If you are deathly ill in Laos, leave! A shake of the head is the response a pharmacist gives in response to the word “doctor.” There’s not a medical school in Laos. Medicine is prescribed and sold at the pharmacy, in Laos. A miming of the symptoms provides the pharmacist with how to treat the patient. The Emergency Room in Luang Namtha is just a place where people watch T.V. and wait for their shifts to be over.
The medicine that can be purchased might be of variable quality. “this one, not so good” a pharmacist/doctor tells me across the street from the emergency room. He indicated the brand of antibiotic that I had purchased.
The C.D.C. has described “a huge market for counterfeit drugs,” which could include the antibiotic that I painfully injected into my muscles, to no avail, for three days. The pharmacist and doctor who told me about the low quality of my antibiotic provides another option, switching to oral antibiotics
Further down the river, at Pak Beng, a self-described D.E.A. agent didn’t recognize the names of the antibiotics, seemingly completely unaware of the presence or use of these commonly available medications, available only by prescription in the United States. His explanation for his ignorance is that he “only deals with illicit drugs,” which I assume doesn’t include potentially deadly fake medications. He explains that “to report counterfeit drugs, you would have to go to the office of a pharmaceutical company and request to speak with their ‘regional head of security.’” His healthy lifestyle includes “running an ultra-marathon in Nepal on a vegetarian diet.”