- Post 18 July 2009
- Last Updated on 18 July 2009
- By Dr Olusegun Fakoya
At the last count, the King of Pop, Michael Jackson was hooked on more than eight prescription medications, including three powerful narcotic pain killers. The western world has woken up to the reality of the imperfection of any system, no matter the height of technological advancement and fairly rigid social control. Western history is littered with numerous cases of prescription drug dependency or addiction, if you like. The news that flitter to our ears relate to those with celebrity status. Numerous cases abound of the common people with dependency on sedatives or hypnotics. I have personally attended to many. Coming to the celebrities, it seems to be a different ball game. Their penchant and pathological love for prescription drugs seems to have no boundary. That is for those who chose not to go the path of the hard stuff, heroin and cocaine, and other such illicit substances.
The Entertainment magazine published June 27, 2009 informed that Michael Jackson was preceded in this game by other illustrious names. Marilyn Monroe was said to have overdosed on prescription medications relating to mental health, conspiracy theories notwithstanding. She was just 36 years of age. Judy Garland followed in 1969 and she was just 47 years of age. Not to be left out, Anna Nicole Smith joined the celestial bandwagon in 2007 following a prescription drug overdose at the age of 40 years. At 30 years of age, Australian star, Heather Ledger died of cardiac arrest following a prescription drug overdose. Also recorded by Entertainer magazine is the prescription drug-induced death of Dorothy Dandridge, at the age of 42 years, the first African American to be nominated for a Grammy Award. Let us not forget that Jimi Hendrix, the legendary guitarist died from overdose of sleeping pills and inhalation of vomitus. Something is very ominous, the death of Michael Jackson would certainly not be the last in the saga in a problem that is, frankly speaking, no longer limited to developed countries. The sad fact is that even here in Africa, even in Nigeria, this problem exists and must have caused numerous unexplained deaths attributed to the “works of enemies”, witchcraft or such supernatural causes.
Africa is besieged with numerous unexplained deaths. Many could rightly be attributed to the consequences of poverty and dearth of a well organised and non-epileptic healthcare and social infrastructures. The reality is that we also have our own deaths from medications. Our health care system is such that many medications that should rightly come under prescription drugs are sold in the open market. Thus in our environment, they dangerously fall under what is termed Over The Counter drugs (OTC). A situation where antibiotics can be easily bought under the counter leaves much to be desired. Apart from the tendency towards easily building up drug resistance, the harmful effects of these medications are thus difficult to control, with many succumbing to the side effects of these drugs without knowing. A situation where a primary school dropout, manning a “chemist” shop is deemed competent by ignorant Nigerians to have the knowledge to treat most ailments simply because he operates the chemist business is definitely not healthy for any nation and its people. Our chaotic drug market is such that there is no clear distinction between what should be sold over the counter and what should only be dispensed under prescription.
The healthcare system in Nigeria is truly in a very sorry state. Every hospital worker is either a nurse or a doctor, the ward orderlies and domestic staff inclusive. Atrocities are openly committed in the name of healthcare delivery in our dear country. Hospital attendants have practically assumed the lofty roles that doctors should normally be occupying. I must confess that their patronage is fascinating. They dabble into all sorts of treatment. I write from what I saw happening and not from fiction. I used to know of a hospital attendant in a part of Lagos State who was so “good” at this job that she had to open an office to attend to patients at the close of work every evening. The queue that she attended to daily is better imagined. This woman treated ailments from the “common” malaria to even diabetes. I knew another whose speciality was in termination of unwanted pregnancies or abortions. Of course, she dabbled in all sorts of treatment but this seemed to be where her expertise was most felt. I need not say that she succeeded in sending many to early deaths. I used to know another who worked as a leprosy vaccinator in one of the General Hospitals in Lagos State. The knowledge of his specific job was only restricted to those privileged to work with him at the hospital. To the ignorant masses outside, he was a “doctor”. Dr Jaguar (as he was well known) operated from the confines of his room where his little centre table served as the slaughter table (sorry, theatre table). Dr Jaguar killed so many from incomplete abortions, septic abortions, perforated uteri and so on. He was arrested so many times by the Nigerian Police and always found his way out. As I write, Dr Jaguar still commits atrocities freely. I can write loads on the sorry state of termination of unwanted pregnancies in Nigeria but this would be a story for some other day.
The Nigerian drug market, just like the generator market, is a jealously guarded one with powerful cartels that would do anything to protect their interest. The consequence is that the supply chain is chaotic, unregulated, uncontrolled, dangerous and yet vibrantly active. True, many Nigerians may not have the financial means and access to the sophistication of drugs consumed in the western world, yet in the crudity of our consumption lies death that has consumed many unrecognised. In the ensuing confusion and with the lack of distinction over what constitutes prescription medications, many Nigerians, mostly out of ignorance consume lethal cocktail of medications almost routinely. Interestingly, pain killers also feature prominently in our consumption. I have a friend whom I visited on my last trip home. It was early in the morning and I met my friend in the process of carrying out his daily ritual, that of consuming bizarre combinations of multivitamins and pain killers. My protestation and attempt to educate him on the dangers of his way fell on deaf ears. He informed me that taking these potential killers give him the buzz to face the daily demands of living. My friend took many capsules of, hold your breath, Ibuprofen, Piroxicam, Voltaren and different multivitamins (the compound preparations). To those who know, he was only taking the same pain killers (non-steroidal analgesics) in different preparations and brands. The non-beneficial effects of indiscriminate multivitamin consumption has been emphasised times without number, but apparently falling on deaf ears in Nigeria. Tell me, if that was not overdose of pain killers, then I wonder what it was. If my good friend had access to Propofol (the powerful anaesthetic agent) like Jackson had, I am sure that he would have used it. His remains symbolic of the level of ignorance pervading amongst Nigerians on the dangers of medications.
There was a time when it was the craze for a medication popularly called “mawu-mawu”. This was in the mid-nineties up till some few years back. This is a form of steroid which I suspected must have been banned in advanced countries as I failed to find a reference to it in most drug formularies. It was a drug called Dexacotin, a steroidal preparation which was immensely abused in the weird African concept of equating beauty with obesity. Our women folk massively abused this drug as a short cut to getting fat and hence attractive. Like the numerous bleaching creams in our markets, “mawu-mawu” was freely sold and widely consumed. There was total ignorance on the harmful effects of indiscriminate steroid consumption. I was not surprised when some time ago, a professional colleague told me of the upsurge in diabetes, kidney problems and other such ailments. An ignorant society must pay the price of its stupidity. That is our case in Nigeria.
“Mawu-Mawu” was not the only culprit. A form of multivitamin that was effective as an appetite stimulant was also massively abused by our women folk in the craze for getting fat. Abused in the sense that the recommended dosages were often exceeded in their attempt to achieve the desired result in the shortest possible time. This drug is known as Cypron and is obviously still available in the Nigerian market. Abuse of antimalarials, on the other hand, is almost legendary in our fatherland. This unfortunate scenario was probably enhanced in an effort to obtain cure in the days when fake drugs ruled the land. This was definitely before the advent of Aunty Dora who effectively re-branded NAFDAC. Unfortunately, the habit remains with us, especially when the cost of treating malaria has sky-rocketed with the pronounced inefficacy of chloroquine as a treatment remedy. Desperate Nigerians would approach the Chukwus and Kolawoles that are making millions at the expense of the health of their fellow citizens. The concept of “mix mix” developed from this. The obstinate ignoramuses that man the millions of chemist shops that litter our landscape would give people different mix of medications, some at above-normal doses and some at sub-normal doses. In the mixture would be different antimalarials, different pain killers, multivitamin preparations, antibiotics, antihistamines and so on. The end result is what is medically termed Chemical Hepatitis from the damaging effects of these different chemicals on liver cells. The unfortunate victims come out with a flourishing form of jaundice that often require hospitalisation to curtail – that is for those who survived. On the same level with this absurdity is the penchant for some Nigerians to open up capsule preparations and pour the content into Guinness stout or other alcoholic preparations in an effort to obtain cure for their ailments. The ignorance knows no limit.
There is no medication that cannot be openly obtained in the open market in Nigeria. Drugs that ordinarily should not be sold over the counter are common place. Try any Nigerian market and you can openly buy drugs for treating malaria, for inducing ovulation, for treating psychosis, migraine, epilepsy and so on. Insulin, the dangerous hormonal preparation for treating diabetes is so common place with different preparations, types and strengths. No drug is deemed too sacred to be sold in Nigeria. The benzodiazepines which have street values in Europe are openly sold in Nigeria. Ours is a society where human lives can be easily snuffed out at the cost of a penny.
That Nigeria is killing her citizens is an understatement. The situation is very critical and yet almost neglected in the melee of political confusion brought about by lack of sincerity in our fatherland. Anybody can treat anybody in Nigeria. Healthcare delivery has no sacred ethos. It is a game of money and business. Human life is just another business. We plough through hard times which we call life in Nigeria and at the end of it, further shortened our human existence out of ignorance and confounding government indifference. Chemist shop owners commit all sorts of atrocities in the name of conducting businesses. The regulation of these premises is so fluid and open to massive corruption (like anything Nigerian). NAFDAC that should serve an altruistic purpose, sadly enough, also has a hand in the indiscriminate killing of Nigerians.
To date, I am still baffled by the flourishing trade in alternative medicine in Nigeria. The air time allocated to the advertisement of these killer medications is another puzzling phenomenon. Every Yakubu has suddenly become a doctor. Mechanics and panel beaters have suddenly become the inventors and manufacturers of alternative medicines. Our air waves are now filled with shouts of Gbamu Gbamu, Jigbi Jigbi and other such outrageous names of alternative medications that are often described as acting like the complete panacea to all ailments. A single preparation of an alternative medicine is capable of curing malaria, hypertension, diabetes, epilepsy, gonorrhoea (or as often advertised, gonococcus), cough, infertility, low sperm count, etc! This ludicrous situation is often proudly supported by the lunatics in this trade as being “NAFDAC-registered” – how do you beat that? Commercialisation and the undisguised (but much unregulated) attempt to prove to the rest of the world that our traditional medicine has something to offer have led to and would continue to be the death of many. Yet we are supposed to have a government in place.
The tragedy of the situation is that Nigerians are dying from legitimately purchased medications because of a rotten system that failed to protect its citizens. Nigerians are dying from what in other places would be termed prescription medications. Nigerians are dying from ill-conceived and indiscriminately prepared herbal medications sanctioned by the government meant to protect its citizens. Nigerians are dying from poverty and ignorance. Above all, Nigerians are dying from an ineffective, inadequate and almost non-existent healthcare infrastructures and social services. Nigerians are dying because their various governments do not care. Nigerians are dying because of the dearth of sincere leadership committed to banishing poverty, ignorance and diseases. Nigerians are dying because the country is built on falsehood and shifty sand. A house built on shifty stand cannot stand the test of time. This seems to be the fate of Nigeria unless our leaders demonstrate genuine commitment to the ideals of dedicated and committed leadership built on sincerity and fairness. Sincerely speaking, Nigerians are also dying from prescription medications and other heinous atrocities.