It's not just this hospital, it's widespread ([1] report 38%)
[1] https://www.emro.who.int/emhj-volume-26-2020/volume-26-issue...
That's 4 cents per syringe. Seems quite reasonable to me. Seems they don't have economics as an excuse.
https://ailaaj.pk/products/apple-disposable-syringe-5ml-100s
https://ourworldindata.org/grapher/life-expectancy-vs-gdp-pe...
Been poor is your biggest health risk.
> An injection was provided during 53% of patient visits in Rawalpindi and 92% in Tando Allah Yar
> Patients from Tando Allah Yar reported a mean 3.8 visits to a healthcare provider by a member of their household during the previous month, compared to 2.5 by those from Rawalpindi (Table 2). During all such visits, an injection was given. Overall, 56% patients felt that an injection was necessary. Such perceptions were higher in Tando Allah Yar than in Rawalpindi (79% vs. 39%) (Table 2). Providers reciprocated such perceptions in that 44–56% of providers felt that an injection was required for common ailments such as fever, influenza, body aches or diarrhoea.
> Patients expect to receive injections for minor ailments such as fever or influenza-like symptoms and willingly pay for these, on the mistaken belief in the efficacy of injections to overcome common symptoms that eventually abate with time (10). Healthcare providers comply with such wishes and are convinced of the necessity of injections.
> We have previously demonstrated that the total national supply of syringes in Pakistan is sufficient to meet the demand for the ~1.1 billion syringes used annually for immunization, diabetes, laboratory testing and drug administration in clinics or hospitals
On the last point, I did a bit of a search to look for the total number of syringes used worldwide. I'm actually questioning whether that number is using similar methodology to arrive at the ~1.1 billion number, since I'm seeing numbers around 15 billion for the annual number of injections - meaning that Pakistan would be using over double the average per-capita number of syringes (and re-using many of them) while simultaneously having a population that's much younger (23 vs 31 median age) and poorer ($7k vs $26k median PPP/capita) than average.
If those numbers check out, the simple solution would just be to stop giving unnecessary injections, money would be saved, and there'd be no need to reuse syringes.
This seems like an excessive number of doctor visits, too. I can’t imagine a household where someone is going to the doctor almost every week. 45 doctor visits a year and they’re getting injections (of what?) most of the time?
Do you mean "developing?" This is not common practice in rich Western countries.
Additionally, as sibling has already pointed out, sterile disposable syringes are extremely cheap.
So many products are bundled into purchase agreements at hospitals that you can't, in general, sensibly talk about per-unit costs.
You're coming up with an extremely complicated solution that would be a complete non-issue if the yearly salary of Pakistani citizens rose by even a single dollar.
It’s exactly the same way with contact lenses. When I was in college in the ’90s, I could get a pair of permanent contact lenses. They would cost a few hundred bucks, but they would last me several years if the prescription didn’t change. They were the same as glasses. You would clean them everyday and disinfect them, and they would serve quite well permanently.
But the contact lens industry decided that wasn’t good enough, and decided that they could sell subscription services for contact lenses that you would need to discard every night.
And those daily wear contact lenses, the disposable kind, basically forced out of the market the permanent ones and now the optometrist regards me as a Martian when I request permanent lenses instead.
That's driving the insistence on injections, and rural doctors/clinics cutting corners.
Next door to other world leaders doing the same? Is that truly our motivation for not transferring the money? Some generals might illicitly buy houses?
> Until Pakistan cleans up its act
I'm sure "The Generals" are going to help there.
> giving it more loans it throwing good money after bad.
Abandoning them entirely as hostages is not acceptable.
The cost of a new needle, syringe or new gloves is quite cheap.
The cost of an infection is high.
The cost of a HIV infection is life altering.
So, its clear that whoever did this thought that whatever small savings they obtained from not using a fresh syringe was more important to them than the high likelihood their patients would get infections, including HIV.
Latest case, in which an elected Prime Minister Imran Khan was removed from the office due to US sponsored regime change operations by Pakistan Army. Trumps current favorite Field Marshal Asim Munir as he is serving US as Imran Khan could not (US demanded air bases after it exited US from Afghanistan, which was denied by the elected PM and soon after he was ousted). And later, US kept silence over the election delayed in 2023, And then election was stolen in 2024, and everyone knows that Pakistan Army did still US/EU kept silence. Here people talking about poverty and low income about Pakistan.
Since US/EU sponsored government directly ruled by Army and Trumps favorite field marshal Pakistan has not progressed even 1% since then. People income fallen more than 50% more than 60% people is living below poverty. All because of the hypocrisy of US/EU governments. If you guys care so much about people, at least force your governments to not support such regimes. That would be enough for the people of the country. Instead of telling them that they are poor or xyz.
What I described is just a recent history, we go deeper in the history, history is full of such incidents. And I further do not take it as if I am putting total blame on foreign powers, Pakistanis are to be blame as well. But foreign powers sponsor such regimes all the over the world to have control on certain regions.
Does anyone have alternative archival sites? I want to switch away from archive.today because of the uncivil behavior [1] but can't find any other archival sites that can unpaywall websites.
[1] https://arstechnica.com/tech-policy/2026/02/wikipedia-might-...
If you're not willing to do that, it's "uncivil" to pirate their content, wouldn't you say?
It includes the website, the live streaming BBC News TV channel, and a library of documentaries.
I was shocked to see 500+ 'interactions' between me and the healthcare provider! However it turns out the majority of those interactions are very minor things - ie. "Patient received text message reminder about appointment". "Patient was sent letter with test results" etc.
When you count interactions like that, you can get a big number fast.
Well, with such a low mean age it could also be very young people skewing the number, im fully speculating.
It's actually very easy. Sterilization takes place in a stainless steel container that has "windows" on it's sides. When the sterilization cycle ends, these "windows" are closed just as the container is taken out of the autoclave. The container will remain sterile inside until opened.
Also, simply opening the container to take one syringe from it doesn't make it dangerously contaminated. As demonstrated by the article, the biggest danger comes from other people's blood (HIV, HCV, HBV), not ordinary bacteria we have on our skin.
When people complain about healthcare costs, they're not complaining about things that cost the same as a cup of coffee locally.
* Or at least it should be. It seems that Pakistan is different.
As aviation has shown—where human error has been studied for decades—reducing mistakes is difficult and expensive because it requires multiple layers of quality assurance. In countries where labor is costly, especially in healthcare, it has got to actually be cheaper to use single-use equipment, with the added benefit of reducing the risk of infection through that route to zero.
And we had a big scandal locally. Were they doing a shoddy job of colonoscopies? Probably. But genetics left no doubt that they were using one needle per jab, but one syringe per patient. And drawing up from multi-use vials. Stick the hep C patient, in pulling back a bit ends up in the syringe. Discard needle, syringe is still infected. New needle, old syringe, draw from the vial again, vial is now infected.
The same goes for sterilizing such things in a medical setting. I think HCPs are very accustomed to the disposable and pre-sterilized supplies that they don't even consider an item's sterile status or the need to sterilize it after use. So this is the pitfall that comes with all the disposable stuff: that routine sterilization is forgotten as a skill or as a necessity.
My doctor’s office even has a big sign in the waiting room saying they don’t prescribe antibiotics for common infections.
The last time I got strep throat the urgent care clinic was resistant to testing me but finally gave in. When it came back positive the doctor acted oddly like he was reluctantly willing to prescribe antibiotics for it.
On the other hand, the last time I got prescribed antibiotics was probably almost 10 years ago when I ended up in the hospital from an abscess.
Granted, my dad is old, but that part of the world still seems to expect doctors to do more for a common cold than just tell you to rest for a week and take an acetaminophen or phenylephrine if/when needed (even when that's really all you need).
FYI phenylephrine is effectively a placebo and the FDA has proposed ending its use in OTC drugs. (There've been HN threads on the subject, with many comments.)
Pseudoephedrine works great though.
For strep in particular, wiki indicates that not treating with antibiotics isn't unreasonable (presumably opinions will vary by doctor): https://en.wikipedia.org/wiki/Streptococcal_pharyngitis#Anti...
My friend who always used a naturopath would go on endlessly trying to diagnose herself with viral or bacterial to decide whether she should ask for antibiotics, but I definitely got the point.
I suppose many patients simply don’t know the difference.
Oral probiotics tend to work really well (similar effect to getting rid of bad bacteria) because they don't have to survive the stomach acid.
Some doctors argue against using antibiotics for strep, but it's definitely debatable.
I had a horrible tooth infection that anyone with a nose could tell was a bacterial infection yet I was massively gaslit and denied antibiotics until I went to the hospital at 11pm after a week of horrendous pain
Doctors very rarely do any kind of test in my experience (I would have thought oozing stinking green stuff would have been easy to test...)
Later
I am somewhat against antibiotics as I have a fragile/already destroyed gut. But there are times when I don't know what other solution there is after exhausting home remedies, other medication and waiting it out
UK seems very to be very cautious of over diagnosis, while my experience in Eastern Europe was opposite - my infant received 3 different kinds of steroids (potentially what stunned his growth).
IMO there is a huge amount of denial of treatment to save costs. The gaslighting over symptoms, the refusal to refer you to specialist, the refusal to order tests etc is all part of it. And they never ever say it's about costs - just a tight lipped, "I know what's best" attitude
Are there placebos that could be given instead?
My supervisor told me I could stay home for a day, but if longer than that, I would require a doctor’s excuse.
Now, that seemed fair from a labor perspective, but it is extremely unfair to someone like me. Because I do not own a vehicle, and seeing a doctor would involve boarding one or more buses and snorking the entire way there and back. Risking infection for everyone around me was exactly what I sought to avoid by staying home.
So what else could I do, but come into work and carry on? It is this sort of unreasonable requirement that fuels “presenteeism”.
You'd think the supervisor would realize it's in their own self-interest for you to not be around spreading infection (to them) by your mere presence.
There are of course people who abuse systems where doctors notes are not needed, and call in and then go have fun. It's not too hard to come across stories of people getting on short/long-term disability by know the correct doctor (I know of a situation where 3 members of the same family went to the same doctor and got a note for some condition).