"Nearly 50 illegal health clinics in Sierra Leone are to be shut by officials amid claims that botched operations killed patients. The clinics in Freetown were staffed by people with little or no training, who offered inappropriate treatment, deputy minister of health told the BBC."
Sound shocking? Well, it's not. To be honest, I am not exactly sure what group of clinics this article is referring to, but to me this is no surprise. Over the 4+ years I have worked in Salone I often saw children who had been to other so-called clinics prior to coming to me. Mind you, a lot of these clinics did have actual signs outside the doors and unfortunately were probably legal. In my opinion, many of these clinics SHOULD be closed.
So often I would have patients coming in who had been to a so-called clinic only a day or two before. I would often be told that the 'doctor' had not even taken a history or examined a child. Sometimes the child was briefly examined but only very seldom was the blood checked. Once I had a child come in with hemoglobin of around 4 g/dL; a child clinically very anemic. And in the end due to malaria. What had the 'doctor' done for the child? Prescribed antibiotics and 'blood tonic' (a syrup with iron in it). Not very helpful obviously. Meanwhile the mother thinks she is helping the child with the medication and the child dies of untreated malaria. To say it nicely, I was often furious with these clinics. And sad that parents did not realize the bad treatment their children were receiving.
But having said that, there were also pediatricians that really got my blood flowing. Once there was a pediatrician that saw a newborn baby a few hours after birth and because the child was not doing so well decided to give the child diazepam (a sleeping drug). The next day the mom brought the child to me. The child was very floppy and dehydrated. I just couldn't believe a pediatrician would have sent this child home. And really could not believe that the child had been giving sleeping medication. But, it was right there on the prescription paper. Sad but true. Fortunately the mother came to the clinic and I sent the child on to the NGO hospital.
And then there are the prescribing habits of many doctors, nurses and dispensary workers. Almost anyone can prescribe drugs. And to be honest, you can buy practically anything in a pharmacy over the counter. Most times children will already have been prescribed 6-10 various medications, of which 3-5 are usually antibiotics. Another popular drug in the mix is phenargan (promethazine) in adult dose and blood tonic is always a very sought after item as well. The drugs are often only prescribed as a single dose or for a few days, and often in adult rather than pediatric dosages. It's a wonder there isn't more drug resistance in Sierra Leone. And it's not a surprise that many of the children are not getting better. Many pharmacies also have cots in a dark room in the back where intravenous fluids are administered for any number of ailments. If you have a bit of a cold or some loose stools and think that only an i.v. can help then just ask and you shall receive. I actually do not want to know what happens in a lot of the pharmacies.
So, Honorable Minister of Health, I beg for you to continue investigating this matter as I think there are more clinics that are not providing optimal care and need to be shut down. And at the same time, maybe you could investigate what happens in so many of the pharmacies all over the country. Maybe you can put a stop to the terrible things that occur there. And finally, health education for the public would be advised. People need to learn that they do not need a 'drip' or antibiotics everytime they are ill. What they need to do is see a well-trained doctor and follow his/her advice. Of course, this means that health care needs to be both accessible and affordable to the entire population. Thank you.
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