Abdulhakeem F. Akinola
5 October 2008
Lagos — If one looks around Lagos, the city is densely populated, no doubt. But a large number of the estimated 18 million population in the megacity cannot afford to pay for drugs prescribed by medical doctors. For this reason, they patronize quack drug sellers and illiterate chemist shop operators who make good returns from their investment.
Not many people are aware of the dangers of self-medication, but they are aware of the need to take drugs. An opinion by this writer in Lagos shows that the numbers of people who patronize chemist shops almost doubles that of those who consult medical doctors, either at government or private hospitals.
A large number of persons in the densely populated Lagos do not consult doctors when they take ill. Rather, they consult chemist and purchase drugs they prescribed for themselves.
The situation is becoming worrisome because everyone in Lagos household thinks he or she is a medical authority. In line with this practice, it is not surprising that the number of chemist shops and drug hawkers in the state has increased in recent times.
Unlike what operates in Lagos, the implementation of drug control in developed countries, particularly in Europe and the USA, demands that every citizen should have a personal physician. In these countries, even among the "poor" countries of the developed world, a patient cannot buy drugs across the counter without a doctor's description. This is because the law on drug control is strict. However in Lagos and other parts of the country, Nigerians often purchase so many unprescribed drugs across chemist counter, in the commercial buses, from health workers and the likes.
This characteristic is dictated by many factors, according to Mrs. Nahimat Oladeinde, an auxiliary nurse working with a private hospital in Ikeja. She explained that the orientation in the society is as a reaction to the failure of three tiers of government to provide adequate healthcare services.
In Lagos, a number of proprietary drugs are sold over the counter at chemist shops that are manned by virtually illiterates who believed they were trading. Some of the drugs that could be obtained without stress at chemist shops in Lagos are pain relievers, cough remedies, anti-allergic, various vitamins, various tonics, antacids, laxatives and several others. It was discovered further that sensitive drugs like antibiotics are procured across counter without a valid prescription.
Speaking on the hazards of self-medication, Dr. Dapo Ololade of Lagos State University Teaching Hospital (LASUTH) warned that there are some drugs that could be harmful to the body if consumed without prescription. "There are some drugs that are harmful if patients do not take medical advice before using them. If misused, they could have adverse effects on the patient. That is drug abuse and from abuse the patient becomes addicted to it," he said.
In his contribution, Dr. Oyewunmi Nathaniel of Alalade Hospital, Agege, Lagos said the causes of self-medication among people of Lagos is multifaceted. "The principal thing is that there is no regulation. There are some drugs that are called over-the-counter. These are the drugs you can buy over the counter and there are some that you need to have a doctor's prescription before you buy. Unfortunately, most of the chemists in this city and pharmacists shops around do sell both types of drug," he said.
Dr. Nathaniel added that the government does not help the situation. He explained that in most of developed countries, if it is prescription drug, a patient cannot get it across the counter at a chemist even if he or she is dying in the presence of the chemist. The doctor stressed further that all over the country, the law guiding drug sales is not enforced as it ought to be. He gave kudos to the National Agency for Food, Drug Administration and Control (NAFDAC) activities to eradicate the menace of fake drugs in the country, but argued that a lot still needed to be done regarding drug abuse and fake drugs in the country.
Again, Dr. Nathaniel pointed at the poverty level in the country as one major factor why people are running away from hospital. "People look at it that if they must go to hospital, they would need to obtain card that could cost N200, N500 and N1, 000, depending on the hospital. Sometimes, a patient may be required to pay consultation fee. So, people think it is economical to go to nearby chemist and buy drugs rather than go to a hospital to 'waste scarce resources.'
Dr. Nathaniel said, however, that there is need to educate people on the dangers of self-medication. But on its part, government should make hospitals affordable and friendly to the people. Drugs should be supplied at nil cost, and the culture of medical tests should be encouraged.
"Healthcare delivery should be made accessible in terms of location and affordability. Medical facilities should also be provided. With all these in place, we shall surely avert self-medication among our people," he assured.
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