I was on the road in Oman a few years ago with my girlfriend and she had an upset stomach. Not, I hasten to add, as a result of my cooking, but as a result of a hotel stay beforehand that was the tradeoff against an overland trip that we’d agreed in a bargaining session! You know how it is……

            So of course we needed stomach medication. We were passing through the town of Nizwa at the time, and instead of using meds from the medical kit in the Land Rover (which would then need to be replaced – best saved for remote areas I thought…. wrongly?) I called in at a pharmacy. Pharmacists around the world are all trained in English, and wherever you are, even somewhere obscure, if you need an English speaker and some local knowledge you can never go far wrong at a chemists. So in I trundled. I chatted with blokey at the counter and he wheeled out some antibiotics for my better half.

            At this point I made sure I checked the packaging before buying them, and spotted quite a few spelling mistakes. This is a key telltale way to spot fake medication – and there’s a lot around at the moment. I’ve also spotted it for sale in Kenya and Nepal – pretty much anywhere where there is a flourishing trade with China – the source of most fake medicines. This is a big deal, and travellers should be aware of it. Here, then, it’s worth passing on some pointers about avoiding this problem.

            On a long overland trip the most common medications used are painkillers, anti-diarrhoea tablets, antihistamines and antibiotics – and of course anti malarial tablets on trips through regions where this disease is present. It’s often the case that your medical kit runs out of something and you need to ‘top up’ on the road somewhere. It’s also true that many folk cut corners on pre-trip costs by buying medications on the way as they are often cheaper.

            According to the World Health Organisation, fake medications may have inactive ingredients (flour, corn starch, potato, chalk) or even poisonous ingredients (wrong chemicals, or bacteria from poor factory manufacturing conditions). If they do have the correct ingredients, it’s often the case that they haven’t got enough of them – so you need to buy more of the product to get an effect. 93% of fake meds surveyed in developing countries match this last profile. That same recent study in 25 developing countries showed that an average of 28% of medications on sale were fake products – so it’s quite an issue in some places. Most fake products in the studies, by the way, were on sale in unlicenced chemists – shacks at the roadside selling groceries, cigarettes and painkillers, for example. Definitely something to watch on your next trip.

            So how to spot fake medications? – there are some easy signs. Spelling or grammar mistakes on packaging. Manufacturing and expiration dates missing, nonsense or a mismatch between dates on the package and product. Use common sense. If you need to buy medicines in a developing country use the largest most modern looking pharmacy you can find, but above all stock up before the trip – and have a list of which medicine does what, to satisfy bored Customs officials!

            If you have any doubts, Wilderness Medical Training in Kendal are great people to talk to, they really know their stuff about expedition medicine. Give them a shout at  http://wildernessmedicaltraining.co.uk/. Also worth a look is the Oxford Handbook of Expedition and Wilderness Medicine, available as hard copy or Kindle copy, as well as the hard-to-find Royal Geographical Society Handbook of Expedition Medicine.