MEDICS' PERIL

NAIROBI, Kenya, Jun 23 - For the one year that Dr Brian Akaum has been practicing in the medical profession, he has accidentally pricked himself countless times with a syringe while attending to patients.

This puts him at risk of contracting one or more of the over 30 documented diseases that can result from such incidences key among them HIV/AIDS.

“Yes I have pricked myself several times and the most recent was like three months ago,” Dr Akaum says.

He says the most immediate thing to do in such circumstances is to seek post-exposure prophylaxis (PEP), a short-term antiretroviral treatment to reduce the likelihood of HIV/AIDS infection after potential exposure. It is a combination of three or four drugs that are taken for a whole month after exposure.

“This is the normal procedure but trust me I’m not the only one. Such incidences are there in every healthcare provider,” he says.

Dr Akaum says the greatest challenge they face is the different sizes of needles (diameter of the syringe at the tip is different) and the large ones cannot be used on children.

“This is because the veins of the children are pretty small and you need the appropriate size for each patient,” he explains.

“In our set up we do not have enough needles for children so we usually improvise. This is a very huge risk because when we improvise we usually take the tip of a needle, put it in the vein of a child and then break off the plastic part leaving the metal part and this poses high risk of infection especially with diseases like hepatitis,” he says.

The medic says he can attend to up to 100 patients in a day, most of whom require injection or blood collection.

“You tend to make errors when you are worn out and tired,” he says.

Government statistics indicate that about 2.5 percent of new HIV/AIDS infections occur in health care settings.

“If you consider 100,000 new infections in Kenya annually, then we are talking of about 2,500 infections probably occurring in health care settings and this could be due to needle-stick injuries,” Says Dr Daniel Kimani, Technical Advisor on Prevention of Medical Transmission at the Centers for Disease Control and Prevention.

“And the highest risk is among blood drawing because the needles contain blood,” he adds.

Dr Kimani however says repeated needle-stick injuries raises question of competence in the procedures being done and also highlights the areas that need intervention.

“We are trying to find out how many injuries are occurring and which people are getting injured so that interventions can be put in place,” he says

This is why the government in partnership with the Centers for Disease Control, US President's Emergency Plan for AIDS Relief (PEPFAR) and a Medical technology company Becton, Dickinson (BD) have come up with a project aimed at sensitising health workers and improving quality of blood collection across the country.

The project will provide training to health professionals and develop a curriculum focusing on safety of specimen quality and that of health care workers.

“We will train on how to draw blood using existing equipment in the facilities and also introduce a newer technology known as Evacuated Blood Collection System,” says BD Global Health Director Renuka Gadde.

She says about a million pieces of these new equipment will be provided in eight hospitals across the country in the first phase of the project which lasts two years.

“The way this equipment works is that the needle has one end that goes into the patients arm and the other end is where the health practitioner connects the vacuum tubes and when they get connected, the blood flows in automatically in a controlled manner,” Ms Gadde explains.

“With a syringe drawal (the existing equipment) the control depends on how skilled the health worker is,” she says.

And for Dr Akaum who is among the beneficiaries of the training on safe ways of blood collection, this comes as a relief to him and many others in the profession.

“We are learning about new technologies of drawing blood and also using what is available in a safe way to avoid infection,” he says.

Dr Akaum says when the new technology is made available in the public health facilities; it will bring in safety features that will prevent these needle-stick injuries when injecting or drawing blood.

“We are looking forward to having a lot of them around because they will improve safety for us as health care workers.”