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Mental health drugs run short

27th December 2012
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  Minister says not aware of problem
Dr. Hussein Mwinyi

The country is facing a serious shortage of drugs for treating people suffering from mental illness, a situation which has forced some public hospitals to switch to slow and ineffective alternative medication.

Extensive investigation by The Guardian has revealed that public hospitals specialised in mental illness treatment were running short of Haloperidal, which health experts described as the suitable medication for mentally ill patients.

One of the hospitals currently feeling the pinch of the shortage is the Dodoma-based Mirembe Referral Hospital, a government health facility taking care of mental disorders, which can hold 600 patients.

Another one is Lutindi Hospital, in Korogwe District, owned by the Evangelical Lutheran Church in Tanzania [ELCT] – North-Eastern Diocese (NED), which has 100 beds.

There are several non-governmental organisations (NGOs) which offer comprehensive mental health care in the form of treatment, case management and rehabilitation in partnership with local organisations and the government, which are located in Mtwara Region and Pugu in Dar es Salaam Region.

The magnitude of the Haloperidal drug shortage has reached a crisis level, according to impeccable sources in medical circles, forcing some public hospitals caring for mentally ill patients to switch to an alternative drug, Chlorpromazine (CPZ).

“In fact, it’s a big crisis but the general public is not aware of it. The authorities seem not to be bothered by the situation,” said a male nurse at Mirembe Hospital.

On condition of anonymity, the nurse said the shortage of Haloperidal at the hospital had persisted for the last one and a half months, noting that the situation could be the same in other hospitals which take care of mental illness cases.

“I am saying this with certainty because our bosses (at one time) requested the Medical Store Department (MSD) to supply the drug to Mirembe and got a negative response. There is a countrywide scarcity of Haloperidal. According to MSD, there is no Heloperidal in stock at the moment,” he said.

Interviewed health professionals working in public hospitals confirmed the shortage of Haloperidal, saying Chlorpromazine (CPZ) was now being used, though it was slower.
 
“In comparison, recovery speed is high with Haloperidal than with Chlorpromazine (CPZ)…that’s why many health facilities prefer Haloperidal. In short, Haloperidal is the number one drug in the treatment of mental cases in our country (at the moment), with Chlorpromazine (CPZ) taking the second position,” said another medic at Mirembe hospital.

Expounding on the advantage of Haloperidal effectiveness, she said the drug makes a patient fall asleep and enhances recovery (with less side-effects), as opposed to Chlorpromazine (CPZ), which subjects the patient to many hours of sleeping (with slow recovery and severe side-effects).

“Additionally, abrupt shift from Haloperidal (especially for patients who are used to the drug) to Chlorpromazine (CPZ), is not good professionally. That’s why we are pressing the government and other relevant bodies to solve the current shortage of Haloperidal and ensure reliable supply of the drug,” observed the nurse.

“It’s unfair and unjust to force patients who had been using Haloperidal to use alternative drugs…very unfair. The government should move immediately and resolve this problem,” she added.
However, the Health ministry said it was not aware of the reported shortage of Haloperidal, promising to investigate and issue an official statement on the matter.

“I am not aware of the shortage…I am learning about it for the first time from you,” minister for Health and Social Welfare Dr Hussein Mwinyi said in a brief telephone interview with The Guardian yesterday.

The minister promised to check with relevant bodies - ministry officials, MSD and the relevant health facilities - in order to establish the truth of the shortage with a view to resolving the problem.

He admitted that it was impossible for him as head of the Health docket to know about all the issues under his portfolio, which is handling numerous operations and responsibilities.

“I have to check first the source of the problem. There are many forces at work here. Maybe the shortage was caused by inadequate funding on the part of MSD or the respective health facilities had failed to submit their requests (for the drugs) on time…that’s why I am saying I have to check with all these organs (ministry, MSD, and health facilities),” he said.
The minister said a government statement on the controversy would be issued on Thursday.

Tanzania is one of the poorest countries in the world with an astonishing shortage in mental health care. The country has 900-bed capacity for the estimated 1.5 million patients with mental afflictions, according to latest statistics.

SOURCE: THE GUARDIAN