Several Kabul residents say that due to poverty and unemployment, they have turned to self-medication. They add that without visiting a doctor, they purchase medicines directly from pharmacies and take them to reduce their treatment costs. According to these Kabul residents, in the current situation of the country, going to a doctor when falling ill is no longer a priority in their lives due to economic challenges and unemployment.
Some residents of Kabul tell the Hasht-e Subh Daily that although they are aware that the use of certain medicines may be harmful to them, they have no choice but to self-medicate due to economic difficulties and the high cost of medical treatment and laboratory tests. These individuals state that medicines such as 400 to 500 milligrams of paracetamol, ibuprofen, diclofenac, aspirin, amoxicillin, ciprofloxacin, azithromycin, and metronidazole have become part of their daily intake.
Shakila, a resident of Kabul, says that whenever a member of her family becomes ill, instead of going to a doctor, she buys medicine from the pharmacy in their neighborhood. She adds that visiting a doctor requires medical tests, and she finds it difficult to afford their costs. This Kabul resident says: “Whenever my family members become ill, I get medicine from the pharmacy; it is cheaper and they recover faster. I don’t pay a doctor’s fee, and no diagnosis is needed. It is simple and easy. These medicines have not caused any problems for us so far; I even use this method for my three children.”
Nargis, another resident of Kabul, says that under the current circumstances, visiting a doctor is her last option. She adds: “Due to our family’s poor economic situation, when we get headaches or body pain, without visiting a doctor, we buy a paracetamol tablet from the pharmacy to get better. If we go to a doctor for a simple headache, we are forced to go to several places, for example, to get laboratory tests, scans, and go through other procedures.”
Siddiq Omar, a resident of Kabul, says that due to high treatment costs and disorder in hospitals, he no longer has the desire to see a doctor. He adds: “For stomach inflammation, if you visit a doctor, you have to book an appointment days in advance, pay fees, and endure a great deal of hassle. In the end, they prescribe the same medicine that we get from the pharmacy. God forbid if you go to a public hospital; you must wait for hours, and in the end, it is possible that the doctor does not have sufficient knowledge for diagnosis and treatment.”
However, Amrullah and Salim believe that medicines should not be taken arbitrarily before a precise diagnosis of the illness. They call for the enforcement of laws that prohibit the sale of medicine without a doctor’s prescription.
Amrullah adds, “I never take tablets without guidance. For simple illnesses such as headaches and colds, I buy and take paracetamol, and if I cannot visit a doctor or take my family, I consult a doctor about which medicines to use.”
Salim also says: “Examinations should be conducted before using medicine, so it becomes clear what illness the patient has and which medicine should be prescribed. But people, due to not being able to afford examination fees, go to pharmacies for any kind of illness they have and take medicine on their own.”
Farhad Ghafoor, a resident of Kabul, says that Afghanistan’s health system already had its problems, and the Taliban have destroyed it through negligence. He adds, “It is not the people’s fault that they go to pharmacies. The cost of examinations and doctors’ fees is high, and on top of that, people have to pay for medicine, which is why they turn to the easiest option. People have lost their trust in the health system and say that instead of spending money and going to a doctor, they get medicine from pharmacies themselves for headaches or toothaches.”
Meanwhile, some doctors say that the arbitrary use of medicines by people has disrupted their treatment process. They add that the misuse of medicines not only leads to the emergence of new illnesses but also causes the patient’s body to become resistant to medication.
Abdullah Ahmadi, a doctor, says in this regard: “Unfortunately, in Afghanistan and neighboring countries, there are medicines that should be taken according to prescription and medical advice, but these guidelines are not followed, and they cause many problems. One of the consequences of arbitrary use is that when a patient visits a doctor, after many complications, the doctor is forced to begin treatment with a basic medicine, for example, a weak antibiotic, while the patient has already taken several types of antibiotics and not gotten any results. One reason patients experience difficulty is that the doctor does not know which type of medicine and at what dosage the patient has taken from the pharmacy, or the patient does not provide that information. For this reason, the medicines the doctor prescribes may have adverse effects.”
This doctor adds: “Painkillers such as paracetamol and ibuprofen are also available in European pharmacies, and the pharmacist tells the patient how to take them and for how long. Even some stomach medicines are available at specific dosage limits. But in Afghanistan, the misuse of antibiotics, psychotropic medicines, and sedatives is very common, and these medicines should only be taken according to a doctor’s prescription, which is not being observed.”
The head of one of the clinics in Kabul confirms that people are turning to pharmacies. He adds that the majority of people only visit a doctor when their illness has become severe or has gone beyond normal treatment. According to him, doctors are forced to charge high fees because the Taliban impose heavy taxes on them.
This official, who asked for anonymity in the report, says: “Previously, if fees slightly increased, doctors would generously help and might not even collect a portion of the costs. But now heavy pressure has been placed on doctors, and they are forced to charge fees. The situation is very difficult; for example, diagnosing cancers is very complex, and patients who do not have financial means cannot visit a clinic in the early stages. When they reach the hospital, they are often in the final stage of the disease.”
Previously, the World Health Organization (WHO) had announced that after the suspension of aid from the United States, 202 health centers in Afghanistan had ceased operations. This situation has negatively affected the lives of about 1.8 million people in 28 provinces and disrupted the provision of essential healthcare services.
The non-governmental organization Emergency has also warned in a report about the intensification of the deep economic crisis, continuing widespread poverty, pervasive unemployment, and the near-total ban on women’s employment, emphasizing that the collapse of the health system due to budget cuts is highly concerning and that improvement in this situation appears difficult.
You can read the Persian version of this report here:
خوددرمانی در کابل؛ فقر و ناکارآمدی نظام صحی جان مردم را تهدید میکند
