Children are paying for HIV outbreaks in Pakistan

by Ashraf KHAN / AFP

Since his son was diagnosed with HIV when an outbreak occurred between an infant and a child in Pakistan, the stubborn Shahzado Shar has often been forced to choose between food and medicine. ..

His five-year-old was one of hundreds who tested positive after a whistleblower doctor revealed a scandal about needle reuse in southern Sindh in 2019.

According to state health ministry data, the number of patients has grown rapidly, exceeding 1,500 two years later.

Pakistan’s largest HIV testing and treatment center was set up in the rural town of Rota de Ro in the wake of the disaster and provided life-saving antiretroviral drugs.

However, affected families must bear the additional costs associated with the illness itself.

“I’ve been told to go to a private hospital for more tests, but I don’t have enough money,” Shah told AFP, and his son suffers from regular fever, abdominal pain, and kidney pain. I explained the situation.

Even in the small village of Subani Shar, just a few kilometers from Rato Dero, about 30 other children are HIV-positive.

Pakistan’s public hospitals are mostly in urban areas, often chaotic and inefficient, and rural families rarely rely on private hospitals full of unlicensed doctors.

Fatima Mir, a pediatrician at Agha Khan University in Karachi, who analyzed the data, said at least 50 children had died since she was diagnosed.

Authorities accused one doctor, a popular pediatrician in Rato Dero, of causing the outbreak.

Muzaffar Ghangro is currently on bail, and court hearings have been repeatedly postponed, causing anger for many families.

He denied the accusations imposed on him and said that his practice was so successful that other doctors put him in fashion.

“Ruthless” medical malpractice

In poverty-stricken Pakistan, infection control is inadequate and doctors often reuse medical devices to reduce costs.

Doctors who first exposed Sind’s dirty needle scandal say they haven’t changed much since 2019.

“The situation is as bad as it was when it happened,” said whistleblower Imran Akbar Albani, who called domestic malpractice “ruthless.”

Arbani brought his data on outbreaks to the local media after discovering a surprising number of HIV-infected babies at Rato Dero, where he runs a private clinic.

He said authorities responded swiftly at that time, but then the discipline failed.

“For the first three months, quackery and unauthorized practitioners were banned and clinics were closed, but then permission was obtained,” he said.

Rafik Hanani, a doctor and chairman of the Pakistan Infectious Diseases Association, said the regulation was ineffective or routinely ignored.

“Regulatory departments exist only in documents and offices … in fact, they are not effective.”

Following the scandal, the government banned the import of traditional syringes and demanded only disposable self-locking needles that could not be relocated.

But Sindh health officials, who don’t want to be named, told AFP that many doctors have evaded the ban and are still buying cheaper models.

“We are destined”

At Rato Dero’s HIV Testing and Treatment Center, patients sit facing the TV screen and provide medical advice in their local Sindhi language.

A frail 20-year-old man sits quietly with his father waiting for the results of a rapid HIV test.

Pediatrics expert Fatima Mir said the successful mass test was able to identify the victims of the crisis and delay subsequent infections.

But Pakistan now needs to go beyond important anti-retroviral drugs to provide more comprehensive care to patients, Aisha Isani Magade, head of the government’s national AIDS control program, told AFP. Was.

As the sun set in the suburbs, a mother sat down with her daughter draped on her lap and regained her fever.

Hakima Shar says she may forget to give a 4-year-old child a drug that controls the virus and prevents subsequent infections.

“We are very poor … I wake up in the sun and start working, so is there anyone else who gives her medicine on a regular basis?” Said a 25-year-old mother who was also infected with the virus.

Many families had never heard of HIV, but HIV now dominates their lives.

“The government doesn’t provide us with antibiotics or multivitamins and we can’t afford to buy them ourselves,” she said.

“We are destined.”