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This discussion board is a fantastic idea! There are a group of us working post-disaster response and evaluation and I am thrilled you have started this up. I hope it gets wide participation and coverage (I will share with many).
More comments about medicines a topic near and dear to my heart.
1. Donate only essential medicines. Most donated medicines are not essential medicines-- as described by WHO list and good data on this from MSF and Management Sciences for Health. Essentially, medicines like cough syrup, anti-histamine syrups, and other liquids are heavy, a mess and detract from what is really needed.
2. We trained nurses, physician assistants, and physicians in many other countries and they learn about essential medicines and usually do not have access to expensive antibiotics. These medicines arrive and may or may not have their instructions with them-- in English. The health workers and patients get them and often cannot read the labels or warnings. The drugs are impossible to look up and are not available the following week. Thus, the health workers are unable to know what they are giving to patients.
Health workers and patients need labels and materials that are in their language and can be adjusted for the specific patient. We needed good plastic bottles with good lids more than anything.
3. We learned the hard way that labels coming with large donations may not be accurate (to put it nicely). We got a 50 gallon drum of blue pills from a US donor that was labeled as ferrous sulfate tablets-- routinely given for iron deficiency in children and pregnant women. We used them for awhile but then decided to have them tested to be sure they were still chemically active. Turned out they were not iron tablets but pyridium (urinary antiseptic used to treat pain of urinary infections). We had unknowingly been given people something that was not helping their iron deficiency which can be life threatening but were exposing them to an unnecessary drug of no value. Fortunately, it is quite safe but does cause urine to turn bright orange and may have scared people.
4. The most difficult drugs are those for chronic diseases. These are expensive and usually need a "system" or program to dispense them. In disasters patients receiving treatment for epilepsy, high blood pressure, diabetes, tuberculosis, AIDS/HIV, depression, schizophrenia, methadone maintenance, cancer chemotherapy or palliative medicines have few options and end up without their medications. Most relief agencies do not provide strong pain medicines, the stigma against mental health is such that few programs or agencies deal with it and no one donates drugs, and even the more routine medical treatments for "accepted" medical illnesses like hypertension and insulin are very hard to find since aid programs emphasis is on trauma care and infection only. We need to locate programs that are up and running that have the system and means to provide these medicines and then make sure they get them-- partners in health has been doing it for TB and HIV they would be who I would start with to ask about getting these services in place and assured. Then donate the funds for those groups to purchase what they need.
Ditto to what has been said by many.... find people who know the ground and the people and help them do more better.
Sharon McDonnell MD MPH, Dartmouth Medical School |
January 22, 2010 at 09:00 PM
The World Reuse, Repair and Recycling Association (WR3A.org) is a trade association formed to address these kinds of questions. We are currently consumed completely by the questions around exports of used electronics (digital divide orgs vs. anti-dumping enviros). I have found my MBA degree usually answers more questions than my international relations degree, but the time in Peace Corps was invaluable.
This is a link to our "Fair Trade" video, a response to all the legislation banning export of all used electronics (first in CA, now proposed nationally).
Robin Ingenthron |
May 28, 2009 at 08:39 AM
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