Sadia Ali is a National Geographic Young Explorers Grantee who seeks to unravel the conflict between “Western” and “Eastern” medicine, and to illustrate how their intersection can be beneficial to everyone in providing more treatment options and lowering costs. Her project, “A Healer’s Meridian”, focuses on reporting healthcare conditions and practices in Laos, where medicine is both new and traditional.
We spent the last 11 hours motorcycling across the country to Na Kae village just North of Vang Vieng. With no previous experience of riding a motorcycle, the thought of scaling mountains with little to no roads seemed risky, but necessary in order to meet rural and remote healers. With sunset fast approaching and the rain beating down on our backs, we had no choice but to continue with little idea of where we were and at times with no one in sight.
With several accidents along the road, I arrived at our destination with a decent collection of bruises and injuries. My rudimentary first aid kit was running low, so the next morning I decided to visit the local pharmacy for over-the-counter treatments.
My concept of a pharmacy was what we would find in America: Standard over-the-counter drugs were available for pick-up whereas the distribution of prescription drugs is regulated by health professionals. This local pharmacy I visited, however, was a stark contrast between healthcare in the developed versus the developing.
As I approached the counter, I saw that the pharmacy behind served as small living quarters. There was a slight humming coming from the series playing on the television in the back. The television was dwarfed by several cabinets leaned up against the wall stuffed with a myriad of prescriptions and pharmaceuticals. Confused, I called for the pharmacist. From the back of the room, a young boy approaches the counter with authority. He was the “pharmacist.” I explain the aches and pains I had from my accident and he gives me a selection of medications to choose from. To get a better understanding of pharmaceutical regulations, I ask whether or not valium is an option to purchase. Within seconds he pulls out a full box of pills. Stunned, I begin to run through a plethora of questions. He answers disinterested, his attention diverted to his phone and the TV running in the back. I ask if there are any side effects and begin to run through my health history. The boy replies casually that the drug works with everything and there are no side effects. It took three minutes of prodding to have him finally explain the side effects if the consumer were to have an allergic reaction.
This pharmacist in the making is the son of a local doctor. His father works at a nearby hospital during the day, imports drugs from the hospital to his pharmacy, and has his son run the show during his time away. Drugs are relatively cheap; no doctor, no prescriptions, zero regulations. For a community with limited access to hospitals and pharmaceuticals, this model calls into question whether that’s necessarily a bad thing.
Eighty percent of pharmaceuticals in Laos are sold privately, like in this small shop. The problem is a double-edged sword. While the private sector increases the access to these pharmaceuticals to remote areas, the quality of care is largely unregulated. Consumers like myself are left misinformed leading to increased risk. The government is doing its part to regulate distribution by putting in place an enforcement system of sanctions for shops like this. The trade-off, however, is its promotion of geographical inequity of access.
Despite the lack of regulations, I chose to take the risk and purchase valium to quell the aches from my accident. With crossed fingers… I can only hope for the best.