REFAMPIN for ABDOMINAL PAIN

Some weeks ago I had a trip to Kishm, a beautiful district to the north of Faizabad. On the way, in a valley called Sabzi Bahar, something like 50 KM away from Faizabad, we stopped to take the breakfast in a local restaurant. This was a small, basic and a real rural restaurant, but with delicious food……… Kabab, and Dashi were outstanding……. As we filled our stomach…..and got some energy to see around, we started arguing with each other about infection in the restaurant……after all we were doctors!!!!!!! We had to think about the infection!!!!!!………but the idea came to our mind after we had everything in our belly. Who knows how many parasites and bacteria were dancing in our body……….To our surprise, where we sat and ate our breakfast, on the back of us on the wall there was a big poster about medical ethics!!!!!!Who knows why they posted in the restaurant instead of a health clinic or hospital………..Maybe they knew that we were coming for breakfast…..and they also knew that we were the key health personnel in Badakhshan……….and maybe that was a kind of protest to change our behavior when we faced with patients…………So we had enough agenda to talk in the restaurant with each other; food, infection, medical ethics…………..we did not come to any conclusion in our short post meal meeting!!! We paid the bail and went to one of few shops near the restaurant to buy some fruits to increase our body immunity against all the infection we had eaten!!!(Actually we did that to please our belly by sending something more!!!). This was a small shop, but had everything, maybe it was a super market for the local people. You could find a small sample for everything……fruit, grocery, shoes, clothes and even medicine…….Yes, there was a small bag full of tablets!!!!!!!!!!!!!!! We asked the shopkeeper to show us the contents of the bag……..He had medicine for every kind of disease…….. “if you have headache take this tablet……. and this is for malaria……. this one is for typhoid fever and these red tablet are very effective for diarrhea and abdominal pain……..” yes he was the real Family Medicine Specialist Doctor……. “my co-worker???!!!” That big red tablet, effective for abdominal pain and diarrhea was REFAMPIN!!!!!!!!!!!! Yes he was giving Refampin as a usual drug. We asked that how he found that the tablet were effective……..and he replied he has used on people!!!!!(Retrospective research!!!) We asked him if he knew anything about TB, Anti TB and drug resistance to TB, the reply was brief idea… but nothing about drug resistance……we tried to explain the dangers of giving medicine, side effects and drug resistance and that he may be legally followed……but nothing could convince him……….it was his market……….finally we give up the argument, got up in our vehicle and had enough agenda to talk and to shorten our long boring trip……….