Sadiyya Sheik
Sadiyya Sheik

Occupational hazard

Employment is a risky thing. I don’t mean the possibility of being pink-slipped or the company liquidating or poisonous cafeteria-unknowns. In my line of work, showing up is a bloody hazard.

I spent the better part of the last three weeks praying desperately for an HIV-negative result. Some light: I’m a medical intern. Most of my days are spent seeing patients and drawing their blood or putting up intravenous lines. Most of these patients are HIV positive — either proven by a blood test or suggested by a gaunt almost skeletal frame.

A few weeks ago, I pricked myself with a needle while putting up an IV line. It was my third needlestick injury in 18 months. What’s that you say? I should be more careful? Yeah, I really should. What was I thinking trying to put up an IV line when I’d been awake for a 28-hour stretch? And I really should have worn correctly-sized gloves to improve my dexterity. And I should have requested assistance in holding down that restless patient.

This is medicine in the public-health sector. A serious lack of doctors means that you work long hours without rest. A lack of resources means that sometimes the only gloves available really are two sizes too big. A lack of nursing staff means that there is often no assistance in managing restless patients.

Healthcare professionals risk HIV and TB on a daily basis and while there are means of decreasing exposure, the Department of Health can do little to protect its servants. The N95 mask (the forerunner in protection from TB bacilli), is frequently out of stock as are gloves that fit. As a result, many doctors have taken to not wearing gloves at all because a glove one size too big is often more hazardous than no glove at all

It took three weeks of waiting for my result because the National Health Laboratory Service (NHLS) had a dysfunctional lab machine. I did the test twice before the specimen was lost between labs. This is not a freak incident by the way, anyone familiar with the NHLS would expect nothing less, or more rather.

My HIV test was negative (thank you private laboratory) but each day presents a new opportunity for infection.

My beef with the Department of Health is this: it is evident that HIV and TB are eating away at our population, why not try a little harder to protect the health-care workers that are trying to stop this decay?

  • http://hardcopyink.com Mo Haarhoff

    Got it. Clearly they have not.

  • Gerry

    Why not? Because they don’t give a pig’s wing for you and your ilk, that’s why. And for the rest of the populous.

    Like 99.9% of all governemnts in the world, they are in it for what they can get out of it, not what they have to put in.

  • ???

    As an OH Professional, I don’t understand the benefit of an HIV test taken at the time of the needlestick incident as the HI virus takes some time to replicate to the point where it is detectable in a blood sample. Therefore an immediate test would always be negative unless the recipient was already HIV+. In my experience a blood sample is taken and stored only for comparison should a later test show up positive for compensation purposes. ARV’s should be commenced according to the risk profile of the donor which in your case is high. PCR test then follows after some weeks to detect the presence of the virus. None of the above takes anything away from your argument for proper protective wear,enough staffing and appalling work rosters for interns and public health workers. Good luck.

  • Judith

    It would seem that government departments can be fully in breach of their own Health and Safety Act with impunity. I am appalled by this when small companies are hammered and closed down for far less serious breaches.

  • Jonas Barbarossa

    My god! This is unbelievable; and the mental anguish that you had to endure…

  • http://blogroid.wordpress.com blogroid

    I have nothing to add to the expressions of horror already expressed… May you remain safe.

  • http://www.thoughtleader.co.za/sadiyyasheik Sadiyya Sheik

    ???, the issue with the HIV test was that I had a prior needlestick injury and hadn’t repeated the test outside of the window period. Then the routine test done at the time of my needlestick injury came back with an “equivocal” result. Twice. I didn’t mention all this because it tends to sound pretty complicated and isn’t really contributory, although I’m sure I can add dysfunctional lab machines to my list of complaints.

  • John

    The chances of an HIV infection were small – you as a health professional should have known that (I HOPE!)

    Hundreds more nurses get killed in taxi accidents in any month than die from AIDS that was got through an IV prick. So then, which is more important!

    You get AIDS from sex, (well over 99% of the time). The rest is occupational hazard like the golf caddies who are struck by lightening or the lifeguards eaten by sharks. Must we give every golf caddy a lightening rod?

    Lets focus on the core issues of both AIDS and SERVICE DELIVERY and not follow some minor cul de sac. Lets face the important shortfalls in both there areas. More ARVs for mothers will save thousands more South Africans than a major exercise in nurse ARVs.

    Kennedy said “let’s not ask what America can do for me but rather what I can do for America”. All South Africans would do well to digest this phrase and start delivering rather than asking the dysfunctional system to deliver to them. This is particularity true of Policemen, health professionals, and civil servants. The Gi’me Gi’me Gi’me group should start delivering…

  • http://southafricana.blogspot.com Dave Harris

    Absolutely, Sadiyya! Thanks for your dedication to the profession!

    The Department of Health should go the extra mile to protect its workers against accidents like this. Asking for an adequate supply of correct sized gloves is the LEAST they can do. The Department of Health should improve their training and education of both workers and patients on how to prevent these accidents and adhere to strict safe disposal policies of contaminated waste. Yes, its important to educate patients as well since they help spread this information virally.

    Carpet-bombing our healthcare system with free condoms, sterile syringes and gloves makes absolute sense in helping prevent the spread of this disease. Of course, the religious fanatics will protest the condom strategy, as usual.

  • http://www.thoughtleader.co.za/sadiyyasheik Sadiyya Sheik

    @ John, I know what the risks are. Are you saying that because the risk is small, my complaints are unwarranted? No matter how small the risk is the fact is there is potential for transmission. I’m not asking for a “major exercise in nurse ARV’s” if by that you are referring to post-exposure prophylaxis. I am asking for better attempts at prevention of needlestick injuries.

    I know that every occupation comes with it’s own hazards, we can’t really prevent lightning but a needlestick injury is often preventable. I therefore don’t agree with your sentiments.

    As for the quip about service delivery, umm it was the act of delivery of a service that caused the needlestick injury, just so you’re clear on that.

  • Sidney Bloch

    well said…btw john’s clearly not a doc and has no clue of the risks involved.

  • Mike S

    @ Dave Harris

    What happened to you? You managed a post without blaming whites or the DA; are you alright?

  • Shehnaaz Peer

    Oh Sadiyya, life as an intern is for the most part an exhausting one.
    Having small hands myself, I remember my intern-call days when I’d arrive to work in the morning and ask a friendly ward nurse to keep my stash of a few pairs of small-sized gloves for me to use later on my call.
    The chance of seroconverting is a slim one but the agony,anxiety and sleepless nights it causes is all gloom.
    Bottom line is HIV/AIDS has taken over every resource in public sector.
    Good luck with the rest of your internship.

  • http://www.valbloggen.nu Kaj

    Im a swedish RN transmitted with HCV at work, the past 10 years have been a living h*ll when i look back on all consequences, i have left my work as a RN and have the past years try to make awarness on needlestick in Sweden, we have a election in Sweden to the parliament 19 september, i have since march visit alla political parties in the Swdish parliment making awarness on the topic and im blogging for all my collegues, doctors, nurses etc.To wait for result if you been HIV transmitted is a big trauma, i have also done a survey among 13 healthcareworkers in Sweden that been exposed of HIV and the fallowing psychological consequences, the 13 Swedish healthcarepersonel did also prevention treatment with HIV drugs during 4 weeks. The result of the survey is published on my blogg friday 20th of august together with a magazine articel on the topic, perhaps some have the chance to translate from my blogg to english thrue any professional contacts if you find this interesting.www.valbloggen.nu
    PS. You all take care, and use safety products/needles!

  • http://www.valbloggen.nu Kaj

    HIV risk! the chance to get “unlucky” and transmitted with HIV is 1/300, but because your NOT transmitted is always a TRAUMA! 2008 the english nurse Juliet Young died in AIDS after she was transmitted at her work in London about 10 years ago.Karen Daley, RN from USA was transmitted with HCV and HIV in 1999, today she is the next ANA president, her “fight” for awarness during many years is a big inspiration for me in Sweden and for us all.The risk getting transmitted with HCV is 1/30 but the risk is higher if the patient has hig virus levels and if the virus is transmitted thru skin/needle penetration or by “blood splash” to eay/cornea. In 2008 a RN in Sweden was transmitted with HCV, it only take ONE needlestick! The risk of HBV is 1/3. I say “Kill the dragon at our work”!Kaj RN Sweden.

  • Jeff

    I believe John missed the REAL point. A traffic fatality kills one person; a cop getting shot kills one person; a lightening strike kills that one person. AIDS and Hepatisis have the chance to kill dozens or hundreds. One nurse or doctor who is infected but does not know it could infect so many innocent people. It is the need to STOP the spread that is as important, maybe more so, than the individuals needs.

    John’s ignorance to the facts and his obvious bigoted hatred of all things government run (hence public service) is appalling.

    Bet he’s the first one to try and get something for free from his municipal or state gov’t, then scream that taxes go up to pay for such abuse.