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Haiti | August 9, 2018

When Medicine Isn't Available

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This piece originally appeared in Physician Family magazine, Summer 2018

We hardly give it a second thought. A cut finger and we grab a bandage from the first aid kit. A slight fever and we run to the medicine cabinet for Ibuprofen. Something more serious and our physician calls in a prescription which we pick up at the nearby pharmacy.

But for millions of people living in poor countries, there are no first aid kits or medicine cabinets. Pharmacies, often a day’s journey or more away, stock medicine far too expensive for the average person—or worse, pills made of useless or toxic materials.

So cuts go untreated and uncovered—often resulting in major infections. Fevers continue to rise and diseases go untreated. And chronic conditions that could be easily managed become an early death sentence.

The World Health Organization estimates more than 2 billion people in resource-poor countries live without access to basic medicines they need. And for health care providers, this statistic is heartbreaking.

“There is nothing worse than seeing a patient, diagnosing her problem and knowing a simple medicine can make her well—then not having access to that medicine,” says Dr. Cece Lugo, a physician working in low income areas of the Dominican Republic. “Even many hospitals here don’t have medicine. So we do our best to help those who are ill but our ability to treat them is severely hampered by lack of access to medicine.”

This is the reason MAP International was started, nearly 65 years ago, by Dr. Ray Knighton, a physician who saw the great need doctors faced in accessing medicine when working in remote and poor areas of the world.

Working with pharmaceutical companies, MAP provides donated and purchased medicine to medical missions working in some of the most difficult places in the world. For Dr. Lugo and others, the medicines make all the difference.

“I am so grateful for the medicines we have received from MAP,” she says. “They are of the best quality and exactly what we need for our patients. And when we are able to tell someone who is ill but has little money that the medicine is free—a gift—the patient often weeps with gratitude.”

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One recent donation went to Dr. Philippe Seneque (pictured above left), the only doctor serving 80,000 Haitians in 69 villages since 1993. For Dr. Philippe, as his patients call him, every day is a fight against malnutrition, malaria, tuberculosis, and other infectious diseases. The closest hospital is more than 60 miles away over a mountain range (more than a three-hour drive) meaning emergencies must often be handled as best as possible on the spot.

The health of Dr. Philippe’s patients is often compromised by their living conditions and economic status. Most live their entire lives without proper nutrition or access to vitamins. For pregnant women, especially, this causes health problems that are too often passed on to the next generation.

And when individuals with compromised health are then exposed to disease, their chances of resisting infection are low. Infant mortality and childhood diseases are particularly high in such rural areas.

Another challenge for Haitians is that a high percentage of the medicine available in the country is either counterfeit, made from such substances as talc or sugar, or is dangerous because it includes substances that are tainted or unclean. With no equivalent of the FDA in most resource-poor countries, “medicines” are often not medicinal at all and too often are actually harmful.

So Dr. Philippe does his best, relying on the donations of medicines from MAP and the visits of nurses and doctors who volunteer to help at the rural Moline Clinic, or one of the other small health facilities in the region.

Because of poor air quality, asthma is an increasing problem among the population, but inhalers are not widely available. Gladys Mungo, a nurse who works with Dr. Philippe through Haiti’s Children, tells this story:

“We had an infant who was brought into the clinic, having trouble breathing.  We didn't have a nebulizer with us.  The doctor quickly got things under control and had the mother breathe the medicine in and slowly breathe it into the baby’s mouth.  It took a while, but her airway were cleared and the wheezing started to subside and the baby was okay.  Dr. Philippe put his arms around the mother and said, ‘You saved your baby.’”

Gladys remembers the story of another baby, left on the steps of a church by a woman who was dying of TB and wanted to be sure her five-week-old child was found and cared for. “We were able to care for the baby with the medicines on hand. Sometimes our work is overwhelming and before I moved the baby to an orphanage I remember crying out to God: 'Why am I here? That baby rolled over and reached for my hand and pulled it to her heart. 

This is why I am in Haiti, for the children. She has since been adopted by a Haitian lady who was unable to have children. Now this baby is the lady’s heart beat. They are both doing very well and the child is in kindergarten now.

For Dr. Philippe, having medicines donated by MAP means that people have enough to properly treat chronic conditions as well. Because most patients cannot afford medicines they try to spread out whatever they have, sometimes skipping doses or only taking it on days when they feel particularly bad. High blood pressure, a common problem in Haiti, is often treated symptomatically instead of on a regular basis.

 When donations make the medication more regularly available, patients can then take the proper daily dose to treat their chronic conditions.

For Dr. Philippe’s patients, donations of medicine are often life-saving. Antibiotics cure infections that have spread and threaten lives. Oral rehydration therapies treat those who are severely dehydrated from diarrheal diseases and cholera. Decongestants help fight the chronic congestion so many children and adults experience. And vitamins—especially pre-natal—guard against diseases common to those who have chronic vitamin deficiencies.

Doctors like Dr. Philippe Seneque, Dr. Cece Lugo and thousands more work where health needs are great, but treatment and cures often depend on the donations of strangers.

Says MAP president, Steve Stirling, “As a child growing up in Korea, I suffered from polio because medicine wasn’t available. Here at MAP, we are dedicated to making sure medicines go to every corner of the world, so no child suffers or dies unnecessarily for lack of medicine."

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