Medications and Pharmacies

Typical pharmacy in Latin America. A few are twice this size and rarely much larger.

In all of the countries that we have been in so far (Costa Rica, Nicaragua, Panama, Colombia, and Ecuador), the pharmacies are similar. They are usually much smaller than a 7-11 store in the USA; often you just walk a step or two from the sidewalk to a counter. They tend to have medicines in a series of deep drawers behind the counter. The staff doesn’t wear any type of name tag or badge so I don’t know if they are “pharmacists” or not. They do tend to be pretty knowledgeable and able to recommend products for colds, coughs, bug bites, etc.

In Panama, Ecuador, and I think Costa Rica and Nicaragua as well, they are called farmacias but in Colombia they are usually called drogerias.

I know in Nicaragua, I could buy generic Xanax and Ambien with no problem, and no prescription. In fact, the generic Xanax was on the top shelf of the glass counter. No limits on how much I could buy either. And very cheap, under $0.30 each if  I remember correctly.

When I talked to the doctor who came to see Dan when he was under the weather in Popayan, he said that the only things that require a prescription in Colombia are antibiotics. I am glad that they require a prescription but it is amazing that you can buy anything else any time you want.

The farmacias tend to have a small selection of supplements, dental items, personal care items, etc. It will be interesting to see the differences in the future countries.

Blister pack of acetomenophen

You don’t generally see items in bulk. They are usually sold by a blister pack sheet, even something as common as acetaminophen is sold by a sheet of about 10 or 12 tablets. Selection is much smaller and options different from the US. For example, if you want a cream to stop itching from mosquito bites, you can’t get a benadryl type cream. And what you can get in one country you may not be able to get in another.

I take a large dose of Vitamin D3 every day so I like to get 5,000 unit gel caps but you are lucky if you can find 2,000 units caps and if you do, they are expensive where as in the US they are pretty cheap.

Face Masks

Mouth guard worn by a few wait staff or vendors

While not really common, it is not odd to see a person on the street with a surgical mask over their mouth (seldom over their nose as well). I have tried to find out the reasons although I confess I haven’t talked directly to someone wearing the mask since I didn’t want to offend a stranger.

I’m told that the reasons for wearing the mask may vary from having a cold to avoiding the dirty air. Neither of these explain why the nose isn’t covered…they can’t all be mouth breathers. And the effectiveness of these inexpensive masks, especially as worn as they are, is probably limited, especially for air pollutants.

On a different but related subject, I see a few vendors, restaurant wait staff, or servers wearing a clear plastic guard that loops over their ears. The purpose is to avoid the person breathing on or coughing on the food. The device is fairly unobtrusive and probably has some efficacy although I would think making it a little bigger would make it much more effective.

In any case, I appreciated the business’s efforts at keeping my food safer.

Face mask on cook’s chin?

This last picture (sorry I don’t have a better image) shows the cook in a local chain restaurant with a face mask, below his mouth. Maybe he is covering a goatee?

Dental Work in Colombia

Braces on students

Dental work in Colombia is very cheap. It is hard to get actual prices and even those could vary based on individual needs. Implants and braces are commonly advertised in the larger cities.

Even though labor is cheap here, I have seen many, many people with lower paying jobs like restaurant wait staff and store clerks with braces on so the braces must be extremely cheap. We spoke to two students when we were on the cable car who both had braces. They said that they cost 150000 Colombian pesos or about $500 for their work and that it must be paid in full up front. That is a lot of money for many people in this country so I am a bit surprised that it costs that much but it is in keeping with the odd price I have seen posted.

Looking on the internet I see mixed reviews of the dental work. Many people rave about the work while others report poor quality. I do know that the parents of the owner of my former workplace go to Guatemala to get their dental work done. They are happy with the results and spend less, including travel expenses, than they would in the US.

I tend to gravitate towards the higher end dentists because of bite issues. So while I had an excellent cleaning for $50 in Panama, I hope to not need any major work while we are traveling. I prefer to stick with my more expensive dentist who I can see whenever I am back in Durango rather than someone I only see while passing through a country.

Healthcare in Panama

Invoices from Clinic visit. Note the charge for the “consultation”, $5 to see the doctor.

We’ve had more occasion to check out the Panamanian healthcare system in our travels than we would have preferred. First Dan had allergies or a virus and saw a local doctor who was raised in the USA but got her medical training in Panama. I saw her to see if she had any different suggestions for the chronic insomnia that I have (some help).

Then last week when we went to Bocas Del Toro on the Caribbean coast I got “amoeba”. The water in Bocas is notorious but from what I can tell, the incubation period for amoeba is 1-2 weeks so I can’t blame it on Bocas. Amoeba seems to be the underlying problem causing dysentery. Gross bloody mucus stools, intense cramping. It came on quickly and I went to the Bocas clinic the next morning.

The clinic is in a large old building. Staff was professional but not overly friendly. The wait for care wasn’t long. I saw a doctor with a face mask on who asked me about symptoms and allergies. She ordered basic blood work, two IV antibiotics, and medications to take home.

It is obvious that sanitation is not a very high priority in this area. While we didn’t encounter mosquitoes in spite of some standing water in some ditches and the doctor wearing the mask, the rest was cursory. Not a single restroom was fully functioning with paper, soap, and flushing toilets. There was some combination of those things in the various restrooms but the only soap was in the treatment room.

The prep of my arm prior to the blood draw or IV insertion was a very quick swipe with a piece of cotton that had alcohol on it. It must have been adequate though.

I went home with two oral antibiotics, antacid, and probiotics. I was shocked (and grateful) that the doctor ordered the probiotics. The IV antibiotics started working within a couple of hours and I am now back to normal.

The entire cost of my test and treatment? $37 which included the medications. I would have gladly paid more to have more sanitary conditions but I know many of the locals couldn’t have afforded that.

Aside from these “adventures”, Dan has seen a skin doctor and will see her again this coming week. The office visit was $40 and the skin biopsies will be about $150 each. I plan to see a dentist locally in the next week or two for cleaning. My understanding is that the dentist himself/herself does the cleaning and that the cost is in the neighborhood of $50.

And in case you are wondering, I really have no idea how I got the amoeba. We have been really careful and use the reverse osmosis water to drink, brush our teeth, rinse many of the dishes, wash veggies/fruits. I had gotten a little lax and drank water in a restaurant in David but so did Dan and he didn’t get sick. We have gotten stricter again, just to be sure.