| ▲ | Hospital at centre of child HIV outbreak caught reusing syringes in Pakistan(bbc.com) |
| 121 points by flykespice 3 hours ago | 72 comments |
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| ▲ | satya71 2 hours ago | parent | next [-] |
| This is common practice in much of developed world. Long ago, they used to have re-usable glass syringes that could be sterilized. Unfortunately, people switched to disposable syringes. The unit costs are...high in the US, unreasonable in developing countries. It's not just this hospital, it's widespread ([1] report 38%) [1] https://www.emro.who.int/emhj-volume-26-2020/volume-26-issue... |
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| ▲ | Marsymars an hour ago | parent | next [-] | | That article also makes it seem like patients in Pakistan are receiving what seems to me like a wildly high number of injections: > An injection was provided during 53% of patient visits in Rawalpindi and 92% in Tando Allah Yar > Patients from Tando Allah Yar reported a mean 3.8 visits to a healthcare provider by a member of their household during the previous month, compared to 2.5 by those from Rawalpindi (Table 2). During all such visits, an injection was given. Overall, 56% patients felt that an injection was necessary. Such perceptions were higher in Tando Allah Yar than in Rawalpindi (79% vs. 39%) (Table 2). Providers reciprocated such perceptions in that 44–56% of providers felt that an injection was required for common ailments such as fever, influenza, body aches or diarrhoea. > Patients expect to receive injections for minor ailments such as fever or influenza-like symptoms and willingly pay for these, on the mistaken belief in the efficacy of injections to overcome common symptoms that eventually abate with time (10). Healthcare providers comply with such wishes and are convinced of the necessity of injections. > We have previously demonstrated that the total national supply of syringes in Pakistan is sufficient to meet the demand for the ~1.1 billion syringes used annually for immunization, diabetes, laboratory testing and drug administration in clinics or hospitals On the last point, I did a bit of a search to look for the total number of syringes used worldwide. I'm actually questioning whether that number is using similar methodology to arrive at the ~1.1 billion number, since I'm seeing numbers around 15 billion for the annual number of injections - meaning that Pakistan would be using over double the average per-capita number of syringes (and re-using many of them) while simultaneously having a population that's much younger (23 vs 31 median age) and poorer ($7k vs $26k median PPP/capita) than average. If those numbers check out, the simple solution would just be to stop giving unnecessary injections, money would be saved, and there'd be no need to reuse syringes. | | |
| ▲ | ceejayoz an hour ago | parent [-] | | A similar thing happens in the US; people demand antibiotics for a cold. It’s easier to say yes than to explain the reason it won’t work. | | |
| ▲ | thayne 23 minutes ago | parent | next [-] | | More than that, it's often easier to just prescribe something than to figure out if it is bacterial or viral. | |
| ▲ | shigawire an hour ago | parent | prev [-] | | Is that true or just a rumor? All the family medicine people I know would not do that. Only in a case where it is 50/50 bacterial or viral like an ear infection in a young kid. | | |
| ▲ | kube-system 31 minutes ago | parent [-] | | There is more effort today to avoid overprescribing antibiotics, but in cases where diagnosis is not certain, most providers will oblige |
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| ▲ | loeg an hour ago | parent | prev | next [-] | | > This is common practice in much of developed world. Do you mean "developing?" This is not common practice in rich Western countries. Additionally, as sibling has already pointed out, sterile disposable syringes are extremely cheap. | |
| ▲ | Ferret7446 13 minutes ago | parent | prev | next [-] | | The reason we switched is because it's cheaper (including the logistics overhead costs). Sterilization and transport isn't free | |
| ▲ | themafia 10 minutes ago | parent | prev | next [-] | | > The unit costs are...high in the US So many products are bundled into purchase agreements at hospitals that you can't, in general, sensibly talk about per-unit costs. | |
| ▲ | SanjayMehta an hour ago | parent | prev | next [-] | | A quick search found a pack of 100 disposable syringes in Pakistan for PKR 1100/- which is less than USD 4. That's 4 cents per syringe. Seems quite reasonable to me.
Seems they don't have economics as an excuse. https://ailaaj.pk/products/apple-disposable-syringe-5ml-100s | | |
| ▲ | CGMthrowaway an hour ago | parent | next [-] | | A month's wage in Pakistan is about $125. So each syringe would feel like a cup of Dunkin does to many in the USA | | |
| ▲ | bastawhiz 40 minutes ago | parent [-] | | I have orders of magnitude more cups of Dunkin each year than I get injections at a doctor |
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| ▲ | mothballed an hour ago | parent | prev [-] | | It's my experience in bumfucklandia in the third world it can be less about cost of products and more about the fact when you run out it costs you 50 bucks to drive into town, 50 bucks to pay the guy at the checkpoint, whatever it costs to ship them / make it worth the time of the shop keep to keep them. And then deal with the fact you're riding 20 people in one Hilux with barely enough room for anything and stuffed into some contorted shape for 20 hours while you go to town and back on the world's bumpiest road. | | |
| ▲ | Loughla an hour ago | parent [-] | | That could have been said without the massive racism. It's less about the money and more about the logistics of transporting and stocking these goods in a country that doesn't have decent basic infrastructure. See? | | |
| ▲ | mothballed an hour ago | parent [-] | | I must be so intensely racist that I have no idea what I even said there that was racist. | | |
| ▲ | alex43578 40 minutes ago | parent [-] | | You can't characterize a country where:
- dozens of people just got HIV from syringe reuse
- that ranks 168th out of 193 countries in HDI
- ranked 136th out of 182 countries in corruption
as backwards, underdeveloped, or corrupt. /s |
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| ▲ | i7l 2 hours ago | parent | prev | next [-] | | Do you know why they couldn't switch back to glass syringes? | | |
| ▲ | ButlerianJihad an hour ago | parent | next [-] | | Equipment that can be sterilized has been forced out of the market by these disposable things. It is far easier to push disposable product on medical providers and encourage rent-seeking and subscriptions to such things. It’s exactly the same way with contact lenses. When I was in college in the ’90s, I could get a pair of permanent contact lenses. They would cost a few hundred bucks, but they would last me several years if the prescription didn’t change. They were the same as glasses. You would clean them everyday and disinfect them, and they would serve quite well permanently. But the contact lens industry decided that wasn’t good enough, and decided that they could sell subscription services for contact lenses that you would need to discard every night. And those daily wear contact lenses, the disposable kind, basically forced out of the market the permanent ones and now the optometrist regards me as a Martian when I request permanent lenses instead. | | |
| ▲ | cromka an hour ago | parent | next [-] | | You completely ignored human error aspect. Before the blood donation centers used one time use equipment, donors were getting infected with something nasty every now and then. You can sure as hell expect people to commonly forget to properly sanitize those syringes. | |
| ▲ | nulld3v an hour ago | parent | prev | next [-] | | It's not like glass syringes are out of production though? They are still pretty cheap, I get them for $0.50 each from China. | |
| ▲ | stratts an hour ago | parent | prev | next [-] | | Daily isn't the only option - you can still get monthly lenses. | | |
| ▲ | ButlerianJihad an hour ago | parent [-] | | Like I said, with proper care and disinfection, permanent lenses could last for years, not days or months! | | |
| ▲ | kube-system 27 minutes ago | parent [-] | | Weren’t those the hard plastic ones with low oxygen permeability? They’re not as good for your eyes. | | |
| ▲ | ButlerianJihad 20 minutes ago | parent [-] | | No, they were soft, “hydrophilic” or for astigmatism, toric. The hard ones were old, old technology, and largely superseded. |
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| ▲ | jonahx an hour ago | parent | prev [-] | | I share your hate of rent-seeking and subscription culture, but tbf disposable contact lenses are legitimately a nicer product to use. I've done it both ways. |
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| ▲ | faangguyindia 2 hours ago | parent | prev | next [-] | | If you forget to autoclave them or not done properly you end up with infected patients, risk is just too much | | |
| ▲ | jjk166 17 minutes ago | parent | next [-] | | We sterilize plenty of other common tools like scalpels so that doesn't seem like a valid reason. Obviously the disposable design is not even an adequate solution to the risk of cross contamination. I would imagine if it were a real concern you could easily add something like a color changing strip that would indicate whether the needle has been autoclaved since its last use without rendering it useless. | |
| ▲ | seb1204 an hour ago | parent | prev | next [-] | | Sounds like the same risk as this situation of reusing them. | | | |
| ▲ | NDlurker an hour ago | parent | prev [-] | | Prions aren't destroyed by autoclave | | |
| ▲ | Marsymars an hour ago | parent | next [-] | | They can "survive" autoclave cycles that render other pathogens dead/inactive, but there do exist autoclave cycles that seem to pretty reliably inactivate prions. | |
| ▲ | Loughla an hour ago | parent | prev [-] | | No but viruses and bacteria are. What's your point and how common is transmitting prions? | | |
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| ▲ | kqgnkqgn an hour ago | parent | prev [-] | | If you can't trust them to follow the very easy directions of "throw away the single use syringe", how likely is it that they are going to follow the much more complicated process of properly sanitizing the glass syringe? |
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| ▲ | nameconflicts 2 hours ago | parent | prev [-] | | 1. They're talking about the current situation, but you're bringing up history.
2. Given the lessons from the past, why would you still want to do something this dangerous? | | |
| ▲ | seb1204 an hour ago | parent | next [-] | | Cost, or availability due to cost. Still a driver in developing countries. | |
| ▲ | SanjayMehta an hour ago | parent | prev [-] | | From the WHO article linked to by GP, the issue is that patients also insist on injections over oral meds. That's driving the insistence on injections, and rural doctors/clinics cutting corners. |
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| ▲ | dwa3592 2 hours ago | parent | prev | next [-] |
| I was in middle school when we were taught that used syringes were one of the causes of HIV. Can't believe a hospital would do this!!! |
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| ▲ | CGMthrowaway an hour ago | parent [-] | | These are hospital volunteers reusing the syringes. There's no telling they even went to middle school. |
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| ▲ | geor9e 22 minutes ago | parent | prev | next [-] |
| There's obviously terrible procedures happening at this clinic, involving contamination, but that one video doesn't seem like the culprit. Notice he removes the needle, then injects medicine into a cannula tube, not flesh. He then re-attaches the needle, draws the second dose, and injects again. That was the problem. The narrator says he then used a brand new syringe for every child, but that initial procedure contaminated the vial. Cannula tubes are primed with saline, that's kind of a long gap for blood to travel to contaminate the vial. Yes he did it wrong, but I get why he thought it would be ok. |
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| ▲ | jaypatelani an hour ago | parent | prev | next [-] |
| US should rather sanction Pakistan than getting IMF loan to it. |
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| ▲ | mlmonkey an hour ago | parent | next [-] | | And what will Pakistan do with such an IMF loan? The Generals would siphon off most of it to buy their palatial Dubai houses and London condos. Until Pakistan cleans up its act, giving it more loans it throwing good money after bad. | | |
| ▲ | themafia 5 minutes ago | parent | next [-] | | > The Generals would siphon off most of it to buy their palatial Dubai houses and London condos. Next door to other world leaders doing the same? Is that truly our motivation for not transferring the money? Some generals might illicitly buy houses? > Until Pakistan cleans up its act I'm sure "The Generals" are going to help there. > giving it more loans it throwing good money after bad. Abandoning them entirely as hostages is not acceptable. | |
| ▲ | ETH_start an hour ago | parent | prev [-] | | The parent comment is suggesting sanctioning them, not giving them IMF loans. | | |
| ▲ | Dusseldorf 10 minutes ago | parent [-] | | It took me 5 rereads before I properly read "should" instead of "would", which totally flips the implication! |
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| ▲ | malfist an hour ago | parent | prev [-] | | How would sanctions help? |
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| ▲ | t1234s 2 hours ago | parent | prev | next [-] |
| death penalty |
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| ▲ | calmworm 2 hours ago | parent | next [-] | | Or maybe better education? | | |
| ▲ | ceejayoz 2 hours ago | parent | next [-] | | > When we showed Buzdar our undercover footage, he insisted it had been filmed before his tenure or that it had been staged. When asked what he would say to local parents watching this footage, he said: "I can say to them with certainty, with confidence, that you should get your treatment done at THQ Taunsa." Not gonna fix this with education if they won't admit to having a problem in the first place. | | | |
| ▲ | jabedude 2 hours ago | parent | prev | next [-] | | Are you claiming that Pakistani nurses and doctors are not educated on the dangers of needle reuse? | | |
| ▲ | kube-system 10 minutes ago | parent | next [-] | | Doctors and nurses are far from the only medical professionals who might be sticking you with a needle. In the US your phlebotomist probably has a high school degree and a certification which required a few classes over one semester at a community college and passing an exam. I doubt Pakistan has higher requirements than most US states do. | |
| ▲ | supjeff an hour ago | parent | prev [-] | | If they aren't educated, throw the whole thing away and start over. if they are educated, and decided to share HIV needles with children, throw the whole thing away, but put them all in prison. |
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| ▲ | esalman an hour ago | parent | prev [-] | | Someone like USAID needs to support such education with funding etc.- https://www.mtapsprogram.org/our-work/health-area/antimicrob... Too bad Elon got rid of it. |
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| ▲ | OutOfHere an hour ago | parent | prev | next [-] | | If it were China, the death penalty would be guaranteed for it. | |
| ▲ | mothballed 2 hours ago | parent | prev [-] | | Pakistanis are in a habit of executing circumspect people with needles after the US helped assassinate Bin Laden through a needle / vaccination campaign. They are highly distrustful in particular of people offering vaccines since it is a trojan horse rather than an act of charity. | | |
| ▲ | corndoge 2 hours ago | parent [-] | | > They are highly distrustful in particular of people offering vaccines FTA > Our investigation suggests that unsafe practices are in part driven by systemic pressures including a reliance on, and cultural preference for, injections as treatment. > Pakistan has one of the highest rates of therapeutic injections in the world, many of them medically unnecessary. Members of the general public ask for them, including for their children, and doctors happily oblige, says Mir. Stop making shit up | | |
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| ▲ | halperter 2 hours ago | parent | prev | next [-] |
| https://archive.is/a9p1X Does anyone have alternative archival sites? I want to switch away from archive.today because of the uncivil behavior [1] but can't find any other archival sites that can unpaywall websites. [1] https://arstechnica.com/tech-policy/2026/02/wikipedia-might-... |
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| ▲ | jjmarr an hour ago | parent | next [-] | | Does the BBC even have a paywall that needs to be bypassed so people can pirate news? | | |
| ▲ | ceejayoz an hour ago | parent | next [-] | | I've been getting one intermittently in recent weeks on the BBC site from the US. | |
| ▲ | LeoPanthera an hour ago | parent | prev [-] | | Currently only in the USA. You can read a few articles for free, then there is a $9/month or $50/year subscription. It includes the website, the live streaming BBC News TV channel, and a library of documentaries. |
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| ▲ | LeoPanthera an hour ago | parent | prev [-] | | Have you considered paying your way through the wall? If you're not willing to do that, it's "uncivil" to pirate their content, wouldn't you say? |
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| ▲ | aussieguy1234 an hour ago | parent | prev | next [-] |
| One way to think of infection control best practice with needles like this. The cost of a new needle, syringe or new gloves is quite cheap. The cost of an infection is high. The cost of a HIV infection is life altering. So, its clear that whoever did this thought that whatever small savings they obtained from not using a fresh syringe was more important to them than the high likelihood their patients would get infections, including HIV. |
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| ▲ | seb1204 an hour ago | parent [-] | | Your cost claims need to be considered with the perspective of the country or location of the clinic. | | |
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| ▲ | calvinmorrison an hour ago | parent | prev [-] |
| expect nothing less from a country that has the largest slave population in the world. |