Essay: Instant Quack

The medical profession is considered as one of the most respected occupations in many countries in the world (e.g. http: / / www.ehow.com/list_5925228_top-ten-respected-jobs.html), probably because doctors save life which people consider the most precious thing they have.  Their average income is also ranked near the top of all professions (e.g. See “The Ups and Downs of Respected Careers” at http://careerbuilder.com) leading to many young people aspiring to become physicians.  However, not everyone is gifted enough to achieve their ambition.  Besides which, it takes several years of costly studies and training to become a fully-fledged doctor, making it seem understandable and justified that they ultimately earn high incomes.  Perhaps because of the attractiveness of this highly respected and lucrative profession, some malicious and deceptive people appear to be drawn to pretend to be doctors without getting a proper medical license.

According to a Japanese newspaper, a man was recently arrested for his illegal medical activities, such as treating injuries and dispensing drugs, in Japan’s northeast area where he began working soon after the region was devastated by the tsunami of March 11 this year (http: / / www.asahi.com/national/update/0819/TKY201108190242.html).  Apparently, he had with him various props to make others believe that he was a bona fide physician, but I wonder why he had not been caught much earlier.  Indeed, nowadays we can easily obtain abundant information on all kinds of illnesses, injuries and drugs, but does this mean that it is easy to pose as a doctor after a bit of studying?

While reading this article, I remembered an experience I had in Tanzania about 25 years ago.  It happened in rural areas near the Zambian border, where there was no doctor in the vicinity.  It was not that I pretended to be a doctor there, but some villagers made me uncomfortable as they somehow believed that I was a physician and expected me to treat them.

There I was doing field work on rural women’s labour-force participation.  For the daily running of our work, we rented part of the parsonage of an old village church as our headquarters, from which our team members went to different villages each day to gather information.  We hired some village women to prepare the meals of our 12-member team.  The church and the parsonage looked quite old as they had been built when Tanzania was still a German territory.  The roof of the parsonage looked as if it was ready to cave in.  There was no running water or fuel nearby, so women had to go to a river to fetch water or to the hills and mountains in the vicinity to gather firewood to prepare our meals.

One evening, we returned to the parsonage, tired and hungry.  Our meal should have been ready, but there was no one in the kitchen.  Not only was our supper not made, but no fire had even been lit.  What on earth had happened?  I became worried.  The villagers lived in dire poverty and for a moment I suspected the women of some wrongdoing, though later I regretted having had such a thought.  It had occurred to me that, while we were out in another village working, they had run away with the food items that had been transported on a jeep from Dar es Salaam.  But rice and maize meal were still there in the kitchen.  So where had they disappeared to without preparing our dinner?

Since, by then, it was completely dark, it was too difficult to go around in the village with no electricity, looking for them.  As we were wondering what to do, the women came back, carrying firewood on their backs.  One of them was dragging her foot painfully, as if she had injured it.  They explained that because villagers had cut down all the trees for fuel in the hills and mountains nearby, they were forced to go farther and farther away each day to gather firewood.  One of them had twisted her foot while walking through the fields.  They had therefore to walk back slowly, supporting her, because she was no longer able to walk normally, hence their late return.

The women immediately began preparing our dinner, but I could not ignore the one with the painful limp, so I took out my medical kit.  In those days, any ILO official on mission in a developing country, especially an area away from the capital city, where there was no doctor, was given a large medical kit containing three syringes, different kinds of drugs, long and short bandages, and so on.  If we got sick or were injured and could not seek medical attention immediately, we were expected to be able to protect ourselves with what was in the kit, at least until we arrived at an area where a doctor was available.  The kit also contained a booklet with detailed instructions as to what drug to take, how much or how frequently, under what condition, etc.  In addition to what was already supplied in the kit, I also carried in it some Japanese medicines familiar to me since my childhood.

When I took a closer look at the woman’s sprained foot, I noticed her instep was a little swollen, though it did not look too serious.  I asked her to wash the foot thoroughly, after which I dried it with a clean cloth.  I then placed and stretched over the instep a few medicated plasters I had brought from Japan, which I considered the panacea for all kinds of muscle pains.  I also gave her some aspirins to alleviate pain and advised her not to exert any more strain on the foot that night by walking too much.  Our dinner was ready in no time as we were all hungry and had helped the women in the preparation.

The next morning, the one who had twisted her foot came to me smiling and reported that the pain had disappeared.  The swelling was also gone.  Surprisingly, however, she had brought with her several villagers who looked sickly.  She had seen my medical kit the night before and appeared to have decided that I was a physician.  As I did not wish to be mistaken for one, I repeated many times that I was not a doctor.  Nevertheless, they insisted on telling me how and where they were feeling sick.

Malaria was endemic there.  What I was taking to prevent it and what malaria patients were given to tackle the occasional symptoms of high fever and shivering was the same.  In such circumstances, I thought it medically acceptable to use my drugs with those who were suffering from the terrible disease.  What worried me was that if I gave my medicine to some, other villagers would find out about it and soon I might end up receiving too many sick people.  Because I still had to stay in the malaria-infested area for a while, I could not give away all my preventive medicines.  But I shared my drugs with those who had been brought to me that morning, though had to stress and make them understand that I had no more medicines to be dispensed.

As I had been aware of my mental limitations, I never thought of becoming a doctor.  Yet, when I was mistaken for one by some villagers in Tanzania long ago, I did not feel bad at all, on the contrary.  Did the quack doctor recently arrested in Japan, I wonder, have a similar experience to mine somewhere in the world?  Did he start illegal medical activities because he could not forget the good feeling he had once had?  If he had not been caught quickly, he might have been quite knowledgeable and capable.  If that was the case, I wonder why he had not made a little more effort to obtain a proper medical license to practice openly, and to enjoy respect and a high income.

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