‘Using fake oxytocics can cause fatalities’

If the recent announcement that certain fake drugs have been imported into the country is true, then we are in for trouble, more so when one of the drugs implicated is an immediate life-saving or emergency drug.

I have heard of painkillers, antibiotics and some blood tonics being faked. For these drugs, if they do not perform their functions well, one has ample time to detect and therefore can switch to more potent ones.

But this is not so with oxytocics (e.g. oxytocin, syntocinon). These are special drugs which help the uterus to contract and thereby augment labour or prevent excessive bleeding in mothers who have delivered.

If the drug fails to control this bleeding, then in most cases the unfortunate mothers will die, and they will surely die. Examples of these deaths abound in our health facilities where patients succumb to uterine atony (failure of uterus to contract) despite conventional management and the maximum use of oxytocic agents.

For a long time, both experts and ordinary people have been struggling to find ways to bring maternal deaths under control but the more they try the more the solution becomes elusive. In my earlier article published on this page, I attempted to bring to light some risk factors contributing to maternal deaths which have not been addressed realistically (see Daily Graphic, January 19, 2013, p 11) but it appears a more serious challenge is being presented.

That is why I was taken aback when I heard that fake oxytocics have found their way even to regional medical stores and are being distributed to hospitals and maternity homes.

The truth is that postpartum haemorrhage (excessive bleeding after delivery) or PPH is a leading cause of maternal deaths in both developing and developed countries and institutional management is essentially similar in these two settings. But the mortality rates from this complication are significantly different and higher in developing countries and the use of substandard oxytocin cannot be ruled out as a contributory factor at this stage.

Ghana, and for that matter developing countries, is struggling to meet Millennium Development Goal five (MDG 5) which aims at improving maternal health and reducing preventable maternal deaths but we will not get anywhere if our system continues to be flooded with fake drugs such as oxytocin  and other life-saving drugs. Imagine the harm that will be caused treating a patient who has convulsions with fake anticonvulsants.

I believe we should spend resources to manufacture our own life-saving drugs for us to exercise more control rather than importing them for which we can be easily deceived. If this cannot be done then the importation of these drugs must be seriously guarded to ensure that they are, indeed, life-saving and not something that will hasten death.

In this regard, everybody must get involved, since maternal death affects everyone  — whether directly or indirectly. All health personnel, particularly doctors and midwives, must watch out for fake oxytocin in the event of uncontrollable PPH, as in their anxiety and attempt to save life, it may escape them that perhaps a substandard, non-efficacious drug is being used to control the excessive bleeding.

The Food and Drugs board must be commended for its vigilance although this finding came a bit too late. Nevertheless it’s better late than never. The role of the Ghana Health Service and the Pharmacy Council in collaborating with the Food and Drugs Board to stop this menace cannot be overemphasised, and I hope appropriate actions will be taken to ensure that never again will fake oxytocin be imported into the country to save the lives of our dear mothers.

Article by Dr Kweku Y. Kese

The writer is Medical Superintendent, Konongo-Odumasi Government Hospital (This email address is being protected from spambots. You need JavaScript enabled to view it.)

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