He usually closes by 7pm, just about the time a peddler few streets away is out for the evening’s business. On most evenings, Mama Kudus, as she is popularly called in the area, sells to Adeleke drug combinations that usually include Indocid, paracetamol and ibuprofen tablets. A dosage of Lexotan is sometimes included to give Adeleke a deep night rest. Adeleke often boasts about the potency of Mama Kudus’ ‘prescriptions’. When he checks on Mama Kudus for his evening drugs, he tells her to ‘mix’ drugs for him.
“After work, I am always tired but when I take her drugs, I feel strong again. Her drugs work for me and that is why I go to her every day after work. My job is energy-sapping and by the end of the day, I am always tired but luckily for me, Mama Kudus is there to take care of me,” he said confidently.
Peddlers displaying drugs from roadside stalls, especially in the evening, are a common sight in Nigeria. Mobile drugs salespersons are also familiar faces in commercial buses in major cities, often with slick narrations of how their drugs have worked for many people and now in high demand.
Findings by Saturday PUNCH show that Mama Kudus is a secondary school certificate holder who has had some experience working as a salesgirl in a chemist.
Like Adeleke, the hopes of many residents in the area lie on Mama Kudus’ small shoulders and she appear to be carrying the weight around with some measures of confidence.
“I have experience because I have worked in a chemist before so I have been doing this for many years,” she boasted.
However, the President, Pharmaceutical Society of Nigeria, Olumide Akintayo, has described Mama Kudus’ activities as criminal. He said the Counterfeit and Fake Drugs Act prohibits the sale of drugs in certain places in Nigeria.
“So Section 2 (1) goes ahead to define in more specific terms drug sales. Drug sales are prohibited in drug markets, ferries, boats, buses, every form of transportation and including drug hawking. These drugs are meant to save lives but they become potent poisons the moment they are not handled properly,” he said.
The Vice-President of the Commonwealth Medical Association and former President of the Nigerian Medical Association, Dr. Osahon Enabulele, also described the trend as dangerous.
He said the regular consumption of Indocid without proper doctor’s prescription would have health implications for Adeleke.
“Imagine that people still consume Indocid with all the complications that we can think of. A lot of gastric ulcer has resulted from the consumption of such products and can result in all sorts of problems. It is a drug that is supposed to be used under strict guidelines and under prescriptions by the doctor,” he said.
But both Akintayo and Enabulele might as well be talking to themselves as findings show that many Nigerians find the peddlers more accessible than doctors and also find their drugs cheaper.
Poor access to health care
For instance, Tajudeen Ajadi, a mechanic in Egbeda area of Lagos stubbornly maintained that he would continue to patronise peddlers. He described visits to the hospital as a waste of his “precious time”.
Ajadi also recalled his last visit to a General Hospital, where he saw a mother and her young boy, who had convulsion, were turned back because of inadequate bed space.
“I felt sorry for the boy and the mother; that is the kind of thing people who put all their hopes in hospitals face. I always have to sit down for a long time whenever I visit the General Hospital close to my house and still have to spend more money.
“You know, I don’t need to collect any registration card before buying drugs from the drug sellers. How much time and money do I have that I will be wasting them in hospitals when I can get the drugs around?” Ajadi asked as he walked away from a peddler he had just consulted for drugs for back pain.
So our correspondent approached the same peddler, feigning to have developed tooth ache. The peddler, who did not disclose her name, showed concern akin to the one often displayed by doctors. She asked a few questions and then selected three drugs which she gave to our correspondent with instructions to take two tablets each morning, noon and night.
The drugs were: Kaka Forte (Paracetamol 500mg, Caffeine 30mg); Propon (Aspirin 300mg) and Mixanal (Paracetamol 500mg, Guaranine 30mg).
An interaction with an openly shocked Secretary-General of the Lagos State Medicine Dealers Association, Olua Uwandu, showed that the combination could be dangerous to health.
LSMDA has over 10, 000 members spread across Lagos State, who are licensed by the Pharmacists Council of Nigeria to sell patent medicine and ‘over the counter drugs’.
Uwandu, who has over two decades of experience as a patent medicine vendor, explained that a patient should not take more than one of the combined drugs given to our correspondent.
“Propon is aspirin, Kaka Forte contains Paracetamol 500mg while the third one also contains an equal amount of Paracetamol. You can only take one of this three with antibiotics. It is wrong for anyone to give a patient all three; it could be dangerous,” he said.
After our correspondent’s experience with the peddler, he decided to try other ones to find out what range of services they offer to their customers.
From a peddler, who identified herself as Funmi, in Agege, Lagos, our correspondent asked for contraceptive.
Funmi regretted that she had just sold her last Gynaecosid tablets, but said she had Postinor, which she described as “also potent”. She said she had Postinor 1 and 2 and went ahead to explain that one was to be taken by a woman before sex and the other immediately after sex.
Eventually, she realised that the Postinor 1 she had left was not enough to complete a dosage.
When our correspondent asked what happened to the missing tablets, she sheepishly said she had used them.
“But take Postinor 2 and tell your woman to use it immediately after sex. It works very well. If you still want to buy Postinor 1, you can come back tomorrow, I would have had it in stock by then,” she said.
Another peddler that our correspondent asked about Propanol and Lexotan said she had them. The drugs are controlled medicines that are supposed to be sold at Pharmacies to patients with prescription notes from doctors.
Meanwhile, investigation shows that those engaging in illegal sales of drugs are predominantly women who have worked as auxiliary nurses or salesgirls in chemists.
Comparatively, the situation in places like Europe, North America and even some African countries, the situation is different from what obtains in Nigeria.
For instance, a Nigerian who shared his recent experience in South Africa, Mr. Bunmi Aderibigbe, described drug control in the country as “very organised”.
Aderibigbe, who suffered food poisoning during a visit to South Africa, said he could not get antibiotics to buy on the counter like he used to do in Nigeria.
“I tried to go to a hospital there but it was too expensive. I had to call my friends in Nigeria who gave me the contact of a Nigerian doctor working in South Africa. I almost died, but the doctor came to my hotel room to administer the drugs I needed,” he said.
Experts speak
Akintayo said that peddlers also kill the potency of drugs by exposing them to direct sun rays, adding that the action could be deadly for consumers of such drugs.
He said, “Drugs for instance should normally be stored in a temperature range depending on what type of drug it is. It is supposed to be stored at between 8-15 degrees centigrade if you want to maintain the potency before it expires. Otherwise, if a drug is labelled that it will expire in three years, if it is not well stored and you are exposing it to direct rays of sunlight – like 30 degrees centigrade, it can have accelerated degeneration.
“If you are not storing at the right temperature. If it is an antibiotics for instance, you risk resistance strains. The microbes become resistant. You will also probably have under doses or less active drugs. Then there is the risk of death because there is a particular drug that if allowed to degenerate, the active metabolite becomes toxic. So if you administer such products when they expire, then you risk killing that patient- outright mortality.”
Speaking further, Akintayo blamed the increasing activities of peddlers on the proliferation of open drug markets in the country and a lack of political will.
He traced the increase back to the 1990s and the early 2000 when the country experienced an unprecedented expansion of open drug markets.
He said, “The peddlers sell everything under the sun. Nigeria is a country where everybody has access to medicine because of the huge and vast network in what we call open drug markets. Ours is a country where all the state capitals and major cities have thriving drug markets.
“There has been an increase in the number of open drug markets. As at 1988, we had a very firm regulation on sub-standard drugs in Nigeria with Decree 21 of 1988. At that time, there were only four major drug markets in Nigeria – one in Idumota in Lagos State; one in Onitsha, Anambra; one in Aba, Abia and one in Sabongari, Kano.
“From four, we now have in every state capital, so you can imagine the quantum leap from four. It shows that there is a ready incentive to embrace this criminality. Examples are the drug markets in Enugu State, Agbeni in Ibadan, Oyo State; Ganboru in Maiduguri; we have in Kaduna and so on. And weak regulations also contributed to it. There is also a lack of political goodwill on the part of the government.
“As far back as Year 2000, the erstwhile 20 local government areas of Lagos State had 112,000 illegal (drug) premises, when at this time, we had barely 800 registered premises in the state. You know what that transcends to in the ratio of registered to unregistered. And that is the prevalent situation in Nigeria.”
Enabulele called on the Federal Government to implement the “recently formulated drug distribution guidelines”.
He said, “The only professionals legally licensed to sell drugs which patients can procure are the registered pharmacists and the only people licensed to prescribe are medical doctors and dentists as well as vet doctors. But over the years, this has been largely abused.”
Enabulele also attributed the increase in the incidence of renal failure in the country to illegal sales of drugs and their patronage. He said there were no proofs that the drugs being peddled on the streets were authenticated and researched.
He said, “There is a rising incidence of renal problems in terms of chronic renal failure in the country and even liver problems. A lot of these are happening partly because of the abuse of drugs. The unregulated use of drugs, which exposes citizens to all sorts of toxic products.
“Some of the drugs we have in the open drug markets now and among the hawkers on the streets have not been researched and authenticated and so most of them are not licensed. People are exposed to unlicensed drugs which may be very inimical to their health and which may of course result in more fatal cases than if they had procured the drugs upon doctors’ prescription.”
He, however, called for more primary health care centres and an expanded health insurance programme in the country to improve citizens’ access to public health care.
He said, “Government should ensure that in each locality, there are some levels of health posts that people can access and ensure that the logistics needed are provided in such facilities to make them useful to the people who want to access them.
“They should also strengthen the linkages between the primary, secondary and the tertiary health system so that access will be more available to the people. Also, government needs to facilitate the expansion of the community-based health insurance scheme so that low income people can have some levels of health package extended to them. They will know they have a ready source they can access irrespective of availability of funds.”
Meanwhile, the public relations officer of the National Agency for Food and Drug Administration and Control, Mrs. Christy Obiazikwor, promised that the agency would not relent its efforts to rid the streets of illegal drug sellers.
She appealed to Nigerians to stop patronising drug peddlers, saying their patronage contributes to keeping them in business.
She said, “We still carry out routine exercises every time and we will not relent. You are able to see them in the night because we have been arresting them, so many of them have now come out in the night. In spite of that, we still go out at night to raid and arrest them.
“You will hardly find them in buses now because we arrest them. But it is also important to let the public know the dangers inherent in patronising these people. We will not rest till we get rid of them, so anywhere you still sight them, notify us and our team will go there to get them arrested.”
Going by the health professionals’ assessment and the dangers inherent in patronising peddlers, Adeleke’s dream of owning one of Lagos’ biggest carpentry workshops may already be in jeopardy.
Source: Punch
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