Rakhee Ghelani

Business Consultant, Writer and Traveller

Medicine at what cost?

After 11 months in India, it finally managed to make me sick…. really sick.  Over the course of four weeks I have managed to spend three weeks debilitated by various stomach bugs.  It hasn’t been fun, and now that we are in the thick of monsoon, I am not entirely sure that it’s over yet.  Whilst getting the runs in India is almost like a rite of passage, I certainly didn’t expect that the medication I was prescribed to heal me could actually do me much greater harm.

After almost a week of stomach cramps I went to visit a doctor who was recommended to me by a work colleague.  The clinic was small and crowded, but this is Mumbai where space is a premium few can afford and privacy is a foreign word.  The doctor examined me and clearly knew what she was doing, as my father (who was a GP) correctly told me, a local doctor will know how to treat the specific bugs that are going around.  I was prescribed two medications, some probiotics and electrolyte mixture and sent on my way.

After taking the first day’s medication, I decided to just quickly “google” what I had been prescribed.  Much to my horror I discovered one of the medications (Entereoquinol), whilst very effective, was actually banned in most countries around the world because it could permanently damage the optic nerve.  So recovering from gastro could make me blind.

What horrified me the most was that this was prescribed by a qualified doctor.  What makes this problem even worse is that in India drugs are readily available and rarely require a prescription.  As a matter of fact, the only time I have been asked for a prescription was when I was trying to get hold of the pill (which funnily enough, I think, no longer requires a prescription in Australia), and whilst one pharmacy knocked me back, the one next door happily sold it to me without prescription.

After some further research, it appears there are many drugs that are banned around the world, including neighbouring countries such as Bangladesh and Sri Lanka, that are still available in India. Medications that are known to cause stroke, liver disease and brain haemorrhage are commonly prescribed. I know in Australia there are very stringent guidelines and processes to go through before a drug is allowed to be prescribed, and also a process to remove drugs if they later are found to be dangerous. So how does it work in India?

Information on the process was a little hard to find, but according to one article clinical trials are required to be conducted in India before a drug is approved by the relevant authority, however some are falling through the cracks. In one review of 39 drugs that were approved, 11 were found not to have the necessary documentation. Worse still, 33% of the ones looked at in the review are already banned in many countries, like USA and Australia, but were still approved to be sold in India  It appears the health of potentially millions of people is not worth even following an appropriate process.

Another article says that drugs can be banned if there are sufficient reports of adverse reactions.  I have seen a few doctors all over India in the past 11 months and not one wrote notes or records of our appointment.  So if doctors do not have proper records about what their patients are experiencing, how can there be reporting for adverse reactions to specific medications?  If there are few reports, then how can drugs ever be banned once they are let loose on the market?

Researching on the internet, I found many articles that talk about how India is a dumping ground for banned medication.  So other countries reject a drug for not being safe for their citizens, and they are sold in India instead.  It appears the Indian government or medical profession doesn’t think their citizens are worthy of protection.  That’s a sad state of affairs.  There are enough people dying of preventable diseases in India because they can’t access medical care, yet even those who do have access are still not safe.

The medical profession recently came under scrutiny in the show Satyamev Jayate  which discussed corruption in the profession, such as doctors deliberately prescribing incorrect medication. The medical profession responded by asking the host to apologise to them…. he refused.  It’s a sad state of affairs when those entrusted with the knowledge to heal use it to hurt instead.

In my case, I don’t believe the doctor I saw was corrupt, I believe she genuinely felt she was prescribing me the best thing for my digestive system.  I don’t know if she knew the medication could damage my eyesight, I never went back.  Instead I found another doctor, and thoroughly researched everything she prescribed before I took it.  So now it seems I have to take responsibility for the medical care I receive in India as well. Luckily I have the means to research things thoroughly, but what about the hundreds of millions who don’t?

20 comments on “Medicine at what cost?

  1. Ashok Mehta
    June 23, 2014

    Rakhee, do you recall which medicine you took in place of Entereoquinol? Thank you!

    • Rakhee Ghelani
      June 24, 2014

      I ended up taking some prescribed probiotics which fixed me over several weeks. At the time I was under the guidance of a gastroentrologist.

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  4. Beatrix
    September 29, 2012

    As a US physician I find the prescribing habits of Indian physicians to be appalling. Indian physicians do not ask if the patient has any known drug allergies, if the patient is taking any other medications, women of child bearing age are not even asked if they are pregnant, etc. Often a proper health history isn’t even taken.
    Luckily, Entero Quinol (quiniodochlor) typically only causes nerve problems at prolonged high dosage.
    I would assume that this physician thought you were suffering amoebiasis?
    Did the physician even take a stool sample to determine EXACTLY what pathogen was causing your illness?
    Probably not.
    Most Indian physicians just ‘guess’ at the pathogen & prescribe some broad spectrum medication that gets rid of the most likely suspects- possible side effects & precautions are never discussed.
    In any case there are safer alternatives to Entero Quinol available in India.

    • Rakhee Ghelani
      September 29, 2012

      Thanks for your advice. No I never had a stool sample taken, even after seeing a specialist, but am happy to say I am fully recovered.

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  6. Zephyr
    August 17, 2012

    I can understand your predicament because I have already lost vision in one eye because of some medication prescribed for another potentially serious problem and am in the process of going blind — no, it was not enteroquinol, but something else. Steroid misuse is rampant too. Litigation against doctors is costly and tedious and so even the well aware citizens don’t take that route. And Rakhee, corruption is not just about money, but about morals and ethics too.

    • Rakhee Ghelani
      August 17, 2012

      So sorry to hear about your vision loss.

      Yes I do agree with you, corruption has a lot more to do with morals and ethics than money much of the time.

  7. gardenerat60
    August 16, 2012

    Drug over dose, OTC drugs in plenty, no prescription needed, doctors not keeping records, doctors not giving proper account of their financial status,doctors prescribing medication only from their favorite companies,.. all are rampant here. Doctors also yell at patients if they ask about their illness or about the drugs prescribed.

    Once upon a time a MBBS doctor , was like God here. He looked after the entire family, and was called family doctor.
    Now he looks after only his family at the cost of others’ health.

    Doctors are viewed with suspicion nowadays. Sad indeed.

    • Rakhee Ghelani
      August 17, 2012

      A very sad state of affairs indeed. It is such a pity that this is how doctors are seen now by many in India.

  8. Never Mind
    July 11, 2012

    Man, this is scary. I would’ve had no idea. When i lived in the States, I always laughed at their adverts for medications, which were 30 secs about the benefits and 30 secs about the awful consequences of taking them. The total opposite of what you find in India, clearly! The medical industry is one area that I don’t want to have to second guess all the time. Glad to hear you’re feeling better anyway.

    • Rakhee Ghelani
      July 11, 2012

      Yep it is terrifying here. I almost now too afraid to go to the doctor.

  9. Jack Scott
    July 9, 2012

    The problem is more common that people realise. Many countries do not require a prescription for drugs (Turkey included, in most cases). Many people cannot afford doctor’s fees so they self-diagnose and self-medicate. I hope you’re feeling much better soon.

    • Rakhee Ghelani
      July 9, 2012

      Yes, I suspect there are many countries in that have these issues.

      I am feeling a lot better, thanks.

  10. Nisha
    July 9, 2012

    Should I say again , “Welcome to India”? :-)

    Well, there are many medicines which are banned but readily available in India and we have been using them off & on. I can understand your concerns but as a common man, do we really have detailed information as what to take or what not? Why it is a common man’s duty to check if a certain medicine is banned or not? In your case, the doc herself prescribed it!
    Till last year there were ads on TV for a medicine called Dcold total even after it was banned!

    What options does a common man has ? India is huge, there are only two sets of people here. No one has time to think for & of others; everybody is busy in either trying to survive or in making money and cost of a life gets dissolved somewhere among all the corruption & ignorance. This is THE harsh reality. I think India is surviving because of very handful people.

    You pointed out very nicely, it is hard to report such cases. I suggest you go to that doc again and confront her. I would like to know how she reacts. It is very much possible that she’s not even aware of the ban! :)

    How are you doing now?
    Soak spoonful of methi seeds at night and gulp it (w/o chewing) in the morning along with the water. Helps.

    • Rakhee Ghelani
      July 9, 2012

      I agree with you, it is very sad indeed. I am not sure what the answer is here, but awareness is a start so people do not take things that are not making them better.

      I am feeling a lot better, but I will definitely taking on board your remedy.

  11. Aakanksha
    July 9, 2012

    Hey Rakhee, Sorry to hear your experience with docs in India. But the pathetic condition you have described is indeed a harsh reality, who knows it better than an Indian born and brought in this country as I am, I have witnessed more side effects around me than effects.

    Have you ever thought about alternate medicines that are still widely practiced here, try the ayurveda, homeopathic or nautropathy solutions, the worst they can do is not cure the problem but they are safe. I myself prefer these, only when immediate relief is desired i go in for allopathy.

    • Rakhee Ghelani
      July 9, 2012

      Thanks

      I have tried alternative medicine, but it doesn’t help with everything unfortunately.

  12. Karen Stuart
    July 9, 2012

    That is scary and a sad state of affairs……just as well you are on top of things!!

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This entry was posted on July 9, 2012 by in Health, India, Medicine, Uncategorized and tagged , , , , , , , , , .

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