If you have used public bus transport from Kampala to Kabale in Uganda, during day hours, you must have experienced some ‘doctors’ selling medicines in buses. In the words of my today’s seat mate, ‘Those basaawo (Local for Doctors) are looking for survival’ by selling health care services to the general public. Usually, these ‘doctors’ seem to have a PhD in their job! Most often, they start with an opening prayer, so they catch the attention of Ugandan’s whose country’s motto is ‘For God and My Country’:-the implementation of the effectiveness of the country’s motto is a different course unit which I shall keep for future blog posts. Immediately after praying, the ‘doctor’ introduces his package in a number of local dialects ie Luganda and Runyankole. Even, they initiate what my former health economics lecturer used to call ‘Impulse buying’ by encouraging clients (passengers) to touch and read the labels on the medicines ‘at no extra cost’. All the medicines are sold at nearly half price compared to clinical prices for example, China tea is sold at 10,000Ugx compared to 20,000Ugx clinical price, the same can be said of panadols, stress relievers etc. Interestingly, some ‘doctors’ sell prescriptive medicines like Coartem which are lacking in local health centres. There’re bloody lots of questions you might ask yourself:
Where do these medicines come from?
Who monitors or even employs these ‘doctors’? etc
We know that the National Drug Policy and Authority Act 1993, Act, Cap. 206 resounds the major role of the body as a regulatory body responsible for regulation of drugs in the country. It ensures the availability at all times of essential, efficacious and cost effective drugs to the entire population of Uganda as a means of providing satisfactory health care and safeguarding the appropriate use of drugs. Ensuring availability and effectiveness of essential medicines also includes monitoring the hand that gives them, no? I think yes. But again, these ‘doctors’ don’t have an NDA identity cards and the public cant easily trace who gave them a certain medicine if it brings adverse effects.
A study by W.O. Erhun (2001) on establishing the factors that have contributed to the preponderance of counterfeit drugs in Nigeria despite the laws found out that drug laws were adequate falling short only in their implementation with the the task forces rated as ineffective thanks to corruption, communication gaps, lack of adequate funds, and lack of vehicles. Would this be any different in Uganda? While we cant only blame it on the government all the time and we go away with it. This #GovernmentiEtuyambe Syndrome needs to be diluted(Government should help us), local Ugandan’s should show some care to ask ‘Who the hell is this guy anyway?’ We all know that health promotion campaigns in Uganda are not consistent, but we have always been told that when you fall sick, see a health professional, and as hell has it, such professionals are in health centres NOT in buses!
The success of these ‘doctors’ is attributed to the poor health seeking of local Ugandan’s who think every headache needs an Aspirin, every bad stomach needs charcoal tablets:- it’s a curative trend which can only be rectified by a stronger focus on building a stronger culture of public health focusing on prevention. –I know the phamaceutical industry wants my head for that, but they know the facts. Is it possible that the Ministry of Health can get these ‘doctors’ to conduct health promotion on dental hygiene, maternal and child health, road safety etc while in the buses instead of selling medicines?
It’s strange that these ‘doctors’ have continued to conduct this activity and nothing is done. What’s even funnier, they board the buses at Police check in stops,and I suppose, the police could have asked them if they went to medical school to deliver such kind of work. But again, I think the police sees that as the job of the ministry, and the ministry sees that as some one else’s job?
© Views expressed herein do not represent those of my current and future employers, but rather myself. Phot credits © Brian Bilal MK, Shared without permission from the ‘doctor’