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    Saturday, February 22, 2003

    Mail Bag: Comments from readers on last week’s posts:

    On British Heart Disease:

    A number of my English friends (middle-aged men) have had the beginning signs of heart problems. All now have private health insurance, which luckily is laughably cheap there by American standards. Last time I was visiting, I asked my friends if they were getting regular screenings. Apparently the NHS does not go for regular cholesterol or even blood pressure tests, nor for regular physicals (nor are there similar privately-run programs such as found in many American cities and workplaces).

    On Iraq and Snakes:

    There is no "snakier" place than Southeast Asia. One briefing I went to began with the briefer stating "There are 100 deadly species of snake in Southeast Asia: 98 are deadly poisonous, and the othertwo just swallow you whole." We survived that...

    On Sex, AIDS, and Africans:

    I was a Special Forces medic in the 1960's, and I not only vivdly recall the practice of local clinics re-using needles, I can remember some cases in which small operators did not even WASH them between patients. This was in SouthEast Asia, but I know people who worked in Africa, and the situation is the same. Compounding the problem is the fact that a lot of the patients do not believe that they have REALLY been treated unless they have received a "shot" (or even an IV infusion), often for very commonplace and self-limited problems.

    Not to be too hard on the "Third World", I also remember when we (in the Army, at least) were still re-using needles. I can still clean the blood from an infusion needle with a wire stylet, sharpen it on an Arkansas stone, check for barbs using a cotton ball, and re-sterilize it. In a true "mass casualty" situation, skills like this are going to be invaluable. We may not always have an endless supply of disposable equipment- but that is another subject. Regarding African AIDS, I have long suspected that this was the case (ie, dirty needles). The relentless politicization of this disease has ill-served many millions of people worldwide, I think.

    If I were bleeding to death, or had meningitis and need IV antibiotics, and the only thing standing between me and life-saving therapy was a dirty needle, I’d take the needle. But, if someone came knocking at my door and wanted to immunize my children with a dirty needle, I’d pass. Which makes me wonder - is it still common practice in Africa and Southeast Asia to reuse needles? If so, then that casts the refusal of parents in those places to immunize their children in a whole new light.

    posted by Sydney on 2/22/2003 08:34:00 AM 0 comments


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