In Burma, Risky Drugstore Sales a Regular Part of Life

By Khine Thant Su 16 August 2014

RANGOON — When 26-year-old Aye Aye Khin came down with a cold earlier this year, she did not go to see a doctor. Instead, she decided to seek the help of a salesman at a nearby drugstore.

As a receptionist at a hotel working eight-hour shifts every day, Aye Aye Khin did not have time to wait in the long line of patients at a clinic in her township. Nor was she able to spend the doctor fees, about 5,000 kyats (US$5), when she only makes a meager monthly income. For less than one-tenth that amount, she knew would be able to pay the salesman at the pharmacy to prepare some medication for her.

Bypassing the doctor’s office is a normal part of life for many people in cities of Burma. But this time, Aye Aye Khin was surprised by the terrifying reaction she had after taking the medicine she had been given.

“A while after, my throat started to tighten up and I couldn’t breathe properly. I was wheezing. My skin also began to itch and rashes appeared all over my body. I was so scared,” she said, recounting the events from one year ago, and adding that she later learned that the medicine included penicillin, which she is allergic to.

Allergic reactions are only one possible danger of buying prescription-only medication without a proper prescription. Dr. Yin Yin May, a primary care physician for more than 30 years, says she has seen patients experience gastrointestinal bleeding and other drug reactions after buying medicine at drugstores. “In emergency cases like that, I have to send the patients straight to the hospital,” she said.

According to Burma’s National Drug Law of 1992, it is illegal to sell prescription-only medicines to someone without a doctor’s prescription. Violators can be fined and imprisoned for up to one year.

Still, whether due to the low prices or the easy accessibility of their medicines, drugstores continue to attract a large patronage.

“You can spend less time and money going to buy medicine at a nearby shop. You have to make appointments and pay a lot more money to go see a doctor,” said a schoolteacher who lives in Hledan Township.

Prescription-only medication can be effective, but it needs to be taken at proper doses to avoid negative side effects. However, some salespeople at drugstores seem to be unaware of the dangers of using these medications without a doctor’s prescription.

“When a person comes asking me to prepare a medication for an illness, such as headache, fever or stomachache, my goal is to help get rid of the symptoms as fast as possible,” said Myo Aung, a sales assistant at a small drugstore in Sanchaung, one of the most populated residential areas in Rangoon.

“A lot of people come to my shop for help when they have some minor illnesses because I can prepare medications that relieve their pain fast,” added Myo Aung, who has been working at the shop since he finished high school.

He has not had any medical education, but he does not believe it is necessary for his job. Some people come to buy medicine with a doctor’s prescription, and he takes note of what the doctors prescribe, so when a patient with a similar illness arrives without a prescription, he can try to replicate the correct medication.

Regardless of socioeconomic status, many Burmese opt for this shortcut in treatment. “No matter what the educational level or financial status of the people, a lot of them are still relying on these shops preparing medications for them,” said Dr. Yin Yin May.

“The main problem, I think, is the public’s weak health knowledge. People should know that every medicine has side effects to some degree. Just seeing an improvement within a day or two doesn’t mean an illness has been cured completely,” she said.

To address this matter while promoting public health knowledge, the existing law should be reinforced, according to a director of the country’s Department of Food and Drug Administration.

“The proposal to systematically implement the rules and regulations of the Ministry of Health was submitted to Parliament last year. After the proposal is approved by Parliament, then we will handle this matter step by step,” said the director.

“We cannot take any drastic measures against this matter because we also have to consider the challenges facing the people involved,” she added.

It may take time to tackle the problem in a way that benefits both the buyers and sellers of these medicines. For now, it seems that many customers are here to stay.

“I am feeling dizzy today so I’ve come to this drugstore to get some medicine. I have to go to work tomorrow so I want to get rid of the dizziness quickly. I think my accident last time was a coincidence. Most of the time, the medicine from this drugstore works for me. So I’ve come to this shop to get medicine again now,” said Aye Aye Khin, smiling as she walked out of the drugstore and onto the crowded street.