The origin of this post comes from the concerns over the deficient universal precaution practices and instrument sterilization in emergency departments at government hospitals. In the course of my education and career, I have worked/ observed the practices in quite a few government hospitals across India.

I am currently working at a government hospital in Tamil Nadu. As a part of my job I am regularly posted in the emergency department of the  hospital where we are supposed to see the trauma patients.

My hospital is a mid sized tertiary care government hospital. Our emergency department gets around 50-100 patients/day with varying degrees of trauma. The majority of cases(50-60%) come with minor lacerations which need to be sutured, after doing the math it comes to around 25-50 patients per day of cases for whom we do suturing and dressing. Whereas there are larger hospitals which get 3-4 times of the above numbers daily. So you can just get an idea of the big number of patients that visit the emergency departments of government hospitals for outpatient emergency care everyday.

But speaking of the supplies of few basic things required for suturing wounds like sterile gloves, suture materials, sterile suturing instruments and dressing materials; many a times we are forced to follow practices which may possibly directly contribute to spread of communicable diseases such as HIV and Hepatitis B.

I am sure if you have ever worked in a government hospital emergency department/ casualty in India you will agree that sterile gloves, sterile instruments and sterile dressing materials are considered a luxury and are always in short supply. Ever heard somebody asking you to complete 6 debridements /dressings with 3 gloves? This is a common argument given for not wasting the [disposable] sterile gloves!

Being publicly funded and providing crucial healthcare free of cost, I am aware that there is not much you can ask for in a government setup. But cutting upon the basics is definitely a thing to worry about, both from patient and healthcare provider perspective. On one hand, the patients come to the hospital to be cured and not to get infected with another unrelated disease. While on the other hand, it is the front line healthcare providers who put their life at risk just because of unavailability of basic supplies such as soap for hand wash and gloves for  patient/ self protection.

Will end this blog post with a question: Is your hospital emergency department actually one of the factors contributing to the incidence of HIV and other blood borne communicable diseases?

If you are an administrator or a decision maker in any of the government hospital in India, it is the time for a little introspection and action.