Health Watch

Attention all patients!

Patient guidance leaflets from Health Ministry:

Nadira Gunatilleke

Look out for the patient guidance / instruction posters in your next (private) hospital visit. Do not forget to read them carefully and keep the points in mind before consulting a doctor. These posters have very important information for you. The information and guidance will save your life from quack doctors and wrong diagnoses made by real doctors!

Committee on Patient Safety and Safety in Practice, College of General Practitioners of Sri Lanka launched very useful posters to educate the Sri Lankan public on consulting doctors and using medicines. The project had been funded by Hemas Hospitals. The posters are in all three languages, Sinhala, English and Tamil.

The main objective of these posters is to help general public make an assessment of their doctors and also to make a self assessment. It also helps patients to assist the doctor to make an accurate diagnosis.

When consulting doctors and obtaining treatment from private sector hospitals, patients undergo a great deal of problems. Complaints pour in both from the patients and doctors. Main reasons for those issues are lack of communication, lack of general knowledge (from the patients’ side) and lack of guidelines for patients and doctors. The new posters will solve most of the problems faced by both patients and doctors.

But still there are things to be improved. If you look question number 9 of the `Your Doctor’ poster you will find the most important question -`Does your doctor promptly inform you when an error is made during care?’. This is something very important, but such a practice is never seen in Sri Lanka at the moment. Without making relevant rules and regulations tougher, we cannot expect this to happen. But still the patient can be vigilant on possible errors by improving their general knowledge and studying (reading) about treatment and medical tests before obtaining them.

Number 11 of the second poster `You and your doctor’ will open the eyes of patients and doctors. Tired and over worked doctors will not do any good to the patients or to themselves! First of all doctor need to be in good health and have mental peace to treat a patient. Therefore it is pointless to consult a doctor and obtain number 97

*********************------------

`YOUR DOCTOR’

1. Is your doctor registered with the Sri Lanka Medical Council?

2. Is your doctor kind and caring towards you?

3. Does your doctor listen to you attentively and give clear answers to your questions?

4. Does your doctor make you feel comfortable and spend sufficient time with you to have a meaningful discussion about your health concerns, even when extremely busy?

5. Does your doctor explain the steps of management and the follow up action necessary for your good health, together with their likely consequences?

6. Does your doctor explain the effects and side / adverse effects of the drugs prescribed and write the prescriptions and relevant instructions legibly?

7. Does your doctor provide a satisfactory service that you can afford?

8. Does your doctor refer you to another doctor, hospital or a relevant service in time when your problem is difficult to solve?

9.Does your doctor promptly inform you when an error is made during care ?

10. Is your doctor accessible in an emergency ?

** Look for the above qualities whenever selecting a doctor for you and for your family.

********************------------

`YOU AND YOUR DOCTOR’

1. Be considerate about other patients too when you visit your doctor

2. When visiting your doctor – be sure to take all your medical records, make sure you take all the medicine you have been taking, make special mention if you have any allergies.

3. Listen to your doctor’s advice carefully and if anything is not clear ask the doctor again. Preferably have a family member of a friend accompany you to the consultation

4. If you are pregnant or breast feeding, make sure your doctor aware of the fact at the consultation.

5. Check the accuracy of the medicine you buy from the pharmacy and compare with the prescription looking in particular for the generic name (not brand name) of the drug and the expiry date.

6. Take your medicine according to instructions given by your doctor regarding the dose, frequency and duration. Do not stop taking the medicine half way.

7. Always buy medicine on a prescription except for simple pain killers like paracetamol.

8. Avoid buying medicine on old prescriptions without your doctor’s advice. Do not use medicine prescribed for others and also do not give medicine prescribed for you to others.

9. While taking the medicine, if you experience any uneasiness, develop an allergic reaction or your condition become worse, stop the medicine and inform the doctor immediately

10. Always obtain a referral letter from your doctor before you consult a specialist and when you go for investigation

11. It is your interest to avoid doctors who are tired and over worked.

** Help your doctor to help you

*******************--------------

Health and social benefits of family planning

Samangie Wettimuny

Addressing a media workshop held at the FPA auditorium recently Consultant Community physician, Family Health Bureau Dr.Loshan Moonesinghe emphasized the importance of using family planning methods as half of all pregnancies in the world are unplanned.

“According to global statistics every minute 400 women become pregnant, but 50 per cent of these pregnancies are unplanned. One fourth of the pregnant women experience pregnancy related complications while 1/8 th (fifty ) of women seek unsafe abortions” he said.

Family planning is globally, nationally and locally important.“Today at a time we are talking about mega level development plans, especially in the post war context, the population growth needs to be controlled as excess population undermines the country’s efforts to provide adequate healthcare, food and employment for all.”

“At the community level family planning can improve the wellbeing of families, serve unmet needs and prevent unintended pregnancies, unsafe abortions, maternal and child deaths. At the global level family planning can reduce the strains on the environment as the increase in population contributes to tropical deforestation, food and fresh water scarcity. Slow economic and social development draw on the scarce resources leading to poor quality of life. Though resources have to be shared the stark truth is that the developed with 1/3 of the world population consumes 80 per cent of the world resources.”

Benefits

Family planning benefits mothers, and children, and in overall terms it brings social and demographic benefits. It reduces maternal morbidity and mortality and avoids adverse pregnancy outcomes by preventing unplanned pregnancies, unsafe abortions and teenage pregnancies.

“It reduces maternal mortality mainly by reducing the number of times a woman becomes pregnant. Women of higher parity face a greater risk of maternal morbidity and mortality. It also reduces the number of unintended and unwanted pregnancies and the number of pregnancies to women of increased risk such as young women under 20 years, women over 35 years of age and women with medical conditions where pregnancy is contraindicated-(heart disease and thalassaemia)”

Dr.Moonasingha also noted that short pregnancy intervals (less than eighteen months) are associated with increased risk of adverse perinatal outcomes. Adverse pregnancy outcomes are avoided by lowering the risk for foetal death, lowering risk for preterm birth and lowering the risk for low birth weight.

Benefits for children

Undoubtedly it saves children’s lives (neonates, infants and under five children) and improves their wellbeing. “Family planning methods improve children’s wellbeing by spacing pregnancies at least 3-5 years as it helps mother to have healthier children and improves children’s chances of surviving and remain healthy, allows parents to spend quality time with children and also more resources can be allocated to children.”

While family planning helps reducing population growth it brings a whole lot of social benefits such as encouraging safe and responsible sexual behaviour, improving the quality of family life, encouraging the role of husband in women’s reproductive health promotion, contributing to the husband’s sense of wellbeing and may permit the family to save money before the birth of the next child.

Dr. Moonesinghe finally said that for every Rs.100 spent on family planning, the government save as much as Rs.2000 in reduced expenditure in health, education and social services.

Lanka Hospitals commemorates World Blood Donor Day

World Blood Donor Day was celebrated on June 14. Lanka Hospitals conducted a blood donation campaign in which the donors were rewarded with certificates and tokens of appreciation for their selfless generosity.

Speaking on the campaign, Consultant Transfussion Medicine of Lanka Hospitals Dr. Sewwandi Thilakawardane , said “Often it is the last minute rush to find sufficient quantities of the right blood group that delays patients with rare blood groups receiving immediate treatment. However, we have worked extensively to ensure that all Lanka Hospitals patients have immediate and sufficient access to all blood groups – guaranteeing immediate service and treatment to each of our patients”.

The Lanka Hospitals blood bank was established in 2002 and has grown since to an astounding 26,243 donors comprising staff, relatives of patients, friends and a host of other generous individuals who donate regularly.

Having tied up with the National Blood Tranfussion service, Lanka Hospitals has a distinct advantage of being able to access rare blood groups at short notice to accommodate patients’.

Thirty-three sound recommendations on the table:

Regulating drugs in Sri Lanka

W Pathirana

Given the complexity of the chemical, pharmacological, toxicological, manufacturing, analytical, environmental, legal, social, administrative and financial nature of medicinal drugs, to establish and run a flawless management set up for the pharmaceuticals is an important development index of a country and points to the civic consciousness of the society.

Most countries take pride in having an efficient drug regulatory mechanism.

There is nothing so narrow and easy as regulating drugs within the confines of the country given the enormity and intricacy of the internationally connected network of multi centre drug research, production methods, regulations governing medicines, distribution, storage and dispensing of pharmaceuticals. There are so many acts, rules and othter protocols and concept papers governing the pharmaceuticals.

The WHO Good Regulatory Practices requirements are an indication that experts knowledgeable in pharmaceuticals and of right integrity and temperament should be appointed to any pharmaceutical regulatory body. They should be bound by ethics, have respect and time to honour all these manifold commitments.

We are one peg in this whole complex network of one of the most respected and graceful professions on earth dealing with medicines, the Profession of Pharmacy. The world guards the medicinal drugs legally with harsh penalties to the offenders with otherwise rare provisions for arrests without warrants, life imprisonment and in certain instances death penalty. All of these are enacted and effective in Sri Lanka too.

The Chief Executive of the Pharmaceutical Affairs Bureau of China was executed by a firing squad in a massive bribe case. A team of directors and managers attached to Green Cross Pharmaceuticals, Japan were sentenced to 12-25 year prison sentences for having marketed HIV contaminated blood products. A US pharmacist was sentenced to 35 years imprisonment for having removed half the content of capsules of an anti-cancer drug. In Sri Lanka a pharmacist had to pay a penalty of Rs. 40,000 for dispensing in ‘good faith’ few asthma tablets worth Rs 25 late in the night by employing a decoy pretending to be seriously ill. There is however legal provision in the Cosmetics Devices and Drugs Regulations to act in good faith by a pharmacist.

Pharmaceuticals are commodities that should be treated on a plane above trade, free trade, loss and profit or you name what as it is a matter of both life and death. One should be reminded here that there are a large number of pharmaceutical organizations around the world operating on a ‘no loss-no profit’ basis. Those who make profits recycle them into research and development work in the discovery of new drugs. Birth of one drug is a one in 50,000 chances, takes over 12-15 years costing billions of rupees.

Sri Lanka’s largest manufacturer-State Pharmaceuticals Manufacturing Corporation (SPMC) and the largest distributor- State Pharmaceuticals Corporation (SPC) - are established and run on a no loss no profit basis. Same is the case with most of the domestic manufacturing based private pharmaceutical firms.

To be continued