18-5
What evidence is there Students can keep a record of problems-such as diarrhea or
of physical harm
‘thrush’—caused by overuse of antibiotics, abscesses caused by
caused to people by unnecessary injections, deaths or harm to women and babies
overuse or misuse of that may have been caused by medicines injected to speed up
medicines?
birth, etc.
What evidence is
there of economic
harm to people
caused by the
overuse and misuse
of medicine?
How often do health
workers, doctors,
or instructors in the
health center appear
to give medicine
simply to please
people-not because
it is necessary?
Students can try to find out how much poor families spend on
health care and medicines (both traditional and modern). Then
try to estimate how much of this is spent on useless or harmful
treatments. Is it worth it? Could health be improved if the
money were spent differently?
We all do it sometimes. Admit it! Discuss it. Is it ever right
to give medicine when it is not needed? How does doing
this create false beliefs, dependency, and mystification of
medicine?
Many programs give out colorful cough syrup and anti-diarrhea
medicine, both of which are unnecessary, in order to attract
mothers to the under-fives clinic. Is this wise?
2. Looking at the causes of local misuse of medicines
The larger causes—national, international, commercial, and professional—are
mostly out of the health workers’ control. Yet health workers need to be aware of
these causes and discuss how they affect the overuse and misuse of medicines
in their own communities. Helping people become aware of the high profits and
dishonesty of the medicine business may lead them to more careful and critical use.
The more immediate personal causes
of misuse and overuse of medicines are
things health workers can do more about.
Perhaps the biggest personal cause
of medicine misuse by health workers
is ‘popular demand’. We know of health
workers who feel they have to give at least
2 or 3 pills to every ‘patient’—no matter
what his problem. As a result, these health
workers regularly use up their monthly
supplies of chloroquine (for malaria) and
sulfa in the first week or so. This means
that many people who really need those
medicines must go without!
Overuse of medicines, where the supply is limited,
causes increased illness and death.