A CALL TO ACTION.

The ward round was quite lengthy.For some reasons we had so many patients to review.
However,there was more to it than that.We saw a couple of patients that gave insight to the debilitating nature of mental illness and Schizophrenia in particular.

There was a good representation of both patients from low socioeconomy background and those from good socioeconomic background.Of course the theme of their delusions are different based on their respective backgrounds,but the striking thing is how it turns people from the sharp and intelligent people with good judgement to people with poor judgement and ridiculous delusions.
It is really split mind as it was described.

The impact of schizophrenia on the significant others is better imagined than experienced.A situation where someone will reject all good things of life from the relatives and choose to suffer because he/she simply believe that they are against him/her.You can now imgine the impact of that on the relatives.A wife sees her once loving husband become withdrawn and suspicious,and a husband has all his gift to his wife rejected because she believes that he wants to kill her.

There is also the effect on the social funtioning of the patient.Imagine what happens when somebody is suspicious of everybody at work.In a country like mine when persecutory ideas are really common and people always find an enemy responsible for all their failures or predicaments,it may go on unnoticed for sometime before it is detected.

Another issue that was highlighted is the issue of the high cost of the antipsychotic drugs.We are still largely restricted to the typical antipsychotics!The high cost of the atypicals is simply prohibitive.Not many of the patients who would have done well on these drugs can afford them and as such we have to simply make do with the typicals and as such sometimes we don't get the desired results most especially with the negative symptoms schizophrenia.

This brings us to the issue of the parameters used to assess the importance of illnesses.To see that the treatment of tuberculosis and HIV/AIDS have become free simply because of the mortality involved with them while psychotrophic drugs are exorbitantly high despite the morbidity involved is something we should ponder about.Maybe we are not doing enough advocacy about mental illness and the shattering effect they can have on the lives of people in all ramifications in terms of global assessment of functioning and the effect on the social networks.
At least we should also note that these mentally ill people may commit suicide when it is severe.This may be more common with depression,but also holds for schizophrenia expecially when they gain insight into the chronicity of the condition.Moreover,some of them may respond to hallucinatory voices telling them to kill themselves! All these should make us cry for the liberalisation of these drugs to force down the prices even if they are not free.

These brings us to the issue of the Doha declaration as was highlighted a couple of months ago by my friend in his blog.The declaration states that developing countries must use public health safeguards written into the World Trade Organization’s intellectual properties rules to access less expensive, generic versions of patented medicines.For more about the Doha declaration check the link below;
AdvocateHealth!: In the Spirit of the Doha Declaration