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In Indonesia, a tsunami of useless medicines

by Sophie Boudre
Banda Aceh, Indonesia (AFP) Jul 28, 2006
== Tonnes of drugs and medical equipment that have poured into Indonesia in the wake of a slew of major disasters are often damaged, out of date and unusable, aid workers said.

Donors jumped into action following disasters ranging from the 2004 Indian Ocean tsunami which killed 168,000 people in Aceh province, to a massive earthquake on Java in May that claimed some 5,800 lives.

But according to aid agency Pharmaciens Sans Fronti�res (PSF), or Pharmacists Without Borders, donated medicines have created more headaches for the government than benefits for the victims.

"It's a second tsunami, a huge wave of drugs donations that authorities are totally unable to handle," PSF pharmacist Laurence Boiron told AFP, referring to some 600 tons of expired, damaged or inappropriate medicine pouring into Aceh.

Some 200 tons of unusable drugs taken from Nias Island, hit by a deadly earthquake in March last year, are to be incinerated Friday at a cement factory in Bogor, south of the Indonesian capital Jakarta.

In early July, 150 tons of drugs donated to Aceh were burned and PSF planned to destroy another 50 tons of donations made to victims of the May 27 Yogyakarta earthquake.

At Banda Aceh's Zainoel Abidin hospital, parcels from around the world cram the corridors of the once tsunami-devastated building and chief pharmacist Abu Sa'adi is puzzled.

"We are all victims of the tsunami and do thank the international community for its generous help. But all these drugs take so much space. We would have rather had quality than quantity," he said.

The World Health Organisation has established strict guidelines for donated drugs. They must comply with the WHO official list of approved medicine, be in use in the receiving country and have, upon arrival, a remaining shelf life of at least one year.

But the standards are frequently eschewed. In Aceh, 70 percent of donated drugs were labelled in a foreign language other than English or Indonesian, contrary to another WHO guideline.

"Countries such as Poland, China, South Korea or Spain are regulars when it comes to single-language labelling," said Sylvain Denarie, a WHO supply manager in Jakarta.

Banda Aceh hospital's pharmacist Sa'adi recalled receiving cases of injectable Pantozol, a drug used to treat gastritis.

"But in Indonesia we only use it in tablets, so doctors had never seen these. We didn't use them in fear of killing patients," he said.

"We'd wonder, is this an antibiotic or an analgesic?" said another employee at Zainoel Abidin of trying to understand labelling on other drugs.

The eventual cost of dealing with the drugs can easily outstrip their usefulness.

"With a cost of 250 dollars per ton to incinerate, we could (instead) be building a health centre," said Astrid Kartika, a health advisor for the United Nations Development Programme which is organising and footing the bill for Friday's incineration.

"Indonesia, with all these disasters, has turned into a dumping ground for Western countries. It's criminal," Kartika said.

The drugs also pose a threat to the environment if stored over a long period of time -- and many end up fuelling the local black market, experts said.

"Between the time we finished identifying the drugs and the moment we closed the warehouse to take them to the cement factory -- that is, four months -- 250 tons of unusable drugs vanished in thin air," PSF's Boiron said.

Bahron Arifin from the Indonesian Ministry of Health added that his government never asked donors for drugs when the 2004 tsunami first hit.

"What we need in times of emergency are blankets, shelters and food," he said. "Drugs, we have enough of them here."

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Strong quake jolts Indonesia's Nias
Jakarta (AFP) Jul 27, 2006
A 6.1-magnitude earthquake shook the Indonesian island of Nias on Thursday but there were no casualties or concerns for possible tsunamis, officials said







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