The Doctor's Consultation
by Dr. Iain Corness
Copy drugs and the internet
I am sure that
you are like me. Every day I receive at least four internet email offers of
cut-price drugs that will keep me in a state of perpetual priapism. For
those unsure of this condition, it is a state of continuing (and painful)
male erection and the term was coined after the Greek god Priapus who is
shown in paintings to have a central member that puts the (in)famous John
Holmes of porn movies to shame.
However, this is actually a serious situation. If most drugs are only
available through pharmacies world-wide, on the prescription of a doctor, is
it safe to just buy over the internet, without any doctor’s advice?
I believe it is not safe. As the American Food and Drug Administration (FDA)
reports in its website, “Patients who buy prescription drugs from websites
operating outside the law are at increased risk of suffering
life-threatening adverse events, such as side effects from inappropriately
prescribed medications, dangerous drug interactions, contaminated drugs, and
impure or unknown ingredients found in unapproved drugs.”
The FDA goes on to warn “… certain drugs be dispensed only with a valid
prescription because they are not safe for use without the supervision of a
licensed health care practitioner. Generally, before the practitioner issues
a prescription for a drug the patient has never taken before, he or she must
first examine the patient to determine the appropriate treatment.
Subsequently, the patient receives the drug from a registered pharmacist
working in a licensed pharmacy that meets state practice standards.” That
situation is certainly not the case when you look at buying blue diamonds
over the ‘net, is it?
The incidence of internet pseudo-pharmacies is also very high. In the US,
according to the American Medical Association, there are at least 400 web
sites that both dispense and offer a prescribing service - half of these
sites are located in foreign countries. Some have estimated that the number
of websites selling prescription drugs may now be closer to 1,000.
As far as I can see it, one of the big problems is the lack of regulation
that these “net pharmacies” work under. Are the blue diamonds ‘real’ Viagra?
According to the World Health Organization (WHO), it has been fighting drug
counterfeiting since it became a major threat in the 1980s. The problem was
first noticed by the pharmaceutical industry. They saw that their own
products were being copied, and it went on from there.
In fact, the WHO estimates that 25 percent of medications bought in street
markets in developing countries are fake. My own experience in some of the
poorer SE Asian countries has been that another 50 percent are real but out
of date, leaving around 25 percent genuine manufacturer’s stock.
Some authors say that the figures are even worse than that. An international
study published in Tropical Medicine and International Health in 2004 found
that 53 percent of Artesunate tablet packs sold in the region did not
contain Artesunate. And Artesunate is a vital antimalarial drug. You can see
The reports come in from all over the world. The WHO cited the case of a
counterfeit iron preparation that has killed pregnant women in Argentina in
the last two years. Hundreds of children in Bangladesh suffered kidney
failure and many died due to a fake paracetamol syrup diluted with
diethylene glycol, according to a study published in the BMJ in 1995.
The FDA in the US estimates that worldwide sales of fake drugs exceed USD
3.5 billion per year, according to a paper published in April 2005. The
Center for Medicines in the Public Interest in the US predicts that
counterfeit drug sales could reach USD 75 billion globally in 2010 if action
is not taken to curb the trade.
According to WHO, drugs commonly counterfeited include antibiotics,
antimalarials, hormones and steroids. Increasingly, anticancer and antiviral
drugs are also faked. And you can add to that the ‘blue diamonds’. Never
forget the phrase “Caveat emptor” (Let the buyer beware).
You have been warned. Get your medications on prescription from a pharmacy
you can trust.
Heart to Heart
This is an authentic letter sent to Dear Deirdre of the Sun Newspaper.
“I am a sailor in the merchant navy. My parents live in Torry, Aberdeen
and one of my sisters is married to a guy from England. My Father and
Mother have recently been arrested for dealing crack cocaine and are
currently dependent on my two sisters, who are prostitutes. I have two
brothers, one is currently serving a non-parole life sentence in
Peterhead Prison for the rape and murder of a teenage boy in 1994, the
other currently being held in Craig inches remand centre on charges of
incest with his three children. I have recently become engaged to marry
a former Thai prostitute who indeed is still a part time working girl in
a brothel; however, her time there is limited as she has recently been
infected with an STD. We intend to marry as soon as possible and are
currently looking into the possibility of opening our own brothel with
my fiancée utilizing her knowledge of the industry working as the
manager. I am hoping my two sisters would be interested in joining our
team. Although I would prefer them not to prostitute it would at least
get them off the streets and hopefully the heroin.
My problem is this: I love my fiancée and look forward to bringing her
into the family and of course I want to be totally honest with her.
Should I tell her about my brother-in-law being English?”
I find it impossible to comprehend that anyone would have such a low
mentality to write the following, yet it’s supposed to be a true story!
How would Hillary respond?
Hillary must be more astute than her fellow comrade in pens, Deirdre of
the Sun. This is obviously not a genuine letter as it claims he is going
to marry a former Thai prostitute, who is actually still working. This
is obviously not correct, as prostitution as we all know is against the
law in Thailand, so it must have been made up!
Actually, Tim my Petal, this is an old one (it’s even older than
Hillary) and you fill in your favorite country to ridicule for the
brother-in-law. Thank you for thinking of Hillary, and bowing to my
superior wisdom in these matters.
How did you spend the festive season? Are you several kilos heavier from
all the chocolates and champagne? Or did you have to spend the time in
rehab? With the constant cries for champers and chocolates, you must be
about 20 stones by now!
You have obviously been reading the letters I have received over the
years from that awful Mistersingha wretched person. I certainly wouldn’t
be going over the limit with his offerings, which never materialize,
despite all his protestations that it is on its way. So is Xmas 2007.
Nor, for that matter, did I get anything from you, so I don’t really
know why you are asking such things. However, for those of my readers
who did send me the goodies, I thank you very much. All the champagne
went to a good cause (loosening tongues) and the chockies sweetened me
up for 2007. You also gave away your nationality when you wrote “20
stones” as avoirdupois measure is only still used in the UK. In the US
it would be 280 pounds (14 pounds to the stone at last count), or in
Thailand which is metric, that would be around 126 kg.
At the end of last year, someone called “Hughie” suggested you were like
Oprah in the States and should get more money. How stupid was that?
Everybody knows that Oprah is a big star and sindicated (sic) all over
the place, while you are just an old aunty writing for the idiots in
Pattaya. Why anyone even bothers to read your advice I don’t know
either. If you get payed (sic) anything you should think yourself lucky.
What an interesting name you have, my Petal. Did your parents give that
to you or was it a nickname that you earned? I note with interest that
you wonder why anyone would read my advice in the column, but what
amazes me is that you do. Don’t you, Spewie! Mind you, it is obvious
that spelling lessons were also something that you did not bother to do
either. The words you were striving (unsuccessfully) for were
‘syndicated’ and ‘paid’. After you have passed third grade, please do
Can you assist me about dowries. I am close to marrying my Thai
girlfriend and I am curious, how much should be paid? I have never seen
a concrete amount assigned. Is it something like America where the
engagement ring is two months salary? I have been led to understand that
the amount should reflect how much I love the girl; however, I can not
give her family the world.
You will usually be advised by an “Uncle” of the amount deemed
satisfactory. There is no two months salary equation here, my Petal.
It’s an “Open your wallet and say after me - Help Yourself” equation I’m
afraid. Generally it is in the range of 30,000 to 100,000 baht for the
farang suitors. Make sure she’s worth it. The dowry is non-returnable!
Camera Class by
It’s as easy as One-Two-Three
we go through the festive season, everyone seems to have a small
digital camera in a purse, pocket or handbag, which is
brandished triumphantly as everyone attempts to record the “good
This is an admirable use of the digital camera, but
unfortunately the “good times” are often spoiled by “bad
pictures”. And unfortunately, one of the reasons is the
One-Two-Three. That is the “One-Two-Three” that every social
photographer seems to think has to be said before popping the
shutter, which is accompanied by the photographer holding up
One-Two-Three fingers, leaving the camera held in one hand only.
Now I am aware of the fact that the new mini, compact digitals
will easily fit in one hand, but just as in conventional (old)
film photography, to get a sharp picture, you have to make sure
the camera is still while the shutter is tripped. One handed
picture taking just doesn’t keep the camera still enough.
Especially when as the happy festive photographer is waving the
free hand in the air, the camera is also waving around!
Coincidentally, I had just written the introduction to this
week’s column, when in came my photographic friend Ernie
Kuehnelt with an article written by Don Sambandaraksa about
image stabilization with digital cameras. Now I have been in
touch with Don previously, and this chap knows more about pixels
than certain politicians know about tax evasion. In the article
he mentions the various ways the different manufacturers do this
stabilization, but basically it is either the lens or the sensor
that is programmed to move to counteract unsteadiness in the
camera, caused by the photographer not holding the camera firmly
- or perhaps suffering from Parkinson’s disease.
However, it is not the be all and end all. You only need a
slight movement in the camera to produce ‘soft’ photographs. You
will not realize this when you look at the postage stamp sized
LCD screen on the back of your camera, but when you go for
larger prints it all becomes too obvious.
With the larger cameras, SLR’s and the like, it becomes even
more important to avoid camera shake. After all, why spend
thousands of baht to buy super sharp lenses and get soft
“blurry” photographs. You might as well have stuck with a cheap
disposable “camera in a film box” and saved your money for booze
- which will also give you the shakes just as easily but
possibly more enjoyably!
The simple fact of the matter is that to get sharp photographs,
the camera must be held still while the shutter is held open,
despite all the electronic froofrah. Now, in most daylight
situations if the camera is set on “auto” it will select a
shutter speed of around 1/125th of a second, and while that
sounds “fast” it really isn’t. You will still get noticeable
“softness” in the final print if the hand holding the camera has
allowed any movement.
The secret really is in the grip. And it is a two handed one.
You will not see any professional photographer taking shots with
one hand free. I also recommend that you take a short breath in
and then hold it while gently squeezing off the shutter. Another
good practice is to keep the elbows in by your sides, and even
lean against a solid object, like a telephone pole! In overcast
weather when the camera will select slower shutter speeds, this
is even more important. Your camera will also most likely have
two “hand/finger” impressions on either side of the camera body.
They are not there for decoration. Use them!
No, if you really must let your subjects know that they are
about to be recorded for posterity, a simple verbal
One-Two-Three (while hanging on to the camera with two hands) is
all that is necessary. I guarantee you will get pictures more
sharp than you used to get before.
Money Matters Graham
Macdonald MBMG International Ltd.
“Hard-a-starboard! Full speed astern ... hard to port!” Part 1
There are a number of theories as to the cause of one of the most
earth-shattering disasters of the last century - the sinking of the Titanic
(does everyone remember the plans to bring the movie version of the ship to
Many people subscribe to the easy view that it was Captain Edward J. Smith’s
fault. Having proclaimed less than 5 years earlier that “I cannot imagine
any condition which would cause a ship to founder. Modern shipbuilding has
gone beyond that,” it’s believed that complacency caused Captain Smith to
ignore seven iceberg warnings from his crew and other ships choosing not to
slow down and potentially avoid the ultimate disaster.
A more recent theory is that the standard of steel used in shipbuilding at
that time was so inferior to what would be acceptable at the present time
for any construction purposes and particularly not for ship construction.
However, that doesn’t alter the fact that if the Titanic had not collided
with the iceberg, it could have had a career of more than 20 years just like
its sister ship, the Olympic, which was built of similar steel, in the same
shipyard, and from the same design, but which never encountered a giant
Another popular theory points the finger of blame at Bruce Ismay, the
managing director of the White Star Line who, it is believed, may have put
pressure on Captain Smith to maintain the speed of the ship.
Others prefer to blame the fact that the ship’s architect, Thomas Andrews,
the managing director of Harland and Wolff had designed a ship with sixteen
watertight compartments but hadn’t made these as high as, in hindsight, they
should have been (the White Star Line only wanted these to go as far as E
Deck in order to maximise living space in first class).
The commissions of enquiry into the disaster in both America and Britain
placed most blame for the deaths at the hands of Walter Lord who captained
the Californian, which had stopped for the night about 19 miles north of
Titanic. At around 11.15, Californian’s radio operator turned off the radio
and went to bed. Sometime after midnight the crew on watch reported seeing
rockets being fired into the sky from a big liner. Captain Lord was informed
but it was concluded that the ship was having a party. No action was taken
by the Californian. If the Californian had turned on the radio she would
have heard the distress messages from Titanic and would have been able to
reach the ship in time to save all passengers. However, that relates more to
the rescue operation than the sinking.
Far less people point the finger at First Officer William McMaster Murdoch.
First Officer Murdoch was at the bridge at the time of the collision and
immediately prior to the collision issued the order “Hard-a-starboard! Full
speed astern ... hard to port!” Had Murdoch reversed the port engine, and
reduced speed while maintaining the forward motion of the other two
propellers (as recommended in the training procedures for this type of
ship), some experts believe that the Titanic might have been able to
navigate around the iceberg without a collision. Other experts believe that
if the Titanic hadn’t altered its course at all and had run head-on into the
iceberg, the damage would only have affected the first or, at most, the
first two compartments and the ship would have survived.
All very interesting, but not what you’d normally find in an article from
MBMG. Why are we devoting so much space to a maritime tragedy from almost a
century ago? In many ways this is the best parallel for the recent events in
Thailand. A minor economic disaster happened last month but who’s to blame.
Like with the Titanic, everyone has a theory about who’s to blame and like
with the Titanic, the easy view might not actually be the most perceptive.
Initially, Tarisa Watanagase, governor of the Bank of Thailand, announced
that foreign investors bringing in cash worth US$20,000 or more
(approximately Bt700,000) would need to park 30 percent of the amount in
financial institutions (who, in turn, would remit the funds to the BoT on
the 7th of every month - analogous to withholding tax - allowing the BoT to
generate returns on the withheld amount) with the withholding being fully
returned if the cash wasn’t taken out of the country within 12 months.
Tarisa is the first female governor of the Bank of Thailand, who was
appointed as the BoT’s 21st governor by the interim government to replace MR
Pridiyathorn Devakula, who became deputy prime minister and finance minister
of the new government. Tarisa, 57, is a civil servant who has worked as an
economist for the central bank since 1975 and has been deputy governor since
Tarisa said, “We think this measure will help slow down the short-term
inflows as it would increase costs for speculators.” The measure was
introduced to counter offshore baht speculators and followed inflows of
billions of dollars in recent months which had pushed the baht to a level
disadvantageous to Thailand’s exports. In November, inflows amounted to
US$300 million per week, increasing to $950 million per week in the first
few weeks of December, according to Tarisa. As a result the baht shot up to
a nine-year high - Bt35.06 - a 16 percent increase year to date.
The measure, as initially introduced, did not apply to foreign direct
investment (FDI) or to exporters or to Thai individuals or corporations
repatriating foreign earnings. Governor Tarisa believed that the new measure
would effectively discourage speculative inflows and reduce baht volatility,
but, in recognition of what a step into the dark this was, she advised that
the central bank would closely monitor baht performance adding that the BoT
might cancel the measure, change the reserve amount, or change the time
limit depending on the situation and that it was unclear how long the
measure would last. The reserve measure was the preferred solution to the
problem because taxation legislation would be too cumbersome, taking too
much time to introduce and being inherently less flexible than the BoT’s
solution. At the time of implementation, Tarisa recognised that the move
could also adversely affect the debt market but the BoT were also keen to
prevent speculative inflows into the debt markets.
Tarisa was at pains to point out that several countries had previously
successfully implemented similar measures to curb currency speculation -
Chile had used the 30% reserve arrangement for less than six months before
being able to cancel the measure.
Deputy Prime Minister and Finance Minister MR Pridiyathorn Devakula
supported the BoT’s arrangements as being positive news for investors and
exporters (whose price competitiveness in US$-aligned economies had declined
as the baht had strengthened - currently, the export sector accounts for 62
percent of the country’s GDP - up from 38% in 1997 - and any damage to this
sector and to tourism which also suffers from a strong baht could be
cataclysmic for the country’s economic prosperity as a whole) and he
welcomed a weakening of the baht.
The immediate reaction of the markets was panic - foreign investors
interpreted this as backdoor “capital control” and prior to a meeting
scheduled to explain the new programme to securities dealers drove the SET
down alarmingly causing the Stock Exchange of Thailand to order a stock
trading halt for 30 minutes at 11.30am. In a single trading day, the Thai
stock market lost Bt800 billion as the SET index plunged by a record 14.84
percent - the worst since Black Monday in 1987.
The news caused a ripple around the regions with Jakarta down 2.85 percent;
Kuala Lumpur, down 2 percent and Singapore, down 2.23 percent. However, the
effect on the baht was as intended with the currency depreciating by almost
two percentage points to about Bt36 per dollar.
Deputy Premier and Finance Minister Pridiyathorn Devakula said the Bank of
Thailand had acted in the interests of the private sector, especially
exporters who were suffering from the strong baht. Some commentators
interpreted this as the interim government acting in the interests of the
Thai economy over the interests of foreign speculators (which is surely
their job and to us it’s indicative of the mindset of many of the
programme’s most vocal critics that they should see this as being a
negative). To us the criticism of the measures fell into 2 camps:
1) The hysterical self-interests damaged by these measures (those who in
many cases were meant to be the intended victims)
2) Constructive criticism such as Teerana Bhongmakapat, an economist at
Chulalongkorn University, who accepted the rationale behind the policy but
queried the details saying that the reserve requirement on Thailand’s
capital inflows should be cut to five percent from the current 30 percent so
that negative impacts are lessened (this would effectively cut the capital
inflow tax to 2.53 percent instead of the 10 percent that has been
Fund managers (and ex-fund managers) invariably squealed the loudest - Nasu
Chansom, head equity fund manager of Ayuddhya Fund Management, complained,
“Our good performance so far this year collapsed in one day. Our portfolio
value was depreciated by billions of baht.”
At least Chatri Sophonpanich, chairman of Bangkok Bank Ltd (BBL), admitted
that the BoT has no better alternative to protect against baht speculation
and that failure to do so could lead to a situation reminiscent of the
financial dislocation and crisis in 1997 - “The BoT’s measure is necessary.
If they don’t do it, it will lead to a problem. Though the measure will
intercept foreign capital inflow, we need inflow of money for long-term
investment not for speculation.”
Jeremy Warner in The Independent viewed the programme as being farce.
However, we tend to think that any commentators who feel the need to point
out that Thailand is run by a military government and that a “popular
democratically elected prime minister was overthrown by force” are
journalists with little or no understanding of Thailand but who feel
compelled to file a story on the subject.
Warner felt compelled to write, “The size of the capital inflows, strongly
suggestive of another bubble in the making, seem to indicate that investors
have yet to learn their lesson. Perhaps so, yet many of these economies
today give cause for genuine confidence in the future, even if the actions
of their governments do not.”
Alongside Warner we dismissed many similar commentaries with equal contempt
(the idea that regional commentators based in KL who’d been silent about the
ringgit policy in 1997 but now felt able to vent spleen that was almost a
decade old raised our eyebrows).
The above data and research was compiled from sources believed to be
reliable. However, neither MBMG International Ltd nor its officers can accept
any liability for any errors or omissions in the above article nor bear any
responsibility for any losses achieved as a result of any actions taken or not
taken as a consequence of reading the above article. For more information please
contact Graham Macdonald on [email protected]