l By N. Bassey l

Caro woke with a headache and some malaise. She told her sister who said "Na Malaria jare" and bought her a 'quick combo' from the Patent Medicine Shop. Caro died a week later. Many curses were piled on 'wicked people who can't see other people's children progress. The cause of death remained unknown, no autopsy was done. If one was done, she would have found that she had an abscess, in her liver. 

Caro's story is not new. It’s one of thousands, some dead, some still alive but coping with loss of limb or function, some asymptomatic but waiting for their luck to run out... 

The practice of lay citizens, neighbours, relatives, friends, strangers  and 'healers' taking over the task of diagnosing and prescribing medication for an ailment in Nigeria is commonplace. Sometimes, it is accurate, or even life saving: 'Expose the child with fever, tepid sponge and give a teaspoon of analgesic syrup', 'Give the child some salt-sugar solution and see a doctor as soon as possible', 'Pluck an eye lash, to drain an early stye'. 

At other times, it is cruel, idiotic, absurd and in cases like Caro's, fatal. 

Why do Nigerians, treat themselves and each other without seeking out Medical doctors? 

Firstly, because it is allowed. Anyone can walk into a pharmacy and get any but a few 'control' drugs without a diagnosis, let alone a prescription. 

Secondly, because it is acceptable. A man that tries to fix his own power supply problems would be dubbed suicidal. One that tried to write his own legal agreements, stupid. But a Nigerian that guesses a diagnosis and makes a drug recommendation is thought to be smart; one able to 'take care' of himself. 

How much of this absurd national practice is self care and how much is suicide? For a region notorious for its lack of data on anything, it is hard to say. One can guess (yeah, it’s safer in essays) that most of the time it is 'harmless'. After all, most drugs, taken according to the prescription sheets that come with them are designed to be just that. What harm can there be? In taking one's third dose of antibiotics and anti-malaria tablets for the dreaded 'Typhoid-Malaria' (a creation of hungry quacks)? a lot. It appears. Apart from the obvious fact that the 10, 000 odd naira that 'treatments' cost would have been useful for other things like savings, pension funds and recreation expenses, it is also a health risk. 

Taking drugs one doesn't need for ailments one doesn't have is one of the easiest way to get liver disease, incurable infections or worse. Every drug is a poison. Used sparingly and appropriately, they kill viruses, protozoa, fungi, bacteria and cancerous cells. Used unreasonably, illegally, inappropriately, they kill organs, create drug resistance and give nasty and-- sometimes-- permanent side effects. 

Studies have shown that people tend to get unprofessional medical advice when they are in resource limited settings with few doctors. To curb this menace, the national Health Policy on Diagnosis and Prescriptions needs to be reviewed. 

It is also worrisome to find that sometimes, other healthcare workers masquerade as medical doctors. It is sad to imagine that people trained in the medical field assume diagnosis and prescription is a matter of a guesswork. Medical management demands team work. Doctors should be the only members of the medical team to diagnose and prescribe drugs. Quack medicine must be discouraged.

We must frown at the thought of guessing the cause of our symptoms. We should seek to see trained medical personnel to see us when we need medical attention. 

The act of walking into pharmacies to buy drugs without a prescription should be outlawed. More doctors should be trained. Stricter control should be exerted over pharmacies and Patent Medicine Shops (PMS) to make sure drugs that treat ailments are not sold without prescription especially those with dire side effects. 

Hospitals and clinics need to simplify their consultation protocol to encourage patients to come. 

Above all, enlightened Nigerians should find ways to get medical attention, formally or informally. We need to get creative about accessing care. Can you arrange free medical campaigns in your church, community or club? What about having that struggling young doctor give your staff a check up and simple prescriptions in exchange for an honorarium? Can senators make plans to cover transport costs to hospitals? 

The answers to these questions may vary, but if we are determined we can get proper medical attention, diagnosis and prescriptions for our health needs. 

What matters most is that we stop this abuse. That we realise that life is too precious to guess, joke and toy with. That like it or not, the current trends and practices of quack care and prescription must stop. We must begin to re-think the value of a Nigerian life, starting with yours and mine.


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