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    A Place Where The Opioid Problem Is Upside Down

    While the opioid problem in the U.S. is about too many opioids, in some countries there are few options for treating or controlling pain.
    by Jason Beaubien Sep 27, 2019 6 minutes
    Orthopedic surgeon Kebba Marenah and his team get ready to perform knee surgery on a 14-year-old at the Edward Francis Small Teaching Hospital in Banjul, the capital of Gambia. The country struggles with a lack of access to sufficient pain medications.

    In the U.S., the opioid crisis is about too many opioids. In some other parts of the world, the opioid problem is about the exact opposite — a lack of access to powerful pain management drugs. As pharmaceutical companies are being sued in the U.S. for flooding the market with opioids, doctors in West Africa say they can't even get hold of those painkillers.

    When prescribed appropriately, opioids can be vital tools in hospitals and clinics. The drugs make patients more comfortable and can speed recovery.

    At Gambia's only teaching hospital, Dr. Kebba Marenah says managing pain is part of the challenge of practicing medicine in Gambia.

    "I think most of the things we do here orthopedic-wise cause pain," says the 37-year-old orthopedic surgeon.

    Marenah is prepping to oversee two operations in the surgical theater. He's pulling on scrubs.

    "When you deal with the bones, there's lot of pain receptors," he says. "If you've ever seen orthopedic surgeons, we are always holding hammers and saws

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