BEST PRACTICE PRINCIPLE #6: NO DOUBLE STANDARDS

Statement 6: No Double Standards. Today we want to affirm that when doing healthcare in an international setting it is essential not to compromise our standards. We should not accept any hint of a double standard in the work we do. What do we mean? 

• • Give medications in a health-care setting: (Promote preventive practices, attitudes and behavior before or at the time of giving medications) (one could argue that a church is a health-care setting or should be)
  • In-country local primary health care provider who knows the patient and the culture should prescribe the medications.
  • No experimental medications
  • No expired medications. I think we can all agree on this one. But when it comes to not yet expired medications there is some flexibility. For example there is the 
    

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WHO GUIDELINE FOR DRUG DONATION:

After arrival in the recipient country all donated drugs should have a remaining shelf-life of at least one year.
 
Most are aware of the severe shortage of medications that most clinic’s/hospital’s in developing nations experience on a nearly day to day basis. Medications that are brought legally into another country will likely be used up very quickly and we believe flexibility in this WHO standard is appropriate so long as it is assured that the leftover medications are left with a licensed professional who is able to monitor the use and distribution of the medications.
 

• Safe distribution of medications
  • Child-safe
  • Labeled
  • WHO essential medications

• Purchase medications in country – this is obviously a hot button topic since so many are now using medications received from foundations and individuals who really want to do good for those suffering from a lack of access to affordable medications. But by bypassing the local system we allow for the perpetuation of a local system that is not meeting the need. Also by buying in country we can help stimulate the local economy. Local purchases would of course need to be made with reputable sources and assurances as to the quality would need to be made.

• We support the Core Principles of the WHO guidelines on donated drugs:

1. Maximum benefit to the recipient
   
2. Respect for wishes and authority of the recipient
   
3. No double standards in quality
   
4. Effective communication between donor and recipient

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• No drugs should be donated that have been issued to patients and then returned to a pharmacy or elsewhere, or were given to health professionals as free samples.
• Sit side by side with the local physician who is prescribing medications.
• Make sure to obtain an adequate history with medication allergies, a good examination and any laboratory or imaging studies as needed
• Give important information about the medication to the patient
  • Labeled in the local language – medication, dose, and prescription.
  • What the medication does and what to do if the medication does not work.
  • Discuss adverse effects of medications
  • Site for follow-up
  • Risks associated with overdose
• We will obtain informed consent for any anything that we do for people including prescribed medications.
• We will keep accurate and accessible medical records and make arrangements for their long-term local maintenance.
• We will correctly utilize interpreters so that the people understand health information and what we are doing on their behalf and what they can do to stay healthy.