Editor's Comment

Drug shortages: Who should patients blame?

LOOKING frail and tired, a nine-year-old girl leans on her mother, as scores of other patients wait to receive medical treatment at Lusaka’s Kanyama clinic.
The clinic is fully packed with people seeking medical attention for different ailments.
Some have been here since 06:00 hours in the morning in an effort to beat long queues.
It is difficult to know what time they will receive treatment as the clinic has only one doctor.
For the nine-year-old girl, who has come to the clinic with her mother, Martha Namwinga, the waiting seems like eternity.
When she unexpectedly developed a fever, her mother rushed her to the clinic. After thorough examination by medical personnel, her mother was told that she had malaria.
She had high temperature coupled with vomiting and diarrhoea. The doctor recommended that Ms Namwinga’s daughter be put on a drip. Unfortunately, the clinic had run out of the intravenous (IV) bag.
Ms Namwinga was instead given a prescription to buy the IV bag from a named drug store in town.
“I never expected that the clinic would ask me to go and buy the IV bag from a drug store. I was a bit skeptical about going out into an illegal drug store to buy the IV bag. But after assurances from the medical personnel and looking at the condition of my daughter, I was left with no choice but to go and buy the item,” Ms Namwinga said.
However, Ms Namwinga wonders why people should pay for medical services at the clinic as well as buy IV bags when such things should be readily available at the clinic.
“I can understand a prescription to go and buy panado or cough mixture, not an IV bag. Government should quickly do something about this situation because I suspect some medical personnel just want us to buy these things from their drug stores. That is the reason people are being directed to go and buy from there,” she said.
And Joseph Mapulanga, a diabetic patient, said investigations should be conducted at the clinic to establish why people are told to buy medicines and other materials, which are always in short supply despite Government stocking them in clinics.
Mr Mapulanga accused medical personnel at the clinic of stealing medical supplies, meant for patients.
“Investigations must be carried out because these are the same people directing us where to get these IV bags and other medicines,” he said.
His concerns were echoed by John Phiri of Matero Township. After being diagnosed with a sexually transmitted disease (STD), the medical personnel at Matero referral clinic gave him a prescription to buy the medication from a drug store in Matero market.
“I had a burning sensation on my private parts for weeks; initially I had opted for self-treatment after consulting a physician at a drug store at the market. Unfortunately, the medication did not help. I then decided to seek advice from the medical professionals at Matero Clinic, only to be told there was no medicine. Ironically, they instructed me to go and buy from the same drug store. Apparently, the medicines there are genuine,” Mr Phiri said.
Mr Phiri said many of his friends and relatives have also in the recent past been directed to the same pharmacy because Matero Clinic has had constant shortages of medication.
“We come to the clinic for adequate medical assistance but you can even see for yourself that we are hardly given the drugs.Government says the health centres have been fully supplied with drugs but are usually given only paracetamols,” Mr Phiri said.
Mr Phiri said it does not make sense for people to pay for medical services which are not available.
Another resident, Veronica Miti, said she had the same experiance when she took her brother to Matero referral clinic for medical attention.
She said her brother had been complaining of a stomachache, body pains and constant headaches.
“My brother was put on a drip but a prescription was given, because there was no medicine. This is not fair because Government supplies medicines in all public health institutions but what we get when we come here are prescriptions,” she said.
And Joseph Manda said after 50 years of independence, the people deserve better services.
“Government, through the Ministry of Health, should address the current problems being faced in most clinics,” he said.
However, during an on-the-spot check by the Sunday Mail, some health workers at Matero clinic, who spoke on condition of anonymity, admitted that the clinic frequently experiences shortages of drugs.
The health workers refuted claims that they sell medicines meant for patients to drug stores as a way of earning an extra income.
“When drugs are procured, they don’t cover the time frame due to the increasing number of patients. Sometimes, management contributes to shortages of drugs because they take long to procure these drugs. And one thing people should realise is that Matero Clinic caters for a wide catchment area. There is nothing sinister about drug shortages,” they said.
The Zambia Medical Association (ZMA) is aware of the numerous reports about drug shortages in many clinics.
ZMA president Aaron Mujajati said reports of shortages of medical drugs needed to provide clinical care in all health institutions  have continued reaching his office.
Dr Mujajati attributed the erratic supply of drugs at the clinic to inconsistency between Ministry of Health (MoH) and Medical Stores Limited (MSL) in effectively carrying out their mandates.
“Many health centres in the country have been having the same problem, various items needed for providing medical care in health centres are missing in most parts of the country,” he said.
Dr Mujajati said many tertiary health institutions in the country such as the University Teaching Hospital (UTH) are lacking adequate medical supplies despite the statements by MoH and MSL that the institutions have all the needed supplies.
“My office has been receiving reports about medical shortages from health workers themselves.We know what is really happening on the ground.It is not right to paint a picture of things going well when they are not, we are dealing with human life. We need to work together with Government to find a lasting and conclusive solution,” he said.
But when contacted, permanent secretary in the Ministry of Health Davy Chikamata said the ministry has procured enough drugs to be used in clinics and hospitals in Lusaka.
Dr Chikamata said the distribution of the medical drugs is done by MSL.
“I don’t understand why there are drug shortages because my ministry has procured enough drugs, including essential drugs. But I will investigate the matter with MSL personally,” he said.
Dr Chikamata said he recently had a meeting with MSL concerning drug shortages at the University Teaching Hospital (UTH) and stated that MSL has opted to deploy one of its officers at UTH to monitor the dispatch of drugs at the institution.

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