Use of Antibiotics: As a Social and Legal Dilemma (A Multi-sited Ethnography)

Abstract

Pakistan ranks third position in consuming antibiotics among low- and middle-income countries. This multi-sited anthropological thesis, entitled “Use of Antibiotics: As a Social and Legal Dilemma” explains governmental concerns and the medical community’s response regarding policies and their implementation along with sociocultural interaction for appropriate usage of antibiotics in Khairpur Mirs, Sindh. The main argument of this thesis is to explain the tendency of addressing the issue of overuse of antibiotics with the help of medical teachings and policies along with their implementation at the community level. In addition, this research provides cultural interface, medical practices, and their attributes in the usage of antibiotics. The selected locales were three cities of Sindh Province i.e., Khairpur, Karachi, and Hyderabad. A sample of 58 respondents was selected for the data collection from which 22 respondents were selected through purposive sampling to explore the required data from the knowledgeable people related to the research objectives and the remaining 36 respondents through snowball sampling which allowed me to access those participants that were not accessible without references i.e., authoritative personalities, unlicensed doctors, quacks, etc. The methodology employed for the data collection included Participant Observation, in-depth interviews, short interviews, Focused Group Discussions (FGDs), and case studies. The research provides a holistic perspective to understand the belief in the practice of antibiotics such as sociocultural determinants, medical teaching, and policy makers' way of problematizing the global threat of antimicrobial resistance caused by direct or indirect consumption of antibiotics. The findings of the study suggest that despite the alarming issue of antibiotic resistance globally, the medical teachings are still not serious about dispersing proper knowledge about antibiotics usage, antibiotics resistance, and the policies and programs to curb antibiotics resistance. The study also observed that various socioeconomic and cultural determinants influence antibiotic consumption such as self-medication, over-the-counter purchase, economic constraints, time limitations, limited access to healthcare facilities, etc. Furthermore, semiotics, sociolinguistics, doctors’ professional or scientific gaze, and cultural incompetency encourage people to overuse and misuse antibiotics. The medical professionals, pharmacists, and healthcare sectors are driven by economic interests which often contribute to excessive antibiotic consumption. Key Words: Antibiotic, Antibiotic Resistance, Medical Curricula, Practitioners, Policies, Socio-cultural Determinants.