Medicalization

Fatima’s bathroom in Salé is stocked with products. When taking a shower, one has a choice of at least five different kinds of shampoo, three kinds of soap in addition to the shower gels standing at attention in the windowsill. There are conditioners, bubble baths, and a variety of scrubbing utensils. Next to the shower hangs a shelf with creams, lotions, gels, concealers, bleaches, deodorants, perfumes, tonics, and anything else anyone might ever need. My house in Rabat has no bathroom, but there is no shortage of beautifying products here, either: each sister has a large collection of bottles and jars in their section of the big wardrobe standing on one end of the sitting room.

My host family, in other words, is highly concerned with its personal hygiene. In the same material way they are highly concerned about their health. There are pill bottles, ointments, creams, and inhalers to be found all over the house, to which the members of the family take recourse at the first sign of illness.

These people are constantly ill. When someone has a headache or a sniffle – which, with so many people in one house, occurs at least once a day – they immediately pronounce themselves “mrid” or “malade.” They will install themselves on the couch under a blanket, cover their eyes and/or forehead with a scarf, lean back on a pillow, and let everyone else take care of the household while they look on with pain in their eyes. It also means pills, always.

Not only are they quick to take some kind of medication; it also does not seem to matter too much what kind of medication it is. My host mother and sisters have all taken my Excedrin at least once, without so much as a glance at the bottle. Their own collection of pills is stored in unmarked jars, or in bottles whose label clearly does not match what is kept in them. Khadija once shook two kinds of pills out of an Advil bottle – actual red Advil tablets, and something blue and unidentifiable. For her headache, she said. Just in time, I was able to stop her from taking the blue ones by telling her I thought those were for something else. These women seem to take anyone’s word for it, including mine (a stranger’s, in a sense), that the pill being taken is in fact meant to cure whatever ailment they seek to alleviate. And I get the sense that this is a general Moroccan characteristic. At a party about a month ago, an interesting communal sharing of pills occurred. One woman asked her neighbor if she might have anything for a headache with her. Upon which this neighbor opened her bag and pulled out at least three different kinds of pills. “Take these,” she said, “they’re from the military hospital, really strong, really good.” Eagerly, the first woman indeed took these tablets, which were clearly on prescription. And not only did she do this; overhearing this conversation, at least three other women expressed an interest in these military pills. A cup of water was brought over, and all of them took a dose of medication.

This seems like very risky behavior to me. Not in the least because I get the sense that fairly often, the pills or other medications taken are indeed meant for a completely different ailment. Who knows what these military pills – or the blue pills in the Advil bottle – were for? My friend with the Dutch blog has a post about her own trip to a pharmacy in rural Morocco. Looking for vitamins and anti-diarrheal salt, she was given a range of choices – from sleeping pills to medication for intestinal infections - but none of it what she was looking for.
And from my own observations: Maria once burnt her hand while making soup. After holding her hand under the water, she rushed to the bathroom to put some “pommade” on the burn. Hours later, as she brought out the tube to reapply, I noticed that this ‘pommade’ was in fact hair removal cream. Which it clearly said on the package, in French. Which she can read.

Needless to say, when I was offered medication for my Salé-related headache last weekend, I politely declined. This was hard to sell to them – being so liberal with medication themselves, it took a while for them to accept the idea that I didn’t like taking anything.

With this general impression of fairly extensive medicalization, I am really curious to learn how people feel about psychiatric drugs – antidepressants (“antidepressor”), anti-psychotics, the like. Are they as liberal with these pharmaceuticals as they are with anything else? Would these be shared in the same way that the pain medication was at this party (assuming it really was pain medication)? If so, what does that mean for the practice of psychiatry, and how does the use and impact of psycho-pharmaceuticals affect the practice of traditional healing practices? If not, what makes psycho-pharmaceuticals so different from any other kind of medication? I wonder how I am going to figure this out. As far as I know, no one in my immediate network is on any kind of psychiatric medication. I’m trying to think of a pretext to pay a visit to a pharmacy myself and do some exploring. Vitamin pills, perhaps. But how will that get me on the trail of psycho pharmaceuticals?