Dirty needles: A sore point
A mutant strain of hepatitis B has now killed more than 70 people in Gujarat in what is now becoming one of India’s biggest medical scandals. The outbreak has been traced to used and dirty hypodermic needles which should have been incinerated but instead were simply washed, repackaged and sold back into the medical industry for reuse.
Within the past week, police have discovered a staggering 75 tonnes of neatly packaged waste – including needles, paediatric droppers and syringes – waiting to be resold to private medical clinics. Police describe the waste scandal as a “serious organised crime racket”. Authorities admit they have no idea how many thousands of dirty needles may already be in use in medical clinics across the state – they say that they are unlikely to find them all.
There is no law forcing the 13,000 private medical practitioners across Gujarat to reveal where they bought their equipment. Police said many were “refusing to co-operate and admit if they bought these dangerous tools or not”.
So far the list of those supplying needles has included pharmaceutical companies, individual doctors and a state hospital. At that hospital, dangerous medical waste that had been left out for incineration was collected by cleaners and porters and then sold on to gangs who traded in it. “Everyone got their cut,” said a police spokesman.
In 2004 a study was conducted at 84 centres by the IndiaCLEN (International Clinical Epidemiology Network) to estimate the burden and safety of injection use in India.Interviews were carried out with over 24,021 households and 3,562 health facilities across India. 17,844 injection processes and 24,030 client-provider interactions were observed.
The study found that nearly 62.9% of injections were unsafe. Nearly one-third of administered injections carried the risk of spreading blood-borne viruses and nearly 44.8% of health facilities didn’t have proper injection disposal
According to World Health Organisation estimates, there are an estimated 30,000 HIV infections and over 21,000,000 Hepatitis B infections every year due to unsafe injections. However, Dr Narendra Arora, executive director of INCLEN (International Clinical Epidemiology Network) which had conducted the 2004 study chose to differ.
“There is a great need to improve the quality of our injections and the way they are administered, but a lot has been done since the study. The government has introduced auto-disposable syringes in all immunisation programmes, which are much safer than the glass syringes used earlier,” Dr Arora said. Experts agreed that only 17% of injections come under the immunisation programme, the rest are given for curative purposes, a sector that isn’t as well regulated. “We have also set up 20 model injection centres across the country for training medical professionals on how to give injections in a safe manner,” said Dr Arora.
The state of biomedical waste management is a joke in this country. Doctors can no longer feign ignorance for what is clearly an act of omission. Coupled with rampant unawareness of the need for disposable syringes and needles, the conniving black market only serves to promote these death godowns. Clearly in these dire times, lots more needs to be done.
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