HEALTH: How bad is India's used-syringe epidemic?

Recycling may be virtuous but in India it can also apparently be fatal. The country's seen an unsettling surge in incidents stemming from used medical waste, including a deadly hepatitis outbreak earlier this year; in Gujarat, the police arrested "100 medical scrap dealers and 22 doctors" last month after 70 people died from hep B and another 240 were infected.

The World Health Organization estimates that "300,000 people die every year as a result of dirty syringes in India." And a survey by the private Indian Clinical Epidemiology Network estimates that more than 30 percent of needles used in India are reused.

The issue of dirty Indian syringes has received a fair amount of attention lately:

• UK's Times: "Used needles are causing a health crisis in India"
• The AP, via the Cleveland Plain Dealer: "Tainted used syringes, repackaged and sold as new, blamed in deadly Indian hepatitis outbreak"

So, how bad is the problem?

We put the question to a couple Indian health experts:

• Dr. Niranjan Saggurti, a Senior Program Officer at the New Delhi office of the Population Council, a group that works on HIV and other health-related projects among vulnerable and low income populations in India.
• Anita Raj, an Associate Professor at the Boston University School of Public Health

Dr. Saggurti doubts the 300,000 figure is accurate but agrees that the number is definitely on the rise:

"It is good that the issue on use of dirty syringes came into forefront in India now, but I believe, it had been the practice for several decades and it did have major impact on public health.  It is easy to critique government and health facilities about the use of dirty syringes in India; but the challenges to monitor the control measures on such issues remain due to its population size."

Saggurti said the reuse of used syringes is not only common in urban low income communities but also in rural India. "This practice is commonly seen among unqualified doctors or doctors who provide services to the patients at a very low cost," he said. 

A number of doctors in low income communities are known to sterilize used needles and reuse them for injections. But even that's not happening in India, said Anita Raj.

"An unclean needle is a good storage mechanism for the virus to be transferred. It is not surprising in India with the oversight of medical practice, that the threat is quite substantial now," she said.

More on the outbreak here.

Watch this NDTV interview with a syringe dealer:

More From UK's Times Online:

There are nearly 14m people living in Delhi, a third of whom inhabit slums just like this one. When people need medical care, they go to a local doctor for an injection. They would rather have a needle than a tablet — it is seen as a miracle cure, a panacea, and the pinch tells them it’s good for them. But the syringe the doctor will use will probably have been used before, and may carry lethal infections such as hepatitis B or C, or HIV.In India, the average person has three to five medical injections per year. Around 62% of these will be delivered by unsterile or reused syringes.

The use of tainted syringes caught public attention only after a nationwide media campaign, "One Injection, One Syringe" was launched by the UK charity SafePoint in November 2008.

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