Atter reading a story about woman who had a terrible accident in Nepal and how her own IV needles saved her from infection I always pack a set when I go away. I didn't really belived that medical professionals can be that ignorant and use dirty needles yet still just in case I would pack a set since they don't weight much and there is always 100 different uses for them. I was in Peru for the last few weeks and got to work with Peruvian Med Evac on couple of Altitude Sickness victims and extreme exhaustion/dehadration case... The first few cases were air lifted with just basic oxygen theraphy but the last case needed a fluid transfer which meant IV. I saw a medic reaching into this big bag of needles that was lying on the floor (and I tought it was a garbage) and pulling one of them, dirty, no cap... He told me they get the stuff as leftovers from hospitals and local clinics. I felt bad for that girl, so I gave her one of my spares but it was kind of a rude awaking.. Same thing goes for oxygen masks which been on the O2 bottles for months, constantly being reused and people coughing into them. Yikes...

Matt

Thanks for pointing out the potentially disasterous difference between the levels of care we westerners have come to expect and that which we may find while traveling.

We often mistake poverty for ignorance. Given the choice I am certain that any medical professional who is basically aware of infection would use sterile equipment every time. Unfortunately not even all american services can afford to treat everything as disposable. The hard choice between possible infection from needle or mask reuse or certain death from lack of treatment is usually required because of the lack of funding necessary to replace items after single use.

In the experience you relate about medivac, do you know if they wiped down the Ox mask with alcohol after use or autoclaved the needles for re-use? I would think that even in impoverished conditions that these precautions could be taken.

Masks were not wiped with alcohol since they are handed out to guides with a tank at the begining of the trip and nobody knows if they were used during duration of the climb or not. Masks are not sealed, they are already attached to the tanks.

Matt

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

My FAK contains some gelled alcohol hand sanitizer and some alcohol wipes. I would think that this sort of a problem could be somewhat ameliorated in this fashion.

Yes of course, for a normal concious person it wouldn't be a problem. But if you barely can breathe, a your head is pounding you will take or do anything to feel better and your logic maybe altered.