
900 Children Test Positive for H.I.V. in Pakistani city of Ratodero - LeoNatan25
https://www.nytimes.com/2019/10/26/world/asia/hiv-aids-pakistan-ratodero.html
======
scarmig
What's (not) shocking is how stigmatized the HIV-positive population is.
Authorities are literally segregating the HIV-positive children into a
different side of the room from the rest.

An obvious effect of this is that people will be terrified to get tested at
all, as it's all downside with the possible upside of treatment being a
distant dream. And that makes it both harder to evaluate the spread of the
disease, and also harder to prevent further transmission of it.

As a selfish aside, I will never get a shave from a barber who doesn't have an
autoclave.

~~~
ars
Quarantining infected people who have an incurable disease is not really that
illogical when you have no medication capable of treating them.

Can you imagine if the US had done mandatory testing and quarantine all those
years ago? Obviously many people would have had their rights violated to do
that, but it might have stopped the disease a long time ago.

Voluntary self-quarantine clearly doesn't work.

> will be terrified to get tested at all

Or the opposite: Anyone not tested will be assumed to be infected.

> And that makes it both harder to evaluate the spread of the disease, and
> also harder to prevent further transmission of it.

Not if you have mandatory testing.

~~~
dfasdfasd
Yikessss the 1980's US government quarantining a huge percentage of the gay
community... That ain't it.

HIV is not easy to communicate to other people. Education and PrEP have
reduced the problem immensely.

~~~
apta
HIV is much more prominent in homosexual men, not sure what your point is.

~~~
foldr
What is your point?

~~~
apta
That engaging in a known risky activity is dangerous, and people shouldn't be
surprised if they get affected if they willingly put themselves in such a
situation.

~~~
foldr
Who are you talking about? It sounds as if you are saying that people with HIV
deserve to be quarantined.

------
fouc
>Health officials now say that Mr. Ghanghro is unlikely to be the sole cause
of the outbreak. Visiting health workers saw many cases of doctors reusing
syringes and I.V. needles. Barbers take the same razor to the faces of
multiple customers, they said, and roadside dentists crack away at patients’
teeth on sidewalks with unsterilized tools.

~~~
andrewstuart
Even here in Melbourne the barber offers to use a cutthroat razor to give the
neck a clean shave after a haircut.

He's always a little puzzled when I'm "no thanks" to the razor.

~~~
solstice
Woah, I never thought about this possibility.

~~~
andrewstuart
Even if you don't get HIV from the razor you could still get one of the forms
of hepatitis.

I've never seen a barber with an autoclave for cleaning his equipment.

~~~
Consultant32452
Barbicide kills HIV and hepatitis.

------
belltaco
This is sad. They spend like 20% of their budget on their army and the army
runs so much of their economy, and is on the stock market and owns stocks.

Not to mention all the F-16s and Mirage fighters etc costing like $20 million
each

[https://en.wikipedia.org/wiki/Pakistan_Army#Corporate_and_bu...](https://en.wikipedia.org/wiki/Pakistan_Army#Corporate_and_business_activities)

[https://foreignpolicy.com/2019/03/21/poor-nation-rich-
army/](https://foreignpolicy.com/2019/03/21/poor-nation-rich-army/)

~~~
onetimemanytime
Geography! Pakistan is screwed, India is a neighbor and can always outspend
Pakistan [https://akm-img-a-
in.tosshub.com/indiatoday/images/bodyedito...](https://akm-img-a-
in.tosshub.com/indiatoday/images/bodyeditor/201906/India_pak_budget_graphic-01-1200x3806.jpg?6paYKFwTTA22sA4fVrkXZxF91FHauLz0)
. Don't spend on the military is cute and all, until you get invaded or
Findlandized.

~~~
ahbyb
That might not be the worst thing that could happen to Pakistan, though.

------
bstar77
If 900 children have HIV then how many thousands of other children have blood
born infectious diseases related to this guy?

------
umeshunni
In some jurisdictions, auto-disposable needles are now required to be used to
prevent things like this:
[https://en.wikipedia.org/wiki/Safety_syringe](https://en.wikipedia.org/wiki/Safety_syringe)

~~~
killjoywashere
One of my dad's first jobs out of college was designing needle-grinding
machines for BD. they have a relatively complex 3-facet cutting edge, but the
plastic hub allows you to accurately orient them on the grinder. I can imagine
collecting, cleaning, sterilizing, and resurfacing needles could be a cottage
industry in the developing world. 23G 1.5" becomes 23G 1.25", and so on.

[https://www.google.com/search?q=micrograph+of+hypodermic+nee...](https://www.google.com/search?q=micrograph+of+hypodermic+needle)

[https://www.ncbi.nlm.nih.gov/pubmed/2773053](https://www.ncbi.nlm.nih.gov/pubmed/2773053)

------
pcardoso
Dreadful. I wonder how this could be avoided.

A single individual from a developed country could help pay for some as basic
as discardable syringes for a whole town.

~~~
nickthemagicman
Are they educated enough to understand why to use them?

------
egtiller
This news report makes my mind boggle. Reuse of syringes? In this century?

The doctor says he was too poor to afford syringes! So reuse of syringes is
the solution? Bill the cost of the syringe to the patient. Ask for donations.
Do whatever it takes but never reuse a syringe. How can a doctor find reuse of
syringes remotely acceptable?

~~~
oefrha
The doctor says the parents of the patient were too poor to afford syringes;
and the family was already starving in order to pay for the medicine.

Wouldn’t it be nice if patients could afford anything. Reality doesn’t work
that way though, and some first world people just can’t imagine what real
poverty is like (I can’t either).

> When Mr. Jalbani protested, he said, Mr. Ghanghro snapped at him and told
> him he was using an old syringe because Mr. Jalbani was too poor to pay for
> a new one.

> “He said, ‘If you don’t want my treatment, go to another doctor.’” Mr.
> Jalbani said. “My wife and I had to starve ourselves to pay for the
> medicine.”

~~~
hn_throwaway_99
I still for the life of me can't understand how anyone with any medical
training at all could reuse a syringe. Some other shortcuts I could imagine,
but reusing a syringe is like eventually guaranteeing this kind of outbreak.

~~~
throwaway8941
Because you don't know what real poverty is like (neither do I)? I remember a
story from one of Atul Gawande's books (was it Complications?) about how rural
Indian surgeons operate. As he described it, they were missing many kinds of
equipment that western surgeons consider absolutely indispensable in doing
their work. They replaced it with whatever was available, stuff like plastic
piping from the nearest plumbing store, which then comes into contact with the
entrails of the patient, so to speak.

~~~
zbentley
That was in the book "Better". They found surgical tubing at a nearby market
(not a plumbing store, presumably some sort of medical resale), and sterilized
it with a steam autoclave before implanting it in a patient suffering from ...
some form of meningitis, I believe?

------
knzhou
We will possibly end up with nearly 1000 children killed by a single man.

A sobering reminder that our problems are, almost always, nothing in
comparison.

~~~
scarmig
Likely many more than 1000 children were infected.

That said, hopefully the government of Pakistan is embarrassed enough to fund
free treatment for this population. With treatment and compliance, HIV-
positive people usually lead long, healthy lives.

~~~
DoreenMichele
I don't know if Pakistan really has the resources. Last I checked, they were a
very young country in terms of average age of the citizens. Poverty is pretty
widespread, from what I gather.

------
avb333
Pakistan is under developed in my opinion and only because their priorities
are not focused towards making the country better but rather on political and
Kashmir issues

~~~
dang
Please don't post nationalistic flamebait to HN.

------
farazbabar
Abhorable. Root cause may indeed be poverty and greed but also the
uncontrolled population growth that in itself is the cause and effect of
poverty.

Pakistani government (read military for all intents and purposes) is focused
on concentrating wealth, power and land in the hands of generals, their
children and a few land owners while the population at large is fed a steady
diet of lies about enemies at the border and beyond.

This fear of others (india, isreal, america even) is used to spend and
therefore siphon the resources into the pockets of powerful few. The stage is
different, the story not so much.

------
Alex3917
I mean not exactly surprising. We literally just had a measles outbreak in
Brooklyn last year. Vaccination rates are basically a prediction market on
events like this happening.

~~~
minitech
What does measles vaccination in Brooklyn have to do with syringe reuse in
Ratodero?

~~~
ktta
Lack of proper understanding of healthcare science?

~~~
ars
Seems like the issue here is poverty, not lack of understanding.

------
known
Can Bill Gates Foundation help these kids?

~~~
ggggtez
This isn't the Bill Gates Foundation help forums. Go send them a message
yourself?

