Last week, after my #Dabinogate article, someone sent me an email saying that I could have done more. That, in addition to talking to the manager, I should have gone ahead to report the supermarket.

‘Randa Abdel-Fattah said, “Bad things happen when good people remain silent.” What You  did wasn’t loud enough.”

The email reminded me of an incident that happened to my younger, more naïve self, years ago.

It started with a simple prescription. As a doctor, I had seen many cases of heavy menstrual bleeding in my years of practice. This was no different—or so I thought. Mefenamic acid 500mg, 8 hourly for 5 days. I wrote this for Safiya, my neighbour, a 32-year-old primary school teacher suffering from heavy menstrual bleeding. She had been complaining about it since she inserted her IUD. Straightforward case.

“This should ease the pain and reduce the bleeding” I reassured her.

Safiya nodded gratefully and headed to the nearest pharmacy—a small, dusty patent medicine store tucked between a vulcanizer’s shed and a restaurant shack selling rice and beans with oil and pepper. The “pharmacist” (a title she gave herself) glanced at the prescription, squinted, and reached for a box.

“Ah, Mefe… Mefe… Metformin! Yes, this one is for blood. Take two daily.”

Three days later, Safiya was rushed to the emergency room—weak, dizzy, and vomiting. The doctors were able to revive her after it was determined that her blood glucose was dangerously low.

One of them took a detailed history and demanded to see the medications she was on. She showed him. Metformin, a drug for diabetes, had been dispensed instead of Mefenamic acid, a Non-Steroidal Anti-Inflammatory drug used for menstrual cramps and reducing bleeding.

Safiya had almost died from hypoglycaemia because of a foolish half baked ‘pharmacist’.

“But the chemist said this was the correct drug!” she gasped between laboured breaths.

Lucky for me, she still had my prescription. The doctor at the emergency room looked at it and realised who was at fault. Recognising my signature, I was called. My stomach was in knots by the time I reached her room. ‘Had I done something wrong? Did I mess up a prescription? Or was my handwriting no longer legible after years of practice?’

The managing team pointed out that I was not at fault that the prescription was correct, and my writing (thankfully) was and still is very legible (none of that doctor squiggles, thank you very much!). I asked where she bought the medicine from and took it upon myself to investigate the matter.

As expected, the “pharmacy” was owned by a woman with a diploma in environmental health. Her sales girls were young recently graduated secondary school students. All of them had no medical background and the shop was not registered with the Pharmaceutical Society of Nigeria (PSN).

In Nigeria, a “patent medicine store” or “patent medicine vendor” (PMV) is a retail establishment that sells over-the-counter medications and health products, often without requiring formal pharmacy training, and is a major source of medicines for ailments in Nigeria. 

Unfortunately, this story is not an isolated incident. Across Nigeria, countless lives are put at risk due to medical quackery by individuals who have no formal training in pharmacy or medicine. The most notorious offenders are patent medicine stores, commonly referred to as ‘chemist’ shops, found on nearly every street corner in both urban and rural areas. These shops, often operated by individuals with little or no pharmaceutical knowledge, sell prescription drugs indiscriminately, often without understanding their effects, contraindications, or proper dosages.

Other horror stories include: A child given adult-dose antihistamines for a cold, leading to seizures. A hypertensive patient sold fake BP drugs, resulting in a stroke. A man treated for malaria with expired antibiotics, worsening his condition. The World Health Organization (WHO) estimates that fake or wrongly dispensed drugs contribute to over 100,000 deaths annually in Africa.

Safiya’s condition made me livid. Together with a friend of mine, I approached the store owner and told her the repercussions of what she had done. The woman who was much older than I was, shocked us with her indifference. She said, ‘it was an honest mistake’ and that ‘these things happen’. ‘Was the patient not still alive?’

Undeterred, I reported the matter to PSN, NMA and Private Health Institution Management Agency (PHIMA). Within a week, the shop was closed.

I did good, abi? Wrong.

When Safiya, my neighbour got better, she came visiting looking glum. Instead of the pat on the back I thought I deserved, she was angry at me that I had caused an ‘innocent woman to lose her source of livelihood’. That ‘the woman was arrested’ but after her neighbours (Safiya inclusive) begged the officials ‘she was released’ (code for money exchanged hands). I stared in shock as she accused me of ‘taking things too far’. Was she (Safiya) not better? Had Allah not protected her?’

At this point, I cut her off mid-sentence. I could not listen to her nonsense any longer.

Jira, Jira, Jira. Let us leave Allah out of this conversation.

What if you had died? I countered. Do you know how many people die from hypoglycaemia? Do you know how many people the said ‘pharmacist’ must have killed that we do not know of? How many men, women and children have suffered from her quackery? Instead of you to form a committee to make sure that other patent medicine stores in the neighbourhood are held accountable, you dare come here spewing rubbish?

Of course, that was the end of our relationship.

News spread across the neighbourhood that one wicked, elite doctor had robbed a hardworking woman of her means of livelihood. Because of that I was given the cold shoulder for the next few months.

To be honest, the whole episode left me more shell shocked than angry.

A woman tried to kill you and yet I am the bad guy? Wonders shall never end.

So yes, dear readers; these days my voice is not so loud because I have learnt my lesson.