VOA慢速英语--卢旺达生产自己的吗啡为贫困患者服务

Rwanda Makes Own Morphine to Serve Poor Patients

Rwanda is aiming to provide free medicine to all its citizens who suffer from pain caused by life-threatening illnesses.

The country is leading efforts to produce the painkiller¹ morphine locally. That would mean the country would not have to depend on costly² opioid medicines sold by large companies.

Experts say large drug companies cannot make a lot of money selling low-cost, generic³ morphine to the poor and dying in countries like Rwanda. Most people in sub-Saharan Africa do not have the money to pay for costly opioids like oxycodone and fentanyl.

In this photo taken Tuesday, Nov. 5, 2019, palliative care nurse Madeleine Mukantagara, 56, left, uses a pulse-oximeter to check on the health of Vestine Uwizeyimana, 22, right, who has spinal⁴ degenerative disease and is taking oral liquid morphine.

In this photo taken Tuesday, Nov. 5, 2019, palliative care nurse Madeleine Mukantagara, 56, left, uses a pulse-oximeter to check on the health of Vestine Uwizeyimana, 22, right, who has spinal degenerative disease and is taking oral liquid morphine.

About 90 percent of opioids are used by people in the world's richest nations -- where just 17 percent of the world's population lives. Those estimates come from the International Narcotics⁵ Control Board, or INCB. Most users of opioids are in the United States, Canada, Western Europe and Australia.

In much of the world, a rise in opioid prescriptions⁷ began in 1997, INCB data examined by The Associated Press shows. Since then, opioid use worldwide has increased by three. The rise led to a massive increase in opioid addiction⁸ in the world's wealthiest countries.

However, this rise in painkillers⁹ only involved costly opioid products that became very profitable for large drug companies, INCB data showed. The use of morphine, which costs far less and is considered one of the most dependable painkillers, remained flat.

Morphine produced by large manufacturers costs, in general, six times more in many low- and middle- income nations than in wealthy ones, the INCB reports. Experts say this is partly because small countries with low opioid usage rates are not in a position to negotiate prices with drug companies.

A major study by the Lancet Commission on Global Access to Palliative Care and Pain Relief recently examined the inequality between rich and poor countries. The study estimated that it would cost just $145 million a year to provide enough morphine to ease end-of-life suffering around the world. Yet millions still suffer without pain medication in the poorest places.

So, a growing number of African countries – including Rwanda, Kenya and Malawi – have begun to make and give out morphine on their own. The efforts generally include cooperative activities between governments and nonprofit organizations.

"Pain is...torture," said Diane Mukasahaha, who leads Rwanda's national effort for palliative care. She told the AP she had seen patients without morphine nearly starve to death because they were too sick to eat. "People should have medication like an American person. We are all human beings. The body is the same."

Madeleine Mukantagara, a 56-year-old nurse, provides morphine to pain sufferers. On a recent day, she walked through fields in a rural area of Rwanda to get to her first patient of the day, Vestine Uwizeyimana.

For 15 years, the 22-year-old Uwizeyimana dealt with severe pain as a disease damaged her spine¹⁰. She could no longer walk and had trouble even turning over in bed. Her life narrowed to a small, dark room with a dirt floor. Then, one year ago, relief came in the form of locally produced liquid morphine.

"Without this medicine I think I would die," Uwizeyimana said as her nurse arrived. Mukantagara sat on the edge of her patient's bed and the two began with a prayer.

"Now I think everything is possible," Uwizeyimana said. The nurse and patient held hands and prayed again, quietly. Uwizeyimana then closed her eyes.

Another patient of Mukantagara is an 89-year-old woman who has been sick for five years and has been taking liquid morphine for three of those years. "With pain relief I can eat. I can go outside," the patient said. "I can greet my neighbors. I can walk slowly, slowly and go to church."

Like other painkillers, liquid morphine can be addictive¹¹ and abused. But the Rwandan government has taken control of the supply in an effort to prevent mass shipping¹² of pills -- which helped fuel the opioid crisis in the United States and other countries.

In Rwanda, the drug is only given to the nation's sickest people. And only the supplier of morphine powder makes money -- which prevents mass marketing¹³ efforts aimed at expanding sales.

Words in This Story

opioid – n. a drug that is opium¹⁴ based and used to reduce pain

generic – adj. a product that is not sold with the name of the company that produced it

prescription⁶ – n. an order written by a doctor that says a patient can be given a medicine or treatment

income – n. money that is earned by working, investing, or producing goods

palliative – adj. relieving pain without dealing¹⁵ with the cause of the condition

church – n. a building where Christians go to worship

1 painkiller   

n.止痛药

参考例句：

• I shall persuade him to take the painkiller.我将说服他把药吃下去。
• The painkiller only provides him a short respite from his pain.止痛药仅仅让他在疼痛中有短暂的疏解。

2 costly   

adj.昂贵的，价值高的，豪华的

参考例句：

• It must be very costly to keep up a house like this.维修这么一幢房子一定很昂贵。
• This dictionary is very useful,only it is a bit costly.这本词典很有用，左不过贵了些。

3 generic   

adj.一般的，普通的，共有的

参考例句：

• I usually buy generic clothes instead of name brands.我通常买普通的衣服，不买名牌。
• The generic woman appears to have an extraordinary faculty for swallowing the individual.一般妇女在婚后似乎有特别突出的抑制个性的能力。

4 spinal   

adj.针的，尖刺的，尖刺状突起的；adj.脊骨的，脊髓的

参考例句：

• After three days in Japan,the spinal column becomes extraordinarily flexible.在日本三天，就已经使脊椎骨变得富有弹性了。
• Your spinal column is made up of 24 movable vertebrae.你的脊柱由24个活动的脊椎骨构成。

5 narcotics   

n.麻醉药( narcotic的名词复数 )；毒品；毒

参考例句：

• The use of narcotics by teenagers is a problem in many countries. 青少年服用麻醉药在许多国家中都是一个问题。 来自《现代汉英综合大词典》
• Police shook down the club, looking for narcotics. 警方彻底搜查了这个俱乐部，寻找麻醉品。 来自《简明英汉词典》

6 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

7 prescriptions   

药( prescription的名词复数 )； 处方； 开处方； 计划

参考例句：

• The hospital of traditional Chinese medicine installed a computer to fill prescriptions. 中医医院装上了电子计算机来抓药。
• Her main job was filling the doctor's prescriptions. 她的主要工作就是给大夫开的药方配药。

8 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

9 painkillers   

n.止痛药( painkiller的名词复数 )

参考例句：

• The doctor gave him some painkillers to ease the pain. 医生给了他一些止疼片以减缓疼痛。 来自辞典例句
• The primary painkillers - opiates, like OxyContin - are widely feared, misunderstood and underused. 人们对主要的镇痛药——如鸦片剂奥施康定——存在广泛的恐惧、误解，因此没有充分利用。 来自时文部分

10 spine   

n.脊柱，脊椎；(动植物的)刺；书脊

参考例句：

• He broke his spine in a fall from a horse.他从马上跌下摔断了脊梁骨。
• His spine developed a slight curve.他的脊柱有点弯曲。

11 addictive   

adj.(吸毒等)使成瘾的，成为习惯的

参考例句：

• The problem with video game is that they're addictive.电子游戏机的问题在于它们会使人上瘾。
• Cigarettes are highly addictive.香烟很容易使人上瘾。

12 shipping   

n.船运（发货，运输，乘船）

参考例句：

• We struck a bargain with an American shipping firm.我们和一家美国船运公司谈成了一笔生意。
• There's a shipping charge of ￡5 added to the price.价格之外另加五英镑运输费。

13 marketing   

n.行销，在市场的买卖，买东西

参考例句：

• They are developing marketing network.他们正在发展销售网络。
• He often goes marketing.他经常去市场做生意。

14 opium   

n.鸦片；adj.鸦片的

参考例句：

• That man gave her a dose of opium.那男人给了她一剂鸦片。
• Opium is classed under the head of narcotic.鸦片是归入麻醉剂一类的东西。

15 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。