This news report makes my mind boggle. Reuse of syringes? In this century?
The doctor says he was too poor to afford syringes! So reuse of syringes is the solution? Bill the cost of the syringe to the patient. Ask for donations. Do whatever it takes but never reuse a syringe. How can a doctor find reuse of syringes remotely acceptable?
The doctor says the parents of the patient were too poor to afford syringes; and the family was already starving in order to pay for the medicine.
Wouldn’t it be nice if patients could afford anything. Reality doesn’t work that way though, and some first world people just can’t imagine what real poverty is like (I can’t either).
> When Mr. Jalbani protested, he said, Mr. Ghanghro snapped at him and told him he was using an old syringe because Mr. Jalbani was too poor to pay for a new one.
> “He said, ‘If you don’t want my treatment, go to another doctor.’” Mr. Jalbani said. “My wife and I had to starve ourselves to pay for the medicine.”
I still for the life of me can't understand how anyone with any medical training at all could reuse a syringe. Some other shortcuts I could imagine, but reusing a syringe is like eventually guaranteeing this kind of outbreak.
Between this and no treatment, the choice is easy for most people. Although I do find “rummaging through the trash” for syringes astonishing. If you’re gonna reuse it, at least sterilize it (failing that, rinse it) and store it somewhere clean?
This is what I've never understood about the "you don't know poverty" argument... sure they may not have equipment but there are basic best practices that cost little more than time
Perhaps there are more people that would prefer to watch the world burn than we think
Poverty also correlates with lack of education, so there’s also that. I heard (without any verification) that until recently a large percentage of rural population in India find nothing wrong in drinking from and shitting in the same river (let’s put aside technicalities like upstream/downstream).
Because you don't know what real poverty is like (neither do I)? I remember a story from one of Atul Gawande's books (was it Complications?) about how rural Indian surgeons operate. As he described it, they were missing many kinds of equipment that western surgeons consider absolutely indispensable in doing their work. They replaced it with whatever was available, stuff like plastic piping from the nearest plumbing store, which then comes into contact with the entrails of the patient, so to speak.
(assuming the anecdote is correct) Rummaging around in the rubbish for a syringe is not about poverty, except perhaps that in real poverty you only have access to the worst doctors or none at all. Even if economics make fresh needles impossible, it takes so little effort make an attempt to sterilize that this sort of behavior is criminal. Start by not storing needles you might want to reuse in the rubbish bin and donations of scraps of wood to boil water.
That was in the book "Better". They found surgical tubing at a nearby market (not a plumbing store, presumably some sort of medical resale), and sterilized it with a steam autoclave before implanting it in a patient suffering from ... some form of meningitis, I believe?
Have you ever gotten a non-emergency medical treatment so beneficial that it was worth getting HIV in exchange? Do you know anyone who has? I wish we had medicine that amazing, but it doesn't exist.
In theory, such a treatment is possible, but in reality, they're just making everything worse.
This is a possible solution for healthcare in the first world, but not the third world.
"Affordability" makes no sense when these families (families, not individuals) are earning a few pennies a day. The only solution is to give stuff away for free at a loss. No amount of innovation or cost savings can fix the fact that people (and even institutions) cannot afford syringes.
The only real issue in the third world is none other than lack of capital generating opportunities. Anyone who has capital can participate in the global economy and fix their own problems. Anyone who has a job can perform daily labor to earn capital that can fix their problems. The people who get lost - the people stuck in the third world - are offered no opportunities that would enable them to trade their labor for capital. If there were enough of these opportunities, all of these problems would go away.
In the third world, when IVs are not available to treat dehydration, they spoon feed people water. It takes up to two hours, but it's safe and effective.
I did it once for one of my children. He was four and I didn't want him to be subjected to an IV.
Possible solutions include an oral or topical medication to replace the injected medication.
The poor in the US often also need actual affordable solutions that work. That seems to have improved some in recent years.
Money is not what matters and hasn't mattered for a long time. What matters is access to capital, governed by statistics such as credit score, which itself is affected by your mental faculty and ability to hold down a job (i.e. follow instructions, assuming you have job opportunities which are abundant in any U.S. city compared to the third world).
>According to a 2015 assessment by the U.S. Department of Housing and Urban Development, 564,708 people were homeless on a given night in the United States. At a minimum, 140,000 or 25 percent of these people were seriously mentally ill, and 250,000 or 45 percent had any mental illness.[1]
The homeless problem is a mental health problem. Sure, people can fall into hardship and get e.g. their houses foreclosed on and go bankrupt - but those same people generally are back on their feet a year or two later. Basically everyone who does not suffer from severe mental illness has the capability to raise enough capital on a monthly basis to put a roof over their heads. Now, they may have to work hard, and perhaps unreasonably hard in a sadly large amount of cases, but they can still do it and still do do it given that 99% of the country is not homeless.
No, homelessness is not (just) a mental health problem. Your own source indicates less than half of homeless people have a mental health issue and lists depression, anxiety and substance abuse as some of the mental health issues suffered by homeless individuals. All three of those can be caused or worsened by being homeless.
There are many factors that contribute to homelessness. Physical ailments can help lead to homelessness, but so can the high cost of housing:
Research by Zillow Group Inc. last year found that a 5 percent increase in rents in L.A. translates into about 2,000 more homeless people, among the highest correlations in the U.S. The median rent for a one-bedroom in the city was $2,371 in September, up 43 percent from 2010. Similarly, consultant McKinsey & Co. recently concluded that the runup in housing costs was 96 percent correlated with Seattle’s soaring homeless population. Even skeptics have come around to accepting the relationship. “I argued for a long time that the homelessness issue wasn’t due to rents,” says Joel Singer, chief executive officer of the California Association of Realtors. “I can’t argue that anymore.”
In a hard place at a push, syringes could be sterilized before reuse. Sterilization is not effective against prions but some doctors without supplies could possibly resort to it.
The story is gut wrenching. Children in poverty need free basic health services everywhere.
I think you are getting distracted. The real problem is abject poverty, and ineffective government. We could be endlessly horrified about what actually goes on in the world’s most disadvantaged places, rather than just what makes the NY Times.
I mean not exactly surprising. We literally just had a measles outbreak in Brooklyn last year. Vaccination rates are basically a prediction market on events like this happening.
My point was that the cluster of unvaccinated folks in Brooklyn shows an uptick in people betting that the risk of something like this happening surpassed the risks of measles. Many/most people in Brooklyn eventually got vaccinated after the outbreak started, showing that they weren’t philosophically opposed to vaccines, but rather were making a bet based on perceived risk.
That said, the epidemic itself is thought to have started as an offshoot of the epidemic in Israel. And right before the epidemic in Israel there was one in Pakistan, so there may be a direct connection as well.
>Health officials now say that Mr. Ghanghro is unlikely to be the sole cause of the outbreak. Visiting health workers saw many cases of doctors reusing syringes and I.V. needles. Barbers take the same razor to the faces of multiple customers, they said, and roadside dentists crack away at patients’ teeth on sidewalks with unsterilized tools.
I can't speak for their situation but the standard here is that when a barber holds up something that looks like a cut throat razor, it's a "shavette", which actually takes a disposable blade.
Same here, and I live in a poor country. First he sticks the metal tool into some liquid, to sterilize it, then opens new disposable blade in front of you and installs it to machine.
Genuine question, if the razor is soaked in barbosol(?) between uses, is it not thoroughly disinfected. Aren't most medical tools metal? If a barber used an autoclave, would it be acceptable then?
Jesus. These are the medical standards of the early 19th century. On net, it's probably better than nothing at all, but there is so much further to go.
The paragraph before was far more perplexing to me.
> The doctor recently renewed his medical certificate and now works as a general practitioner at a government hospital on the outskirts of Ratodero, despite laws that make the reuse of syringes an offense that is not eligible for bail.
So he was arrested for it, then while still not convicted, got a new certificate and is back at it?
One of my dad's first jobs out of college was designing needle-grinding machines for BD. they have a relatively complex 3-facet cutting edge, but the plastic hub allows you to accurately orient them on the grinder. I can imagine collecting, cleaning, sterilizing, and resurfacing needles could be a cottage industry in the developing world. 23G 1.5" becomes 23G 1.25", and so on.
> Health officials now say that Mr. Ghanghro is unlikely to be the sole cause of the outbreak. Visiting health workers saw many cases of doctors reusing syringes and I.V. needles. Barbers take the same razor to the faces of multiple customers, they said, and roadside dentists crack away at patients’ teeth on sidewalks with unsterilized tools.
Sounds widespread, probably not just that one man.
Likely many more than 1000 children were infected.
That said, hopefully the government of Pakistan is embarrassed enough to fund free treatment for this population. With treatment and compliance, HIV-positive people usually lead long, healthy lives.
I don't know if Pakistan really has the resources. Last I checked, they were a very young country in terms of average age of the citizens. Poverty is pretty widespread, from what I gather.
Pakistan is under developed in my opinion and only because their priorities are not focused towards making the country better but rather on political and Kashmir issues
What's (not) shocking is how stigmatized the HIV-positive population is. Authorities are literally segregating the HIV-positive children into a different side of the room from the rest.
An obvious effect of this is that people will be terrified to get tested at all, as it's all downside with the possible upside of treatment being a distant dream. And that makes it both harder to evaluate the spread of the disease, and also harder to prevent further transmission of it.
As a selfish aside, I will never get a shave from a barber who doesn't have an autoclave.
Quarantining infected people who have an incurable disease is not really that illogical when you have no medication capable of treating them.
Can you imagine if the US had done mandatory testing and quarantine all those years ago? Obviously many people would have had their rights violated to do that, but it might have stopped the disease a long time ago.
Voluntary self-quarantine clearly doesn't work.
> will be terrified to get tested at all
Or the opposite: Anyone not tested will be assumed to be infected.
> And that makes it both harder to evaluate the spread of the disease, and also harder to prevent further transmission of it.
1980's US government quarantining a huge percentage of the gay community.
The US government didn't quarantine anybody. If they had, as was done for every other fatal communicable disease for a century, hundreds of thousands of gay and other men could have been saved.
That engaging in a known risky activity is dangerous, and people shouldn't be surprised if they get affected if they willingly put themselves in such a situation.
Are you fucking serious? Fighting putting gay people in 'quarantine' camps is not tone policing. My god. You people even know this is fascist but you're advocating it anyway.
> Quarantining infected people who have an incurable disease is not really that illogical
This. We choose to do things different in the past and hide the disease. In retrospective it was a terrible mistake IMHO.
The lets call it "human rights" way focused into preserving the rights of 10.000 or 100.000 people in the 80's. This proven to be a "genocide-level" idea for Africa (and other third world countries) that toke the lifes of 35 millions of people and helped to spread the disease from 100.000 to 75 millions. Currently there are 37 millions of people alive positive for the virus, and increasing.
We could instead to have choosed the, I will call it, "fascist way". Being ruthless about forcing the diagnostised carriers to be transparent about the condition. Having zero tolerance specially to the people caught infecting deliberately other people again and again. This would made the life more difficult for many innocent people, but the new cases would had stopped suddenly overnight. The VIH would have been solved in a decade saving millions of lives past and future.
The problem was that only the first way assured the future bussiness for the companies investing lots of money for developping the cure, so there was (more than probably) a strong marketing machine to teach us that any other option is taboo and evil.
Is a huge price that we had paid for the goodism. Maybe we should start refusing to keep paying it and do something. AIDS was a "once in life" event, a disease jumping between species by mistake in 1940, and there is not any logic reason to not point all our weapons into removing it from humans once and for good.
Yes, it is. Not only that, you're conflating "people caught infecting deliberately other people" with the totality of the HIV-positive population. That is a tiny, tiny group of people.
I can't believe this shit. It's not even worth arguing against it's so fucking depraved and immoral.
Among many other issues, the world you fantasize about would result in far more cases of HIV. What actually decreased HIV transmission rates was destigmatization; more people being tested; creating a cultural norm around condom use; and new treatment regimes and adherence strategies that decrease viral load to undetectability. All three of the latter have a core dependency on destigmatization, which your proposed policy would fail miserably at.
> the world you fantasize about would result in far more cases of HIV.
I think that the opposite is infinitely more probable. Less new cases when people has the knowledge to take reasoned decisions. The right to african wifes to know that her husband has become a carrier should prevail over the right from those men to hide the disease and remain silent for convenience. African doctors should assure to inform the wife by default in their protocols, because this people have rights also, and the number of cases are all except "tiny".
Desestigmatisation is exactly the opposite to hiding the disease, that is what we really are doing (and is not working).
And I say that is not working because still there are thousands of new cases in the world each year with the difference that nobody cares yet. Young generations do not developped the danger sense about HIV that scarred older generations in 80's and 90's. Some of this adolescents are being caught in the most stupid way (And good luck telling some people that must buy and use a condom every time).
Being transparent and loyal to your partner and society about the condition is a first requisite for desestigmatisation.
Not being a fucking fascist on the Internet is better for society but look where we are?
You’re ignoring all the reasonable evidence that what you’re suggesting doesn’t fucking work. This isn’t a new idea and tons of countries would fucking love throwing HIV positive people into camps if they could get away with it.
Stop. Being. Fascist. If not, hopefully someone bashes some sense into your dense skull.
> Not being a fucking fascist on the Internet blah blah blah...
I would prefer to speak as adults. Thanks.
By the way I never talked about camps, and to call fascist to other people in a discussion currently (instead to show real counter-arguments), is a really worn out strategy and a sign of laziness. Everybody does it (and it never solved anything).
Stop being morally depraved and have some goddamn sense and maybe we can “speak as adults”. What the fuck is “rounding up all the HIV positive people” _other_ than throwing them into a camp?
I don’t have “debates” with fascists because your ideology is violent and should be met in kind. I don’t give a shit about putting my effort into my argument because you obviously don’t give a shit about basic moral decency. Fuck you.
You know what did solve things? Shooting the goddamn thugs who’s idea it was to throw HIV positive people into camps in the first place.
This is, frankly, idiotic, on moral, legal, and logistical levels.
Who is testing mandatory for? The entire population? And to be effective it'd have to be done on a quarterly basis (as that's the period of time where many tests won't detect the antibodies, and also when the virus is most communicable).
Okay, so now you identify tens of thousands of HIV positive individuals every month. What do your quarantine camps look like? How expensive are they to maintain? Are death rates lower or higher in these HIV concentration camps than in the outside world?
If this is a brilliant idea, why haven't other countries with few to no rights (e.g. Russia) implemented it to deal with their HIV crisis?
First time in hearing about a barber being able to spread HIV and my anxiety is now through the roof, having left haircuts with minor cuts from tapering my neckline etc. with no sanitization between customers whatsoever.
What is the likelihood of a barber passing an transmissible disease? Any stats? Thanks.
Unless you’re going to sketchy back alley barber shops where they’re regularly cutting you with infected blades, you’re probably fine. It’s not as easy to transmit as you may think. Did you know there’s only a 25% chance a pregnant woman with HIV will pass it on to her child? It’s less than 1% if she’s taking medication.
Also, it’s really easy to get tested for it, you could go and get checked.
Well if Pakistan were to create a sustained and irreversible environment absolutely free of terrorism, India would be very glad to export some cost-effective medical supplies to them.
Abhorable. Root cause may indeed be poverty and greed but also the uncontrolled population growth that in itself is the cause and effect of poverty.
Pakistani government (read military for all intents and purposes) is focused on concentrating wealth, power and land in the hands of generals, their children and a few land owners while the population at large is fed a steady diet of lies about enemies at the border and beyond.
This fear of others (india, isreal, america even) is used to spend and therefore siphon the resources into the pockets of powerful few. The stage is different, the story not so much.
102 comments
[ 4.1 ms ] story [ 167 ms ] threadThe doctor says he was too poor to afford syringes! So reuse of syringes is the solution? Bill the cost of the syringe to the patient. Ask for donations. Do whatever it takes but never reuse a syringe. How can a doctor find reuse of syringes remotely acceptable?
Wouldn’t it be nice if patients could afford anything. Reality doesn’t work that way though, and some first world people just can’t imagine what real poverty is like (I can’t either).
> When Mr. Jalbani protested, he said, Mr. Ghanghro snapped at him and told him he was using an old syringe because Mr. Jalbani was too poor to pay for a new one.
> “He said, ‘If you don’t want my treatment, go to another doctor.’” Mr. Jalbani said. “My wife and I had to starve ourselves to pay for the medicine.”
Perhaps there are more people that would prefer to watch the world burn than we think
In theory, such a treatment is possible, but in reality, they're just making everything worse.
What would be nice is if someone tried to find a viable solution for this issue, something that actually worked and was affordable.
"Affordability" makes no sense when these families (families, not individuals) are earning a few pennies a day. The only solution is to give stuff away for free at a loss. No amount of innovation or cost savings can fix the fact that people (and even institutions) cannot afford syringes.
The only real issue in the third world is none other than lack of capital generating opportunities. Anyone who has capital can participate in the global economy and fix their own problems. Anyone who has a job can perform daily labor to earn capital that can fix their problems. The people who get lost - the people stuck in the third world - are offered no opportunities that would enable them to trade their labor for capital. If there were enough of these opportunities, all of these problems would go away.
I did it once for one of my children. He was four and I didn't want him to be subjected to an IV.
Possible solutions include an oral or topical medication to replace the injected medication.
The poor in the US often also need actual affordable solutions that work. That seems to have improved some in recent years.
It won't exist if no one even bothers to try.
If money alone were all that mattered, you would think a country like the US wouldn't have thousands of homeless, etc.
>According to a 2015 assessment by the U.S. Department of Housing and Urban Development, 564,708 people were homeless on a given night in the United States. At a minimum, 140,000 or 25 percent of these people were seriously mentally ill, and 250,000 or 45 percent had any mental illness.[1]
The homeless problem is a mental health problem. Sure, people can fall into hardship and get e.g. their houses foreclosed on and go bankrupt - but those same people generally are back on their feet a year or two later. Basically everyone who does not suffer from severe mental illness has the capability to raise enough capital on a monthly basis to put a roof over their heads. Now, they may have to work hard, and perhaps unreasonably hard in a sadly large amount of cases, but they can still do it and still do do it given that 99% of the country is not homeless.
[1] https://www.bbrfoundation.org/blog/homelessness-and-mental-i...
There are many factors that contribute to homelessness. Physical ailments can help lead to homelessness, but so can the high cost of housing:
Research by Zillow Group Inc. last year found that a 5 percent increase in rents in L.A. translates into about 2,000 more homeless people, among the highest correlations in the U.S. The median rent for a one-bedroom in the city was $2,371 in September, up 43 percent from 2010. Similarly, consultant McKinsey & Co. recently concluded that the runup in housing costs was 96 percent correlated with Seattle’s soaring homeless population. Even skeptics have come around to accepting the relationship. “I argued for a long time that the homelessness issue wasn’t due to rents,” says Joel Singer, chief executive officer of the California Association of Realtors. “I can’t argue that anymore.”
https://www.bloomberg.com/news/features/2018-11-20/the-homel...
The story is gut wrenching. Children in poverty need free basic health services everywhere.
Compare that with $300 USD to see my GP for fifteen minutes...
That said, the epidemic itself is thought to have started as an offshoot of the epidemic in Israel. And right before the epidemic in Israel there was one in Pakistan, so there may be a direct connection as well.
He's always a little puzzled when I'm "no thanks" to the razor.
I've never seen a barber with an autoclave for cleaning his equipment.
If I trusted that the autoclave was properly used, of course. Same as the dentist.
So far they have always put on a new razor without asking.
10 cents for a blade. I'm sure in Melbourne they can afford it.
At their wages reusing duller blades would cost them more in lost time.
There's also no evidence anyone has gotten HIV from a razor or it's really possible.
> The doctor recently renewed his medical certificate and now works as a general practitioner at a government hospital on the outskirts of Ratodero, despite laws that make the reuse of syringes an offense that is not eligible for bail.
So he was arrested for it, then while still not convicted, got a new certificate and is back at it?
https://www.google.com/search?q=micrograph+of+hypodermic+nee...
https://www.ncbi.nlm.nih.gov/pubmed/2773053
A sobering reminder that our problems are, almost always, nothing in comparison.
Sounds widespread, probably not just that one man.
That said, hopefully the government of Pakistan is embarrassed enough to fund free treatment for this population. With treatment and compliance, HIV-positive people usually lead long, healthy lives.
A single individual from a developed country could help pay for some as basic as discardable syringes for a whole town.
An obvious effect of this is that people will be terrified to get tested at all, as it's all downside with the possible upside of treatment being a distant dream. And that makes it both harder to evaluate the spread of the disease, and also harder to prevent further transmission of it.
As a selfish aside, I will never get a shave from a barber who doesn't have an autoclave.
Can you imagine if the US had done mandatory testing and quarantine all those years ago? Obviously many people would have had their rights violated to do that, but it might have stopped the disease a long time ago.
Voluntary self-quarantine clearly doesn't work.
> will be terrified to get tested at all
Or the opposite: Anyone not tested will be assumed to be infected.
> And that makes it both harder to evaluate the spread of the disease, and also harder to prevent further transmission of it.
Not if you have mandatory testing.
HIV is not easy to communicate to other people. Education and PrEP have reduced the problem immensely.
> many people would have had their rights violated
The worst part about you is that you fucking know this is wrong but you're making it out like a 'rational' decision. That's straight nazi shit.
Sorry for the misunderstanding. I just feel like I’m taking crazy pills reading these comments.
This. We choose to do things different in the past and hide the disease. In retrospective it was a terrible mistake IMHO.
The lets call it "human rights" way focused into preserving the rights of 10.000 or 100.000 people in the 80's. This proven to be a "genocide-level" idea for Africa (and other third world countries) that toke the lifes of 35 millions of people and helped to spread the disease from 100.000 to 75 millions. Currently there are 37 millions of people alive positive for the virus, and increasing.
We could instead to have choosed the, I will call it, "fascist way". Being ruthless about forcing the diagnostised carriers to be transparent about the condition. Having zero tolerance specially to the people caught infecting deliberately other people again and again. This would made the life more difficult for many innocent people, but the new cases would had stopped suddenly overnight. The VIH would have been solved in a decade saving millions of lives past and future.
The problem was that only the first way assured the future bussiness for the companies investing lots of money for developping the cure, so there was (more than probably) a strong marketing machine to teach us that any other option is taboo and evil.
Is a huge price that we had paid for the goodism. Maybe we should start refusing to keep paying it and do something. AIDS was a "once in life" event, a disease jumping between species by mistake in 1940, and there is not any logic reason to not point all our weapons into removing it from humans once and for good.
Yes, it is. Not only that, you're conflating "people caught infecting deliberately other people" with the totality of the HIV-positive population. That is a tiny, tiny group of people.
I can't believe this shit. It's not even worth arguing against it's so fucking depraved and immoral.
Nope. I'm not saying that. Read my post again
I think that the opposite is infinitely more probable. Less new cases when people has the knowledge to take reasoned decisions. The right to african wifes to know that her husband has become a carrier should prevail over the right from those men to hide the disease and remain silent for convenience. African doctors should assure to inform the wife by default in their protocols, because this people have rights also, and the number of cases are all except "tiny".
Desestigmatisation is exactly the opposite to hiding the disease, that is what we really are doing (and is not working).
And I say that is not working because still there are thousands of new cases in the world each year with the difference that nobody cares yet. Young generations do not developped the danger sense about HIV that scarred older generations in 80's and 90's. Some of this adolescents are being caught in the most stupid way (And good luck telling some people that must buy and use a condom every time).
Being transparent and loyal to your partner and society about the condition is a first requisite for desestigmatisation.
You’re ignoring all the reasonable evidence that what you’re suggesting doesn’t fucking work. This isn’t a new idea and tons of countries would fucking love throwing HIV positive people into camps if they could get away with it.
Stop. Being. Fascist. If not, hopefully someone bashes some sense into your dense skull.
I would prefer to speak as adults. Thanks.
By the way I never talked about camps, and to call fascist to other people in a discussion currently (instead to show real counter-arguments), is a really worn out strategy and a sign of laziness. Everybody does it (and it never solved anything).
I don’t have “debates” with fascists because your ideology is violent and should be met in kind. I don’t give a shit about putting my effort into my argument because you obviously don’t give a shit about basic moral decency. Fuck you.
You know what did solve things? Shooting the goddamn thugs who’s idea it was to throw HIV positive people into camps in the first place.
> and to call fascist to other people in a discussion
Your words.
You should really have a long hard think about what you're saying. What you are proposing is utterly disgusting.
Who is testing mandatory for? The entire population? And to be effective it'd have to be done on a quarterly basis (as that's the period of time where many tests won't detect the antibodies, and also when the virus is most communicable).
Okay, so now you identify tens of thousands of HIV positive individuals every month. What do your quarantine camps look like? How expensive are they to maintain? Are death rates lower or higher in these HIV concentration camps than in the outside world?
If this is a brilliant idea, why haven't other countries with few to no rights (e.g. Russia) implemented it to deal with their HIV crisis?
What is the likelihood of a barber passing an transmissible disease? Any stats? Thanks.
Also, it’s really easy to get tested for it, you could go and get checked.
Not to mention all the F-16s and Mirage fighters etc costing like $20 million each
https://en.wikipedia.org/wiki/Pakistan_Army#Corporate_and_bu...
https://foreignpolicy.com/2019/03/21/poor-nation-rich-army/
Pakistani government (read military for all intents and purposes) is focused on concentrating wealth, power and land in the hands of generals, their children and a few land owners while the population at large is fed a steady diet of lies about enemies at the border and beyond.
This fear of others (india, isreal, america even) is used to spend and therefore siphon the resources into the pockets of powerful few. The stage is different, the story not so much.