By Dr. Tilak S. Fernando Courtesy Ceylon Today

Only when something comes up in print or exposed on television, people who have been affected by the highlighted topic(s) will emerge out of their shells to either join public protests or respond with their type of experiences (as feedbacks). The Saturday Column on 11 March, in Ceylon Today, on “Bogus Pharmacists galore” managed to bring out mind-blowing responses from various members of the public with their own personal experiences; some even with good advice to improve the pathetic situation of bogus pharmacies where the health of innocent and naïve people has been affected by wrong medicine given by unqualified ‘pharmacists.’

‘Ananda’ from the US commented: “Thank you for bringing this issue of unlicensed pharmacists to light, for it exposes the health of the people of the country to great danger and uncontrolled abuse of many drugs, which can be used as narcotics by drug addicts. In addition to enforcement of licensing and oversight requirements, the entire pharmacy system should be computerized nationwide. Each prescription should be dispensed together with written information on use and the hazards of misuse, and each patient provided a verbal consultation by a licensed pharmacist if the medicine is a prescription new to the patient. Control of stock and the daily sales journal maintained by each pharmacy should be part of that computer database. Such a system would not only safeguard the health of the patient, but would contribute to reducing drug use by addicts, and enable bulk buying by the government to deliver the lowest possible price and highest possible quality to patients. However, I must say this: Most medicines are much cheaper in Sri Lanka than in the United States, which is a boon for our citizens in Sri Lanka (sic).

Fowl scratches

Kingsley Wijesinghe came out with an exceptionally vibrant and appropriate suggestion pointing a finger at some of the doctors who write prescriptions akin to ‘fowl scratches,’ which are highly illegible. “Unqualified pharmacists sometimes incorrectly fill such prescriptions. Why do doctors have to write prescriptions in virtually illegible squiggles, which can lead to genuine mistakes even by qualified pharmacists”?

He cited an incidence where his friend’s mother died having taken the drug ‘Peritol’, (an anti-histamine) given by a pharmacist, whereas the doctor’s prescription had been ‘Peritrate”, coronary vasodilator, which dilates blood vessels. The death of course was debatable but it could well be attributed to the pharmacist’s erroneous reading of doctor’s prescription, not being one hundred per cent legible. With that comes his question as to “why can’t the Sri Lanka Medical Council or the Ministry of Health or whatever the appropriate authority concerned, make it mandatory for prescriptions to be written in block capitals, so that such mistakes do not occur?

Computerization

This suggestion blends one hundred per cent with Ananda’s idea where “the entire pharmacy system should be computerized nationwide,” but just by computerisation of pharmacies alone could not be the one and only answer to overcome this debacle.

Because it would then be much easier for any cashier to refer to the computer and issue the drug where qualified pharmacists presence become less imperative. The ideal solution would be for drug inspectors to regularly visit pharmacies throughout the country on spot checks and to effectively carry out investigations.

Whereas, in the case of “fowl scratches” on prescriptions, the ideal solution to overcome this obstacle would be to emulate GPs and the government hospital model in the UK, where prescriptions pop out of a printer once the medical officer taps on the keyboard of his computer.

With the help of advanced technology, tailor-made computer data packages, designed exclusively for doctors, are available in the UK. Such programmes help the medical officers to record patients’ health history into the database where at the touch of a finger, patients’ whole medical history will be on the screen. In the UK everyone has to be registered with a GP in the area. The British law stipulates that any patient visiting a GP three consecutive times with the same complaint should be referred to a specialist hospital. In such instances a referral is given to patients and the hospital after treatment writes back to the GP concerned so that the patients databases could be updated.

Wrong drug

‘Sanath’ from Thalawatugoda came out with two episodes where he experienced from a pharmacy in Kadugannawa .The “pharmacist” had given him the wrong drug that nearly killed his grandmother. The owner of this particular pharmacy is allegedly working at the Kandy hospital, and his presence at his pharmacy is limited; apparently during his off times from work only. The insincerity of the occurrence was compounded when Sanath brought this incident to the notice of the licence holder of the pharmacy (owner), where his reaction to the problem had only been a derisive grin. Sanath seems to believe that many a complaint by several others, akin to his grievance, has fallen on deaf ears.

A local resident received Betadine Antiseptic Liquid, by a cashier working in a pharmacy, used for cuts and abrasions, when actually his request had been for Betadine Germicide Gargle for sore throat and mouth sores. With the presence of mind the patient managed to read the label on the bottle before use, and rushed back and complained, but the response from the pharmacy was only a pathetic ‘ sorry.’

Grin and bear

Ben Simon in Moratuwa, who had been working in the UN, Geneva, wrote to say: “What do we do rather than to read articles like yours and grin and bear? We are blessed by God to experience and develop our own patience and compassion. As both my wife and I are heart patients, we know how much of medicine we gulp down every day at exorbitant costs, just to survive another day. We continue to do so, with or without knowing whether the pharmacist is qualified or not. Yet, are we not naïve or reluctant, unlike someone like you, to ask whether the pharmacist is qualified? Having read your article, I made a few copies to give to the owners of two or three pharmacies we patronize, so that they could make sure they employ qualified pharmacists and save our souls for a few years more.

tilakfernando@gmail.com