marketed, are the only aspect of Western health care they have any
experience of. With the emerging demand for medicines from the West, there
has been no growing awareness of modern concepts of health and disease. The
rudimentary principles of hygiene, nutrition and sanitation are practically
unknown. The train of thought for both the patient and the practitioner is simply
- you get sick, you see a doctor, nurse or pharmacist, he prescribes a medicine
(or more often several medicines, at least one of which should be an injection)
and you are made well again." (2)
The problem is not just the lack of organised health services. Health planners
and doctors are responsible for encouraging dependence on medicines, as David
Werner, author of Where There is no Doctor, explains: "In Latin America, many
of the new programs under the Ministry of Health, Ministry of Education, and
other agencies to deliver services and promote community health in rural and
marginal areas have been designed by prestigious but poorly informed and outof-date doctors and nurses. The result is that training and manuals for village
health workers still tend to promote bottle feeding rather than breast feeding,
restricting food to children with diarrhoea, and overuse and misuse of medication
like Entero-Vioform, cough syrups, diarrhoeal plugs, etc." (3)
The widespread promotion of modern drugs has had a decidedly negative impact
on some poor communities. An anthropologist, analysing the situation in Central
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