Small Changes That Add Up - minimizing the use of needles
There are a surprising number of little changes that can add up to major impact in global health. These are not necessarily changes one person can make on their own, but they are changes that one health clinic, or one NGO can make. This post is the first in an ongoing series about the small changes that add up.
Today's small change: minimizing the use of needles.
Needles are inherently dangerous; anything sharp and intended to puncture the human body is an accident waiting to happen. Health care providers and patients alike are endangered by needle sticks. Patients are put in danger by needles that are poorly cleaned and then re-used. Getting used to the sight and use of needles is bad for society as a whole. In addition, minimizing the use of needles is good medical and public health practice. Needles are the tools of chronic illness and emergency. We want to provide care that prevents the need for needle use. There will always be accidents and emergencies that require intensive medical care, but they are exceptions.
In the developing world, 95% of injections given are for medical treatment not vaccination. Most of those shots are unnecessary. Three studies in Sub-Saharan Africa and Asia found that between 60 and 80% of all injections given were unnecessary and sometimes dangerous. The most frequently injected medications were antibiotics. (WHO)
One thing that injections lead to is needle sticks. Health providers are at risk of blood-borne disease cause by accidental needle sticks. This includes in particular Hepatitis B and C, and HIV. Every single time a needle is used, it puts the provider at risk.
Injections put patients at risk, too. Needles are often improperly sterilized and then re-used. This puts patients at risk for HIV and hepatitis. In additional, poorly administered injections can causes bruises or even paralysis. Injections are also expensive, an expense that is passed on to the patient - some research says they are favored by health care providers because they can charge more.
Lastly, there is a strong argument to be made that over-use of medical injections leads to injecting drug abuse. People get used to receiving injections. In many cases, they are given syringes to take for home treatment as well. In a society where almost everyone knows how to give themselves an injection, there is no learning curve when you need to inject a drug for entertainment. And there are more needles around to use for that propose.
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