Our Pharmacy provides limited but essential medecines to our patients daily. As there are so many language barriers due to the variety of different ethnicities and literacy levels presented at the Clinic, all medications are dispensed with pictorial as well as written instructions.
History and services
When MTC first started, it had no budget to provide medicine for patients. For its first two years, medication was donated to the Clinic by a Catholic organisation, with staff having to collect the necessary medicine from a supplier each week. As well as this donation, visitors to the Clinic would sometimes donate medication. From 1992 – 1997, Médecins Sans Frontières donated medicine on a monthly basis. While struggling to secure its own vital medicine, the Clinic’s pharmacy also provided of medicines to five student camps along the border for a few years, until they got support from their own donors.
In 1998, with the assistance of the Mae Sot Hospital, the Clinic began to purchase supplies from medical companies in Bangkok. All pharmaceutical services were performed by a pharmacy attached to the Medical Outpatient Department (OPD), with a small storeroom, supplying medications to all departments. Each department had their own area in the storeroom and placed a quarterly order.
In 2008, an old kitchen space was renovated, providing an office with a large storage room for a new central pharmacy. A network computer allows our pharmacist to have up to date information on the amount of supplies available and medication orders from each department.
A networked computer system was developed which now allows for each department to order medications from the Central Pharmacy on a weekly basis, resulting in efficient and accurate delivery of supplies to each department. This also means a more accurate inventory system and simplified quarterly supply orders to wholesalers in Bangkok. This system helps to save money and prevent the medication shortages that occurred frequently in the past; shortages which required expensive emergency medication purchases to be made from pharmacies in Mae Sot.
All of this work is coordinated by a dedicated group of medics who have all been trained in pharmacy management. They are responsible for keeping track of inventory levels, ensuring the medications are of good quality, and verifying that the medications are used for the proper illness, in the proper doses. The staff of the Central Pharmacy is in a unique position because, unlike the other clinic departments, which work relatively independent of each other on a day-to-day basis, the pharmacy is linked to nearly every department. The pharmacy staff can be looked to as a valuable source of medication information; they are always willing to discuss how a medication is properly used and any precautions that should be observed. The hope for the future is that more medics will utilize this valuable support.
The medication used at the clinic follows the Burma Border Guidelines, a publication put together by the health organisations working along the border to standardise care services offered.
You can see these guidelines here. Link
You can see our pharmacy wish list here, Link
Just as in any health care setting, there is a challenge in ensuring patient understanding of their medication and treatment. After the clinic had identified difficulties with the patients’ understanding of both their ailments and treatments, a protocol was established whereby the medic who sees the patient also prescribes and explains the medications.
The Communication and Language Assessment Research Project launched in 2005 provided insight that lead to improvements. The research revealed that patients usually understand their diagnosis, but mix up doses of their medications. This led to establishment of a new system which created medicine bags marked with dosage and time of day indicated in pictorial form. Staff with additional language skills was also added at this time to avoid language barriers. Pharmacy staff members need to speak various languages – the estimated breakdown of patient languages is 52% Burmese, 34% Karen, with the remainder speaking other ethnic languages.