Medicine shortage forces doctors to sedate patients to avoid attacks
Supplies held up by tender quarrels
The lack of medication for mentally-ill patients has increased violent behaviour medical staff must cope with on a daily basis.
Doctors and nurses at the Oshakati State Hospital have resorted to sedating mentally-ill patients to avoid being assaulted. This due to a severe lack of psychotropic medication, which the hospital has suffered for months now.
Patients who are in need of antidepressants and antipsychotics are reportedly mostly turned away as the hospital has been in short supply for over a year, the doctors told Namibian Sun this week.
Oshakati’s psychiatric department has a capacity of 70 beds.
A doctor - who spoke on condition of anonymity and who is frustrated by the conditions in which they operate - said some patients can present with challenging and sometimes violent behaviour, which can include grabbing, biting, punching other patients or healthcare staff, or injuring themselves.
What is worse is that these patients may not be aware of their actions, and as a result, some require physical restraints, they said.
No other choice
“Although never the first option, rapid tranquillisation may be required to ensure patient and staff safety when a patient displays violent behaviour,” the doctor said, adding that if a patient is aggressive or violent, short-term interventions include de-escalation, physical restraint and moving them to an alternative setting where they have little interaction with others.
“However, if all else fails, we do not have a choice but to sedate patients.”
Namibian Sun has been informed that the medicines that have been in short supply for close to a year include the antipsychotics Chlorpromazine, Risperidone, Haloperidol and Sulpiride. Olanzapine has been out of stock for months as well. Clozapine oral medication is also out of stock, but the injectable form is still available.
Health minister Dr Kalumbi Shangula last week confirmed to a local publication the shortage of medicine at public hospitals.
Things fall apart
Oshakati State Hospital's medical superintendent, Dr Ruben Kanime, said the shortage has been going on since the controversial multimillion-dollar condom tender, which was cancelled in February last year by the Central Procurement Board of Namibia’s (CPBN) review panel - citing that it was unlawful.
“Since the cancellation of that tender, everything started to fall apart. Life has been a nightmare. Not only in Oshakati; it’s a national crisis.
“I cannot say when doctors can expect the full stock of the medicine to be made available. We have engaged the [health ministry’s] executive director [Ben Nangombe] on several occasions. He will be able to give a clearer answer.”
Why sedation?
Kanime explained that patients who took antipsychotic drugs and had their conditions controlled might relapse in the absence of medication.
“Their condition was controlled. In the absence of the drugs, they relapse and they become aggressive. Such cases are becoming common. As a precautionary measure, doctors have to sedate the patients. Otherwise they roam around aggressively,” he said.
He explained that the Central Medical Store is mandated to provide medication to all facilities countrywide, but they either receive minimal stock, or they don’t get anything at all.
“We have engaged [Nangombe] on several occasions. We are not getting any favourable answers. We just let it be the way it is,” he said.
Kanime added that they have also urged patients who can afford it to go to private pharmacies for their medication.
“They [the ministry] are frustrating healthcare workers. If someone is on controlled chronic medication, their doctors had to fight to make sure the dose works. When you abruptly stop the drug, we are fumbling with their life. We expect a relapse. It is uncalled for in terms of medical ethics,” he stressed.
Nangombe acknowledged receiving an inquiry from Namibian Sun, but failed to respond by the time of going to print.
– [email protected]
Patients who are in need of antidepressants and antipsychotics are reportedly mostly turned away as the hospital has been in short supply for over a year, the doctors told Namibian Sun this week.
Oshakati’s psychiatric department has a capacity of 70 beds.
A doctor - who spoke on condition of anonymity and who is frustrated by the conditions in which they operate - said some patients can present with challenging and sometimes violent behaviour, which can include grabbing, biting, punching other patients or healthcare staff, or injuring themselves.
What is worse is that these patients may not be aware of their actions, and as a result, some require physical restraints, they said.
No other choice
“Although never the first option, rapid tranquillisation may be required to ensure patient and staff safety when a patient displays violent behaviour,” the doctor said, adding that if a patient is aggressive or violent, short-term interventions include de-escalation, physical restraint and moving them to an alternative setting where they have little interaction with others.
“However, if all else fails, we do not have a choice but to sedate patients.”
Namibian Sun has been informed that the medicines that have been in short supply for close to a year include the antipsychotics Chlorpromazine, Risperidone, Haloperidol and Sulpiride. Olanzapine has been out of stock for months as well. Clozapine oral medication is also out of stock, but the injectable form is still available.
Health minister Dr Kalumbi Shangula last week confirmed to a local publication the shortage of medicine at public hospitals.
Things fall apart
Oshakati State Hospital's medical superintendent, Dr Ruben Kanime, said the shortage has been going on since the controversial multimillion-dollar condom tender, which was cancelled in February last year by the Central Procurement Board of Namibia’s (CPBN) review panel - citing that it was unlawful.
“Since the cancellation of that tender, everything started to fall apart. Life has been a nightmare. Not only in Oshakati; it’s a national crisis.
“I cannot say when doctors can expect the full stock of the medicine to be made available. We have engaged the [health ministry’s] executive director [Ben Nangombe] on several occasions. He will be able to give a clearer answer.”
Why sedation?
Kanime explained that patients who took antipsychotic drugs and had their conditions controlled might relapse in the absence of medication.
“Their condition was controlled. In the absence of the drugs, they relapse and they become aggressive. Such cases are becoming common. As a precautionary measure, doctors have to sedate the patients. Otherwise they roam around aggressively,” he said.
He explained that the Central Medical Store is mandated to provide medication to all facilities countrywide, but they either receive minimal stock, or they don’t get anything at all.
“We have engaged [Nangombe] on several occasions. We are not getting any favourable answers. We just let it be the way it is,” he said.
Kanime added that they have also urged patients who can afford it to go to private pharmacies for their medication.
“They [the ministry] are frustrating healthcare workers. If someone is on controlled chronic medication, their doctors had to fight to make sure the dose works. When you abruptly stop the drug, we are fumbling with their life. We expect a relapse. It is uncalled for in terms of medical ethics,” he stressed.
Nangombe acknowledged receiving an inquiry from Namibian Sun, but failed to respond by the time of going to print.
– [email protected]
Comments
Namibian Sun
No comments have been left on this article