Re: Injection Policy and AIDS: Promote the use of glass syringes

[Guest guest]

[This is in response to Air Mshl L K Verma's posting on,Injection Policy and

AIDS: " Promote the use of glass syringes " ]

Dear Mr. Verma,

I am a development worker. Presently managing a

Nutrition and Health Education Program in Bhuj. I was

involved with a number of Health Education projects in

the states of MP, Bihar and Rajasthan wherein the

government grass root functionaries were targetted to

improve the qulity of service delivered by them.

I observed that most of the health functionaries who

are actually involved in the immunisation of children

are not provided with adequate facilities to sterlise

syringes and other equipment particulary in the remote

rural and tribal areas. Those who have Kerosine stove

do not have kerosine to make use of it. then there is

a acute problem of transportation for the

functionaries.

An Auxillary Nurse and Midwife (ANM)

who picksup the Vaccine carrier from the mother

Primary Health Center (PHC) travels around 10-25 kms

by some public transport then walks for some more

kilometers. it is not easy for a lady to carry the

vaccine carrier to that distance, now if we expect her

to carry the stove and cooker along we are asking for

too much.

the public in general is not very supportive of this

lady (though we successfully tried community support

in some places)to volunteer for this task.

so what i feel is in addition to demand for a re-entry

of the glass syringe, we need to push the state

governments really hard for them to provide adequate

equipment and consumables to the ANMs. An unintrrupted

supply of kerosine and other consumables is a moust if

we really want this to work. On the other hand

community mobilisation and sensitization to support

the grass root functionaries is equally important.

Normaly the villagers keep complianing about the

workers without appriciating their problems and

condition under which they work.

Manish Mathur

Project Coordinator

CARE Inc. (Child Survival and Disease Project, Gujrat Earthquake

Recovery Initiative)

E-mail: <mmathur_in@...>

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[Guest guest]

No doubt glass syringes are the best provided the various health

settings make sure they are sterilized properly. Can we be sure of

propoerly sterilized glass syringes being available across the

country? Of course, you can also be not sure about the disposable

syringes owing to corruption.

I think, glass syringes can definitely be promoted in controlled

settings as I know in IISCO hospital at Asansol.

Dr Ashok Kumar Agarwal, MBBS,MD

108, Rastraguru Avenue,

Nager Bazar, Kolkata -700028, India

E-mail: <drashok_1963@...>

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[Guest guest]

Dear forum members

Glass syringes certainly have a lot of advantages. One major advantage is the

cost. They have a lot of disadvantages too. One is that sterilization as

pracitised in most hospitals is often very inadequate. Boiling is an effective

means of disinfection. But, the usual practice of boiling several syringes and

needles and then keeping them in a bowl, from which syringes and needles are

removed as required, should perhaps be discontinued.

When several persons handle these syringes, as in a hospital ward, it is

possible to have used syringes /needles in the same bowl which results in

contamination of the entire lot. Autoclaving with steam and then keeping each

syringe and needle in its own pack should be the norm. Since the needles are

reused, they need to be cleaned and often unblocked, using a cleaning wire, all

of which adds to risk for cleaning staff. Setting up a central sterile supply

means employing additional staff and installing equipment.

A very large number of infections occur every year from unsterile injections

given in hospitals. When the cost of human suffering and medical care needed for

these infections are taken into account, the cost of disposable or single use

syringes may not seem so much.

Dr.M.Prasanna Kumar

E-mail: mpkumar@...

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