PAYING THE PRICE OF A FREE ADVICE

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Arooj, 21, wanted a fair complexion. One of her class fellows in college gave her advice to use a specific combination of creams and medicines. There was a marriage in the family and she wanted to look her best especially because she was not satisfied with her complexion. She followed her friend’s advice and amazingly, in a few days her face color started to turn white and glowing. Everyone noticed the change at the wedding. Her cousins and friends were astonished on her color transformation. This gave a boost to Arooj’s confidence. The mission was accomplished!
The story however, does not end here. In a few weeks the fairness and glow of her skin started to fade out. One day she spotted a pimple on her face. She took it as a routine matter but in the next few days the number of pimples increased in dozens which covered all her face. This scared her. When nothing seemed to help, she rushed to a dermatologist who asked her to stop using the creams immediately and prescribed some medicines. Long story short, after one year’s continuous treatment, she finally got rid of the skin problem. But at the cost of losing thousands of rupees and a friend too. All because of following a free advice.

Giving free advice is common in our society. And when it is given regarding health, it can be deadly. It is said that in Pakistan, everybody is an expert at least in three fields; architecture, religion and health. If you share some health problem within your social circle, there is a high chance that you get a number of advices from different people and sometimes even from strangers. Of course not with a malicious intent. The motive behind it is chalo kisi ka to bhala ho jaye (At least someone would benefit from it). It is probably human nature, because when we find someone in trouble we naturally tend to help him. But what we do not realize is that instead of giving benefit, the advice can sometimes prove harmful for the individual. Arooj’s story is one of its examples, when her friend thought about taking her out of the misery. Though Arooj’s problem was a cosmetic one but in our country people do not even care about their genuine health problems. Instead of going to a physician they follow all unnecessary advices given by others.
Disease burden of different kind in Pakistan is mammoth. According to WHO, Pakistan ranks seventh in diabetes prevalence with approximately 6.7 million people suffering from it, more than 150, 000 people suffer from CKD every year and nearly four million people have been exposed to hepatitis B virus and about eight million to hepatitis C virus in the country. Moreover, Pakistan’s maternal and infant mortality is the highest in south Asian region with maternal mortality estimated to be 276 deaths per 100, 000 live births and infant mortality is about 66 deaths per 1000 live births.

According to Gen Mahmud Ahmad Akhtar, Prof Emeritus in Medicine, our health situation is critical. Health indicators tell a horrifying story. “All this is happening due to lack of awareness and following wrong advices”. Adding further he says, in developed countries, even experts do not say a single word beyond their expertise. They simply refuse to give any advice and ask their patient or client to go to the relevant specialist. “But unfortunately in our country, an ordinary person becomes an expert when he sees someone in a problem”.
Muhammad Riaz, a resident of Islamabad suffers from diabetes. He is chauffeur by profession. One of his friends told him about a home remedy and asked him to stop using medicines prescribed by a doctor. He followed the advice and in a few days his diabetes reached to a dangerously high level which landed him in the hospital in a critical condition. He narrowly escaped even worst likely complication. “I see such patients daily who come to us after complicating their problem by following such advices,” says Dr Mahmud Majeed, a medical specialist at Shifa International Hospital, Islamabad.  Riaz was lucky that he was brought to the hospital timely and his eyesight was saved. Following such advices means risking your life. Dr Majeed advises that simply listen to your doctor. “Trust him, he knows better about your problem than others”.

Not all, however, blindly pay heed to advices given by non-professionals. Naeem Shah, another diabetic reacted quite differently to such advices. When his friends came to know about his disease, they waited no minute to pour in their suggestions. Some told him to avoid sugar, some advised him to skip certain foods, some recommended home remedies while others emphasized on lifestyle modification. They were not just giving advises but claiming high about them and even mentioning people who had earlier tried it. “One of my friends simply told me to stop taking the medicine and never think of switching to insulin as it would make me dependent and I will have to take them for life”. Naeem listened to everybody but followed what the doctor said. Nowadays, he is doing well and his diabetes is under control. His doctor is hopeful that if he uses the medicines regularly and does lifestyle modification, he would gradually be less dependent on medicines.
Dr Rizwan Aziz Qazi, a medical specialist at PIMS Islamabad says, Pakistan had almost gotten rid of polio but unfortunately now the number of polio cases is on the rise. “The reason behind it is unsolicited and wrong advices. People have wrong beliefs about diseases which they pass on to others as well”. According to Dr Rizwan he has met allergy patients who stopped drinking milk because it can worsen their condition. Some patients say they do not take egg because it is hot and can cause high blood pressure. “On inquiring I usually find out that their friends and family members advised them to do so”.

Pregnancy is an important stage in a woman’s life. More than relying on the doctor’s advice, expectant mothers follow what others tell them, from what they should eat to lifestyle modification. For instance, they are asked to avoid hard work, restrain from exercise and omit certain foods from their diet. Dr Tasneem Akhtar, a gynecologist at Shifa International Hospital Islamabad disapproves all these advices. “Performing normal household chores, doing recommended exercise and eating healthy food is necessary for a pregnant woman”, she says before adding, “instead of listening to the oldwives tales, women should visit their gynecologist during this time to make sure things are smooth”.
Another practice which is common in our society is that for minor ailments like, fever, headache or body pain, people tend to asks friends or relatives what to do and which medicine to take. They suggest medicine which had proved beneficial to them once for the ailment. This is sheer ignorance. Before suggesting such things people should understand that they may even complicate the problem by suggesting a wrong medicine as the patient may not necessarily have the same problem. Gen Mahmud strongly discourages this behavior. “Self-medication can be harmful. It is only the doctor who can suggest the medicine and the dose as well. Your loved ones are important but they are not specialists”.

Advices from loved ones can sometimes be hard to ignore. But we should know that they can be harmful. Listen to them but follow what the doctor recommends. Gen Mahmud says that advices relating to character-building like being righteous, avoiding a lie, etc should be taken from others. But not anything related to health. As far as a stranger’s advice is concerned, only a “thank you” accompanied by a smile can get you out of the situation. And of course, if someone tells you to stop risky behaviors like one-wheeling or smoking, listen to them.
Experts believe illiteracy and ignorance are the reasons to the problem. Gen Mahmud emphasizes that government should make efforts to educate its people. “Nations which have high literacy rate do not give unnecessary advices”. Giving an example he says, although a poor nation, Sri Lanka has a literacy rate of 98 percent. And its peoples’ health is comparatively better. Average age in Sri Lanka is 76 years. “Bangladesh, which is several years younger to Pakistan, has good health indicators, because it has prioritized education”. Pakistani government should also prioritize education and media should play its role in spreading appropriate awareness. “Health subjects that educate children about diseases should be included in the curriculum”, says Dr Rizwan.

Prioritize your health. You need to look after yourselves as you have a great responsibility of taking care of your family. Stop taking risks by following others advice. All you need to do is visit a physician. Moreover, if you see somebody in a health problem, do not poke your nose unless you are guiding them about a relevant expert. Share good experiences about the best specialists in town instead of handing them a  “prescription”.

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