Besides the skills of the practitioner and the environment in which the patient is cared for, an essential element for the care of any person in need is the presence of essential, reliable supplies that can be reached as soon as needed. There is a huge range of variables to be considered when describing the equipping of an ideal health centre which determine its capacity to manage the many problems relating to the skin. The commonest medicines in the tropics include essential drugs for infections such as impetigo, superficial mycoses, scabies, insect bites, eczema, burns, wounds and with geographical variation, other neglected tropical diseases that affect the skin.
Warning Most Governments provide an essential drug and devises list which will satisfy only if in its preparation it had the input of experienced advisers with knowledge about the skin.
Much of the more expensive high technology purchased or donated for therapy in the Developing World is so poorly maintained that it is quickly out of service. At the road side and even in some dispensaries there are many fake drugs to be purchased and many in the drug industry offload medicines that have long passed their shelf life. Adverse drug reactions are a major cause of skin failure.
Action Dermatologists must give priority to the giving of good advice to the preparation of essential drugs and devices lists of hospitals, national governments and the World Health Organisation. Organisations concerned with skin care that give advice include The International Foundation for Dermatology, The International Skin Care Nursing Group, The World Alliance for Wounds and Lymphoedema Care (WAWLC), International Federation of Leprosy (ILEP), the International Lymphoedema Framework (ILF) and the Global Alliance for the Elimination of Lymphatic Filariasis (GAELF). Many more can be elicited but these are the ones regularly making reference to dermatology in the developing world. Fortunately, most skin diseases can be treated with cheap and simple preparations. It is important to identify the commonest skin problems and provide for them.