Home' Trinidad and Tobago Guardian : January 20th 2015 Contents A21
Tuesday, January 20, 2015 www.guardian.co.tt Guardian
PROPERTIES FOR SALE BY MORTGAGEE
Address of Properties
LOT #136 KOSTER BLUE AVENUE, LA RESOURCE SOUTH, D'ABADIE
2 Storey residential building on 476.1 square metres land
[1st floor 3 bedrooms, 2 baths. Ground Floor Apartment 2 bedrooms, 2 baths]
#7 UPPER BELMONT VALLEY ROAD, BELMONT
Flat concrete residential land 7,390 square feet. [2 Bedrooms / 1 Bath]
LOT #28 MONTROSE MAIN ROAD, CHAGUANAS
Flat concrete residential / Commercial 5,288 square feet land
#56 RAGOONANAN ROAD, ENTERPRISE, CHAGUANAS
2 Storey residential on 478.5 square metres land
[6 bedrooms, 4 bathrooms]
LOT #106, SIXTH STREET, OFF ANDREW LANE, MAUSICA
2 Storey dwelling house on 4,999 square feet land
OPPOSITE EP #28 ROAD RESERVE, OFF TUMPUNA ROAD, COCORITE STREET, ARIMA
2 Storey residential building on 393 square metres land
10 ALMOND DRIVE, OFF SEWLAL TRACE, FYZABAD
Single storey residential property on 5,000 square feet land
#99 SADDLE ROAD, MARAVAL
3 Buildings on approximately 13,207 square feet Freehold Land
[Bounded at the back by the Maraval River]
LOT #3 MAHABIR GARDENS, LP #8 ST. LUCIEN ROAD, DIEGO MARTIN
Single Storey 3 Bedroom Residence on 5,186 sup feet land
Kindly forward sealed offers in writing to:
THE CREDIT MANAGER
P.O BOX 1153, PORT OF SPAIN
"RE: OFFERS FOR SALE"
For further information kindly call 671-4747 followed by the above extension.
The Mortgagee does not bind itself to accept the highest or any offer.
Unsuitable offers would not be acknowledged.
The problem is common. It is
not new. It s been going on
for at least a generation. The sce-
nario goes like this.
"The child have fever, doctor.
Since Tuesday." It s Friday.
"Open your mouth, please! He
has tonsillitis!" This is said with
vigour and determination.
"Here, take this prescription to
the pharmacy downstairs and give
it to the child for the next five
days!" Again, energy and confi-
The next day, fever gone. Fantas-
tic! Antibiotics. Wonder drugs.
Two doses given and wham! Fever
gone. What a doctor! Knew exactly
what she was doing.
Multiply this scenario by ten.
"The child have a cold." "The child
has a rash." "The child has diar-
rhoea." "The child has a headache."
"She belly hurting." "Earache, doc-
tor." "Cough since last week."
"Sore troat!" "Glands in the neck."
"It hurts when she pees." The
result is always: take an antibiotic.
Problem is, everything is wrong.
A litany of mistakes. Yet the child
is better. The parents are happy.
The doctor believes she has done
her job. If she is poorly trained. If
she is well-trained, she is a hyp-
ocrite. She knows she has done
nothing and that the child was
going to get better regardless of
what she did. And if she still reads
medical magazines or even articles
in the press, (perhaps ten per cent
of doctors?), she knows she has
contributed to what WHO belated-
ly now calls an "emerging global
threat to public health": antibiotic
So what s the problem? Problems
really. There are so many things
A child has had fever for three
days. Ninety per cent of children
who have a three-day fever will be
afebrile within hours. Another 9.9
per cent, 48 hours later. By the
Friday, this child s fever was about
to break, the infection causing it
fought off by the child s immune
system: migratory white blood cells
of various types; aggressive anti-
bodies from previous infections;
antimicrobial peptides; natural
killer cells, various kinds of benefi-
cial hormones and so on.
The diagnosis is the second
problem. Most doctors are not
accustomed to looking down
children s throats. Children
normally have large tonsils.
Adults do not have large ton-
sils. In children up to SEA,
large tonsils do not mean
pathology. Large tonsils and
fever do not equate to tonsilli-
tis. Children, especially under
the age of six years and more
especially, those with a runny
nose, who are febrile and have
"large" tonsils, do not have
tonsillitis. Doctors who rou-
tinely diagnose tonsillitis when
they see a child with a fever
and "large" tonsils are making
a mistake, one that is coming
back to haunt us.
So the child gets an unnec-
essary antibiotic. Another
unnecessary medication that
costs money both to the par-
ent s pocket and to our foreign
exchange position. Multiply
this by the times the mother
has to give the medication, to
fight up with the child, the
crying and holding down and
vomiting and parental frustra-
tion. And for what?
It gets worse. The length of
treatment for bona fide tonsil-
litis, "international best evi-
dence practice," that term so
beloved of late of health
administrators (what were they
doing before?), is ten days. If
you have tonsillitis, the length
of time needed to treat the ill-
ness and eradicate the bacteria
causing the tonsillitis, is ten
days. T-E-N days! Time after
time one hears about children
getting a five-day course of
antibiotics for a throat infec-
What does the parent do
when the fever is gone? You
are lucky if the child gets
more than two or three days
of the antibiotic.
Any marginally competent
doctor know all this. So why
does the doctor write out a
The answer is complex and
deserves an entire article but
basically comes down to two
things. The first is socioeco-
nomic pressure exerted on the
doctor by society and by the
parents to do something. Ours
is a medically naïve society,
one step removed from the
envelope days, when you went
to the doctor and had to leave
with a little brown envelope in
your hand containing some
pills and if you did not do
that, the doctor was no good.
The competent doctor, in this
simplistic view, is the one who
The second is the doctor
herself. Personality, family
upbringing, training and expe-
rience play a role. Suffice it to
say that some doctors cannot
say no, whether it is a sick
leave certificate or a prescrip-
tion. Some doctors sell medi-
cines under the guise of it
being for emergencies. Some
go so far as to sell samples
given to them by pharmaceu-
tical companies. Patients actu-
ally seem to appreciate this.
The result of injudicious use
of antibiotics, sold over the
counter by unscrupulous phar-
macists, or improperly pre-
scribed by doctors or not
given properly whether in
inadequate doses or not for
long enough by parents, is
that in these circumstances,
bacteria invariably develop
resistance to the antibiotic.
Soon, if we do not stop the
practice of taking an antibiotic
for trivial problems, antibiotics
will become useless.
This is nothing new.
Umpteen articles have been
written in the last 30 years
about this problem. Now it
seems the chickens are coming
home to roost.
The Minister of Health is
correct to be concerned about
pharmacists selling antibiotics
over the counter but the phar-
macists are not the only part
of this problem. The doctors
and their influence over the
public play a role too.
ANTIBIOTIC CHICKENS COMING HOME TO ROOST
DAVID E BRATT, MD
Ours is a medically naïve
society, one step removed
from the envelope days,
when you went to the doctor
and had to leave with a little
brown envelope in your hand
containing some pills and if
you did not do that, the
doctor was no good. The
competent doctor, in this
simplistic view, is the one
who does something.
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