Islamabad: Grown up under constant fear of militancy and drone attacks, a number of youth in the tribal areas use sedatives to relieve themselves from anxiety and depression, locals and health officials say.
Dr. Zaffar who practices in Wana, the headquarters of South Waziristan, told News Lens Pakistan, “The issue is endemic and posing a great risk to locals’ health as most of youngsters are addicted to sedatives.” He said that the business of foreign-made medicines is at its peak in other tribal areas.
Foreign-made smuggled medicines, he said have no manufacturing or expiry dates and the business is thriving at accelerated pace without any check by the authorities’ concerned.
The area, he rued is now in grip of what he said, “substandard smuggled medicines amid startling revelations that youngsters use tranquilizer such as Alprazolam, and Bromazepam tablets to reduce their tension due to unrest in the region.”
Widely regarded as a lawless belt, Pakistani military launched its first anti-Taliban operation codenamed Rah-e-Nijat (Path to Salvation) in 2009 in the tribal region to flush out foreign militants and their local collaborators.
Sher Hassan 28, a resident of Wana told News Lens Pakistan by phone,“I’m feeling a sense of tension and anxiety for the last several years due to uncertain situation.”
He daily takes four Alprazolam or Bromazepam tablets to alleviate his tension. “Ten tablets cost me only Rs. 10, cheaper than locally-made Lexotanil tablets which costs around Rs. 200,” Hassan added.
Habib Khan, owner of a medical store in Wana, said that foreign-made “medicines bear no expiry date or price tag. Mostly youngsters are addicted to these sedatives.”
Hassan said that he spent sleepless nights if he doesn’t not take tranquilizers as he is now addicted.
Khan said that most of the medicines are Indian or Iranian, which are much cheaper in prices than local medicines.
Ishaq Burki, a clinical pharmacist, said that the government should extend Drug Act 1976 to Fata region to control the illegal medicine business.
The tribal region needs at least 14 drug inspectors to be deputed to every agency, he said, suggesting that the government should establish pharmacy cells or drug testing laboratories in the volatile area.
Burki said that the Drug Regulatory Authority of Pakistan (DRAP) should have its representatives in the region to have a check on “spurious and expired drugs.”
In his early 30, a medical store owner in the bustling Wana bazaar wishing to go unnamed because of security reasons said, “Smuggling of foreign-made medicines is underway with the connivance of local authorities.”
However, Habib Khan said that foreign-manufactured drugs are being smuggled from Afghanistan in “huge quantity” but he has no exact figure because the smuggling activities fluctuate. People prefer to buy foreign medicines because of cheap prices, he added.
Haji Nizamuddin, a tribal elder, said that medicines business continues to flourish because their owners’ earn more money by investing less. “You can see for yourself more and more medical stores have been opened at every corner of Wana because the business has turned lucrative following an influx of foreign-made medicines,” he remarked.
Pakistan shares 2, 611 kilometers long border with Afghanistan and the Federally Administered Tribal Areas (FATA) lies cheek by jowl with the Afghan border.
In addition to three trade corridors, it said that the two countries have “around 100 frequented and unfrequented routes as well.”
Also, Saifullah Khan Mahsud, director Fata Research Center (FRC), said that Pakistan has porous border, offering “a better ground for smuggling of foreign-made medicines and other commodities.”
A number of border areas between Pakistan and Afghanistan are “smuggling prone”, he added.
“Maybe the violence that plagued the tribal region forced youngsters of the area to use sedatives but loose management of the porous border can be blamed for smuggling of the contraband,” the FRC director noted.
A senior official at the local administration told News Lens Pakistan on condition of anonymity because he is not authorized to speak to media that the tribal region has no custom officials to check smuggling but “local Khasadar force – an ill trained force discharging several duties simultaneously- has been deployed on known entry and exit points to check illegal moment.”
“The local administrations in different parts of the tribal regions have strict directions from the governor to check illegal moments and smuggling on the border but the border is too porous to be managed properly,” he acknowledged.
A detailed report ‘Expanded Program on Immunization’ by Directorate of Health Services FATA stated that as per 2012 facts and figures, a total of 751 professional doctors are serving in FATA.
The report said that health sector in FATA is in shambles with one doctor for 5,728 persons. In addition, it said that the restive region is facing severe shortage of female medical staff also.
Dr. Zaffar said 50% people in tribal region use tranquilizer to fight anxiety and depression. “They prefer foreign-manufactured medicines because of their weak economy,” he added.
He said that the medicines are being sold without health department’s authorization but private medical practitioners do the business in far-flung villages of the area.
Burki said that rampant smuggling of medicines specifically tranquilizers pose a serious threat to health of the people and local pharmaceutical companies. “The influx of foreign-manufactured medicines is underway unchecked for the last several years, which restricted local drug manufacturers,” he added.
Another tribesman, Muhammad Bilal 38, said he has been using Grucid tablets made by Indian Global Combitic Private Ltd, and Omiprazol tablets 40 mg to relax him. “My entire family members use foreign-made medicines because they are cheaper in prices,” he added.
There are dozens of drugs’ stores selling Indian made medicines, he said, adding that the store owners have their stocks of medicines. “Well-off patients buy locally manufacturing medicines but most of poor people prefer to buy cheaper medicines,” Habib Khan added.
A packet of ten Indian-made Alprazolam tablets is being sold at Rs. 10, he said, adding that a large number of people have been addicted to this tablet.
In his early 30, an owner of a drugs’ store, said that he and his other colleagues supply the smuggled medicines in wholesale to people running stores in remote villages.
A packet of Alprazolam containing 30 tablets of local pharmaceutical companies is being sold at Rs. 150 to Rs. 200 while a 100 tablets packet of Aximax—substitute to Alprazolam— can be found at Rs. 30 to Rs. 35, he added.
Medics said that continued violence and war in tribal region led most of the people to post traumatic stress disorder, anxiety and obsessive compulsive disorder.
Most of the medicines have Indian-manufacturing tags, locals added. Professor Dr. Farid Aslam Minhas, head of institute of psychiatry, expressed grave concern over the health situation in Fata.
He said that seminars and training sessions should be arranged to train doctors working in tribal belt to treat psyche patients.
Dr. Khurshid, a psychiatrist in Dera Ismail Khan, a city with access to North and South Waziristan, said there is visible increase in patients of stress and depression in tribal areas since 2003 when the militancy was gaining momentum.
He said he was almost checking 20 patients with psychological problems daily with frustration levels of most of the patients is very much high.
Dr. Munir Dawar, assistant profession at Dera Ismail Khan Teaching Hospital, said he was treating almost 100 psycho patients who come for immediate treatment.
Most of the patients, Dr. Dawar said were coming from the tribal region. “Also, most of the patients are youngsters, and even students who complain of depression and social phobia,” he added.