WHERE THERE IS NO DOCTOR THE MEDICINE KIT
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The Medicine Kit
This is a reprint from
WAere There Is No Doctor
(Indian adaptation)
published by the
Voluntary Health Association of India
C-14 Community Centre
Safdarjung Development Area
New Delhi 110016
377
CHAPTER
The Medicine Kit
Every family and every village should have certain medical supplies ready in
case of emergency:
• The family should have a HOME MEDICINE KIT (see p. 380) with the
necessary medicines for first aid, simple infections, and the most common
health problems.
• The village should have a more complete medical kit (see VILLAGE
MEDICINE KIT, p. 382) with supplies necessary to care for day-to-day
problems as well as to meet a serious illness or an emergency. A responsible
person should be in charge of it—a health worker, teacher, parent, store
keeper, or anyone who can be trusted by the community. If possible all
members of the village should take part in setting up and paying for the
medical kit. Those who can afford more should contribute more. But
everyone should understand that the medicine kit is for the benefit of
all—those who can pay and those who cannot.
On the following pages you will find suggestions for what the medicine kits
might contain. You will want to change these lists to best meet the needs and
resources in your area. Although the list includes mostly modern medicines,
important home remedies known to be safe and to work well can also be included.
How much of each medicine should you have?
The amounts of medicines recommended for the medicine kits are the smallest
amounts that should be kept on hand. In some cases there will be just enough to
begin treatment. It may be necessary to take the sick person to a hospital or go
for more medicine at once.
The amount of medicine you keep in your kit will depend on how many people
it is intended to serve and how far you have to go to get more when some are used
up. It will also depend on cost and how much the family or village can afford.
Some of the medicines for your kit will be expensive, but it is wise to have
enough of the important medicines on hand to meet emergencies.
Note: Supplies for birth kits—the things midwives and pregnant mothers need to
have ready fora birth-are listed on pages 300 to 301.
378
HOW TO CARE FOR YOUR MEDICINE KIT
1.
CAUTION: Keep all medicines out of the reach of children. Any medicine
taken in large doses can be poisonous.
2.
Be sure that all medicine is well labeled and that directions for use are kept
with each medicine. Keep a copy of this book with the medicine kit.
3.
Keep all medicines and medical supplies together in a clean, dry, cool place
free from cockroaches and rats. Protect instruments, gauze, and cotton by
wrapping them in sealed plastic bags.
4.
Keep an emergency supply of important medicines on hand at all times.
Each time one is used, replace it as soon as possible.
5.
Notice the DATE OF EXPIRATION on each medicine. If the date has
passed or the medicine looks spoiled, destroy it and get new medicine.
Some medicines, especially tetracyclines, may be dangerous if they have passed
their expiration date.
Keep medicines out of reach of children.
379
BUYING SUPPLIES FOR THE MEDICINE KIT
Most of the medicines recommended in this book can be bought in the
pharmacies of larger towns. If several families or the village get together to buy
what they need at once, often the pharmacist may sell them supplies at lower cost.
Or if medicines and supplies can be bought from a wholesaler, prices will be
cheaper still.
If the pharmacy does not supply a brand of medicine you want, buy another
brand, but be sure that it is the same medicine and check the dosage.
Read the fine print on the bottle or box to make sure it is the right medicine you want.
When buying medicines, compare prices. Some brands are much more
expensive than others even though the medicine is the same. More expensive
medicines are usually no better. When possible, buy generic medicines rather than
brand-name products, as the'generic ones are often much cheaper. Sometimes you
can save money by buying larger quantities. For example, a 600,000-unit vial of
penicillin often costs only a little more than a 300,000-unit vial—so buy the large
vial and use it for two doses.
326. V Main, I Block
Koramnng^la
Bam'1'e-’60034
India
380
THE HOME MEDICINE KIT
Each family should have the following things in their medicine kit. These
supplies and medicines should be enough to treat many common problems in
rural areas.
Also include useful home remedies in your medicine kit.
SUPPLIES
Supply
Use
T
Price
(write in)
t
Amount
recommended
+
See
page
FOR WOUNDS AND SKIN PROBLEMS:
sterile gauze pads in
individual sealed envelopes
---------- -----------
20
1-, 2-, and 3-inch
gauze bandage rolls
-------- -------------
2 each
100
1 small
package
85,96
•300
_____ -------------
2 rolls
98,262
____ _______
1 bar or
small bottle
410
clean cotton
_______
adhesive tape (adhesive
plaster), 1-inch wide roll
disinfectant soap (like
Lifebuoy, or Cinthol,
70% alcohol
rubbing alcohol
____
hydrogen peroxide.
in a dark bottle
110,262
309
54 liter
85,300,
355
____ _______
1 small
bottle
96, 225
254 255
-------------
1 bottle
104,111
194.242
petroleum jelly (Vaseline)
white vinegar
54 liter
242, 286,
338,355
sulfur
100 gm.
242, 247,
24'6,
tincture of iodine and
tincture benzoine
_____
________
1 small bottle each
scissors (clean.
not rusty)
____ _______
1 pair
98, 300,
308
tweezers or forceps.
--------_______
1 pair
97, 213
with pointed ends
381
Price
(write in)
Supply
Use
---- t----
T“
"F
See
page
Amount
recommended
------ f-------
FOR MEASURING TEMPERATURE:
thermometers
for mouth
for rectum
1 each
36,37
several
237,378
FOR KEEPING SUPPLIES CLEAN:
plastic bags
MEDICINES
Use
Medicine
(generic name)
’
I
Local brand
(write in)
i
Price
(write in)
+
Amount
recommended
f
See
page
FOR BACTERIAL INFECTIONS:
I. Penicillin, 250
mg. tablets (2,00.000 U).
40
397
2. A sulfonamide,
500 mg. tablets
_
100
402-
3. Ampicillin,
250 mg. capsules
_
24
399
FOR WORMS:
40 tablets
of 500 mg.
or 2 bottles
4. Piperazine,
tablets or syrup
FOR FEVER AND PAIN:
5. Aspirin, 300 mg.
(5 grain) tablets
____________
____________
50
414
____________
____________
’/a kg.
182
————
10
envelopes
416
100
424
FOR DEHYDRATION:
6. Sodium bicarbonate
(also salt and sugar)
or prepackaged mix
for rehydration
drink
-
fOR ANEMIA:
7. Iron (ferrous
sulfate), 200 mg.
pills (best if
pills also contain
vitamin C and
folic acid)
Do not buy capsules. They are very expensive, and not more effective than tablets.
COMMUNITY HEALTH CELL
47/1. (Fiifi ' Icor, St Mftks Read
Banqa!'"'
r" '
382
Use
Local brand
(write in)
Medicine
(generic name)
“*
?—
See
Amount
Price
(write in)
page
recommended
------ 1------I------
FOR SCABIES AND LICE:
8. Lindane (gamma
benzene hexachloride)
____________ ,
______________
1 bottle
411
____________
____________ _
12
.419
.
----------------------
1 bottle
1 tube
409
____________
----------------------
1 tube
413
12. 20 percent sulfacetamide ____________
eye drops
_______________
1 bottle
413
------------------------------------------------ —
1 bottle
414
------------------------
1 bottle
414
______________
1 bottle
418
FOR ITCHING AND VOMITING:
9. Promethazine,
25 mg. tablets
FOR MILD SKIN INFECTIONS:
10. Gentian violet,
small bottle; or an
antibiotic ointment
FOR EYE INFECTIONS:
11. Antibiotic eye
ointment
FOR EAR INFECTIONS:
13 Boroglycerine ear dtops
14. Eardropswithchloramphemcol-------------FOR STUFFY NOSE:
15 Decongestant nasal drops ___________
THE VILLAGE MEDICINE KIT
This should have all the medicines and supplies mentioned in the Home
Medicine Kit, but in larger amounts, depending on the size of your village and
distance from a supply center. The Village Kit should also include the things listed
here; many of them are for treatment of more dangerous illnesses. You will have
to change or add to, the list, depending on the diseases in your area.
ADDITIONAL SUPPLIES
Supply
Use
T
FOR INJECTING:
syringes
Price
Amount Page
5ml
10ml
5 ml. needles #22,3 cm. long
#25, I'/icm. long
3-6
2-4
383
Supply
Use
T
Price
~r~
■
Amount Page
~r
+
~F~
FORTROUBLE URINATING:
catheter (rubber or plastic #16 French)___
2
284.
FOR SPRAINS
AND SWOLLEN VEINS:
elastic bandages.
2 and 3 inches wide
3-6
115,213,
255
FOR SUCKING OUT MUCUS:
suction bulb
1-2
FOR LOOKING IN EARS, ETC.:: small torch
1
97. 301.
308___
42-301355
ADDITIONAL MEDICINES
Use
~r
Medicine
Local Brand
—f—
—f------
Price
Amount
-------- f—
Page
~t~
FOR SEVERE INFECTIONS:
' 1. Penicillin, injectable;
if only orfe, procaine
penicillin 600,000 U. per ml.
2.
Ampicillin, injectable
250 mg. ampules
3.
Tetracycline, capsules
or tablets 250 mg.
-------------------------
---------
20-40
398
20-40
399
40-80
400
FOR AMEBA AND GIARDIA INFECTIONS:
4.
Metronidazole, 250 mg. tablets
40-80
407
FOR FITS,TETANUS, AND SEVERE WHOOPING COUGH:
5. Phenobarbital
15 mg. tablets
and 200 mg. injections
40-80
15-30
422
6.Paraldehyde. 2 mg. and
10-20
423
5 mg. ampules
FOR SEVERE ALLERGIC REACTIONS AND SEVERE ASTHMA:
7. Adrenaline injections
ampules with 1 mg.
----------------------- _
_____
5-10
419
---------------------- _
_____
20-100
418
9- Ergonovine, injections of 0.5. mg. ---------------------- .
______
6-12
423
FOR ASTHMA:
8. Ephedrine, 15 mg. tablets
FOR SEVERE BLEEDING AFTER CHILDBIRTH:
OTHER MEDICINES NEEDED IN MANY BUT NOT ALL AREAS
WHERE DRY EYES (XEROSIS) IS A PROBLEM:
Vitamin A, 200,000 U. capsules
384
Use
Local Brand
Medicine
Price
Amount
Page
2-4
bottles
421
50-200
401
2-6
421
Chloroquine
tablets with 150 mg. of base
50-200
405
Primaquine tablets
with 26.3mg base
100-200
405
30-50
413
25-100
411
3-6
425
----- f-----WHERE TETANUS IS A PROBLEM:
Tetanus antitoxin, 50,000 units
WHERE TYPHOID IS A PROBLEM:
Chloramphenicol, 250 mg. capsules
WHERE SNAKEBITE IS A PROBLEM:
Polyvalent antivenin
WHERE MALARIA IS A PROBLEM:
WHERE ELEPHANTIASIS IS A PROBLEM;
Hetrazon 50
tablets
WHERE HOOKWORM IS A PROBLEM:
Thiabendazole, 500 mg. tablets
(or another hookworm medicine)
TO PREVENT OR TREAT BLEEDING IN UNDERWEIGHT NEWBORNS:
Vitamin K, injections of 1 mg.
---------------- ------
-----------
MEDICINES FOR CHRONIC DISEASES
It may or may not be wise to have medicines for chronic diseases such as
tuberculosis, and leprosy, in the Village Medicine Kit. Often, to be
sure a person has one of these diseases, special tests must be made in a health
center where the necessary medicine can usually be obtained. Whether these and
other medicines are included in the village medical supplies will depend on the
local situation and the medical ability of those responsible.
VACCINES
Vaccines have not been included in the Village Medicine Kit because they are
usually provided by the Health Department. However, a great effort should be
made to see that all children are vaccinated as soon as they are old enough for
the different vaccines (see p. 175) ■ Therefore, if refrigeration is available vaccines
should be part of the village medical supplies-especially the DPI, polio,
and cholera vaccines.
385
WORDS TO THE VILLAGE STOREKEEPER
(OR PHARMACIST)
Dear friend.
If you sell medicines in your store, people
probably ask you about which medicines to buy
and when or how to use them. You are in a
position to have an important effect on people's
knowledge and health.
This book can help you to give correct advice
and to see that your customers buy only those
medicines they really need.
As you know, people too often spend the
little money they have for medicines that do not
help them. But you can help them understand
their health needs more clearly and spend their
money more wisely. For example:
■■ If people come asking for cough syrups, for a diarrhea-thickener like
kaolin for vitamin B-] 2 or ,iver extract to treat simple anemia, for.penicillin
to treat a sprain or ache, or for tetracycline when they have a cold, explain to
them that these medicines are not needed and may do more harm than good.
Discuss with them what to do instead.
■ If someone wants to buy a vitamin tonic, encourage him to buy:vegetables
eggs, or fruit, instead. Help him understand that these have more vitamins and
nutritional value for the money.
■ If people ask for an injection when medicine by mouth would work as well
and be safer—which is usually the case—tell them so.
■ I f someone wants to buy 'cold tablets' or some other form of 'expensive
aspirin' for a cold, encourage him to save money by buying plain aspirin tablets
and taking them with lots of liquids.
You may find it easier to tell people these things if you look up the
information in this book, and read it together with them.
Above all, sell only useful medicines. Stock your store with the medicines and
supplies listed for the Home and Village Medicine Kits, as well as other medicines
and supplies that are important for common illnesses in your area. Try to stock
low-cost generic products or the least expensive brands. And never sell people
medicines that are expired, damaged, or useless.
Your store can become a place where people learn about caring for their own
health. If you can help people use medicines intelligently, making sure that
anyone who purchases a medicine is well informed as to its correct use and dosage,
as well as the risks and precautions, you will provide an outstanding service to
your community.
Good luck!
Sincerely,
The book Where There Is No Doctor is available
at Rs 29/- plus postage. Multiple copies of reprints
of various chapters are also available.
Please write to:
Publications Officer
Voluntary Health Association of India
C-14 Community Centre
Rafdarjung Development Area
New Delhi 110016
Rs. 1.00
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