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900 Children Test Positive for H.I.V. in Pakistani city of Ratodero
- known 7y agoCan Bill Gates Foundation help these kids?
- ggggtez 7y agoThis isn't the Bill Gates Foundation help forums. Go send them a message yourself?
- egtiller 7y agoThis news report makes my mind boggle. Reuse of syringes? In this century? The doctor says he was too poor to afford syringes! So reuse of syringes is the solution? Bill the cost of the syringe to the patient. Ask for donations. Do whatever it takes but never reuse a syringe. How can a doctor find reuse of syringes remotely acceptable?
- Gatsky 7y agoI think you are getting distracted. The real problem is abject poverty, and ineffective government. We could be endlessly horrified about what actually goes on in the world’s most disadvantaged places, rather than just what makes the NY Times.
- andrewstuart 7y agoThis is how poverty works - they probably genuinely have no way if getting the needed stuff even if they knew how important it is.
- sures 7y agoThis! And the general lack of safety culture also plays a role in incidents like this.
- i_feel_great 7y agoPoverty exacerbated tremendously by financial and social corruption all around.
- masonic 7y agoToo poor to even afford a simple chlorine bleach solution to rinse syringes (at minimum!) is very poor indeed.
- oefrha 7y agoThe doctor says the parents of the patient were too poor to afford syringes; and the family was already starving in order to pay for the medicine. Wouldn’t it be nice if patients could afford anything. Reality doesn’t work that way though, and some first world people just can’t imagine what real poverty is like (I can’t either). > When Mr. Jalbani protested, he said, Mr. Ghanghro snapped at him and told him he was using an old syringe because Mr. Jalbani was too poor to pay for a new one. > “He said, ‘If you don’t want my treatment, go to another doctor.’” Mr. Jalbani said. “My wife and I had to starve ourselves to pay for the medicine.”
- hn_throwaway_99 7y agoI still for the life of me can't understand how anyone with any medical training at all could reuse a syringe. Some other shortcuts I could imagine, but reusing a syringe is like eventually guaranteeing this kind of outbreak.
- oefrha 7y agoBetween this and no treatment, the choice is easy for most people. Although I do find “rummaging through the trash” for syringes astonishing. If you’re gonna reuse it, at least sterilize it (failing that, rinse it) and store it somewhere clean?
- tomc1985 7y agoThis is what I've never understood about the "you don't know poverty" argument... sure they may not have equipment but there are basic best practices that cost little more than time Perhaps there are more people that would prefer to watch the world burn than we think
- oefrha 7y agoPoverty also correlates with lack of education, so there’s also that. I heard (without any verification) that until recently a large percentage of rural population in India find nothing wrong in drinking from and shitting in the same river (let’s put aside technicalities like upstream/downstream).
- strainer 7y agoIn a hard place at a push, syringes could be sterilized before reuse. Sterilization is not effective against prions but some doctors without supplies could possibly resort to it. The story is gut wrenching. Children in poverty need free basic health services everywhere.
- adrr 7y agoEven if he re-used a syringe. Couldn't he have disinfected it with heat or flushing the needles with a water/bleach solution?
- cbhl 7y agoArticle also says that the doctor charged 20 cents (presumably US cents) to treat a patient. Compare that with $300 USD to see my GP for fifteen minutes...
- Symbiote 7y agoSyringes cost 2-4¢ in a developing country (from a quick search) so that explains the problem.
- bstar77 7y agoIf 900 children have HIV then how many thousands of other children have blood born infectious diseases related to this guy?
- Alex3917 7y agoI mean not exactly surprising. We literally just had a measles outbreak in Brooklyn last year. Vaccination rates are basically a prediction market on events like this happening.
- saagarjha 7y agoUnfortunately, I doubt the children of Pakistan are getting a vaccine against HIV.
- keithnoizu 7y agoor propholaytics which do actually exist.
- minitech 7y agoWhat does measles vaccination in Brooklyn have to do with syringe reuse in Ratodero?
- ktta 7y agoLack of proper understanding of healthcare science?
- ars 7y agoSeems like the issue here is poverty, not lack of understanding.
- Alex3917 7y agoMy point was that the cluster of unvaccinated folks in Brooklyn shows an uptick in people betting that the risk of something like this happening surpassed the risks of measles. Many/most people in Brooklyn eventually got vaccinated after the outbreak started, showing that they weren’t philosophically opposed to vaccines, but rather were making a bet based on perceived risk. That said, the epidemic itself is thought to have started as an offshoot of the epidemic in Israel. And right before the epidemic in Israel there was one in Pakistan, so there may be a direct connection as well.
- fouc 7y ago>Health officials now say that Mr. Ghanghro is unlikely to be the sole cause of the outbreak. Visiting health workers saw many cases of doctors reusing syringes and I.V. needles. Barbers take the same razor to the faces of multiple customers, they said, and roadside dentists crack away at patients’ teeth on sidewalks with unsterilized tools.
- andrewstuart 7y agoEven here in Melbourne the barber offers to use a cutthroat razor to give the neck a clean shave after a haircut. He's always a little puzzled when I'm "no thanks" to the razor.
- solstice 7y agoWoah, I never thought about this possibility.
- andrewstuart 7y agoEven if you don't get HIV from the razor you could still get one of the forms of hepatitis. I've never seen a barber with an autoclave for cleaning his equipment.
- Consultant32452 7y agoBarbicide kills HIV and hepatitis.
- deleted 7y ago[deleted]
- SighDucks 7y agoDon't they usually have disposable blades? The barbers in Melb I go to do.
- technion 7y ago
- umeshunni 7y agoIn some jurisdictions, auto-disposable needles are now required to be used to prevent things like this: https://en.wikipedia.org/wiki/Safety_syringe https://en.wikipedia.org/wiki/Safety_syringe
- killjoywashere 7y agoOne of my dad's first jobs out of college was designing needle-grinding machines for BD. they have a relatively complex 3-facet cutting edge, but the plastic hub allows you to accurately orient them on the grinder. I can imagine collecting, cleaning, sterilizing, and resurfacing needles could be a cottage industry in the developing world. 23G 1.5" becomes 23G 1.25", and so on. https://www.google.com/search?q=micrograph+of+hypodermic+needle https://www.google.com/search?q=micrograph+of+hypodermic+nee... https://www.ncbi.nlm.nih.gov/pubmed/2773053 https://www.ncbi.nlm.nih.gov/pubmed/2773053
- knzhou 7y agoWe will possibly end up with nearly 1000 children killed by a single man. A sobering reminder that our problems are, almost always, nothing in comparison.
- oefrha 7y ago> Health officials now say that Mr. Ghanghro is unlikely to be the sole cause of the outbreak. Visiting health workers saw many cases of doctors reusing syringes and I.V. needles. Barbers take the same razor to the faces of multiple customers, they said, and roadside dentists crack away at patients’ teeth on sidewalks with unsterilized tools. Sounds widespread, probably not just that one man.
- scarmig 7y agoLikely many more than 1000 children were infected. That said, hopefully the government of Pakistan is embarrassed enough to fund free treatment for this population. With treatment and compliance, HIV-positive people usually lead long, healthy lives.
- DoreenMichele 7y agoI don't know if Pakistan really has the resources. Last I checked, they were a very young country in terms of average age of the citizens. Poverty is pretty widespread, from what I gather.
- pcardoso 7y agoDreadful. I wonder how this could be avoided. A single individual from a developed country could help pay for some as basic as discardable syringes for a whole town.
- nickthemagicman 7y agoAre they educated enough to understand why to use them?
- avb333 7y agoPakistan is under developed in my opinion and only because their priorities are not focused towards making the country better but rather on political and Kashmir issues
- dang 7y agoPlease don't post nationalistic flamebait to HN.
- scarmig 7y agoWhat's (not) shocking is how stigmatized the HIV-positive population is. Authorities are literally segregating the HIV-positive children into a different side of the room from the rest. An obvious effect of this is that people will be terrified to get tested at all, as it's all downside with the possible upside of treatment being a distant dream. And that makes it both harder to evaluate the spread of the disease, and also harder to prevent further transmission of it. As a selfish aside, I will never get a shave from a barber who doesn't have an autoclave.
- ars 7y agoQuarantining infected people who have an incurable disease is not really that illogical when you have no medication capable of treating them. Can you imagine if the US had done mandatory testing and quarantine all those years ago? Obviously many people would have had their rights violated to do that, but it might have stopped the disease a long time ago. Voluntary self-quarantine clearly doesn't work. > will be terrified to get tested at all Or the opposite: Anyone not tested will be assumed to be infected. > And that makes it both harder to evaluate the spread of the disease, and also harder to prevent further transmission of it. Not if you have mandatory testing.
- dfasdfasd 7y agoYikessss the 1980's US government quarantining a huge percentage of the gay community... That ain't it. HIV is not easy to communicate to other people. Education and PrEP have reduced the problem immensely.
- ars 7y agoI agree, but PrEP isn't available to them. So what else do you expect them to do?
- masonic 7y ago1980's US government quarantining a huge percentage of the gay community. The US government didn't quarantine anybody. If they had, as was done for every other fatal communicable disease for a century, hundreds of thousands of gay and other men could have been saved.
- belltaco 7y agoThis is sad. They spend like 20% of their budget on their army and the army runs so much of their economy, and is on the stock market and owns stocks. Not to mention all the F-16s and Mirage fighters etc costing like $20 million each https://en.wikipedia.org/wiki/Pakistan_Army#Corporate_and_business_activities https://en.wikipedia.org/wiki/Pakistan_Army#Corporate_and_bu... https://foreignpolicy.com/2019/03/21/poor-nation-rich-army/ https://foreignpolicy.com/2019/03/21/poor-nation-rich-army/
- onetimemanytime 7y agoGeography! Pakistan is screwed, India is a neighbor and can always outspend Pakistan https://akm-img-a-in.tosshub.com/indiatoday/images/bodyeditor/201906/India_pak_budget_graphic-01-1200x3806.jpg?6paYKFwTTA22sA4fVrkXZxF91FHauLz0 https://akm-img-a-in.tosshub.com/indiatoday/images/bodyedito... . Don't spend on the military is cute and all, until you get invaded or Findlandized.
- ahbyb 7y agoThat might not be the worst thing that could happen to Pakistan, though.
- AwfulCaptain 7y agoWell if Pakistan were to create a sustained and irreversible environment absolutely free of terrorism, India would be very glad to export some cost-effective medical supplies to them.
- ijiiijji1 7y agoIs HN really the best place for pearl-clutching poverty porn?
- farazbabar 7y agoAbhorable. Root cause may indeed be poverty and greed but also the uncontrolled population growth that in itself is the cause and effect of poverty. Pakistani government (read military for all intents and purposes) is focused on concentrating wealth, power and land in the hands of generals, their children and a few land owners while the population at large is fed a steady diet of lies about enemies at the border and beyond. This fear of others (india, isreal, america even) is used to spend and therefore siphon the resources into the pockets of powerful few. The stage is different, the story not so much.