M203 Diary

Wednesday, June 20, 2007

Of condoms, lipstick, and other related products.

Among other exciting trivia, I learnt from my O&G attachment that condoms, as latex-based products, were rendered fairly useless by oil. Which is food for thought - and I don't mean the strawberry-flavoured-condom-type food, either - considering oil is the base for quite a number of lubricants products, such as Vaseline, aromatherapy oils, baby oil...

And, as I recently found out, lipstick.

As part of my Psychiatry Special Study Module, I got to spend 1 afternoon with Southampton's mobile needle-exchange team. The team goes around Southampton in a van, picking up used needles (or "pins", as they call it), and distributing fresh ones to drug-addicts, so that they do not share needles. Most of you would probably know that this is harm-reduction, aimed at reducing harm related to needle-use, such as blood-borne diseases.


















This is one of the team-members, doing a mock heroin cook-up for me. The kit comes with a needle, syringe, alcohol swab, a filter through which to draw up the heroin, and even a little tin-foil container. Apparently, the dirty spoons, which addicts tend to use, can be a source of infection as well.


















Seriously, the van was like the Weasley's tent in Harry Potter & the Goblet of Fire; looks like a regular, white, standard-sized van from outside, but inside...
There were plush sofas on either side, built-in cupboards with needles, condoms, a notice-board, a rack of leaflets, a sink, and even a COOKER!


















Drawing up the cooked "heroin" through a filter, to prevent sand, and other grit from entering the needle, and subsequently entering the bloodstream.


It is not just about preventing the spread of hepatitis B, C and AIDS; the van also hands out leaflets with pictures of the leg, in order to teaching drug-addicts the exact location to inject the drug right into the femoral vein, as opposed to nicking the artery, nerve, or giving themselves a groin-abcess from infection. (All of which are nasty things; in case you couldn't tell from my tone.)

I remember when the needle-exchange programme was implemented in Malaysia, and the subsequent furore that arose:

"You are encouraging them to keep taking drugs! And encouraging other people to try, also! Somemore, using our money!"

And indeed, it was an about-face on the part of the government. First, the government labels drug-addicts "sampah masyarakat" on the back of the Moral textbooks, and suddenly the government wants to help them?

What I had not realised then, but have realised now, is that it is not called a drug-ADDICTION for nothing. That it is an uncontrolled, chronic compulsion for the drug, made worse by changes in the brain wrought by the drug, which further fuels the addiction.

It's a vicious, vicious cycle.


That afternoon, a lady came onto the van. She had been sexually-abused as a child, ran away, got involved with drugs. She prostituted herself to men, in exchange for drugs, or a floor to sleep on. A few years ago, 3 men picked her up, drove her to an abandoned area, gang-raped & beat her, threw her out of the moving car as they drove back, and literally, left her for dead. When I saw her, she was depressed. Terrified, because she would have to face the men in court to testify against them. Still living on the streets. Still on drugs.

She was trying to kick the habit, trying to sort out a proper place to stay, and she needed out help filling-in the relevant forms. When everything was done, she asked for a fresh supply of needles, and condoms. She needed the latter because she was still prostituting herself to support her drug-habit.

After giving her 2 full bags, one of the team-members said, "Do you know, lipstick dissolves condoms? So, if you're going to give a job to a man, make sure you get a new one on before you do it proper. If you don't, you could still get a disease."

"Really?"

"Yep, I just read it in a paper a few months ago."

"Cheers for telling me that. I'll remember next time."

As the van door closed behind C, my team-coordinator turned to me, and said,

"How can anyone say that it is not a drug ADDICTION? I defy anyone, anyone, who would choose to live the way C is living now."
"I thought, the reason I could not kick my addiction was because I did not have enough willpower. Now, I understand that it was not just because I was weak; the drug itself made it difficult for me to stop, and that is why I needed so much help."

- Former heroin-addict.

Take-home messages?

1) Drug addiction IS an addiction.
2) Lipstick, and other oil-based products, dissolves condoms.

Random picture:



















Femidom. A female condom made of plastic, used to cover the whole of the vagina. In the words of the sexual health nurse, "These are being phased out now, because as you can imagine, they are rather unpopular."

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Monday, June 04, 2007

Diagnosis Wenckebach

I know I rarely post here, but since this will be my first blog post in over a year, here is something for you medical students who are studying ECG. Enjoy. :)

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