Sick

This is my second cold since coming to Georgia.

The first one took about two weeks to fully go away. I have a pattern with colds – they start in my nose, then sort of move back to my throat and end up in my lungs. So usually I’ll have sniffling and sneezing for a few days, followed by a sort throat and a cough that lasts for up to two weeks. I imagine this one will go much the same way, although I’m optimistic that it’ll go away sooner or not leave me with a lingering cough.

Getting medication here is interesting. There are tiny pharmacies all over the place – there have to be at least thirty within easy walking distance of my house – although I wouldn’t expect there to be that many in the provinces. It’s not impossible to find at least one English-speaking pharmacist, although her level of English isn’t guaranteed to be very high. I say her because all pharmacists here are women – and usually it’s two or three women, together, behind the counter. So by my count, there are something like a hundred women at any given time working as pharmacists within a fifteen minute walk of my house. That’s weird.

I do know that there are a ton of unemployed doctors in Georgia. One of my students at the police academy is a doctor – she currently works as a police radio dispatcher. So maybe these pharmacists are all doctors? I’ve heard suggestions that they are, although I wonder if that isn’t a linguistic difference. I also wonder what constitutes a “doctor” here and what medical school is like… especially given the hospital horror stories I’ve heard.

Anyway, I walk into a pharmacy – often labeled აფთიაქი, or “apothecary” (aptiaki) – and there are two or three women behind the glass. If there are more than two customers waiting, I just move on to the next one. Why? Because there are so many, and because the average customer takes five to ten minutes to serve, and while I’m waiting and looking for the medicine I want, invariably some other Georgian person comes in and crowds the counter and ends up cutting me on line. This isn’t done out of malice – people just don’t wait on line in Georgia. Basically if I can’t ask for what I want quickly and confidently, I don’t get it, and so in cases where I don’t know the exact product name and can’t describe it adequately in Georgian, it’s better to just find an empty pharmacy, especially since there’s invariably one right across the street or something.

The medicines themselves are mostly Russian, with some Georgian, Turkish, Indian, and other random stuff thrown in there too – I suspect German, Israeli, and American medicines find their way to Georgia in one way or another. Some of the stuff is made specifically for the Georgian market – like the OnceAir, which is printed in Georgian and Latin characters, but made, I believe, in Turkey. Other stuff is printed in Cyrillic characters, and oddly many things have names printed in the Latin script but with no further information in English or Latin letters.

Take, for example, Coldrex – a brand name that designates a number of cold and cough medicines for sale in Georgia. The one I have in front of me is Coldrex Broncho, or Колдрекс Бронхо. It contains гвайфенезин, or guaifenesin, which is widely considered to be the most effective cough medicine on the market. However, I don’t read Cyrillic particularly well, so finding Coldrex Broncho was more a matter of luck than anything – I happen to be just OCD enough to actually know the active ingredients in all of the medications that I take and research exactly what they do, so when I asked the pharmacist to tell me what was in Coldrex, and she read the Cyrillic for me, I recognized “guaifenesini,” as Georgians say it in the nominative case, as the active ingredient in my cough medicine of choice.

By the way, Coldrex Broncho in syrup form is old school medicinal cough medicine that smells and tastes like stale thickened Jagermeister.

Anyway, that was my last cold. This time around, I ran out of the Advil Cold and Sinus that I brought with me – it’s strong stuff that will drain my sinuses instantly, which is awesome. Unfortunately its active ingredient is pseudoephedrine, which, aside from being awesome for treating cold symptoms, is also a key ingredient in the manufacture of methamphetamine. So it’s been regulated to shit in drug war countries like the US and Georgia (as I’ve said before, Georgia is somewhat involved in the US drug war) and anyway, the point is, they don’t seem to carry it at the pharmacies here. Its substitute, phenylephrine, is controversial in its effectiveness… basically, big pharma says it works, everyone else says it doesn’t.

I personally visited at least fifteen pharmacies here yesterday looking for pseudoephedrine or something like it to treat my cold. Nada. One pharmacist suggested something labeled “cold and flu” but when I looked at it, with my now somewhat better grasp of Cyrillic, I was able to divine after some minutes that its active ingredient was phenylephrine. Discouraged, I did not buy that medicine, but instead called my co-teacher to ask for advice. She recommended something, that I ended up buying, that has phenylephrine anyway, but it also has an antihistamine, fever reducer, painkiller, and caffeine, so it’s sort of like a nuclear bomb for a cold, so whether or not the phenylephrine is decongesting me, I feel kind of vaguely okay, at least, in conjunction with massive quantities of black tea with ginger, honey, and lemon.

To condense this long, sad epic story into something useful, here’s my advice on getting medicine in Georgia:

1. Do some research in English. Georgia has almost every medicine available in America, but mostly under different names. The internet can tell you, for example, that the product marketed in America as “Advair” is marketed in the EU as “Seretide.” So if you go and ask a Georgian pharmacist for Advair and she looks at you like your head’s come off, you can ask for “Seretide” (writing it down might help, as might declining it into the nominative “Seretidi”) and you’ll get the product you’re looking for. It could help to write down a few different brand names before you go to the pharmacy.

2. Know the active ingredients. You might not be able to get Advil, but you can certainly get “იბუპროფენი,” or “ibuprofeni.” Similarly, you can get “guaifeneseni,” “omeprazoli,” etc. Writing these things down in English, Georgian, and or Cyrillic can definitely help, because odds are you have a weird foreign accent that the Georgians behind the counter can’t understand.

3. Don’t be shy. You might need to point. You might need to mime coughing. You might need to point to letters in an unfamiliar script and ask “ra es aris?” I’ve done all of these things, and looked like a fool, but I have all of my medications without having once had to drag a Georgian friend or TLG staff member to the pharmacy with me to translate.

4. Ask for help. When all else fails, don’t be afraid to ask a host family member or coteacher or TLG member or Georgian friend to translate over the phone or go with you to the pharmacy. Georgians are usually very happy to help.

5. Bring your medicine with you. If you have medicine that you need more of, just bring the container or whatever to the pharmacy. Often they can figure out what’s in it and what the equivalent Georgian or Russian thing would be even if it’s in English and they don’t seem to know English.

6. Don’t be afraid of Georgian medicine. I’ve heard all sorts of rumblings about lower-quality drugs, warnings about cheap knock-offs, and general hand-wringing about living outside the aegis of the FDA. That’s nonsense. Georgia imports pharmaceuticals from modern and developed countries – for instance, I just discovered that the weird Russian cough medicine, Coldrex, is actually manufactured in the exotic United Kingdom. My asthma medication is from Turkey, and my GERD medication is from India. I’m not going to get into the politics here, but there’s a whole world outside of America that somehow manages to make and sell safe, quality medications at a tenth of the price of what you’ll find in the US, notwithstanding US propaganda about having the best health care system in the world.

7. Finally, be persistent. Georgia hasn’t been fully indexed and digitized the way the Western world has, and a lot of things have to be found in much the same way secret quest items are found in roleplaying games. When I walk around Gldani I have the same feeling of exploration, mystery, and vague danger as I did the first time I played The Legend of Zelda: A Link to the Past – you basically wander around randomly, try not to get lost, watch out for holes in the ground and stray animals, talk to villagers, decipher strange glyphs, sort fact from rumor, and basically try to make sense out of the series of disparate, riddle-like bits of information that will be all you’ll get for your troubles. In the end, it pays off – Eventually, you’ll find that well with the piece of heart in it.

***************************************

This would actually be a great movie:

For this one, the payoff comes after the 2:30 mark:

And this… this is truly amazing:

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6 Responses to Sick

  1. Russ says:

    Hey, Neal!

    What a fantastic blog! I really enjoy the depth of your comments concerning Georgia. I was working there from Aug-Nov ’09 with the US government. I also have a blog where I’ve commented on Georgia and other countries I’ve worked in but certainly didn’t have the insight into the former that you do. I think that’s because I was shielded from the ‘real’ Georgia by being a government employee and the living conditions that afforded. Anyway, I will keep checking in for your fascinating experiences. Russ

  2. pasumonok says:

    hey! so here i am back with my unasked and unwanted opinions!
    you’re right, many pharmacists are doctors, pediatricians, chemists and whatnot. I worked for a pharmaceutical company a while ago. all of those girls have some kid of medical background. which is why we often ask them for advice on what medicine to get–even without doctor’s prescription.
    once, i cut my finger, the cut became swollen,covered with white stuff, i couldn’t move it, etc…i just showed my finger to the pharmacist and saved a trip to a doctor.
    also, when in hurry i get into any pharmacy, but honestly, i prefer the big, chain, pharmaceutical giants and monopolists like Aversi (cheaper and crappier) GPS (better and more expensive, but usually excellent service) and PSP (more expensive, but not too ridiculous). all of this pharmacies are not only stores, but also importers and distributers of many pharma brands. most of them are exclusive partners for world-wide know firms. often, when u ask for a vague cold medicine, they will try and sell their product first. also, they usually have several brand names of the same product.
    for example, i need thyroxine coz my thyroid glands don’t produce any. i trust berlin chemie L-thyrox. berlin chemie is a well-known european pharmaceutical company. depending on where i go, they might or might not offer berlin chemie to me (though they might have it) when i ask for thyroxine. they have about 5 different thyroxine packages in a large pharmacy.
    as for Cyrillic, all of the big pharma comps have a regional head office, where they translate them for the whole region–georgia is too small to get a special georgian box and georgian instructions. obviously, british medicine is written in english and then translated for a local costumer. this is why it makes sense to ask for a chemical component–just like u did–instead of a drug name–names get changed, translated, etc…
    any of the bigger chain pharmacies ( especially big pharma markets) will have girls that are educated enough to recognize written chemical component.
    also, usually, they have the same drug produced by different countries, hence the difference in prices. turkey, india and ukraine being the cheapest and europe and states being the most expensive.
    and i am going to end my lecture now…:-):-) are u bored yet?

  3. Chantelle A says:

    i had a stomachache and they gave me laxatives. that was an embarrassing day.

  4. Andrew says:

    #7 made the post for me. So is there regulation on possessing pseudoephedrine or just buying and selling it?

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