Saudis have a tendency to visit pharmacists more than their own doctors because of the convenience. As of 2013, the doctor-to-patient ratio was one physician for about every 400 patients. In the Makkah and Riyadh provinces there are about 502 and 547 patients respectively for every bed.
Medical health care in Saudi Arabia continues to improve, but it’s no wonder that Saudis seek their medical advice from pharmacists who are more readily available. But let’s face it, it’s far easier for Saudis to get the type of medication they want for their illnesses and aches and pains from the pharmacy whether it’s the right kind of medication or not.
During a recent trip to the United States, I had the occasion to make trips to the pharmacy and one trip to a doctor regarding my daughter’s eye infection. In two instances with the doctor and pharmacist, both were reluctant to prescribe medication for her eye. Since eye infections were common in infants, they preferred to wait, suggesting we use a cold compress unless it got worse. An eye doctor I consulted simply said eye infections were not within her expertise, and like the other medical professionals, she declined to suggest medication.
Not only do many pharmacies in the West insist on giving verbal instructions on a medication’s use, including obtaining information from patients on allergies, they often have patients sign a form that they have been given those instructions.
Yet in Saudi Arabia anyone can receive just about anything from a pharmacist just by asking. The other night, I stopped by a chain pharmacy on a busy Jeddah street to pick up a few things. It was located on a street corner and the foot traffic was heavy.
As I stood in a queue about four people deep, I noticed an older woman who looked to me to be from a low-income family. In her hand was an empty box for painkillers. When she asked the pharmacist for three boxes, he happily provided them for her. She also asked for medication for her ulcer. Again, he handed over the medicine without asking a single question. It was obvious from the type of painkillers she was asking for that it could cause bleeding in the stomach, hence her request for ulcer medication.
Being the nosy person I am, I told the woman that her painkillers could cause stomach bleeding, but she simply shrugged her shoulders and said this was the combination she always took. The pharmacist said he could not refuse her because he didn’t have the “authority” to say no. That doesn’t ring true to me, but that was his defense.
Another man in the queue then asked the pharmacist for an antibiotic to clear up his baby’s eye infection. Without seeing the baby or asking any questions about the infant’s ailment, he handed over an antibiotic. The recklessness of this transaction of applying an antibiotic to a child’s eye without an examination is truly terrifying by exposing the child to creating problems with its vision.
Patients in every country often rely on a pharmacist in lieu of unavailable physicians. But the consequences of relying on an individual who has no expertise in infant eye infections, and one who even abdicates his or her role as a pharmacist charged with carrying out doctor’s orders and prescription, can be life altering.
This conduct is careless and takes advantage of people in pain and their ignorance. Restrictions by the Ministry of Health should be imposed on over-the-counter drugs and prescriptions filed only by an authorized pharmacist. Sure, receiving over-the-counter drugs that in other countries are highly restricted and available only by prescription has spoiled us.
But we are playing fast and loose with drugs that we really have no business — and certainly no real knowledge about its effects — using. Antibiotics are not the answer for every ailment, and indeed, are usually not the answer. But we believe them to be a cure-all. Government intervention in the form of laws to curb abuse of pharmaceutical drugs seems to be a reasonable solution.
