Day 169: Practicing Medicine Without a License

I’m spending the next 2 weeks at a police training facility in Herat. I spend the morning seeing patients with an Afghan doctor in his clinic and spend the afternoon teaching a first aid class to the police students. It is a nice break to leave Camp Stone and have a change of scenery for a few days.

This morning we saw an 18 year old kid who was complaining of headaches and eye pain. He was hit in the right eye 6 years ago and since has had difficulty seeing out of it. Since arriving a month ago for training, his vision has affected his ability to train and consequently he was sent to the public hospital for evaluation and treatment. Rather than go to the hospital, he told me that he had just gone to the local pharmacy and bought some medications for his eye. Now here in Afghanistan you don’t need a prescription for medication. You just go in, tell them what’s wrong, and they give you something to “make it better”. So this kid had gone into the pharmacy 3-4 times and each time was given a different medication. He was given antibiotics, steroids, and finally at his last visit was given atropine--a medication that dilates the pupil. Notice how large his right pupil is compared to his left in the picture. Over the last few days he has been using atropine eye drops which has dilated his pupil and which has caused him light sensitivity and headache.

I quickly told him to stop everything he is using and sent him to officially see the eye doctor. He probably has corneal scaring (this is the white you see over the pupil) caused by his injury 6 years ago. Regardless, all of the medications he was given was hurting him more than helping him. Experiences like this remind me of why we require people to have a prescription prior to buying potentially dangerous medications. Just randomly putting medications into your body, especially in your eye, without knowing what it is, is probably not a very good idea.