Zainabu Sesay, a woman in Sierra Leone has breast cancer. The tumor has burst through her skin leaving an open wound weeping blood. She says it burns like fire. A nurse who comes ten miles every day to visit gives her Tylenol and tramadol, which is only ten percent as strong as morphine. Imagine having a cancerous tumor bursting out of your body and having someone hand you Tylenol. This woman is going to lie there burning until she dies.
Momoh Sesay (no relation) is two. He fell into a pot of boiling water and burned his thighs and belly. As the burned skin dies it's scrubbed off, which is incredibly painful. He gets intravenous fluids and antibiotics but nothing for the pain. If he were in New York instead of Sierra Leone, he'd get morphine.
Abdulaziz Sankoh is seven. He has sickle cell disease and moans in pain at night. In New York he would probably get morphine.
Musa Shariff is eight months old. He has meningitis and his scalp is so swollen he can't close his eyes. It's very painful. In New York he'd probably get morphine.
Tramadol, one tenth as strong as morphine, is the strongest pain medication allowed any of these patients, if they can afford it -- it costs $1.65 per vial. Morphine isn't sold in Sierra Leone, but it sells in India for 1.7 cents per pill. It's not only cheaper than morphine, it's made by the same company which sells tramadol; I'm sure they'd be happy to supply the Sierra Leone market too, if they were allowed.
But they're not allowed, because the anti-drug faction is so hysterical with fear that they justify depriving even the dying of relief from their pain -- easily available and very cheap relief -- with the excuse that it's too dangerous to risk the patient being addicted.
Could someone please explain to me just why it matters whether someone with a terminal disease gets addicted to their pain meds?? [headdesk]
Seriously, if they make a miraculous recovery, then is the time to worry about weaning them off the drugs.
In the US, opiates are given even to babies -- like the burned two-year-old, or the seven-month-old with meningitis -- if the need is great enough. Drugs like morphine can be administered with care and without causing permanent problems for the patient.
The other worry officials in Sierra Leone have is that if they're allowed into the country, some of the drugs will find their way onto the black market. And they're right -- they probably would. But is it worth it to leave so many of a country's citizens in horrible pain, teasing them with a substitute drug only one-tenth as good which most of them probably can't afford anyway, because the government is afraid of feeding the black market?
I have news for them -- if there's a market for opiates in their country, they'll be imported anyway. No matter how much money you spend on border patrols and customs inspections (and I doubt Sierra Leone can afford to spend much) drugs will still make it across the border if there are buyers for them. The flood of illegal drugs that comes into the US every year proves that. So what are they torturing their sick and injured citizens for again...?
Ironically, I wouldn't be surprised if there are illegal opiates flowing around the country. I have a hard time believing that with such a great need and such incredibly cheap prices, someone isn't smuggling the good stuff to Sierra Leone. Not for recreational purposes, but for people in pain who just want to not hurt for a while. It'd be interesting to see some investigation into that. Except that I'd hate to see it published openly and maybe tip the government off; this is one case where I'd definitely be rooting for the drug smugglers.