Una Jeringa, Una Sola Vez

Tom and Evelyn McKnight gave a presentation on injection safety to Guatemalan healthcare workers
Tom and Evelyn McKnight gave a presentation on injection safety to Guatemalan healthcare workers

Tom and I were privileged to participate in a mission trip to Guatemala, led by Guatemala Esperanza’s Ron Noecker, a former HONOReform board member.

Our team co-operated with several other organizations to provide health screenings, build a health clinic and provide healthcare provider education.

Guatemala is a lovely country, very lush with beautiful cities, lakes, volcanoes and villages. It also has many challenges. Term limits of four years on the federal administration impedes progress. Most of the people have a sixth grade education or less. There are more than twenty languages, causing communication challenges. According to the World Bank, 75% of the people live below the poverty line. Accessing healthcare is often very difficult for the indigenous people who live in remote rural areas.

We bumped along mountainous, rough roads from our base in Antigua to San Martine Jilotepecae, where we provided education on a variety of healthcare topics to a doctor and nurses who work with Hombres y Mujeres en Accion. They man a mobile clinic in seven sites, in remote villages far removed from medical centers.

Through an interpreter, I told how I was infected with Hepatitis C through unsafe injection practices. Despite the aforementioned factors that can compromise healthcare safety, the doctor and nurses were as surprised as American healthcare workers are when I related how nurses reused syringes, causing 99 Nebraskans to contract Hepatitis C. I finished the presentation by passing out resources in Spanish from the One and Only Campaign (www.cdc.gov/injectionsafety).

As we bumped down the mountain back to home base at the end of the day, I reflected on how difficult it was for the indigenous people to access healthcare. In addition, the extreme poverty, lack of resources, and minimal education are challenges that could certainly result in reuse of needles, syringes, single dose vials and other medical equipment intended for one time use. And these challenges do not exist solely in Guatemala. Indeed, it is estimated that globally, unsafe injection practices result in 20 million new cases of Hepatitis B, 2 million cases of Hepatitis C and 250,000 cases of HIV per year (Ezzati, M et al. The Lancet, v 360; issue 9343, Nov 2002).

I was so honored to have some impact on healthcare improvement in Guatemala. Their needs are great, so great that it can be overwhelming. But I remembered the words of the nursing professor after the very first lecture I gave to a group of student nurses. She said to me, “Today you have told your story to a few nurses. But they will never forget your story, and through their hands, you will save many lives.”

My first foray into international injection safety work was richly rewarding, very exciting and a bit adventuresome. I hope to have more such adventures.

Later this month we will share the thoughts of our Guatemalan healthcare worker hosts on injection safety.

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