Time to Face the Pain
A man on vacation fractures his knee cap. The hospital has no opioids to relieve his pain. A couple of days of agony later, he is stopped at the airport on his way home. They would not let him fly because he was in too much pain!
This happened to Dr Josh Ruxin, Columbia University development expert and founder of Rwanda Works, he writes about it in the New York Times asking about palliative care:
Last year in Mexico, just a couple of days into my vacation, I fractured my kneecap. In the emergency room, through pain so severe I found myself yelling at all helpful parties around me, particularly my wife, the doctors noted that they did not have painkillers to send home with me. “WHAT!?” I screamed. “No oxycodone, hydrocodone, nothing?” They explained that Mexico’s drug laws had grown so strict due to the actions of the narcotraficantes that pain meds were tough to come by (and only provided to patients who had been admitted to the hospital).
Two days later at the airport, the gate agent for American Airlines nearly refused to let me fly because she could see how much pain I was in and thought I might force the plane to make an emergency landing. After much haranguing I was finally allowed to board and made it back home for surgery and painkillers. But this incident compelled me to look at the state of pain management in developing countries.
It is clear that we live in a world where inequities of healthcare are paramount: there are millions dying of AIDS in Sub-Saharan Africa for want of drug therapy, while expensive surgeries for cancer, heart disease, or even to repair an injury like mine is out of reach for the world’s poor.
But what of the inexpensive palliative measures for those experiencing pain? I don’t have to dig very deep in my memory to pull up countless images of people I’ve witnessed in excruciating, seemingly never-ending agony. In Cambodia I came across a man who had lost half of his arm clearing mines, and hours later at a health clinic, he still hadn’t received so much as a Tylenol.
Commenting on the article, Alierias from Airville, Pennsylvania says:
“My heart bleeds for those who don’t have that option”
Dear Alierias, thank you for your compassion. Your heart is going to be very busy. It is going to have to bleed for an unbelievable 5 billions – 80% of the global population that have no access to effective pain relief.
What make it worse, are the opportunists who try to cash in on the pain, making sure that cheap effective opioids are not available, but that very expensive ones are.
Watch out for the “Morphine Manifesto” that global organizations are bringing out together on World Cancer Day, the 4th of February 2012, demanding access to simple inexpensive opioids before making expensive alternatives available.
In the meantime, dear Josh Ruxin, Alierias and all others who have that spark inside them demanding justice for those in pain, please keep the fire in your belly burning. We in developing countries need your help.
Thank you Meg O’Brien of Global Access to Pain Relief Initiative (GAPRI) for bringing this to our attention.