Tb. Arie Rukmantara, Jakarta – Primum non no cere – above all, do no harm – is the rule for all physicians when they treat patients.
But the reality here is often different, with doctors prescribing patients many medicines they do not need and which could have significant side effects. Their patients, meanwhile, are none the wiser, especially if they are children.
A recent study shows that about 70 percent of Indonesian parents gave their toddlers more than four kinds of drugs at one time to treat their illnesses. More than 35 percent of them took from five to seven different kinds of medicines, the study says.
A spokesman for the Foundation of Concerned Parents, Dr. Purnamawati S. Pujiarto, who announced the findings Thursday, said 85 percent of children in the study had taken antibiotics for every malady they suffered. The respondents interviewed in the study admitted they did so at the advice of doctors, she said.
"This phenomenon is dangerous. First, not all diseases can be treated with medicines – like influenza for example. Second, such an amount of consumed drugs could harm our children's health, especially their livers," Purnamawati said at the World Health Organization office in Jakarta.
Over-prescribing goes against a 1985 WHO recommendation that requires doctors to prioritize therapeutic measures that have fewer side effects and save patients money, she said.
However, Purnamawati, who is a specialist in liver problems, dismissed arguments that the uncritical parents who bought medicines for their children were mostly uneducated or poor.
"A government study in 2004 revealed that most health consumers – 68 percent – paid the full prices of medicines at private health centers, while only 32 percent spent money at state medical institutions," she said.
She offered tips to health consumers on how to avoid taking unnecessary medicines. "You and your doctor should develop a harmonious relationship and become an active dialog partner to avoid curative-oriented solutions. Don't panic. Don't think to go to doctor every time you or your child is sick. Recognize the symptoms of the disease first. Seeing a doctor and taking medicine should be the last option."
If people are forced to see doctors, Purnamawati said, they should ask them some basic questions – what is wrong, what to do and when to worry. "And then you should also ask, 'Do I really need medicine?'" she said.
In an effort to improve awareness of how to deal with disease, Purnamawati and members of the foundation have held a series of public discussions. "We're not antidoctor or antimedicine, we just want to empower health consumers to be smarter," Luluk Soraya, a foundation member, said.
The Health Ministry's director of child health, Rahmi Untoro, said her office would add to people's knowledge about health, especially parents, by revitalizing about 7,700 community health centers and 250,000 integrated health service posts across the nation.
"Our health officials and community members will work together to tell others that doctors and medicines are not their guardian angels," she said.
Rahmi said that instead of putting their children's fate in the hands of doctors and medicines, parents should focus more on keeping their children's eating patterns healthy by providing nutritious food, and immunizing them. "And loving them wholeheartedly as well. For that, no doctors in the world can give you a prescription," she said.