By Dawda Nenegalleh Jallow
In The Gambia, it is a common practice for both men and women to turn to private drug stores as the first point of contact when they or their children fall sick. This reliance on private drug stores as the primary source of healthcare is deeply ingrained in Gambian society and has its roots in factors such as convenience and accessibility. These stores are found in almost every street in the Greater Banjul Area and one or more in communities across provincial Gambia and are often seen as the first point of contact. However, this widespread practice is not without its share of associated problems, which have long-lasting implications for public health.
One of the most significant issues linked to seeking assistance from private drug stores is the absence of proper medical diagnosis. While these establishments may offer a wide range of over-the-counter and prescription medications, they often lack staff with the necessary medical expertise and/or facilities to accurately diagnose ailments. This deficiency can result in misdiagnosis and inappropriate treatment, ultimately compromising the health of individuals and their families.
The tragic incident of the Acute Kidney Injury in The Gambia around July 2022 stands as a grim reminder of the potential dangers which might be associated with medicines when proper regulations are not put in place to control the import and intake of medicines. In this devastating episode, more than 70 children lost their lives after taking contaminated medicines that contained Diethylene glycol (DEG). The lack of stringent regulatory oversight allowed these harmful substances to infiltrate the healthcare system, leading to catastrophic consequences. Most often, in the streets of Serekunda, at the ferry terminals in Banjul and Barra, and in other parts of The Gambia, street peddlers are seen holding boxes of medicines and shouting “Relieve”, “Paracetamol” and others “Lekki musu bandu” in Fulani – meaning “medicine for body pain”.
Although opinions differ, a key concern is the profit motive that often drives these private drug stores. These businesses, like any other, are primarily focused on maximizing their earnings, which can sometimes lead to practices that prioritize financial gain over patient well-being. As a result, they may promote unnecessary medications or prescribe improper dosages to boost sales, ultimately jeopardizing the health of their customers.
Recently, on 17th October 2023 to be precise, a sister who hails from my home town, Basse, sent me five pictures of medicines her brother and sister-in-law bought from the pharmacy for their child whom she said had “diarrhoea”. The mother was seeking advice on which medicines to give her child. This lack of patient education is another glaring issue when it comes to private drug stores. Employees in these establishments may not always provide adequate information about the medicines they dispense. This deficiency in patient awareness can result in the misuse of medications, leading to adverse side effects and complications that could have been avoided with proper guidance. Someone might be wondering what my advice was; it was simple – “Immediately take the child to the nearest health facility for proper diagnosis and management”.
Counterfeit drugs also pose a significant threat in the context of private drug stores. These establishments may, whether knowingly or unknowingly, distribute counterfeit medications to their customers, further endangering the health of those who rely on them for their primary healthcare needs. An article by Cherno Omar Bobb in the Point Newspaper of 4th November 2019 has it that a 45-year-old lady of Guinean nationality was caught at the Nyamanarr Customs Border Post in Upper River Region smuggling dozens of fake drugs into The Gambia. Was this lady going to sell these fake drugs to the Ministry of Health? Absolutely not! It’s obvious that those fake drugs would have ended up in our local pharmacies and with the street peddlers. On a larger scale, on the 14th of July 2020, BBC published an article titled “Fake pharmaceutical industry thrives in West Africa” and in it, Mr Mohammad Babandede of the Intellectual Rights Property Unit of the Nigerian Customs Service explained how more than 30 million counterfeit tablets were seized in one week and how these drugs are labelled as “Humanitarian Donations”.
To address these concerns and mitigate the associated risks, it is imperative to encourage individuals in The Gambia to make healthcare facilities their first point of contact when they or their children are sick. These public health institutions, staffed by trained medical professionals, are better equipped to provide accurate diagnoses and appropriate treatment. These facilities are also subject to regulatory oversight, which helps ensure the quality and safety of the services they offer.
The Ministry of Health’s Directorate of Health Promotion and Education should conduct/strengthen public education campaigns and community outreach programs to shift the societal perception of private drug stores as the default healthcare providers. These initiatives can raise awareness about the risks associated with these establishments and emphasize the importance of visiting healthcare facilities for proper medical care.
Although private drug stores might offer convenience, they are not always the safest or most reliable option for healthcare in The Gambia. The tragic Acute Kidney Injury incident involving contaminated medicines from Maiden Pharmaceuticals Limited (Haryana, India) serves as a stark reminder of the potential dangers associated with medicines. For every Gambian and resident of The Gambia to safeguard their well-being and of their families, it is essential to prioritize professional medical help from healthcare facilities, and it is equally crucial that the healthcare system is restructured to ensure better access to quality healthcare for all, reducing the need to rely on profit-driven entities for medical services and fostering a healthier and safer society.