In an ideal world, there would be no need to ship packs of essential medicines from the UK and Europe to help vulnerable communities in low- and middle-income countries. Ideally, everyone could obtain medicines sustainably and reliably.
In many settings however, supplies of needed and safe medicines are sporadic, shortages are frequent and fake medicines plague the market. For millions of people around the world, lack of access to medicine has a direct and sometimes devastating impact on quality of life.
Olatunji Olaleye, a Nigerian born health practitioner working in the UK, knows first-hand the realities of healthcare practice in his home country. “I trained as an anaesthetist and worked in government hospitals in Nigeria for almost 20 years. The healthcare infrastructure in Nigeria is poor, particularly in rural settings, where there are very few health facilities. Despite the government’s efforts in providing healthcare to the people, accessibility to quality rural healthcare continues to be a major challenge.”
“The strict regulations we have for healthcare practice here in the UK do not exist in the same way in Nigeria in terms of enforcement. Unfortunately, this leads to many private hospitals being run by people who are not medically trained – putting patients at huge risk,” he said.
Distrust of government services and widespread poverty also limit people’s ability to access the healthcare they need. Government-run or private hospitals where staff are qualified, cost more and many cannot afford to pay, meaning they turn to cheaper, unregulated alternatives.
Olatunji recently led a team of health professionals to communities in Nigeria with one of IHP’s Essential Health Packs (EHPs) and was able to treat around 1,000 patients during his time there, with all medicines distributed free of charge.
An EHP is a pre-packed kit, filled with a range of essential medicine, to support critical primary healthcare delivery in any setting. They are highly portable so that they can be transported to wherever they might be needed and act as a mobile pharmacy.
“The team visited two places in Nigeria. First was Owode Yewa, Ogun State, a semi- urban area in the southwest of the country with a population of around 200,000. There is not a single general hospital in the area. The closest is about 30km away in Ota, close to Lagos. There are however, privately run clinics but only about three of these are run by qualified doctors. Many of the people here, who are predominantly local traders and farmers, cannot afford these and will instead visit the clinic or Patent Medicine store that is offering the cheapest rate.”
When the treatment does not work, they’re forced to find additional money to seek safe and proper medical care from a professional – this can lead to further complications in their condition, unnecessary suffering and sometimes even death.
“Take for example a pregnant woman in labour in the rural area – her first port of call would usually be to visit a cheap Traditional Birth Attendant (TBA). When she goes into prolonged or obstructed labour with feto-maternal distress, and it’s clear she needs an operation to save her life and that of her baby, she would be unable to afford the treatment because she would probably have already spent the little she had on a therapy that will not be able to save her,” Olatunji said.
“Indeed, it is a terrible situation and has been like this for a long time in Nigeria. More must be done to help alleviate people from poverty. In addition, the government need to help to facilitate affordable quality rural healthcare so that people don’t have to take these risks with their health,” he added.
“The second place we visited was Ago-sasa Yewa, Ogun State, another remote rural area in the southwest of the country. The communities here are made up of different tribes and many people are farmers and don’t have much. Infrastructure here is also very poor – the roads make accessibility difficult and there is little potable water. There is only one district hospital in the area which was built in the 1970’s but is severely understaffed with little or no medical equipment. Again, the people here rely on these cheap TBAs, Patent Medicine stores and private clinics, many of which are not run by qualified professionals.”
“Whilst the team was in both Owode and Ago-sasa, we worked with local qualified doctors and nurses to administer care to patients using medicines from the EHP. The health concerns were broad from chronic conditions like high blood pressure, asthma, and diabetes, to other pathologies like malaria, hernias, bronchitis and infections.”
“Words cannot describe how useful the EHPs were in treating these patients. There was not a single type of medicine that went unused.”
“One lady complained of persistent headaches, shortness of breath, palpitations and she had severe trouble sleeping - classic signs of high blood pressure. That day she was placed on anti-hypertensives from the EHP. On the third day she came back to visit and was full of gratitude saying that for the first time in many months she slept like a baby. Upon checking again, her blood pressure was coming under control.”
“As well as being unable to afford treatment, many people fall prey to the use of fake medicines which is another huge problem in Nigeria,” said Olatunji. All of the medicines contained within the EHPs are regulated by the Medicines and Healthcare Regulatory Agency (MHRA), are long-dated and contain patient information leaflets which provide information on safe usage.
“Every time I visit Nigeria and these communities, I find it incredibly humbling yet frustrating to see the circumstances in which health professionals practise, doing their best in challenging circumstances to administer care; and the obstacles people must overcome to access safe healthcare. It shouldn’t be this way. Many patients cried when we left because the situation without the support of NGOs and volunteers is so difficult.”
“The work of International Health Partners is incredibly important, and the medication used was able to give a lease of life to vulnerable people who would otherwise be unable to afford treatment. To any doctors or nurses thinking of using Essential Health Packs in the future, I couldn’t recommend them more – In fact, I will be applying for another one myself soon!”