BETWEEN CHEAP CHINESE FAKE DRUGS AND NIGERIAN HAWKING PHARMACISTS!

By Yakubu Ozohu-Suleiman On the streets, by the roadsides, inside commercial buses, at the bus stop, even at traffic junctions, drug hawking is increasingly becoming a popular trade in Nigeria. Whether or not one is educated up to the secondary school level, he can become a Pharmacist and/or Doctor, provided he knows that Panadol cures headache. Health matters are supposed to be considered crucial and handled with utmost care. A science student who wishes to read pharmacy or medicine is cautioned on the rigors of the course, and he has to sit tight and read very well to gain admission to the university in Nigeria. The reason is not farfetched - one is going to be dealing with human life. Medical students often find it necessary to bury their heads in the library; else they stand the chances of wasting lives upon graduation. Today in Nigeria, things are different. There are very few trained Doctors and pharmacists, but an army of them are seen practicing! The fact is that the law permits a businessman who may not necessarily possess even the primary school certificate to own and operate a pharmaceutical store. This is done with careless disregard to the same law, which says that such a person must employ a qualified pharmacist who would carry out dispensary works. Chemists are owned by illiterates who prescribe and dispense drugs. A qualified pharmacist is not necessarily one who is trained and certified by the appropriate professional body, but one who has had years of experience as a ward attendant in the hospital, or as an errand boy in a chemist shop. These categories of persons are employed or even own shops as pharmacist, and they could prescribe drugs, administer injections on people and even carry out surgical operations! In the true sense of their titles as Doctors, they are respected and highly patronized. But even worse than the above, is the present disposition of taking prescription and dispensaries to the streets. Once the general public observed the permissiveness of the government on this matter, everybody simply took to drug hawking. In every city today, people carry drugs in waste baskets, and walk around the streets looking for those who are sick or injured to treat. Drugs are now displayed and sold on bare roadside in the same fashion as used clothes, popularly known as Okirika are sold in the markets. The entire strength of the sun bears down on drugs that ordinarily should not be exposed to the direct sunray. The dust that accompanies vehicle and human settles on the drugs which, a pedestrian can equally walk upon by mistake. And like shoes displayed on a platform, the drugs are cleaned of dust with rags by the hawkers who are eager to make a sale. In Lagos, Kaduna, Kano, Enugu and all major cities of the country, drug hawking is prevalent. There are those who carry these drugs side by side with cobblers and tailors from places to places. There are equally those who board long passenger truck popularly known as Molue which travels all over the country. The latter category identifies themselves as Mobile Advertisers. According to them, they are just sales agents. They assist pharmaceutical companies to advertise drugs. Inside commercial buses, the mobile advertisers are addressed as Doctors. In an encounter with one of them who refuse to disclose his name, we gathered that the first qualifying factor to be a mobile advertiser is your ability to talk at great length and convince people. You must be fluent in Pidgin English, and should have a fair knowledge of some local languages. This is to communication with the ignorant people whom one is going to deal with.

Some key strategies are employed, and the first of these is price reduction. The second is religion; the third has to do with the tendency for majority of people to avoid consulting qualified Doctors and physicians on their health problems for the fear of consultancy charges and protocols. All these strategies are working well for the drug hawkers. In fact the way they are patronized clearly reveals how ill-informed the Nigerian public is on health matters. When the drug hawker enters the Molue, they begin with salutations. I greet you all in this vehicle. I ask the women in this vehicle to cover their heads, and the men to remove their caps as we pray. Once a hawker presents himself as a decent and religious person, he is bound to win the sympathy of the majority. You will hear people respond with a loud Amen. When the prayers are concluded, the hawker introduces himself or herself. The hawker cannot go straight into presenting his drug items. He must crack some jokes to draw the attention of passengers. This is followed by a presentation of drug items at incredibly cheap rates. This drug which I am presenting can cure cancer, ulcer, rheumatism, headache etc. It was manufactured in April 2001. Expiry date is May 2004. It was imported from London, and we are the sole distributors in Nigeria. If you go to shops, this drug will cost N150.00 per sachet of 10 tablets, but inside the vehicle, if you have only N20.00, we will give you. Take one in the morning, one in the afternoon and one in the evening. 2 days is too much for you to regain your health. I am telling you that this drug will clear all those Nyama-Nyama (different kinds of) diseases wey dey (that do) affect your body Yes, any one for it? Many drugs are presented, and in the same fashion, the response of customers is very high. They buy the drugs without any regard the possible toxic effects of same. It is said that every drug that cures an ailment could result in another illness. Hence leaflets are enclosed in sachets and containers, stating the dosage and administration, indication and counter indications of drugs. Even the actions to be taken whenever counter actions occur are stated. Meanwhile, it was expected that the individual knows the sort of drugs and food to which his/her body is allergic. The body of Mr. A. cannot tolerate a particular drug, which the body of Mr. B can tolerate. Body chemistry also differs among individuals. All these factors do not come to play when drug hawkers carry out their job .This perhaps explains why one takes a drug only to complicate an ailment or cause another. The normal procedure is that a patient should go for a laboratory test to diagnose his ailment. The result of the test will be produced and passed over to a qualified medical doctor who will prescribe drugs to be supplied by a qualified pharmacist. If this procedure is observed, the patient can be rest assured that his ailment will be cured. Unfortunately, many people avoid this protocol because of what they describe as its time wasting and money consuming attributes. They resort to drug hawkers or illiterate chemists who cannot interpret complaints properly. There are cases of patients who are given drugs in excess of what is required to cure an ailment, because the hawkers or chemists want to make money. But even worse than that is the fact that almost all the drugs carried by these hawkers are fake! The most prominent of them is them is the potency drug. If you glance at the hawkers basket, the first thing you will likely notice is a picture of a man and woman holding each other. In this respect, a hawker who declined his identity disclosed that people, especially men, buy drugs a lot. There is a clear indication that the drug hawkers themselves are aware that their trade is a wrong one. Those whose faces appear on photograph were taken by surprise. The drugs are fake and substandard says Emeka Uchechukwu, a pharmacist in Idu community. Emeka added majority of the drugs you see in the market today do not actually contain the components they claim to have been made of in some of the drugs, you find sawdust. This is common in capsules. In others, what you find is

powder. The problem is from the importers of drugs. They travel abroad and consult with some drugs manufacturers in India and China to produce drugs for them. The production cost of a drug depends partly on the milligram level of the components. The importers may request that appropriate aid pharmacopoeia be used, but that the milligram of components is reduced, so that the production cost will equally reduce. This is to ensure that when they finally import the drugs, profits are maximized. The drugs so produced are branded same as the genuine ones. They are given the same name with slight adjustments in spellings. The milligram of each of the components of the fake drugs is written same as those of the genuine drugs, whereas the fake drug bears a lesser milligram. Majority of local consumers use brand names to search for drugs. The milligrams level of the component of drugs can no longer be used to distinguish between the genuine and fake drugs, because the fake ones are labelled as containing equal milligram as the genuine one, and the color of packages are identical. The Nigerian public is one that generally takes interest in cheap things. The drug hawkers cannot afford the superior drugs from standard pharmaceutical companies, because they are expensive. So, the entire stock they have on their tables and in their baskets, are obtained from the importers of fake drugs. This is why their drugs are very cheap. It cannot be said that the authorities are not aware of this development. Rather they chose to be indifferent about it. The issue the is that if the public should be left with the choice of patronizing either fake drugs or genuine ones, then we should equally expect tremendous increase in the death rate and severe competition for bedspaces in the hospitals, most of which themselves lack facilities and expertise.