Benin – health: they take care of themselves…

The sale of street drugs is banned in the lakeside city of Sô-Ava in Benin. But sellers continue to sell them discreetly and this fuels the practice of self-medication in homes. Only 11% of the municipality’s population attends the health services.

Ouestafnews – In the lakeside town of Sô-Ava, in the south of the country, people rarely go to health facilities for consultations or treatment. They prefer to take care of themselves. Despite the risks.

Sitting on the edge of a bed in a hospital ward, Albertine Hounsa never takes her eyes off the infusion device that connects her daughter Sèna to life. Her breathing is jerky, the girl of about four is sleeping, her eyes half closed. “She Today she opened her eyes and asked for an orange”, whispers the child’s mother, visibly relieved.

That day, the sick child and her mother were at the Saint Joseph de Sô-Tchanhoué Medical Center in Vekky, a neighborhood of Sô-Ava.

The day before, this shopkeeper was in fear for her life when she saw her daughter pass out among her playmates, according to her own testimony. Three days before her, to combat her daughter’s fever, Albertine had resorted to a medicine saleswoman. The latter had sold him, for a few hundred FCFA, tablets to administer to the child. “She took them for three days. The fever has gone down. I thought she was healed,” says Albertine Hounsa.

Half an hour’s sail from there, in the Sindomey district of the main district of Sô-Ava, Dieudonné Dègbo, a 14-year-old orphan, is suffering in his flesh. Victim of a wound caused by a nail, the boy, due to lack of money, cannot go to the health center and is treated with the means available by the mothers of his neighborhood.

Each of his mothers followed their own method: hot water compresses or warm herbal teas applied to the open wound here; tablets to swallow to “kill” the wound there; nothing was spared the boy. “The child’s foot was so swollen it was scary,” says Bernadette Kokodé, the boy’s restaurateur and neighbor. She adds that at least they “managed to get the pus out” of the boy’s foot.

This therapeutic relentlessness, however, did not lead Dieudonné Dègbo out of the woods. His “little wound” has turned into a purulent sore. Dieudonné is now limping. Faced with his deteriorating state of health, the boy found himself at the health center through an NGO informed of his precarious state of health.

Common practice

Sèna and Dieudonné are not isolated cases. Self-medication is a common practice here, as in the rest of Benin and many other countries for that matter.

Self-medication, according to the World Health Organization (WHO), consists of resorting to a drug on one’s own initiative or on that of a loved one, with the aim of treating a condition or symptom that an individual has identified himself , even if identified, without resorting to a health professional.

In Sô-Ava, the populations first prefer to cure themselves by their own means. “Seeing people come in for a consultation on their own is rare. They believe that by doing so they will spend a lot», explains Aurèle Aïtchédji, director of the Saint Joseph Medical Center in Sô-Tchanhoué. This is confirmed by Mahumin Koudédo, a mother: “With 500 or 1000 FCFA, I can pay for home care. At the health center, the consultation costs money, not to mention the drugs “.

In 2020, in the municipality of Sô-Ava, only 11% of the population used health services against a national average of 53.8%.

In Africa this practice is also associated with counterfeit medicines which may not have any active ingredients; with a reduced active ingredient or contain toxic substances.

According to WHO, 10% of pharmaceutical products in the world are counterfeit. A rate that reaches 30% in Africa.

In collaboration with Interpol, the Beninese government organized in February 2017 and throughout the territory, the “Pangea IX” operation against illicit drug trafficking. However, counterfeit medicines have not disappeared from the municipality of Sô-Ava, due to its proximity to Nigeria, where the traffickers get their supplies. The trade is now underground. Vendors no longer display products prominently on their stalls. They sell them clandestinely to a clientele they’ve managed to keep.

Bernadette Kokodé has her designated suppliers. “When I’m sick, I go to the vendors. I explain my illness to them and they sell me the appropriate medicines,” she says.

The municipality of Sô-Ava has only one pharmaceutical depot, which is difficult to access, especially in times of floods, as well as a few units for the sale of generic medicines at the level of health centres.

Dangerous cocktails

Self-medication carried out with industrial drugs is also associated with the pharmacopoeia. For greater effectiveness, some combine the tablets with herbal teas before consuming them. Mahumin Koudédo, a mother, says she does it to treat her children: “When they get sick, I treat them at home with Nigerian medicines and herbal teas.”

These combinations, made by consumers without any supervision, without any knowledge or skills, involve risks.

“If the two products have the same action”, the patient can very quickly find himself with an “overdose problem (…), which is necessarily deleterious for the sick person”, explains Constant Vodouhê, doctor of pharmacology and cell biology , warning that it can destroy vital organs such as the liver, kidneys or heart.

Dr. Olympiade Akouehou, head of the dispensary of the Saint Joseph Medical Center in Sô-Tchanhoué, also cites cases of improper use of drugs, especially products containing Tramadol, an opiate used in medicine as a pain reliever. “They take them as performance-enhancing drugs to work without getting tired. At some point, they can no longer do without it and become addicted,” regrets Dr. Akouehou.

Behind all these problems, the supply of health services in Sô-Ava is insufficient. For about 145,000 inhabitants, the city had only 8 health facilities in 2020, according to official statistics. The nursing staff consisted of a doctor, fifteen nurses and seven midwives. WHO recommends 25 skilled agents per 10,000 population. In 2021, Benin had 4.8 officers for every 10,000 inhabitants.

NPF/fd/ts

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