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Re:900 Children Test Positive for H.I.V. in Pakistani city o... by egtiller on Sunday October 27, 2019 @11:53PM (#21374098)
This 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?

Re:900 Children Test Positive for H.I.V. in Pakistani city o... by oefrha on Monday October 28, 2019 @12:04AM (#21374151)
The 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.”

Re:900 Children Test Positive for H.I.V. in Pakistani city o... by hn_throwaway_99 on Monday October 28, 2019 @12:18AM (#21374232)
I 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.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by throwaway8941 on Monday October 28, 2019 @12:29AM (#21374280)
Because you don't know what real poverty is like (neither do I)? I remember a story from one of Atul Gawande's books (was it Complications?) about how rural Indian surgeons operate. As he described it, they were missing many kinds of equipment that western surgeons consider absolutely indispensable in doing their work. They replaced it with whatever was available, stuff like plastic piping from the nearest plumbing store, which then comes into contact with the entrails of the patient, so to speak.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by zbentley on Monday October 28, 2019 @09:27AM (#21376748)
That was in the book "Better". They found surgical tubing at a nearby market (not a plumbing store, presumably some sort of medical resale), and sterilized it with a steam autoclave before implanting it in a patient suffering from ... some form of meningitis, I believe?
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by stubish on Monday October 28, 2019 @05:13AM (#21375380)
(assuming the anecdote is correct) Rummaging around in the rubbish for a syringe is not about poverty, except perhaps that in real poverty you only have access to the worst doctors or none at all. Even if economics make fresh needles impossible, it takes so little effort make an attempt to sterilize that this sort of behavior is criminal. Start by not storing needles you might want to reuse in the rubbish bin and donations of scraps of wood to boil water.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by hn_throwaway_99 on Monday October 28, 2019 @08:40AM (#21376310)
The point is if you are in real poverty, doing nothing is cheaper and healthier than reusing a syringe.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by oefrha on Monday October 28, 2019 @12:23AM (#21374253)
Between 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?
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by tomc1985 on Monday October 28, 2019 @02:05AM (#21374643)
This 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

Re:900 Children Test Positive for H.I.V. in Pakistani city o... by oefrha on Monday October 28, 2019 @03:00AM (#21374854)
Poverty 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).
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by hn_throwaway_99 on Monday October 28, 2019 @08:42AM (#21376324)
Surely the doctors have some education, though.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by nitwit005 on Monday October 28, 2019 @01:26AM (#21374509)
They'll just end up even poorer if their kids get diseases through the syringes.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by adrianN on Monday October 28, 2019 @02:17AM (#21374694)
The alternative is that the children don't get medical treatment and die.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by nitwit005 on Monday October 28, 2019 @02:17PM (#21379869)
Have you ever gotten a non-emergency medical treatment so beneficial that it was worth getting HIV in exchange? Do you know anyone who has? I wish we had medicine that amazing, but it doesn't exist.

In theory, such a treatment is possible, but in reality, they're just making everything worse.

Re:900 Children Test Positive for H.I.V. in Pakistani city o... by adrianN on Tuesday October 29, 2019 @06:16AM (#21385545)
I really doubt that people who can't afford a clean syringe go to the doctor for non-emergency treatments.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by nitwit005 on Tuesday October 29, 2019 @12:20PM (#21388890)
Then you don't believe the article in the first place.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by DoreenMichele on Monday October 28, 2019 @02:23AM (#21374708)
Wouldn’t it be nice if patients could afford anything.

What would be nice is if someone tried to find a viable solution for this issue, something that actually worked and was affordable.

Re:900 Children Test Positive for H.I.V. in Pakistani city o... by nexuist on Monday October 28, 2019 @02:34AM (#21374742)
This is a possible solution for healthcare in the first world, but not the third world.

"Affordability" makes no sense when these families (families, not individuals) are earning a few pennies a day. The only solution is to give stuff away for free at a loss. No amount of innovation or cost savings can fix the fact that people (and even institutions) cannot afford syringes.

The only real issue in the third world is none other than lack of capital generating opportunities. Anyone who has capital can participate in the global economy and fix their own problems. Anyone who has a job can perform daily labor to earn capital that can fix their problems. The people who get lost - the people stuck in the third world - are offered no opportunities that would enable them to trade their labor for capital. If there were enough of these opportunities, all of these problems would go away.

Re:900 Children Test Positive for H.I.V. in Pakistani city o... by DoreenMichele on Monday October 28, 2019 @02:39AM (#21374757)
In the third world, when IVs are not available to treat dehydration, they spoon feed people water. It takes up to two hours, but it's safe and effective.

I did it once for one of my children. He was four and I didn't want him to be subjected to an IV.

Possible solutions include an oral or topical medication to replace the injected medication.

The poor in the US often also need actual affordable solutions that work. That seems to have improved some in recent years.

It won't exist if no one even bothers to try.

Re:900 Children Test Positive for H.I.V. in Pakistani city o... by oefrha on Monday October 28, 2019 @03:02AM (#21374859)
While I agree with your general sentiment, you do realize that “the poor in the US” and the poor in Pakistan are orders of magnitude apart, don’t you?
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by DoreenMichele on Monday October 28, 2019 @03:23AM (#21374933)
Yes. So are the rich in the two countries and the US is very prone to designing a world that only works for the upper classes.

If money alone were all that mattered, you would think a country like the US wouldn't have thousands of homeless, etc.

Re:900 Children Test Positive for H.I.V. in Pakistani city o... by nexuist on Monday October 28, 2019 @12:06PM (#21378170)
Money is not what matters and hasn't mattered for a long time. What matters is access to capital, governed by statistics such as credit score, which itself is affected by your mental faculty and ability to hold down a job (i.e. follow instructions, assuming you have job opportunities which are abundant in any U.S. city compared to the third world).

>According to a 2015 assessment by the U.S. Department of Housing and Urban Development, 564,708 people were homeless on a given night in the United States. At a minimum, 140,000 or 25 percent of these people were seriously mentally ill, and 250,000 or 45 percent had any mental illness.[1]

The homeless problem is a mental health problem. Sure, people can fall into hardship and get e.g. their houses foreclosed on and go bankrupt - but those same people generally are back on their feet a year or two later. Basically everyone who does not suffer from severe mental illness has the capability to raise enough capital on a monthly basis to put a roof over their heads. Now, they may have to work hard, and perhaps unreasonably hard in a sadly large amount of cases, but they can still do it and still do do it given that 99% of the country is not homeless.

[1] https://www.bbrfoundation.org/blog/homelessness-and-mental-i...

Re:900 Children Test Positive for H.I.V. in Pakistani city o... by DoreenMichele on Monday October 28, 2019 @01:20PM (#21379144)
No, homelessness is not (just) a mental health problem. Your own source indicates less than half of homeless people have a mental health issue and lists depression, anxiety and substance abuse as some of the mental health issues suffered by homeless individuals. All three of those can be caused or worsened by being homeless.

There are many factors that contribute to homelessness. Physical ailments can help lead to homelessness, but so can the high cost of housing:

Research by Zillow Group Inc. last year found that a 5 percent increase in rents in L.A. translates into about 2,000 more homeless people, among the highest correlations in the U.S. The median rent for a one-bedroom in the city was $2,371 in September, up 43 percent from 2010. Similarly, consultant McKinsey & Co. recently concluded that the runup in housing costs was 96 percent correlated with Seattle’s soaring homeless population. Even skeptics have come around to accepting the relationship. “I argued for a long time that the homelessness issue wasn’t due to rents,” says Joel Singer, chief executive officer of the California Association of Realtors. “I can’t argue that anymore.”

https://www.bloomberg.com/news/features/2018-11-20/the-homel...

Re:900 Children Test Positive for H.I.V. in Pakistani city o... by andrewstuart on Monday October 28, 2019 @12:02AM (#21374139)
This is how poverty works - they probably genuinely have no way if getting the needed stuff even if they knew how important it is.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by sures on Monday October 28, 2019 @12:11AM (#21374191)
This! And the general lack of safety culture also plays a role in incidents like this.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by masonic on Monday October 28, 2019 @03:26AM (#21374946)
Too poor to even afford a simple chlorine bleach solution to rinse syringes (at minimum!) is very poor indeed.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by i_feel_great on Monday October 28, 2019 @12:31AM (#21374286)
Poverty exacerbated tremendously by financial and social corruption all around.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by strainer on Monday October 28, 2019 @12:07AM (#21374165)
In 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.

Re:900 Children Test Positive for H.I.V. in Pakistani city o... by Gatsky on Monday October 28, 2019 @12:43AM (#21374338)
I 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.
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by adrr on Monday October 28, 2019 @12:35AM (#21374304)
Even if he re-used a syringe. Couldn't he have disinfected it with heat or flushing the needles with a water/bleach solution?
Re:900 Children Test Positive for H.I.V. in Pakistani city o... by cbhl on Monday October 28, 2019 @02:03AM (#21374635)
Article 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...

Re:900 Children Test Positive for H.I.V. in Pakistani city o... by Symbiote on Monday October 28, 2019 @03:42AM (#21374997)
Syringes cost 2-4¢ in a developing country (from a quick search) so that explains the problem.