When you return home from the West what strikes you most is the huge number of pharmacies – locally called medical stores – that line our bazaars. They are everywhere like flying dust. Even a small market has dozens of them. Their ubiquitous presence causes no amazement or worry to the people who frequent them as if they are eateries. These medical stores, always thronged by customers, do brisk business and make a quick buck. The scene makes you believe that half of our population suffer from ailments. Against it, you find it hard to spot pharmacies in the West as they are far and few. They are not medical stores either in our sense of the word.

The simple difference between a medical store and a pharmacy is that the former sells health-related products while the latter dispenses prescription medications under the supervision of a licenced pharmacist.

First, we should try to briefly understand why we have such a large number of medical stores and how they run their businesses. Their large number is a testament to one thing i.e. prevalence of sickness. Sickness is their raison d’etre; sick people are there to whose needs they cater. Why are people sick in such a large number? Because of their food and living conditions? Our food is not merely tainted, it is poisonous. The reason is that our farmers/growers are not aware of the effects of the insecticide, pesticides, fertilisers and chemical sprays they use on the crops to have better yield. And those who know don’t care.

Unrestrained use of chemicals impacts the crops and what we eat comes mostly from the crops. In between the growers and the end consumers are what we call middlemen (Aarhti), commission agents, stockists and shopkeepers who adulterate the food products to make illegitimate money. There is hardly any check on them. All the government departments concerned with agriculture and food quality control are parasites that thrive on the bribes they extract from those connected with the food supply chain. People forced to eat the food laced with deadly chemicals naturally fall sick. It’s a matter of garbage in, garbage out.

As to the living conditions, the majority of our people are forced to live an unhygienic life because of poverty, official neglect and cultural habits. Poverty means living in run-down areas which are congested and dirty. Our institutions concerned with civic life pay little attention to such areas which house the overwhelming majority of our people. The greater the number of small houses the narrower the roads, for example. Our rigid class society led by an obnoxiously class conscious bankrupt elite believes people need much less than what they do; being fully human depends on one’s class and status. Since people have been living in squalor for long enough they have developed habits of accepting the filth and dirt as a part of their life. So from personal hygiene to general cleanliness everything is marred by apathy.

Another factor is malnutrition born of scarcity and low quality food. Additionally, our way of cooking food is also unenviable. Our food is unnecessarily deep fried and overcooked which harms its nutritional value. People living in such conditions are naturally prone to falling sick.

When sick, people from lower income groups consult quacks, traditional and modern, for treatment because they suffer from mental acuity. Secondly, they cannot pay the hefty charges of qualified doctors and consultants who in any way don’t give an ordinary patient more than three minutes. They don’t allow them even to narrate their tale of woes and are wary of talking to them in their language. Instead of being compassionate they betray a bureaucratic streak as a hallmark of being persons with special knowledge.

Thirdly, our authorised health professionals, say national and international investigative reports, prescribe more medicines than needed to their patients to please the pharmaceutical companies which reward them through different material and social incentives.

Fourthly, medical professionals with low levels of competence also indulge in such a practice. Being not sure of diagnosis and treatment, they prescribe more medicines than required thinking one of them would do the trick. To buy medicines you don’t need a prescription. Just walk into a medical store and buy whatever you want to. Most of the medicines are available over the counter. What you are required to have is money, not the prescription. If you are not sure of the medicine you need no problem; the sales person can help you out by suggesting what is the best for you. And he/she would render the service with the confidence of an experienced doctor. If you are finicky and trust neither the doctor nor the sales person you can self-medicate for your ailments. There is no bar on it because you are free to choose the medicine you think will cure you. Medical stores round the corner of your street would readily serve you by offering whatever you want.

A professor of medicines told me that there was a landlord in Multan who whenever sick would consult three best doctors of the city, get three different prescriptions and go back to his outhouse (Dera). He and his favourite servant would sit together and make their own prescription choosing from what the three doctors prescribed.

To sum up, the presence of a huge number of medical stores in our cities and towns is not an isolated phenomenon; it’s symptomatic of a wider malaise that afflicts our socio-economic structures put in place not to look after the general welfare of all, but of a particular segment of the powerful who are an accomplice in creating conditions where a few can enjoy a healthy life at the expense of so many. That the health of each would be the condition for the health of all is still a distant dream. — soofi01@hotmail.com

Published in Dawn, October 21th, 2024