Dear Editor,

Yesterday I visited the Cay Hill Pharmacy to get a "refill" on one of the many medicines I have been prescribed to take by my consultant physician in Malta after I suffered a stroke about a year ago. The pharmacist on duty insisted that I presented him with a valid prescription for these medicines, issued by a local physician (I only had a scanned copy of an earlier prescription by my Maltese physician on my computer which of course was useless) and advised me to go to the emergency department of the hospital, right around the corner.

After waiting for more than 15 minutes with none of the hospital staff ever showing his/her presence (apart from some security guard that was hanging around in the waiting area), I finally decided to use the hospital's main entrance where I was shown to the admissions window, where note was taken of all my personal details and where I had to leave an imprint of my credit card to guarantee the payment of the eventual costs involved after which I was sent again to the emergency department where I had just come from.

The advantage this time was that I ran into a doctor, who explained me that he would attend to me as soon as he finished doing what he was doing and indeed after a few minutes he came back, asked me to sit down, took my blood pressure (which had increased above normal levels in the meantime) and pulse rate and ordered another doctor to actually write the prescription.

With the prescription in hand, the only thing to do was to report back to the cashier's office and settle my bill which was hefty NAf 95 for just writing out a simple refill order. Of course one has to consider all the personnel that had to be involved in this simple procedure. Why is healthcare these days becoming unaffordable? Obviously all the administration costs involved!

But little did I know that I had to go back to the doctor one more time. The good man wrote me the prescription for the dose that is available back home: i.e. 100 mG which is unfortunately not being sold in St. Maarten. Only 75 mG is available here so I had to return to the doctor to make him modify the prescription (by cancelling the 100 and putting

75 on top of the 100; this time no expense involved) and only once I presented the modified prescription I was able to obtain the wanted and needed medicines.

I gave this letter a second title, Rules...when stupidity gets in the way and to see more about the catastrophic consequences that the application of rules according to the letter one should have a look at this site (which was not the case in this particular event of application of the rules to the letter):http://www.snopes.com/photos/accident/trainfire.asp

There should be simpler ways to get a "refill"; if the medicines do not go into a dangerous substance category, there should be no problem for a pharmacist to be able to fulfil such a request to a bonafide customer upon the presentation of a finished container of the same medicine. This is the case in many European countries/pharmacies and I see no reason why it could also not be possible here in St. Maarten.

And for those that want to know more about stupidity in general I would suggest to read more on the subject from the hand of Mr. Carlo M.

Cipolla (http://en.wikipedia.org/wiki/carlo_M._Cipolla

In the hope that there is hope for St. Maarten and that things will improve in the not too far future, I remain, enjoying your gorgeous weather,

Edward Bijl