Unfortunately, reuse of medical devices is common in many areas of the world. I am glad you had the opportunity to visit, observe and return safely from Peru. I will be making my annual trip to Ecuador on July 18th as part of health care team. I too have witnessed in many of the rural areas reuse of needles and syringes. This is the reality for much of the world where medical professionals receive little in the way of compensation, the average Ecuadorian rural physician makes about $200/month, a fair amount in an area where the average income is around $60-75/month. However, much of the medical equipment and supplies, which they much purchase, is pretty close to what it costs here in the US. In fact much of the medical equipment, EKGs, IV pumps, etc are more expensive there than here, due to shipping and maintenance. The two physicians, who host us, requested some medical equipment that we would consider standard to have at any US hospital. The firefighters, with whom I have instructed and have developed a close bond with in Tosagua, have a fire truck provided to them by the government and that is it. No training, no protective equipment, no supplies, there are 13 members, they are students, farmers, work in town or are unemployed, they have no financial support or mechanism to buy equipment. There is no oxygen equipment of any kind in the immediate area. I have been fortunate to be able to buy and/or have donated some medical equipment for the physicians and protective gear for the firefighters, but am now facing problems in bringing the items with us. We normally pack what ever we are bringing in our luggage, but this trip we have much more to bring. We contacted the airline to see if they would allow us to bring extra bags for humanitarian reasons, but were told that there is an embargo on extra baggage to South America and could not accommodate our request. We dare not ship the items, as past experience has shown us, things are often stolen or lost. Hopefully, things will go well and I will be able to share some of our experiences. Last trip I had the fortunate or unfortunate opportunity to repair a broken muffler while on a narrow dirt road sitting on a 200-foot cliff in the middle of the night. By the way, there is a product which is a sealed prepackaged set of sterile needles, syringes, sutures, and dressings which you should be able to obtain with a prescription from your physician or through a health department health clinic for you own personal use while traveling internationally. Pete