Street vendors who ply their trade in African cities aren't generally viewed as posing a serious danger to public health. That is, unless one buys medicines and other forms of treatment from them -- as the citizens of Gabon are discovering. The vendors sell smuggled and counterfeit treatments that are often cheaper that those available over the counter.
Street vendors who ply their trade in African cities are routinely the target of criticism. Passers-by grouse at being made to step over their wares, displayed on pavements. Local governments grumble that they’re nothing more than a public nuisance.
But, if one discounts the fact that they may raise the blood pressure of city officials, vendors aren’t generally viewed as posing a serious danger to public health. That is, unless one buys medicines and other forms of treatment from them — as the citizens of Gabon are discovering.
Take the case of Ursule Bouassa.
“I bought vials of placenta at the market to make my hair grow, but three months later I noticed that the tiniest tug of a comb made my hair come out. I figured out that the product was no good … Ever since, I’ve had painful sores on my scalp,” she said in an interview in the Gabonese capital, Libreville.
Pierre Gotta tells a similar story.
“I’m not healing because according to the specialists, the lightening creams I bought at the market changed the structure of my skin,” he notes. “I went to see all the dermatologists, but nothing worked.”
The high cost of drugs has prompted many Gabonese to start buying medicines from market sellers and vendors who sell smuggled and counterfeit treatments that are often cheaper that those available over the counter.
However, these drugs may have a dire effect on the health of persons who are not fully informed about the medicines they are buying. Certain drugs offered for sale have expired, and others lack the active ingredients that are necessary for healing.
“Cases of gastric and renal dysfunction, stomach problems, several poisoning deaths … were seen recently at the hospital after people took questionable medications not prescribed by a doctor,” notes Isabelle Mboumba, a pharmacist at a Libreville hospital.
Adds paediatrician Obame Moyo: “The sale of counterfeit medication in the markets does, for the most part, limit prices. But, it engenders a whole series of risks and secondary complications for health … especially among children.”
“If people don’t have a prescription to buy medications, especially antibiotics, which each have different precise dosage requirements, they prefer to self-medicate — even if it brings with it a raft of complications,” he adds.
Indiscriminate use of drugs is also causing bacteria to become resistant to certain medicines.
“For two years, we have treated cases of herpes and hepatitis, many of which were complicated by contra-indicated antibiotics. What we find most alarming is that now many bacteria are resistant to current antibiotics,” says Daniel Fernandes, a physician at a private clinic in Libreville.
Gabonese law stipulates that only pharmacists and authorised agents have the right to import and sell medicines. Health workers argue that this legislation has not been adequately enforced.
“Without a rigorous policy to control the sale of medications by street hawkers or [in] … markets in Gabon, the Gabonese authorities have made all kinds of abuses possible during the past 20 years,” says Emile Mboustsou, a doctor at the Libreville Hospital Centre. “Vendors of all sorts of illegal medications profit from this breach, jeopardising the health of our citizens.”
Last month, the mayor of Libreville, Andre Dieudonne Berre, placed a ban on the sale of drugs in markets and by street vendors.
“The sale of counterfeit drugs by street vendors is illegal and harmful to people’s health. Only duly registered pharmacies and pharmaceutical warehouses are authorised to sell prescription drugs,” he noted, in a press release.
The Gabonese Association of Pharmacists has also tried to raise awareness of the dangers of buying medications from street sellers.
But with some of the medicines offered by vendors selling for half the price asked in pharmacies, the likelihood of Berre being able to stop this trade appears small. According to medical sources in Libreville, the counterfeit drug industry in Africa nets between $10-billion and $15-billion a year.
The situation is complicated by the fact that many Gabonese don’t have the option of buying drugs from legitimate sources.
“Health services are generally not widely available, since 46% of Gabon’s population lives more than an hour away from the nearest treatment centre. In rural areas, this proportion is 86%,” says Samuel Ndong, a nurse.
“In such a situation, people buy the medications that are available to them, and those are the ones they get in the street — which are counterfeit,” he adds.
In 1987, the Ministry of Health — with assistance from the United Nations Children’s Fund — drew up a list of essential medicines. These drugs were supposed to be provided free of charge in public hospitals and other treatment centres.
In practice, however, this never occurred — leaving many to take the dubious route of buying drugs from street sellers.
At present, there are several hundred medicine vendors in and around Libreville, which is home to 650 000 people — most of them poorly educated.
According to estimates by the Ministry of Planning drawn up in 2004, nearly 350 000 inhabitants of Gabon’s three biggest cities — Libreville, Port-Gentil and Franceville — live below the poverty line of $1 a day.
The vendors never reveal where their supplies come from. But, there appears to be a cure for every ailment.
“You can buy packets of several medications in tablet or gel form, antibiotics, syrups with no active ingredient, and even … tablets that girls sometimes take to induce clandestine abortions,” says a Libreville midwife. — IPS