Wednesday, 4 January 2017

Medications’ issue… cauterization

Like the case when a patient complaining of a slight pain sees a doctor, then the physician asks him for some radio scans and laboratory tests to finally discover that the patient is suffering from more than a disease in many parts of the body…

This is what happened in the case we have been discussing here during the last weeks regarding the medications’ issue in Egypt… as we started with an incident that some saw is fake and not true about accusing a pharmacist and certain pharmaceutical company of hiding important medications to cause damage to both people and economy… but the issue went bigger and bigger to the extent that we had several articles, comments and replies demonstrating the matter.

In such regard, I wrote an article last week where I excerpted part of the message sent to me by the pharmacist Raga’i Qousa who was in charge of important positions of the syndicate of pharmacists. Once I published the article, I received a lot of comments on my Facebook page representing different opinions. I will mention two of them here as I believe they shed light over a real dilemma we have in the fields of medicine and pharmacy; whether regarding the education or the practice levels.

The first comment was of Professor Dr. Gamal Mustafa; the eminent professor of public surgery domestically and internationally known in his field. He is also known in the cultural domain and public work through Al-Garrah cultural saloon which tackles the most important and critical problems facing our society.

The second comment came from Professor Dr. Charles Beshri Megally; the prominent Cardiology professor. He is also very much in deep love of the Arabic language and its arts. In addition, he is a big fan of music and singing especially al-Rahbani Brothers and Fairouz and he has a distinguished talent to analyze both melodies and words. And so, I believe both of them are interested in the issue discussed, not due to our friendship, but due to what is more important; they are true to themselves.

Dr. Gamal wrote: “… that’s what I expected… all doctors are being unfairly accused and misjudged… while there are doctors who are kinder to the patient than his own family… as to writing the scientific name of the medications, there are many disputed issues regarding applying such practice, since scientific names are compound, complicated and long because they have basically Latin origins … and those selling medications in pharmacies now are not often pharmacists, but actually holders of average degree of education… and so, there is a risk here that will emerge when applying such practice… however, you stirred a real problem concerning the patient that is more important than any other problems. Here, there are some key points we have to pay attention to:

1- Fresh graduate physicians and pharmacists need long years of practice to memorize the scientific names.

2- The scientific names of some medications could be very similar and may vary in only one letter. This may result that we have two medications, very similar in name, curing two diseases; one for the heart and the other for rheumatoid for example. Here, there is a risk that may reach causing death to the patient if the wrong medication was administered to him.

3- The commercial names include some meanings that are of benefit to the one writing the prescription… as the commercial name may indicate if the medication effect is short- or long-term… it may also indicate if it can be used for male or female patients… it may indicate if the medication contains any dangerous components, like Cortisone for example… it may indicate the organ the medicine will affect… and the way of taking it… not to mention that the commercial name sometimes has a melodic tone and is easier to remember, especially for general practitioners who represent more than 90 percent of physicians and pharmacists.

As to experts like me, only long-years experience determines which medication to use regardless of the production company no matter the temptations they offer, since the physician is responsible of the result of the cure he prescribes… and the production company will be of no good to him if he was prosecuted before law”.

Then, Dr. Charles Beshri Megally wrote: “… most of what came in the pharmacist’s message regarding the fancy cars is nothing but pure imagination… this could be possible if we are talking about the one responsible for registering or pricing the medication, but it is completely unreasonable to be a reward for a doctor to write the medication in his prescription…

Your article has stirred many grudges and generalization issues spread in our society like it is always the case in Egypt and the east in general… of course, we have here in Egypt, like in the whole world, doctors who make profits out of brokering and corrupt dealings… also, there are pharmacists who sell medications they know very well are deadly like, for example, that anti-clotting medication that was deadly and illegally smuggled and that led to killing hundreds of the poor people… there are also pharmacists who hide medications and refuse to sell them waiting for their price to go higher…

We do not live in a community of angels; however, there are doctors and pharmacists here in Egypt who can really make you proud of them… as to writing the scientific name of the medications, this will make a lot of problems like Dr. Gamal Mustafa said… not to mention that most of those selling medications in pharmacies are not qualified… the truth is, our universities right now are producing pharmaceutically-ignorant pharmacists who do not know the names of medications or their uses, and so they make horrible mistakes that can lead to the death of the patient.

In addition, we know very well that the original medication; whether made in Egypt or imported, is different in its effectiveness to what we call “Copies” spread in the market. These Copies, made of law-quality raw materials, are definitely different to the medications fabricated by a company other than the original company after intellectual property rights expire… these medications are called the alternative medicine. This message of the pharmacist made me laugh… too miserable to make you laugh”.

Comments of professors Dr. Gamal and Dr. Charles ended. They shed light on what is more important than the medications’ issue in Egypt because they agreed on the point that we suffer from corruption and ignorance in the fields of medicine and pharmacy. However, they both were against generalization and inciting grudges. Also, they did not deny the deterioration of university education in the faculties of pharmacy. And so, again we come back to the main question: how can we achieve the renaissance of our nation by curing the main problem and not its symptoms?... will cauterization by applying severe punishments be the answer?

The medications’ issue has opened up some abscesses Egypt is suffering from. However, the Egyptian nation is still resisting, like the files of corruption abscess the Administrative Control Agency is opening and investigating in places that were once above judgment.

Now, I ask your permission to pay attention to other issues other than medication, however, we may come back to it if necessary.

Translated into English by: Dalia Elnaggar

This article was published in Almasry alyoum newspaper on January 4, 2017.

To see the original article, go to:

#almasry_alyoum #ahmed_elgammal #medications_in_Egypt #corruption