Monday, June 16, 2014

No medicine

The children bring me to where a sick schoolchild refuses to eat lunch and waits with her head down to see the doctor.

Sweet, smart, dedicated, funny.   This doctor sits at the mobile clinic.  He has no medicine to give any patients.

Why are there no medicines?

Volunteers bring medicines, the partners send money but there is no medicine for day to day illnesses.   Who pays for medicines?  Who picks it up?  Who inventories it?   Is medicine that is donated allowed to be sold or should it be free?

I have thought this over.   The clinic charges for medicine; even donated medicines.   So, in a way this should be like a  micro loan.  The money made back should go into new medicines.  The inventory should, after the original investment, be self supporting.   It should go into buying new medicines but it does not.   It is not clear where it goes but it does not buy new stock and so there is no medicine.  It is never replenished by the clinic in Haiti.  They wait for a new amount of money to buy more.  This would make sense if the medicine was free but it is not.   Where is the profit from the pharmacy and the sale of medicines going?

As for me, I give  the medicine I brought to stop bleeding, directly to the midwives and tell them to keep it with them and never put it in the pharmacy.   It can also induce an abortion so it is a valuable commodity.  Are things taken, sold ?   I have no idea but you can not run a clinic without medicines.   It is an emergency but I can see it is not an emergency- anyway not the stop whatever you are doing and lets change this now, nothing is more important emergency.   The Dr tells me this is a serious problem.  He says people walk hours to come to the clinic and there is no medicine.  He says that is why no one comes anymore.  I say I will try but I am way,way down the line of anything close to having influence.  He begs me. He has tears in his eyes.  I look away.   

I ask whose responsibility this is.  It is, of course,the job of the priest who is also running all the churches, schools, lunch programs and lives on the mainland.  I suspect they think it is paying him great honor to ask him to micromanage things he knows nothing about.  

He tells us his daughter is sick and has to go to a clinic in Port-Au_Prince.  I trust the clinic will have the medicine she needs, he will have the means to get there and was paid so that he can buy the medicine.  

How can it change?    They can stop charging for medicines until the clinic demonstrates  a system of inventory, ordering and record keeping.  After time, let it be a  micro finance pharmacy business and let the pharmacist / clinic make a small profit after re-stocking the shelves.

There is a flurry of solutions proposed but when we leave the midwives have no mobile clinic pharmacy.  Volunteers get sick and we leave.   It is a sort of epidemic so perhaps no one will return for sometime.  No one really expected we could do anything anyway.  We hug and wave goodbye.  I lie face down on the ferry floor, trying to keep myself from throwing up.  I am grateful when the waves pour over me and I am cooled down.  With each sway of the boat, my head is smashed into the bench.  I am going home.  All the medicines I need for the virus will be easy to get.  

Oh the little girl.  She most likely has what many people have; a virus caused by a large, striped mosquito.  It hurts, I know, but I am home now and have pain medications and can get in a warm shower if it really bothers me.   We had nothing to offer her for her pain.  We drove back down the side of the mountain and she walked up a small trail to her home somewhere further up the hillside.  

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