Where There Are No Pharmacists (2nd Edition): A Guide to Managing Medicines for All Health Workers

Where there are no trained pharmacists serving communities, other categories of health workers are called upon to order, buy, store, dispense and advise people on rational use of medicines. Where There Are No Pharmacists explains how to order them, store them, prepare them, dispense them and use them safely and effectively – it is about managing medicines. Information to help communities benefit from the use of medicines is also included.

         This book walks readers through each step, covering topics ranging from policy issues to patient education.  It provides guidance for anyone who is doing the work of a pharmacist; anyone who sells, dispenses, prepares, manages, or explains to others how to use medicines.

         Where There Are No Pharmacists covers:

Ø The concept of National Medicines Policies

Ø Principles of selection: Therapeutics Committees, Treatment Guidelines, Standard Medicines Lists

Ø Procurement, stock management and supply: sources and prices, quantification, quality     issues, storage and stock control

Ø The process of dispensing, and dispensing according to treatment guidelines

Ø Rational Use of Medicines

Ø Integrating vertical programmes like IMCI, STI and HIV programmes, Reproductive       Health

Ø Explaining to patients and communities the role of medicines and how to use medicines       safely

         For communities: Where There Are No Pharmacists contains information to help communities benefit from the use of medicines. It does not provide clinical advice but emphasizes the need to adhere to national standard treatment guidelines or, in their absence, to appropriate texts and guidelines. Whole communities can be empowered through empowering health workers.

         This book does not replace the need for qualified pharmacists; however, there are not enough pharmacists available to manage medicines in all places. The goal of Where There Are No Pharmacists is to fill this gap by increasing the number of health workers who:

Ø responsibly maintain a reliable supply of good quality, essential medicines

Ø manage medicines efficiently by carrying out activities in the best professional way

Ø accurately dispense medicines to the community with relevant information, and

Ø continue to remain competent in their professional role as managers of medicines.

         For ten years the first edition has assisted students, teachers and policy makers as well as health workers doing the work of pharmacists.  Ordinary community members have been able to learn much about medicines affecting their lives. The book has proved to be clearly written and presented for people whose first language is not English – making it easy to translate the concepts into local languages.

    The second edition of Where There Are No Pharmacists includes expanded sections on:

Ø Antimicrobial resistance and the need for wise use of antimicrobial medicines.

     The development of antibiotics was one of the most important advances of medicine. Now, because of the overuse and misuse of antibiotics, bacterial infections that were once easily cured with antibiotics are becoming harder to treat. This section includes practical strategies to help health workers manage antimicrobial medicines wisely in their community.

Ø Tuberculosis (TB)

     TB has become much more difficult to treat because some TB bacteria have become resistant to the medicines previously used to treat TB. This expanded section includes more strategies to help community people understand TB and the best ways to cure this disease completely.

Ø Medicines and older people

     Not all older people are frail but older people often suffer from a number of conditions and need several medicines at the same time to manage their conditions. Their treatment can become complicated and this new edition includes information to help the health workers, carers and the people themselves understand and manage their conditions.

Ø The use of zinc with oral rehydration salts (ORS) for diarrhoea in children

     In children ORS should be given together with zinc tablets. Zinc is a mineral in our body that is lost when we have diarrhoea. Zinc together with the ORS will help a child get better quickly and increase the child’s resistance so they will not catch diarrhoea again for the next two or three months. This section provides instructions on preparing ORS and zinc to give to a child with diarrhoea.

Ø   Waste management

Guidelines are provided for having as little waste as possible and for safe disposal of any unavoidable waste.  Medical waste can be hazardous; if you do not dispose of it correctly, health personnel, waste handlers, and the community risk being seriously injured or infected.

   The resource section has also been updated to facilitate access to the most useful resources.