Halfway through the SA COVID-19 lockdown | Observations

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So the entire world has been on lockdown for a while now; each country at it's own schedule but here in South Africa we are on  the afternoon of day 10 of 21. Exactly halfway though confinement, quarentine or self isolation depending on the term you prefer.

I've made some personal observations which I'd like to share with you below;

☆Leadership and governance:

It seems for once, many were happy at government's decision to lockdown the country (borders, & unnecessar gatherings and travel). Critics were still unsure about how to feel and wanted intricate detail but in the end saw the wisdom in it all. with the unique healthcare status and needs of the nation, such a pandemic could not be allowed to freely settle in. High HIV and TB patients populations mean many compromised immunities, compounding to the normal asthma, copd, and smoker's lung, all amount to higher disease burdens. This coupled with extremely poor, densely populated, infomal communities would set the infection, transmission and fatality rates ablaze.
T'was a good call to lockdown the nation.  The "curve" has already flattened and the death toll remains in the single digits. Now to provide sanitary assistance to these communities is the next urgent step which they've promised to make.  

☆Selfishness and hoarding: 

Panic buying images flooded the internet as soon as the lockdown was announced. They quickly became the viral memes of each day. Long queues at wholesalers couldn't go unnoticed as this highlighted not only the privilege often spoken of, of those who have extra savings, vehicles and storage to stack trolleys and trucks in some instances without concern for others. But also the entitlement, and nasty attitudes from those called out despite the repeated warnings to ration supplies and that grocery store would not be closing. I remember an ENCA news presenter checking us all when he said: check your privilege! This was directed at commenters complaining that township habitants queuing at shops for groceries seemed "late" and "ignorant" while they had only just gotten paid/ grants, and were then doing the same as the first priviledged group. 

☆Solidarity and selflessness: the above negativity led to an almost reciprocal positivity spilt between solidarity and selflessness with many showing compassion towards others and donating to shelters and charity. My feeds were inundated with requests to donate and lend a hand or even volunteer. Humanity still lives and kicks in many hearts! This was beautiful to see and must be commended.  Many companies quickly provided hand sanitisers and sent their staff  to work from home. I personally also received many emails from companies reassuring their clients of measures in place to minimize inconveniences and disruptions. Comforting!

☆Fear and faith: 

Then on the spectrum of motives, many were driven by fear while fewer resorted to faith. Churches were praying together until the ban, and switched to live online stations while others were fixated on news channels further feeding their fears... we were not only fighting an invisible virus but also a much more devastating invisible spirit of fear. Today, it seems fear is quenched and under control. The lockdown circumstances have become a new normal and we have all adjusted (as best we can). My encouragement to all those still gripped by fear is to focus on the solutions, not the problems. These solutions are hygienic measures, confinements, healthy eating, immune boosting and practicing peacefulness (quality happy times, meditating, praying, playing games, exercising etc). You can't change the problem but you can replace the time spent pondering on it with solutuons. 

☆Ignorance and unpreparedness: 

They usually say "stay ready so you don't have to get ready" but in this case people's general unpreparedness was suddenly exposed along with their accompanying ignorance in handling infectuous or communicable diseases. Now to be fair, my antiseptic training in pharmacy school and later in oncology drugs handling has given me a stark advantage; but basic hygiene and "no touching" from primary school should've assisted everyone else at least a bit more. It was shoking to hear some people complain about washing hands etc. Till today, the concept of cross contamination with/without gloves + masks and disinfection of surfaces still evades most.  I always cringe when i see someone with gloves touching their phones and clothing or taking their mask off to cough or sneeze! Perhaps here's an opportunity for individuals, companies and governments to put in place messures for handling similar outbreaks and improve overall preparedness for the future.

☆Essentials vs Non-essentials:
In a time of crisis, focus shifts towards what's most urgent and important. The  concept of essential vs nonessential distinguised and reclassified all our professions and everyday items. Essential services quickly became the theme for praise and gratitude, (and this must therefore mean that when we all go gack to normal life, these very 'essentials' should be compensated and their wages/packages reviewed and improved right? especially low or minimum wage workers like cleaners, security, etc.) although mostly directed at doctors and nurses, we had to include PHARMACISTS & their ASSISTANTS to the mix as cornerstones of healthcare in research, clinical trials, medicine manufacturing & production as well as dispensing among many other crucial roles they play.

Even with selecting shopping centers and essential items, slight confusion arose when no consistency was initially observed from outlet to outlet. In some shops you couldn't buy shampoo or face wash, while in others even clothing was still available.  I think by now all nonessential sections are blocked off in all stores. (I wonder who determines what is actually essential and for who? Pregant moms and newborns surely need a lot of the stuff thats blocked off? What about my reading frames that broke and my lens which came out? Opticians are also closed and now I can't read till next weekend..!?)
Oh well, it is what it is; no one will be 100% comfortable in these conditions.  Im grateful theres no real emergency item I can't wait the16th for. How are smokers doing?

We also saw things like traffic and casualty cases drastically reduce. Nonessentials are really clumsy! (jokes)

At the end of the day, we are all we have. Lets be each other's keepers. Lets check on friends and family. Some are lonely and need a phone call. Others are in need of something you may help with.

Africans unite in your beloved Africa;
 fly the UBUNTU flag higher than ever.
We shall emerge stronger. 

Pharmers Blog

www.pharmers.co.za
Pharmaceutical expertise and care!

Leave a comment! Share your experience.  Ask a question:  info@pharmers.co.za

CoVID19 ABC's and 123's

The virus, is here and there.  It has reached almost everywhere.

Do not fear; get informed.

First of all; fear does nothing for you. All the agitation much like rocking in a chair will get you nowhere.

Find reputable sources for updates. Listen  to rumours only for banter and use sound judgement to discern between the two.

Pharmers is a pharmaceutical consulting business which offers a handful of services. Sound pharmaceutical advice and preventative care services are some examples. Do not hesitate to ask your questions or send comments to: info@pharmers.co.za 

Our CoVid19 statement to our valued members and to the public  is an ABC acronym for easy remembering. It stands for:

A LWAYS wash your hands with soap,

B EFORE touching your face or eating, &

C LEAN your commonly shared surroundings, and surfaces using disinfectants, often.

Simple and effective.

Also remember these 3 things:

1) boosting your immune system (whether using herbal  or chemical remedies) is not going to prevent you catching an infection, you will still carry the pathogen.  It will only help your immune fighters to better cope with the infection and possibly render you asymptomatic in the best case scenario (but still a carrier able to infect others).

2) the best way to prevent an infection is to reduce the probability of contracting it through  physical touch - hence the heightened personal hygiene recommendations and frequent surroundings disinfection as well as reduced contact with others/isolation.

3) be compassionate.  We are facing frustrating times. Buisness as usual has changed, schools are closed, functions and events are cancelled...  Be kind and understanding. Use this time to introspect, reconnect with your reality and realise how frail we all are in the face of microscopic agents; lets remain humble and grateful for what we still have.

Two national SA Covid19 helplines operating 24h a day are: 
0800 029 999 and 0800 111 132. 

#pharmers

#pharmacy

www.pharmers.co.za
Info@pharmers.co.za

Pharmacists: show your preventative care in 5 ways

If you're a pharmacist you might start feeling guilty as soon as you read through the checklist that follows and find that you've fallen short on your duties!

Have you in the past year:

• Initiated & monitored patient therapies
• Conducted/initiated community health talks
• Conducted/initiated health expos/ campaigns challenges or competitions
• Led/ participated professionally in health awareness days
• Led/participated professionally in health screening days
• Demonstrated pharmacological and pharmaceutical expertise in patient interactions or interventions 
• Acted in any other intentional health promotional activity

If you have done some or all; that's excellent  [insert pat on your back] but  the reality is most haven't. Did you know that this is part of your scope and uties as a professional sworn pharmacist? Without getting into the numerous reasons why many have not regardless of subfield or sector; lets try and highlight a few crucial reasons why you now should reconsider. Get involved today!

Shocker: The Global Disease Burden quickly rising with many preventable illnesses, diseases and deaths occuring on your watch. 🙈

1) don't be shortsighted, the smallest act matters:

If you dont plan to intervene on purpose, it will never happen or become effortless.

E.g. lady comes in for morning after pill. You give her the form she signs and you issue the pill.

Now If you had planned for intentional preventative care, you would inform her that as part of preventative care you'd like to add value to her purchase by enquire about her (their) past experiences/concerns if any, with STI's / STD's and offer measures on how to prevent them in the future. Having pamflets ready greatly assist with this. Offering (free where possible) HIV screening to know her status and handing out (free) condoms would also supplement the encounter. Highlighting risks can steer even one person clear. If response is favorable and you notice a trend or young students from a campus near by (school/college/university), go as far as asking for contacts to plan a sexual health talk in a relevant upcoming session/event. 

Even if youre not in retail or hospital don't think you are left out, local park runs, weekend expos and many other community events need you to volunteer. Speak to the organizers. Get a few colleagues together especially interns and students to put together a short 10mins relevant talk  before or after the event.

2) don't outsource, YOU are qualified:

Pharmacists are more than able professionally (and within scope) to conduct primary (preventive) health care. You can do most screenings, immunisations, counselling and basic diagnoses (s3: self limiting)! If not get a PCDT pharmacist who can. Add medication management and reviews and you've got yourwork cut out for an entire day/event! Don't employ additional proffessionals if you dont have to.  Nurses and physicians are great but they will never be pharmacists.  In a pharmacy  you alone have the entire holistic view of the patient's condition. Show expertise. Your call on the actions to take will be most wholesomely accurate. Plus, we are trying to shine the pharmacist light. The other professionals can campaign for themselves! 

If you must outsource, stay on top of things and in the know. Your pharmacology and pharmaceutics are your unique differentiators. Incorporate then in the care process. 
 Never let such a huge aspect of your patient's care be completely out of your hands. Follow ups will be difficult if you don't partake.

3) Do anticipate trends, timely and tailored: 

If the majority of your patients are diabetic, conduct diabetes awareness days, talks, management series etc.  Serve the specific needs of your patients while preventing many more from developing the disease, complications or  deteriorations. Metabolic diseases are majorly lifestyle disease, show the correlations, and tie them up together to demonstrate "cause and effect". Mental health is still very entwined yet ignored, stats will shock and awaken your crowds. Have no sugar days (and I dont mean substitute real sugar for the fake toxic carcinogenic stuff); do biggest loser competitions too and include kids and teen! Both reap tremendous health benefits in the long run. 

4) Do offer prevention products & services:

Preventative vaccines such as those for Influenza or HPV have been demonstrated to greatly reduce disease burden. Especially in the risk groups.

Health isles with preventative medicines such as supplements, boosters, aids etc may also offer great support to patients but still require your expert advice (even if just on cost, effectiveness, combinations or comorbid risks). Couple these with screening services and run monthly competitions for the ultimate "Preventative Care" packages. 
Keep them interested. 
You may already offer these services indivudually but renaming and regrouping them can have a unique flair and appeal.

Encourage healthy weight by measuring patient BMIs to stay within ranges and offer to assist those who fall outside of margins with nutritional supplements or referrals to nutritionists/ dieticians as needed.

5) Do support your patients:

Perspective is everything. If you refer to them as clients or customers, you lose the care aspect to when they are patients. The power dynamics shift and power struggles result. 

Show your patients you care by putting their health needs first.
Smoking cessation is another big topic to tackle, offer close monitoring, otc gums or patches and if needed referals but ultimately patients want to feel heard and understood.  Acknowledge their struggle. Often  the smoker only needs your professional push and assistance to quit/start the quitting journey. Have that chat with them highlighting positive effects and avail yourself. Establish channels and create quick/easily accessible directories/ contact lists. Imparted confidence is what every patient needs to succeed.

There is a lot of work to be done and patients need to see this happening.  Pharmacy is not just pills. Phamacy is you and your added value to therapies.

If you're not a pharmacist atleast now you know all the services you should be able to benefit from; go ahead and request them.

#pharmers

#pharmacy
#preventiveCare
#forTheLoveOfHealth

Upcoming Festive Overindulgence? Try These 4 Tips to Overcome

If you're a part of the majority, you've already set off on the overindulgence 'ke Decemba' train. The month of December is inherently filled with weddings, birthdays, funerals, holidays which all equate to food, food and more food!

There's no need to panic, here are four tips to avoid bloating,  weight gain (water retention), tummy upsets and toxins buildup which can trigger joint pain and other inflammatory conditions.

All suggested medicine are available OTC from your local pharmacy and do not require a prescription. Ask your pharmacist for advice if in doubt or taking other medication concurently. 

 Firstly, liver support - whether you plan to drink or eat more than usual, substantiate your levels of essential phospholipids  with supplements  to assist your liver in its metabolic functions. 1 or 2 tablets up to three time (8hly) a day with food will do. 

Secondly, consider a hydration supplement.  In the heat of the summer, we tend to sweat  (salts are lost) and lose water a lot more than in winter. Increasing our water (fluid) intake is great but a step further is replenishing our electrolytes along with it. This keeps the "thirsty" feeling away and curves more subsequent cravings by maintaining feelings of satiety. One sachet dissolved in a liter of water as required on very hot days will do.

Next, lets consider excess acid levels. PH levels are critical to healthy body tissue states. Alkaline states help your system to better prevent cellular inflammation and  tissue injury/disease. Take an alkaline powder (7.5g) once or twice a day with a glass of water for a good week or so before and during the festivities to curb over acidity in the entire body. 

Lastly, its a good idea to add fiber to your diet. By sprinkling some on your food or in your drink, you ensure your gut remains regular and eliminates waste timeously.  Constipation often results from overindulgence of high sugar, high fat and low fruits/veg diets typical of party foods. Try soluble fibres to avoid this.

Whatever you decide to eat and indulge in, always keep moderation at the back of your mind. Portion sizes matter. Start with the salads and the greens before heading for the meats and the desserts.  Drink water before you leave the house as a prep to redu8ce your overall appetite, while conditioning your digestive enzymes for incoming food. 

Prevention is always better than cure. 

Enjoy your holidays, have a merry Christmas and a happy new Year 2020. 

Stay safe. 

Pharmers 

www.pharmers.co.za 

Antimicrobial Resistance; What's the big deal?

Imaging getting to the hospital for a severe bacterial infection and being told:

Sorry we don't have any effective treatment to give for this stain anymore!

That's where the world is heading;

We are dangerously close!

Listen up: in as little as 10 years we could have run out of options to treat all the super bugs currently being mishandled.

How exactly is antimicrobial misuse linked to resistant strains and treatment failure?

I'm glad you asked;  every time you take an antimicrobial medication incorrectly (dose, duration, frequency, type, or treatment option) you actually give that bug, or others around it a taste of what was supposed to kill it; but instead with this "taste", the bug incorporates the drug in its DNA and subsequently becomes enhanced, empowered and immune to it. 

This simplified explanation is to tell you to be very careful with your medication. When in doubt, ALWAYS ask your pharmacist to explain and confirm your treatment. 

Unfortunately, power struggles in the medical sphere sees a rise in patients demand towards their prescribers (every condition is a suspected infection that requires antibiotics), as well as many prescribers' carelessness in prescribing patterns. With many taking shortcuts when it comes to correctly identifying causative agents. These compounded tragedies are leading us to a point of no return. 

The 4rth industrial revolution is bringing along an unimaginable microbial disaster; if nothing is done. 

Prescribers: be careful. Resort to antimicrobials under extraordinary precaution and care. 

Dispensers: be careful. Counsel and warn your patients with utmost clarity, providing treatment assistance and reminders.  

Patients: be careful. Do not demand from experts what you think you know. They will provide the best treatment option if you remove your "paying-customer-is-king" pressures from their sworn responsibilities, lengthy degrees, and daily clinical experiences. 

Let's all work together in care and respect.  

#Pharmers

#pharmacy 

#antimicrobials 

#stewards

#healthCare 

NATION HEALTH INSURANCE - Should SA Panic?!

Since the signing of the bill and the declaration by government to go ahead with the NHI plans, many have been gripped with fear and consequently have been spreading it to others like wild fire. There seems to be a general negative connotation within the South African environment at the moment with regards to universal health coverage. 

  

A few myths have crept up which we can quickly put to rest: 

-Will the 20% fund the 80% ? 

-How can a system which is already struggling stretch any further? 

-Will the funds be squandered or the entity managed like Eskom and others?

To begin, let's establish a few truths!  

-No health care fund/ system or reform ever began once the nation was "ready" or in an overall "better/good state". The UK for example implemented their NHS after the war when the country was poor and struggling. 

- Neither the current public nor private sectors are doing well. A system change is inevitably needed and a new funding model is a great tool for that change to begin.

- Already 8% of the current GDP is spent on health, how much more can they inject  into health, being at the upper threshold already?  An efficient system is encouraged.

- Most of those who spread fear and negativity have not actually taken the time to read the bill nor have they made contributions to the open documents that exist for commenting:

(https://dearsouthafrica.co.za/national-health-insurance-bill-2019/) 

The NHI is a fund; which will be managed as a schedule 3A public entity and therefore a lot more strictly regulated as opposed to Eskom and the likes which are schedule 2 entities. This means centralize admin,  specific committees,  monthly rationing etc  This fund will also not solely come from tax payer increases as some imagine but mostly from a pool of tax shifts, payroll tax, medical schemes, and surcharges on PIT among others. The "20% cannot and will not fund the 80%"! Everyone is contributing proportionately. 29% of unemployed youth do not represent 80% of the population and payroll tax is only one source of funding as mentioned above. 

Additionally, with the concerns around implementation, phases are being rolled out until the official 2026 full implementation.  Therefore, the "readiness" will inadvertently be ironed out progressively through each phase. For example medical aids will continue as usual until legislation (about 12 of them in total) changes and their new scopes are redefined. 

The issue of staff shortage, is also going to improved. Currently, for every medical practitioner in the public there are five in the private sector; they are concentrated in certain urban areas. By allowing public and private to mix, this ratio can shift resulting in a wider population reached and serviced.  A similar story can be told about facilities where the majority of public facilities are flooded with patients while in private, many institutions have for instance 30% occupancy thus waste resources, charge more to make up for them and hence treat populations inefficiently. Sharing workforce and infrastructure to all patients  will improve efficiency. Of course a point to upgrade and train adequately should be made and is included in the model for sustaining health care services. 

Many have also raised the question on pilots failing? First of all pilots don't fail! They are a testing tool to assess a new avenue. Therefore the "failed" reports can only serve to improve each phase design and implementation onward.  Also, the NHI in itself could not have been "piloted" as the fund setup and other details around it require legislation changes first. Rather, the pilot sites used for testing have had mixed reviews due to poorly documented techniques and results, thus revealing poor  research strategies (copy and pasted plans did not get necessary tailoring per district) as opposed to poor concepts. To understand the value of the roll outs (pilot sites), just ask the primary beneficiaries: the patients who previously had to queue the night before or the full day of collection to receive their chronic medication;  who have already began to receive their chronic medication parcels in many external pick up points of rolled out districts and they are overflowing with gratitude at their new found efficient access to health care.   

One more thing to consider is the majority.  let's put ourselves in the shoes of the poorest; those who have no option, and no alternative. As the privileged bunch, let's not think that attempting to provide for others, is an oppressive attack on ourselves. The search for equity is primordial.
The more we empower people to contribute, the more we also enable them to consume and have options. The right to access quality efficient health care should immediately be followed by the responsibility to contribute towards it. The new health care system will thrive as more patients escape the poor / unemployed / uneducated pool, take on employment and healthy lifestyles which decrease disease burden overall.  Patient education is key. 

 No system is perfect. Any alternative model (suggestions rather than complaints are welcomed) would also have flaws. However this is the option that was chosen and government should now run concurrent models (for example the voucher model) in various districts to establish which model variants work best, confirming their choice. 

It's also important to note that universal health care is not a SA concept. The rest of the world has already fought for decades to try and reach it. The WHO is mandating for the rest to follow suit in their vision 203p for the whole world.

Affordable care and quality care seem to be at opposites of the spectrum. How can they both exist unless some win and some lose? How does equality and equity factor in together? Until we stop viewing the fund as an all or nothing ideal, we will miss the many nuances in between. Being for the NHI doesn't have to be at the expense of precautionary scrutiny and acknowledging evident complexities. 

 SA should definitely NOT panic, rather shake the fear, toss the negativity and get involved in the deep understanding of the great need, the many benefits, and mitigating the flaws, while actively participating in the shaping of the NHI and the ideal health care system which is envisage for all.


#NHI
#Equity
#transparency
#joinTheConvo

#HEALTHCARE
#universalhealth


#PHARMERS by www.pharmers.co.za 

Pharmacy - Cornerstone of Health Care!

Whatever disease, illness or condition you may come across (go ahead and think of at least 3), part or the entire treatment protocol will require medicines. And who says medicine says: PHARMACY!

Who's in charge and running (around in) the pharmacy? Pharmacists of course! With the help of their assistants. 

But that's overly simplified you might think. Medicines being sold in a pharmacy don't quite illustrate the entire health care scenery does it? So why is pharmacy cornerstone?

Well they give you the final products. The end valuable result of the complex pharmacy machine! That's not all! You see,  health care in essence is the organized provision of medical care to individuals or communities. As each component of care giving requires either consumables, medicines or tools; pharmacists are the only licensed, sworn in, and responsible authorities for safely providing these to everyone else.  

To provide quality health care, rigorous investigations must be done. Diseases, their cause and progression, their treatment or management etc is studied with the aim of curing or at least controlling the condition. Pharmacists do that. Any agent which causes a desired physiological response can be deemed a drug, how it works and should be administered to treat and cure diseases is the pharmacists' prerogative! If you're still not convinced,  consider the following concluding points.

5 ways pharmacists are the cornerstones of health care: 

○They manufacture ALL available drugs; no pharmacist, no medication. 

○They understand both sides of diseases: etiologies vs therapies; no pharmacist, no prescription, disease & drug gate keeping. 

○They have basic and advanced knowledge regarding Primary, Emergency and Secondary/ Tertiary health care; no pharmacists, no adequate intermediate resources connecting all treatment levels. 

○They ensure quality treatments from obtaining raw materials, to maintaining quality through storage, manufacturing, packaging, distribution, prescribed indications and patient use. No pharmacist, no quality treatment. 

○they are the ultimate health care multitaskers: making the actual medications, ordering and controlling supply, supervising staff, consulting & counselling patients, intervening in patient therapies, mediating between prescribers and insurance providers, referring or initiating care, teaching and educating communities, while running profitable businesses among many others! No pharmacist, no cross-disciplinary, functional health care system!

You just can't beat them.

Pharmacists remain the undefeated,  unprecedented but ultimately undermined,  health care professionals!

Love and respect your pharmacist. Be patient while your community pharmacist helps you. They are there to optimize your treatment (outcomes) and improve your quality of life but if you rush them and they make a mistake it could really harm you.




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