The Nation, Lahore

Wednesday,February 7, 1996, Lahore
Pakistan

Midweek


[cartoon]

Food for Thought

You can make a difference

By

Dr. Rana Jawad Asghar

Many a time you go to some government office and come back totally dejected. No one hears you there until you pay someone to Just listen to you. Government offices are not the only places for our frustration. We go for shopping and the shopkeepers give us adulterated food, charging us lot of money for substandard items. Even the butchers add unwanted portions of low quality meat in our purchase. If you are a small buyer you cannot expect any thing. They may not even entertain you and you may be in for a long wait. The politicians never return to their constituencies except when it is time for the election campaign. The police does not listen to our complaints. The judicial system has become so complicated and expensive that going to the courts is unthinkable for an ordinary person.

We have lot of complaints against a lot of people and sectors. If we are having a chat with our friends the favourite topic is always about the humiliation and exploitation we suffer at the hands of nearly every one. We discuss it for an hour or so and then again go to the same office, same shop and behave in a manner that nothing has really happened.

May be we are ~o afraid of our powerful classes that we have become subordinate in our approach and no longer demand anything. Maybe it is not a good example to give but some times I feel that we are like chickens closed in a big poultry farm where daily some of our mates are picked and killed and we feel relieved at the end of the day that we were not picked up for that day. How long can we escape if some of us have to die daily? One day it is going to be my turn. Chance or luck cannot save me for long.

OK. But what to do? I cannot advise you to stand against your local police or local politician or even your local postman as it can seriously hurt your interests. But there are some places where while ensuring our personal safety we can take a stand. But does a single person really matter? Who is going to listen to him anyway? What he is going to get in the end? True, he may not achieve anything at the end but there is also a chance, may be a very slim one, that he may prevail in the end. So if it is not a dangerous matter, is it not worth a try? You may get unexpected results.

Our pharmaceutical industry is a highly competitive field. Different companies are engaged in fierce competition with each other. In this cut throat competition only the winner has a right to live so understandably it has become a fight without any rules thanks to our lack of supervising laws or lack of will to enforce them. As a practicing physician it is not new for me when a pharmaceutical representative wants to give me incentives such as that of a colour TV or satellite dish or even cash bonuses against special patronage of drugs. In my early years I would get very upset at these propositions but now I just do not take them seriously. I only tell them that they have come to the wrong person. These ate normally the small companies who cannot compete established companies in direct competition.

Last year I was surprised when a representative of a big multinational came to me with a similar proposal. They had a very popular drug for the last many years but competition has eroded their market share with other equally good multinational firms making the same drug for less than 40 percent of price. Instead of giving the patient the benefit in price they got a novel idea: they will give doctors printed prescription pads whose carbon copies will be collected after some time to have a proof of actual prescriptions of their drug. I was disgusted by just listening to the idea. Doctors are not shopkeepers where such a crude method of sale increase should be adopted (l. Certainly there are good decent methods to increase the sale of a' drug. There maybe no harm in trying to influence your doctor by different method; but getting carbon copies of his sales ... that is, his prescriptions" was too much for me.

I told the concerned representative that this was a bad idea and they should abolish the whole scheme. He told me as be was not the competent authority but he could take my views to the higher ups. I wrote a letter and gave it to him. The scheme was never mentioned to me again. It came to my notice that some other doctors had also objected to the way this scheme was being carried out. After some months one of my friends told me that scheme was still continuing and the company had just dropped the doctors who had objected to it.

I was furious and wrote the whole story and sent it to a medical newspaper. As I was not sure whether they were going to publish it or not as their business is dependent on advertisements from pharmaceutical companies, I also sent a copy to a newsletter published with the help of UNICEF. The medical newspaper tried very hard to get the version of the that big multinational company but the company did not care and did not reply even after numerous tries. After nearly a month of trying the newspaper published the story. Even after this nothing happened. The company just stopped sending me its representative. I got letters from some other fellow doctors who wanted to take this matter to the public press but I declined as I had wanted to keep this matter within the profession.

After few months the newsletter of a subsidiary of UNICEF also published the same story. Again nothing happened. But I was satisfied that I had done my duty and I am not a law-enforcer who can follow them now. Bad luck for the company, a famous international pharmaceutical magazine picked the story from here and it went straight to the company headquarters in the USA. The company had to publicly apologise for the whole affair and they even declared that the persons responsible for this ill-conceived idea were no longer with the company. The senior officials of the company even came down to my humble clinic and apologised for the whole affair.

You can see that by just writing a letter I was able to make some difference to a bad and unethical practice of a big company. So you can also change people's attitudes by just telling them they are wrong. As no one ever tells them that they are wrong they keep doing whatever they please.

If you are denied of any of your rights. tell them that you are serious enough to take back your rights. You have to change this society for better. No angels are going to come for your help. Many American states were in worst condition than us at the beginning of this century. Corruption was rampant and gangs ruled the cities. Police was on Mafia’s payroll and judges were afraid for their lives. But they decided they wanted to change all this not by the help of any outsiders but their own: Every individual tried and many sacrificed their lives for the better tomorrow of their next generations.

I would like to end this article with a note written by one of the readers of the last article (To do or not to do). "Yes! There is still a ray of light somewhere in the darkness. Do you know? No matter how black and formidable is the darkness a little beam of light demolishes its existence and brings the hope for a new shiny day. Just try to be a beam of light in some way; and we will see a whole new bright day"


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