Poor Healthcare and Bad medical practices in Somalia
The drugs are essential to the ailing health of patients if prescribed by certified physicians; handled by pharmacists and instructions of its use followed strictly, this is the case of a place where the rule of law exists and is upheld. However, there is more important thing than that: the drug and food administration which is designed to ensure the safety of the products such as medicine; food, this organization plays a pivotal role of examining locally produced food as well as the imported one, the medical test carried on the drug is very significant to make sure whether a drug is usable for human treatment,
If the drug-controlling and medical ethic enforcement agency is not functioning for one reason or the other; consequently, those doctors who are morally corrupt would not care about the health of the people compounded by the doctor's greed to get rich overnight, then the drugs are no longer a remedy, but lethal.
This is the case of Somalia. Somalia has enough woes from war to famine over-reported; nevertheless, the ongoing horrible atrocities committed by the people who are trained to save lives are ignored by the media.
The motive behind the deliberate massacring of patients is obvious; it's motivated by excessive abnormal material desire. The prescription of one's stock list as street market without diagnosis to boost the drug-store sales turnover is un-doctorly and immoral! Its has been perpetuated for some time now, in spite of that, it was mystery until was exposed to the public by institutionalized corruption of the so-called medical professionals, not one of the doctors ever arrested. I will talk about the two characteristics unknown to the outside world: unethical conduct of the Somali medical community as well as the so- call medicine imports from the Indian subcontinent.
In the latest statistics by nationmaster.com in 1997 the number of physicians are 0 .04 per 1000. The ratio is even higher than that. The Economist dated September 2, 2010 "... studies of anti-infective treatments in Africa and South East Asia have found that perhaps 15-30% are fakes, the UN estimates that roughly half of anti- malarial drugs sold in Africa - worth some $438m a year are counterfeits ", besides blundering accumulated coins from the pockets of impoverished society, the risk the counterfeits pose to the unfortunates is beyond the imagination of human mind! Almost every doctor living in Somalia who exploits victims hold degrees in medicine, none of them ever specializes. Despite of all that, they make a lot of money twice as much as doctors in Easten Africa. They take advantage of the chaotic situation in the country.
The doctors portray themselves as moral medical professionals, but in fact, they abuse the profession which is the one of the most respected fields in the world, each one owns and runs chain of pharmacies of his own! Making his children work as pharmacists without training!, therefore, drug-related diseases count at least half of the Somali deaths at the moment. I saw hundreds of cases where patients caught unfamiliar illnesses in the pre-conflict Somalia like dental cancer, unusual overgrowth in uterus, throat cancer and etc. people here are about to say Shamba's proverb " deception, deception, that's medicine" I am quoting East African doctors book by John Liffe. This slaughter by people who are to having suppose to be having high moral values is degenerating in everyone's eyes, restoration of confidence will take many years
The corruption is everywhere, the worst unimaginable form is preventing pregnant women to deliver babies in Public hospital administered by WHO or local administration such as Somaliland until she pay bribery or " facilitating money" to a doctor on duty. The theft of WHO medical aid including state-of-art equipment is frequent, such as sophisticated device is sold to private sector or smuggled to neighboring countries.
When doctors were asked why are they doing this to their people because this unwarranted cruelty towards the patient no matter local or foreign is unacceptable in accordance with medical standards, they gave lame excuses " the fraudulent activities are in all layers of society, import firms bring inedible food to the country , this is not confined to our field" they said. Their answer is true to some extent, rotten, expired food is everywhere, but that does not justify their brutality, they are trained to save lives not to butcher. Their greediness has triggered many quacks to join and now they are working next to few honorable exceptions which stick to the code of conduct such as Adna Maternity hospital; and Dr Gaboose, Italian trained neurologist, any way, there is no rule and regulation in Somalia, furthermore, the poorly self-trained lab technicians often give false result like "you are HIV positive" consequently, many patients have lost sanity realizing how taboo the disease is; indiscrimination and social segregation is flooded with anyone suspected with STD illness, some of these patient traveled all the way to Addis Ababa ,Ethiopia, but none of them ever diagnosed with such diseases. Mistaken diagnosis had psychological impact for the rest of their lives.
Drug-stores with overstocked medicine cabinets line both sides of the rough roads in Hargiesa run by amateurs are good examples of how far the four-fold profit criminalized industry had gone, its popular destination by both sick and healthy ones who were developed culture of drug consumption, they are addicted to it. Cardiovascular drugs are within the reach of children. Let alone adults, all you need is just one go. No prescription is required at the all , , nobody knows the risks associated with drugs.
Do you know a town where drug-stores outnumber food-stuff shops? Are there entire sick dwellers in one city?, Hargiesa, capital city in Somaliland, is struggling with drug-stores, with population less than a million, the figure of pharmacies is certainly higher than that of Addis Ababa with population over six million or so.
The hard-earned money sent by coolies in the industrialized countries is wasted by greedy doctors; so-called businessmen or women. The bulk of the cash goes to First World War One dilapidated factories which operate in Pakistani tribal area, in my judgment, beyond the government control.
Drug trader by the name of Mumin. Somali national from Mogadishu, is sole, exclusive importer of Pakistani zero quality drugs to Somalia. He is millionaire who profiteered from the vulnerability of his people; currently stays in luxurious hotels of Karachi. I do know the entry points of Somalia including sea and air ports are inspection free, anything can be easily imported without going through checkpoints since no functioning government, again I am quite aware the unethical business people take advantage of this critical situation, charlatans jumped on to bandwagon of opportunists, nonetheless, I did not decipher which ports in Pakistan these toxic substances passed through?, are there ports which are beyond the control of government? its seems unlikely, moreover, the drugs usually imported to Somalia did not passed through quality control, yet expired; re-stamped with new date that seem ok,, drugs are not medically valid because they are made of toxic material that harm human being or at least does not help cure the illness.
Sleeping bills are used as marijuana in substitute of hard drugs since alcohol is either expensive beyong the range of ordinary citizens or ban is in place.
This is far from over, new drug-store start-ups are daily realities for obvious reasons, its easiest business to establish in Somalia, no need pharmacist's degree or anything as such, its highest profit line of trade ever since central government of Somalia collapsed.
To sum up, these over prescribed drugs pose threat to the public health of millions of Somalis stuck inside, the over marketing of zero quality medicine to anarchic people jeopardize the existence of the very few people who survived war; famine, the concerned authorities including WHO should check sources of Somali main drug supply, and monitor at least to mitigate the magnitude of the health disaster.
By Abdirahman Mohammed Dirye, Adis Ababa, Ethiopia