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Pharmacy in Nigeria

By Karim Moukalled and Matt Bennett, P4 students

As part of our fourth year pharmacy rotation, Matt Bennett and I journeyed to Nigeria on a two week-long medical mission trip with GHO (Global Health Outreach). Our team was comprised of Bob Coulter, a pharmacist in La Grande, Oregon, along with 15 members from America ranging from surgeons, anesthesiologists, nurses, and medical doctors. Our American team joined ProHealth Nigerian doctors to provide care to Nigerians. Our first week was in a newly constructed hospital in the state capital Uyo in Akwa Ibom state. The hospital was considered one of the better hospitals in the state with an OR “theatre room”, eye surgery room, doctor counseling rooms, and pharmacy. We were fortunate to have the pharmacy be one of the two air-conditioned rooms along with the post-op recovery room. The hospital featured electricity in each room and functioning plumbing, which is hard to come by in smaller cities. Every day, medical cards were handed out to Nigerians (with priority to pregnant women, children, and elderly), which allowed them to see a consultant doctor that referred them to surgery, an eye doctor, or wrote them a prescription drug order to be taken to the pharmacy. Our mornings began at 6:15AM with an hour dedicated to morning worship and prayer, and ended at 7:00PM followed by a late dinner at 8PM. The GHO group preformed 120 surgical cases dealing mostly with hernias and goiters, while the pharmacy served over 500 patients a day, totaling over 8000 prescriptions during the week. The eye center dealt mainly with cataract surgeries and also provided eye exams.

During our second week, we took a 4 hour drive from Uyo to Oguta, a more rural city in Imo state, which features the Oguta lake landmark and a much higher prevalence of malaria. The hospital in Oguta was considerably less developed than the first, with non-functioning plumbing and a generator used to provide power. The hospital did not have any air conditioning but had similar wards with an OR room headed by 4 local surgeons, an eye surgery room, consulting rooms, and a pharmacy. The pharmacy served over 400 patients a day, each with multiple drug orders. Most common prescribed medications included antibiotics (amoxicillin, ampicillin, ciprofloxacin, doxycycline, bactrim, flagyl, and erythromycin), anthelmintics (albendazole, mebendazole, levamisole), antihypertensives (methyldopa, amlodipine, lisinopril, atenolol, amiloride with hydrochlorothiazide), and antimalarial (atmal/coartem, chloroquine, sulfadoxine and pyrimethamine, artesonate).

In total, over 200 surgical cases were done and over 4500 people were treated in 2 weeks. Thousands of lives were touched including those of many GHO and ProHealth team members. The trip was a valuable and life changing experience that provided a greater perspective on healthcare in a third world country and how pharmacy and medications play a role in people’s lives.