Merchants Of Death Or Saviours: Drug Hawkers Thriving Inside Commercial Buses In Lagos

In saner climes, drugs are not hawked or sold on commercial buses. However, in Nigeria the reverse is the case. If you board a commercial bus at Oshodi in Lagos State heading to Toll-Gate – a boundary with Ogun State – you will see a man or woman rise before passengers as the bus takes off to lead prayer either in Christian or Islamic way. Please, do not mistake this person to be a preacher or cleric. After the prayer, the next thing is that this person will begin by painting gloomy picture of sicknesses and telling you how the drugs which he/she hawks are the answer. This is what happens everyday on this route.

Some of these drugs, the hawker would tell you, can be used to treat as much as five different ailments. It does not stop there. They are also suspiciously cheaper than the usual drugs you buy from regular stores and pharmacies. THE WHISTLER’s investigation shows that these itinerant sellers do not have health-related background and usually do not give their names or address of their office. So, in the event that one reacts negatively to any of these drugs, it is almost impossible to trace the seller.

“WHO – World Health Organisation – and the Ministry of Health advise parents (to) always deworm yourself, deworm your children once in every three months,” says a male drug hawker onboard a bus going from Toll-Gate to Oshodi.

A cursory look at the passengers on the bus, shows that most of them are market women with little or no formal education. So, it is easy to manipulate them with dodgy information.

While the World Health Organisation (WHO) in 2017 recommended periodic, large-scale deworming for children to improve their health and nutrition, it did not specify the time interval for the exercise. So, the recommendation is mainly for those who are exposed to parasitic intestinal worms – mostly the world’s poorest.

“Periodic deworming programmes with a single-tablet treatment can drastically reduce the suffering of those infected with parasitic intestinal worms and protect the 1.5 billion people currently estimated to be at risk.

“Four main species of intestinal worms (also known as soil-transmitted helminths) affect almost a quarter of the world’s poorest and mostly marginalized people. They are a major public health problem because the worms disrupt people’s ability to absorb nutrients, impeding the growth and physical development of millions of children.

“WHO has long promoted large-scale treatment for intestinal worms, but this is the first guideline approved by WHO’s Guidelines Review Committee confirming that deworming improves the health and nutrient uptake of heavily infected children,” said WHO in a statement.

Dr. Sravani Chintapalli, in an article published on MedicineNet defines deworming as the “process of eliminating intestinal parasites” through the use of medication.

According to Chintapalli, experts recommend “that deworming should be done two times a year, or every six months, beginning at the age of two years.” Not every three months as the drug hawker said.

Our correspondent observed that one of the drugs this male hawker was selling called “Cameroonian Precious Seed” does not have the registration number of the National Agency for Food and Drug Administration and Control (NAFDAC). Information on the pack shows that the drug is packaged in Nigeria by Johnson Herbal Company, located at No. 30 Sango Road, Ogun State. However, a quick Google search shows there is no company with that name, which means the company has no website.

A glance at the back of the pack also indicates that the drug is a spiritual, physical and medical body cleanser. It is used for “reduction of fat, rheumatism/arthritis, typhoid fever, malaria, stomach pain, visceral fat, diabetes, infections, running stomach, fruit of the womb, poison, flat tommy, fibroid etc.”

Nigeria is a country with a significant number of its population as illiterates. According to data from the World Bank, literacy rate of people ages 15 and above in Nigeria as of 2018 was just 62 percent. This implies that about 38 percent of the age range in the period under review were illiterates. However, it it surprising that not only the uneducated or the less educated people that patronize drug hawkers, but also the educated ones.

If drug hawkers can confidently engage in their illegal practice in Lagos, the commercial nerve centre of the nation, it is unimaginable what is happening in rural communities across the nation.

They Don’t Work

Ms Joy Adigun, used to patronize drug hawkers. But not anymore. Her decision not to patronize them was not because of the dangers such drugs pose to her health, but because they are not effective.

“They don’t work,” Adigun, a trader, told THE WHISTLER referring to the efficacy of the drugs..

“I used to buy drugs from them, but stopped because the drugs are not effective.”

She acknowledged becoming a regular customer owing to how affordable the drugs are.

“The drugs are cheaper than the ones you buy from pharmacies. That’s why I used to buy them, but realized that they don’t work. So, I stopped,” Adigun said.

While Adigun stopped buying from hawkers because according to her, their drugs are ineffective, Mr. Olushola Adebanjo, a teacher, has a different view. He said the drugs are very effective and would keep patronizing them.

Adebanjo, who buys drugs from both hawkers on buses and on the street, said: “The drugs are working, if they’re not working, I’m not going to continue to buy.”

Continuing, he said: “The drugs they sell are cheaper because they’ll tell you they’re selling at wholesale price, unlike the ones at stores.”

Merchants of Death

A public health expert and Executive Secretary of Health Reform Foundation, Dr Celestine Okorie, said hawking of drugs can cause lots of harm to the population health.

He explained that when drugs are exposed to inclement weather, they can decompose and become harmful chemicals for by-product that can harm human health.

“It’s a very bad practice that’s very harmful to our population health. The reason is that these drugs are hawked by mostly illiterates and semi-illiterates who are not trained on how to dispense drugs. They’re neither pharmacists nor pharmacist-technicians or nurses or doctors. They don’t know anything about drugs,” Okorie told THE WHISTLER.

He stressed the need for public enlightenment to curb the harmful practice, describing drug hawkers as merchants of death.

“The public needs to know that you can’t buy drugs from hawkers,” he said. “If these hawkers don’t find willing-buyers, the practice will stop. The public needs to be well educated that this is a very harmful practice. In fact, those people are merchants of death. People should avoid them, avoid buying drugs from people not properly trained to dispense drugs.”

Every drug has a range of temperature and environmental conditions it should be stored or kept, said Mr. Marcellus Nnadi, a pharmacist.

“Outside such condition, such drug will be denatured to inactive by-products or oxidized (broken down) to other compounds that are dangerous to human health even if the drugs packaging still looks intact,” he told THE WHISTLER.

Nnadi explained that in developed society, drugs are handled like weapons, adding that they are dangerous if not handled properly.

“Secondly, drugs are poison and it requires one with ethics, professional knowledge of the Pharmacodynamics (what our body do to drugs when taking) and Pharmacokinetics (what the drugs do to the body) to dispense drugs and get the desired results…those hawking drugs are quacks who have zero knowledge or have drug leaflets based knowledge which is not enough for one to be allowed to dispense drugs,” he explained.

Nnadi maintained that hawking of drugs defeats the practice of controlled drugs and substances of abuse.

He said: “Pharmacist dispenses such drugs as poison and with authentic prescription while hawkers sell it to anybody and any quantity. They sell drugs in quantity and purchasing power of the buyer not based on dosage required…and this has increased the number of drug addicts and those who use drugs to commit crimes.”

Mr. Friday Ocharifu, another pharmacist, said that one of the dangers of such practice is issue of overdosage and underdosage. According to him, underdosage is attributable to the present prevalence of high antibiotics resistance while overdosage can put the kidney under undue pressure. His assertion corroborates with growing concerns about chronic kidney disease, which experts say, is on the rise in the country.

“The consumer takes drugs that have lost it’s efficacy due to excessive exposure to harsh atmospheric temperature, the reason why pharmacies must have functional ACs to maintain optimum temperature for the drugs,” Ocharifu said.

“Because the hawkers lack the knowledge of the pharmacodynamics and pharmacokinetics of drugs, dosage, frequency and duration of drugs eludes them leading to overdosage or underdosage. Underdosage gives rise to high antibiotics resistance we have today while overdosage put kidney under undue pressure hence the high rate of kidney failure in Nigeria.”

He stated that the practice thrives in Nigeria because of the failure of the government to shut open drug market. Ocharifu called on the government to criminalize and enforce ban on drug hawking.

He said: The practice booms in Nigeria because of the failure of the government to close down open drug market, closing open drug market prevents drugs from finding their way into the wrong hands (quacks).

“Government should criminalize and enforce a ban on drug hawking where severe punishment awaits defaulters.”

Rather Unfortunate

The Pharmaceutical Society of Nigeria (PSN) is the umbrella association of pharmacists in Nigeria. The president of the association, Professor Cyril Odianose Usifoh, described the continuous practice of drug hawking in the country as “unfortunate”.

“The issue of hawking of medicines or drugs in buses or designated areas that are not meant for sale of drugs is rather unfortunate in a country,” he said.

Noting the dangers of the practice, Usifoh said drugs are supposed to be kept in appropriate places at certain temperature level.

He pointed out that aside the drugs being exposed to unhealthy temperature, those that hawk them lack knowledge of what they carry, adding that the practice creates room for those who sell fake and adulterated drugs.

“Most importantly, (drugs) should be under the supervision of a trained personnel – a pharmacist to be precise, who would be able to advise appreciately on pharmaceutical care,” Usifoh stated.

The PSN president advised Nigerians to shun patronizing hawkers and buy their drugs from reputable pharmacies.

“We strongly recommend that people should purchase their medicines from reputable pharmacies and be able to ask questions concerning the drugs they’re given,” he said.

“By and large, we must refrain from buying drugs from these vendors.”

NAFDAC Reacts

Established by Decree No. 15 of 1993 as amended by Decree No. 19 of 1999, which metamorphosed to the current National Agency for Food and Drug Administration and Control Act Cap N1 Laws of the Federation of Nigeria (LFN) 2004, NAFDAC is statutorily responsible for regulating the distribution, advertisement, sale and use of drugs, food, among others. Although the agency frowns at hawking of drugs and has continued to warn against it, the practice persist – a development which portends potential public health risk.

Speaking at a one-day media sensitisation workshop on “Dangers of Drug Hawking and Ripening of Fruits with Calcium Carbide” held in Awka, Anambra State in August last year, the Director General of the agency, Prof Mojisola Adeyeye, noted that because of how sensitive drugs are, they are not supposed to be exposed to certain weather conditions.

Represented by the agency’s Director of Evaluation and Research, Dr Leonard Omokpariola, she said drug hawking constitutes danger to society.

Adeyeye pointed out that most of the drugs sold by hawkers are counterfeit, substandard or expired.

“Many drug hawkers are knowingly or unknowingly merchants of death who expose essential and life-saving medicines to the vagaries of inclement weather which degrade the active ingredients of the medicine and turn them to poisons thus endangering human lives.

“Most of the drugs sold by the illiterate and semi-literate drug hawkers are counterfeit, substandard or expired, and therefore do not meet the quality, safety and efficacy requirement of regulated medicines.

“Prescription drugs are also sold by the itinerant drug hawkers who also hold a consultation, recommend and prescribe medicines to their gullible patients,” she was quoted as saying in a report.

The Resident Media Consultant of the agency, Mr. Sayo Akintola, said the agency’s enforcement officers always arrest hawkers when they come across them.

He assured that NAFDAC would continue to go after them until they run out of business.

“We’ve our enforcement officers. They’re all over the country,” he said. “They always go out and apprehend them (drug hawkers) anytime they come across them,” Akintola told THE WHISTLER.

“When you pursue them along the A direction, they take the B direction, but that doesn’t still stop us from running after them until they run out of business.”

According to him, the agency also engages with members of the public to sensitize them on the dangers inherent in patronizing hawkers.

Akintola informed that the National Assembly is currently working on a bill that would make punishment for the practice more severe.

The NAFDAC spokesperson noted that once hawkers know that the punishment is higher than what they stand to gain, that would be a discouragement to the practice.