Nepal's Health Care System, Part I: Let's Visit a Pharmacy!

It occurs to me that if you're in Nepal, you'll surely get sick at some point. And that means you'll have to navigate the Health Care System, part of which is helpfully shown above. If you're a tourist who stumbled onto this blog while trying to figure out what's wrong with your stomach, my advice would be: Check your guidebook. It'll tell you useful things like "go to CIWEC Clinic," which is an internationally famous traveler's medicine clinic, and since you have health insurance back home and a credit card you won't mind paying the prices. (They're triple the norm, or maybe ten times. I can't remember, because the last time I asked, my wallet jumped up and hit me on the head. Helpful hint: The doctors at CIWEC have outside practices, too, at non-tourist prices.)

But if you live here, what you really do is check sites like WebMD and then go to the local hole-in-the-wall pharmacy to get whatever you've diagnosed yourself with, because living in Nepal has magically turned you into a doctor and if the internet was any faster you'd soon become a specialist. Then they try to sell you Cipro.

This is an actual transcript of my recent trip to our local storefront pharmacy. Incidentally, everything is over-the-counter here. Especially Cipro.

Me: I need some medicine that starts with D. It's kind of like Brucet but with a D. It's for foot pain.

Pharmacy clerk: (showing me Brucet, which is ibuprofen) It's not this?

Me: No, that's Brucet. It starts with D and the pills are little and round. I had the package but I lost it.

Pharmacy Clerk: Do you have a prescription?

Me: A prescription? Ha ha ha, this is Nepal!

All Pharmacy Clerks and Customers in Unison: Ha ha ha ha ha!

Much of this is probably Cipro

Pharmacy Clerk: (Goes to shelf and starts pulling down boxes that start with D) Is it this? Or this? Or this?

Me: No .... no .... no, that's vitamins ... no, that's eye drops ...

Pharmacy Clerk: Or this one.

Me: That's Cipro. It starts with D and it's definitely not Cipro.

Pharmacy Clerk: (Glancing at shelves piled high with dusty pill boxes.) That's all we have.

I don't leave, because success in Nepali is achieved by the patient. (Um, this is definitely not a pun.) Other customers come to the window. They probably get Cipro, because every time you go to the pharmacy you will be offered vitamins and Cipro, which if you're American you'll recall as the super-potent antibiotic to treat terrorist-induced anthrax, but here is used for things like ear wax removal. The pharmacy person ignores me to chat with other pharmacy people, give people Cipro and vitamins, and check Facebook on her cell phone. I stand there patiently and smile. After a few minutes I catch the eye of another Pharmacy Person.

Me: I need a medicine for foot pain that starts with D. It's a little white pill and it's like Brucet but it's not. Also it's not Cipro and it's not anything like Cipro.

Pharmacy Clerk 2:  (Looks at other Pharmacy People. None of them move. Checks cell phone. Apparently Facebook has no updates. Comes over and begins pulling down boxes.) Is it this? Or this?

Me: (reading label) No, that's a vitamin. It starts with D.

Pharmacy Clerk 2: Is it this one?

Me: Yes, that's it! Thanks, you've been so helpful!

And now you know how to get medicine in Nepal. It's actually quite convenient. OK, it won't be so convenient when we all get antibiotic resistance from using Cipro on earwax. But oh well, we can always go to the shamans. My husband had typhoid as a kid and his parents called the shaman, who made him eat the gall bladder of a bear and pigeon poop. At least he didn't get antibiotic resistance. Although he's pretty resistant to another round of bear gall and pigeon poop.

Also available in Nepal: shamans. 
Try this to treat resistant bacteria.