Dave Trott: First do no harm

Marc Koska is not a doctor, yet he's saved nine million lives.

How did he do that?

He did it by preventing doctors doing what they see as their job.

But how can that be a good thing, isn’t that harmful?

No because, amazingly, fatal diseases are being spread by doctors.

He’s preventing a great deal of that.

This didn’t happen back in history, this is happening right now.

Doctors are transmitting fatal diseases by re-using and recycling hypodermic syringes.

In India and Africa the scale of the problem is vast.

Every year 23 million cases of hepatitis are transmitted via re-used syringes.

Every year 300,000 cases of HIV are transferred via re-used syringes.

Koska secretly filmed a hospital where forty patients were given injections from just two needles; whatever disease anyone had was passed along to the rest.

Koska secretly filmed doctors injecting patients suffering from syphilis and HIV, then immediately using the same needle to inject babies and small children.

Nurses tell Koska their hospital routinely uses each needle on thirty to forty patients a day.

Then it’s washed in the same luke-warm soapy water as all the other needles and they’re all used again tomorrow.

Koska has invented a way to stop this happening.

He’s invented the single-use hypodermic syringe.

It’s made on exactly the same machine as ordinary syringes but after one use the plunger breaks off and it can’t be re-used.

It costs 5 cents.

The World Health Organisation estimate it’s saved nine million lives.

The problem is it seems a waste to throw away a syringe.

To doctors a needle is just a way to deliver medicine.

They don’t understand washing and re-using a syringe is doing more harm than good.

Hospital authorities estimate single-use syringes cut an average 60 per cent off the time patients spend in hospital.

So every $1 spent on these syringes saves $200 in hospital costs.

But in India, when 495 people contracted hepatitis, the government spent $150,000 on mass vaccinations.

Each vaccination cost twenty times as much as a disposable syringe.

But 92 people died because the government saved money by re-using and recycling their hypodermic syringes.

And yet in India a bottle of Coke costs 50 cents, the same as ten single-use syringes.

The problem is that doctors have a high-status occupation.

They’ve had many years of training.

They’ve learnt to recognise the symptoms of many diseases.

They know the names of all the medicines available.

They can’t be bothered with something as trivial as needles.

How the right medicine gets into the patient is a trivial concern.

So the doctors concentrate on the complicated part of their job and ignore the simple part.

Because humans are always attracted to a complicated solution.

The more complicated it is, the better it must be.

We are all susceptible to that.

And, like the doctors, we ignore the simple solution and are seduced by the most complicated explanation available.

Which is why, like those doctors, most of what we do doesn’t work.


We never learn: simple works, complicated doesn’t.