Despite the government’s claims to stop reusing of syringes to curb spread of infectious diseases, the practice is prevalent in some hospitals, it has been learnt. For instance, in the main laboratory of Pakistan Institute of Medical Sciences (Pims) there was no syringe cutter available when this scribe took a relative to the lab recently.
After drawing blood from patients, the lab attendants were seen throwing the syringes in a dustbin without cutting off the needles first. Talking to The Express Tribune, sources in the hospital said that this was not the first time, as the practice is going on not only in the main laboratory of the hospital but also in the Children’s Hospital. Allegedly, most of the time, it is done voluntarily.
“It is mainly because of a lack of monitoring, as the laboratories are managed by lab technicians, despite the availability of pathologists, who prefer to perform other duties,” added the sources.
They said that everyday around 500 to 600 patients visit the main laboratory and 150 children go to the Children’s Hospital laboratory for blood tests.
The sources said that the used syringes are then taken by the sanitary staff, which lacks awareness about the safe disposal of syringes, and throw them into trashcans outside the hospital. These are then collected by the scavengers, who sell them off, or are picked up by drug users.
“There are no incinerators in the hospital and all the hospital waste is being taken to the Holy Family Hospital (HFH) Rawalpindi for disposal, where such syringes are separated by the lower staff and sold to unscrupulous elements in the market.”
There is also no proper system for disposing of unscreened leftover blood and its components in the hospital’s blood bank.
Talking to The Express Tribune, a paramedic in the Pims blood bank, on the condition of anonymity, said the leftover blood and its components are dumped in dustbins kept under beds in the blood bank where donors lie down while donating blood.
After the blood components are separated, it is kept in three bags which are interlinked with plastic pipes. When these components are given to the patients, the bags are separated from each other. These pipes, which contain some blood, are then cut off and thrown in the dustbin.
According to a report tilted, “Mapping and Study of Healthcare and Injection Providers In Rawalpindi and Tando Allah Yar” by the Ministry of Health in collaboration with USAID and PAIMAN in November 2010, there are 4,994 healthcare facilities with 7,439 healthcare providers in Rawalpindi. Over 75 per cent of rural and 58 per cent urban of practitioners either give or prescribe injections. Approximately 67-70 per cent of all healthcare practitioners are not doctors, including hakims, homeopaths, dispensers, paramedics and others.
Syringe reuse with injections is around 7 per cent in Rawalpindi. Patients in Rawalpindi could ascertain that the injection they received was with a new syringe 51 per cent of the time. An average patient receives around 4 injections in Rawalpindi, 7-21 per cent of the times with a reused syringe.
The report reveals that therapeutic injections and their reuse are reaching epidemic proportions in Pakistan. National Institute of Population Studies & Macro International estimated that between 4 and 5 injections are received by Pakistanis annually, and that around half of these are unnecessary, with the same proportion being prepared in unsatisfactory conditions. Nearly 12 million Pakistanis are infected with either Hepatitis B or C, which is exclusively transmitted by contaminated syringes and drips viruses, which have a general population prevalence of 3 per cent and 5 per cent respectively.
HIV in Pakistan is present mainly among injection drug users, of whom there are approximately 100,000 in the country.
Published in The Express Tribune, June 24th, 2011.
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