Download JULY Inquiry into hospital `error` proceeds KARACHI, June 30

JULY
Inquiry into hospital ‘error’ proceeds
KARACHI, June 30: Although an inquiry committee has been constituted by the Sindh health minister to look into the
administration of an allegedly wrong injection to an engineering university student, who has been in a coma for a week,
there is almost no chance of any drastic and direct action being taken by the government against the responsible staff or
management of the private hospital concerned.
The patient, Raheel Naeem, an engineering student, was admitted to a hospital in PECHS and operated upon for the
treatment of a sinus and respiratory problem on June 12. He went into a coma during post-surgery treatment.
A Sindh health department notification issued on Sunday (June 29) said that the government had constituted the inquiry
committee headed by Special Health Secretary Dr Abdul Majid (chairman), and comprising EDO Health Dr A.D. Sajnani
(member/convener) and THO Jamshed Town Dr Malika Jaffery (member). The committee would conduct an inquiry
regarding the patient, Raheel Naeem, son of Abdul Naeem, operated at the trauma centre who had gone into a coma after
undergoing a surgery, it added.
The committee is required to fix the responsibility for the gravity of fault, and submit its report on June 30, positively, said a
source.
It is learnt that the committee had already started its task and visited the patient, who at the moment is under treatment at
another private hospital. The committee also visited the administration and medical personnel of the trauma centre on
Monday. The committee has started to interview the hospital’s staff members concerned (including nurses, who have been
placed under suspension), anaesthetist, OT and ICU staff, doctors and pharmacy staff.
Mr Naeem, the patient’s father, told Dawn on Monday evening that he was not satisfied with the attitude of the trauma
centre management and was left with no choice but to pray for a new lease of new life to his young and talented son.
“They have not contacted me since shifting my son to another private hospital where, after a gap of one day, he has again
been put on ventilators,” Mr Naeem added, saying that they (staff at the trauma centre) appeared “careless, inept and
short of ethics”.
Alleging that a wrong injection had caused damage to his son’s brain, he claimed that the errant hospital personnel
maintained that “such mistakes do occur at hospitals”.
(By Mukhtar Alam, Dawn-15, 01/07/2009)
Painful hours
KARACHI: The room in an old style building where several youths and children were lying on beds with blood bags
hanging from stands was quite an emotional sight.
They were all thalassaemic patients registered with a famous blood bank of the city, the Husaini Blood Bank.
Sunil Kumar was one of them. His mother had tied a leather amulet
around his neck to bless the poor soul but even this maternal
gesture couldn’t save him from his troubles.
His parents took him to India, Italy and other countries for a bone
marrow transplantation, but had not found a matching donor.
He regularly visits Karachi from his village. “I am really tired of the
disease, and find it very hard to live with it... sometime I feel that I
was born just for a blood transfusion after every week,” he said.
Resident of a small traditional village Badah in district Larkana, Sunil
is 20 years old but appears to be only 10, as the disease did not
allow him to grow properly. He wanted to be a cricketer, but the physical weakness due to thalassaemia has crushed his
dreams.
Not only Sunil, but almost everyone in the room seemed sad and tired. The blood bank’s administration has kept a
television in the room for their entertainment, but the long hours of blood transfusion are too much for the youths and
children. Husaini Blood Bank is a famous philanthropist society working in the city since 1979 and it has treated millions of
the thalassaemic patients from across Sindh and Balochistan. At this time about 1,170 patients including 780 thalassaemic
patients and 490 patients of hemophilia from across the province are registered with Husaini Blood Bank and these
patients regularly receive blood, food, hospital services and even the transport fair to come from their villages.
Thalassaemia is an inherited blood disorder and can be simply stated as the inability of the body to produce adequate
amount of heamoglobin in the red blood cells. The result is severe anemia.
Thalassaemia Foundation Pakistan Vice-President Dr. S Sarfaraz H Jafry said that the number of thalassaemic patients in
Pakistan has increased alarmingly. Quoting the official data of 36 registered thalassaemic societies of Pakistan, he said up
till now, 60,000 patients were reported, out of which only 24,000 patients were officially registered. “For such large number
of patients, the country needs about 73,000 blood pints every day, but unfortunately Pakistan collects only 5,000 pints a
day and the remaining patients have to suffer the shortfall,” he said.
Dr Jafry also works as the project director of Husaini Blood Bank. He said most of the people in Pakistan are poor and if a
child is born with this disease, the parents have to pay at least Rs 50, 000 annually for the normal treatment of the child.
Qamarunisa, 20, resident of Malir is also a thalassaemic patient and was registered with Husaini Blood Bank eight years
ago. “I visit Husaini Blood Bank three to four times a month and receive blood transfusion, food and medicines...my two
sisters died of thalassaemia and ever since, I am really afraid of the disease,” she said.
“In order to protect Pakistan from thalassaemia, the federal government must make legal amendments and ensure that
every couple has to undergo a blood test before marriage,” Dr Saeed Ahmed, the city’s leading heamatologist and blood
bank consultant, said.
He said that that government also must ensure that the blood group of an individual is mentioned on the national identity
card, so that in case of an accident, the treatment could be started immediately, and also rare blood groups could be
arranged.
“We are trying to provide the best services for thalassaemic patients and we have the most modern equipment in our
laboratory,” said Husaini Blood Bank CEO Asad Ali.
(By Amar Guriro, DailyTimes-B1, 02/07/2009)
PMA urges withdrawal of service charges at hospitals
KARACHI, July 2: The Pakistan Medical Association has appealed to the Sindh government to reverse its decision to
impose “service charges” on essential healthcare facilities availed by patients at public sector hospitals.
PMA president Dr Aziz Khan Tank and other office-bearers of the PMA, Karachi, at a press conference on Thursday, said
the decision amounted to pushing the poor sections of society towards quacks.
At the press conference, copies of a Sindh Health Department circular, dated June 9, were given to the journalists
according to which all executive district officers for health and medical superintendents of the hospitals owned by the
provincial government were directed to collect “users charges” from OPD patients for X-rays, ultrasound and all
investigations.
Patients visiting the department of dentistry will no longer be entitled to avail free scaling and filling services while those
visiting the eye department will have to pay for laser-based interventions.
Rs50 will have to be paid for spectacles, previously available free at a few government hospitals, including the Civil
Hospital Karachi, through an arrangement with local philanthropists.
“We fail to understand as to why poor patients have to be taxed despite the presence of NGOs and philanthropists
assisting hospitals to have these facilities,” said Dr Samrina Hashmi.
The PMA office-bearers also registered their concern, saying that under the notification the money collected as users
charges would be distributed among doctors, paramedics, health-care committee/hospital/NGO and government treasury.
According to the formula, 10 per cent each would be given to the doctors and the paramedics, 30 per cent would be
deposited in the government treasury and 50 per cent with the health-welfare committee, or hospitals or NGOs. They
feared that this would open a new avenue of corruption at the expense of poor patients.Dr Hashmi appealed to the Sindh
government to look into the issue as this might be part of the scheme to malign the democratic government.
Dr Mehmood Khan raised the issue of unilateral imposition of a fee schedule on private hospitals and clinics, without
taking into confidence all the stakeholders.
This, he said, would again make citizens an easy prey for quacks and the brunt would be borne only by them in the
absence of a proper mechanism.
Dr Tank referred to a draft prepared by the PMA to regulate private health-care facilities in 2006-2007 and presented to
the government. “It has, however, been lying with the assembly for long,” said the PMA’s Karachi chapter president.
The PMA office-bearers observed that concerted efforts were required on part of the masses, professionals, activists and
civil society to persuade policy-makers to adopt a realistic approach.
(Dawn-13, 03/07/2009)
Indian doctor gives lease of life to Pakistani child
Six months have passed since Syed Saadat Ali and his wife returned from India after a successful open-heart surgery of
their son, Syed Raahim, who will soon be celebrating his first birthday. As the critical phase of Raahim’s recovery is over,
the couple – who had earlier been avoiding the media – believe that they are in a better position to discuss their case
now.
Ali and his wife, Nadia, travelled to India in December last year, a month after the Mumbai attack soured relations between
India and Pakistan. However, that did not deter the couple from visiting the country, especially after they received a
positive response from Dr Rajesh Sharma of Escorts Heart Institute in New Delhi, who was willing to offer his services to
them.
Raahim had been suffering from a rare congenital heart disorder that obstructed blood flow to the infant’s heart, making it
difficult for him to breathe. Due to the lack of the required surgery facilities in Pakistan, the couple decided to go to India,
but said that they were disappointed that this suggestion came from a friend, and not from local doctors who were
handling Raahim’s case.
“Raahim suffered from shortness of breath since the day he was born and had the ‘Blue Baby’ syndrome in which his skin
would turn bluish or purplish due to lack of oxygen, but even doctors at one of the most leading hospitals of the city could
not understand what was wrong,” said Ali, during an interview with The News at his residence in Nazimabad.
According to doctors, about one out of every 1,000 live-born babies is born with a congenital heart defect in which the
major blood vessels of the heart either do not function properly or are not formed during the early stages of fetal
development. “In Raahim’s case, his vessels had not been formed,” informed Nadia.
“We were asked to take one test after the other along with an ECG, but none of the doctors here could understand what
the complication was and were hesitant to operate. We also took his reports to the Aga Khan University Hospital (AKUH),
where doctors agreed to perform a surgery but failed to satisfy us when we asked about its success rate.”
Ali then sought a second opinion from a doctor in India, as suggested by his close friend and within a day received a
response from a doctor at one of the leading cardiac hospitals in India. Despite the talk of war and blame game between
the governments of Pakistan and India, they decided to fly and save Raahim before it was too late. Unlike a regular visitor,
Saadat and Nadia Ali were soon issued a visa on medical grounds.
“Our governments may have their differences, but once we stepped into India and interacted with the common man, each
one of them welcomed us with open arms,” recalled Nadia. In fact, not only did they open their doors for us, but also their
pockets to save Raahim’s life, added the father. The cost of the total surgery amounted upto Rs0.65 million, most of which
was borne by the hospital trust. “This financial exemption came as a surprise because we could not afford it. For a while,
we had lost hope.”
During their month-long stay in the country and frequent visits to the hospital, Nadia said that she was most touched by
the support and respect they got in their times of adversity. “From the staff to the common visitor at the hospital, everyone
gave us special treatment because we were from Pakistan. This just tells you how political or religious differences never
trickle down to the common man, no matter how hard the government or media in both the countries try. Like us, we want
more families in Pakistan to benefit from the medical community across the border”, the couple said.
(By Aroosa Masroor, The News-13, 03/07/2009)
PMA opposes service charges in govt hospitals
KARACHI: Pakistan Medical Association (PMA) on Thursday rejected the government’s decision to apply service charges
to patients visiting government hospitals for treatment.
PMA President Dr Aziz Khan Khatak, PMA Karachi General Secretary Dr Samrna Hashmi, and Joint Secretary Dr
Mehmood, at a joint press conference at the Karachi Press Club, expressed concern on the imposition of ‘user charges’
on OPD patients for x-rays, ultrasound, and other medical services at public sector hospitals.
They said that according to a letter issued by the health department, the medical superintendents, civil surgeons and
directors of hospital would decide the modalities and collection method of these charges.
While adding that the letter stated that 10 percent of the collected amount would be given to doctors, 10 percent to
paramedics, while 30 percent of the amount would be deposited in the government’s treasury. The remaining 50 percent
would be given to hospital health welfare committees and related NGOs.
They said these directives have been sent to all public sector hospitals. They were enraged and questioned the
government’s interference, saying that when doctors, paramedics and other staff, besides medical associations and
philanthropists are serving the people free of charge at government hospitals, why is the government changing the
system.
They said it is already difficult for the poor and middle social classes to survive when the prices are skyrocketing, and
inflation knows no bounds. They demanded to know what health provisions is the government providing to the masses.
They asserted that health care facilities are one of the fundamental rights of people and it should be given to them free of
cost.
They went on to lament about the imposition of the fee schedule on private hospitals and clinics, which was decided
unilaterally without taking the stakeholders into confidence.
They said that this decision would result in extra fee burden on the patients, especially those who are not well off. Private
hospitals are already shouldering the burden of high electricity tariffs, gas bills, which they do not want to pass on to the
patients but the government is pushing them to do so, they regretted.
They added that there is no clarification regarding the monitoring system, which would open a new Pandora box of
corruption.
They said that PMA wants the government to take all stakeholders, associations of private hospitals, journalists and
citizens into confidence and the whole process should be transparent and accountable.
Meanwhile, Sindh Minister for Health Dr Sagheer Ahmed has said that ‘user charges’ on conducting tests of patients in
government hospitals from June 10, 2009 is aimed at ensuring provision of chemicals for X-Ray films other medical tests.
In a statement, Sagheer said such kind charges had also been enforced for conducting tests in past, adding but now some
people and organisations are raising voice against it, adding they are misguiding the patients.
He said that hospitalised patients and patients coming in the emergency ward as well the poor would be exempted from
such charges.
(DailyTimes-B1, 03/07/2009)
‘Wrong injection administered’
Probe puts blame on trauma centre
KARACHI, July 4: The preliminary report of an inquiry into the alleged ineptness of medical staff at a PECHS healthcare
facility says that the resuscitation of an engineering university student could not be conducted in a timely manner as the
private hospital did not have an instantaneous supply of oxygen and two of the relevant medicines.
The student has been in a coma for the last three weeks due to the alleged administration of “the wrong injection” after
undergoing “minor surgery”.
The inquiry is being conducted by senior doctors and government health officials.
According to the inquiry officers, the severe repercussions of the incorrect administration of ‘Aquran’ to the 20-year-old
student, Raheel Naeem, son of Abdul Naeem, could have been averted if the doctors attending to patients on emergency
calls were provided with the required life-support facilities and emergency medicines on demand.
A doctor started resuscitation when the patient had completely collapsed (cyanosed with no cardiac sound) but that too
without an oxygen cylinder, ambo bag, injections like Atropine, Solucartef and adrenaline, the officials found.
The oxygen and medicines in question were not available on the floor where Mr Naeem was being treated. Later, the
oxygen was collected from the emergency department and medicines from a sub-store located on some other floor, but by
that time it was too late to slow the process of muscle paralysis and brain hypoxia, the inquiry doctors have noted,
according to a source privy to the fact-finding exercise.
As the Sindh government currently has no legislation under which to take direct action against the doctors or the private
medical establishment involved, the Sindh health secretary had the inquiry committee constituted to probe the matter. It is
headed by Special Health Secretary Dr Abdul Majid (chairman), and comprises EDO Health Dr A.D. Sajnani
(member/convener) and THO Jamshed Town Dr Malika Jaffery (member). The patient, Raheel Naeem, was admitted to a
trauma centre located in PECHS on June 10, with no co-morbids, and was operated on by an ENT specialist for an SMR
problem on June 12.
Referring to post surgery developments, the doctors in their report said that the patient was stable at the time of shifting to
the room and injections such as Augumentin, Transimine, Toradol and Indent were procured from the sub-store.
The person in charge of the sub-store, not a qualified pharmacist, handed over the medicines, including the injection
Aquran, instead of Transimine, in a plastic bag.
The inquiry report states that the unfortunate incident took place due to the negligence of three people: the person in
charge of the sub-store, a staff nurse and a midwife.
The hospital had also been held responsible for employing unsuitable people in their medical store, and also for failing to
ensure the availability of an oxygen cylinder and required medicines on the same floor.
Government’s hands are tied
A detailed report, including recommendations, will be submitted shortly, but according to sources in the health department
there is almost no chance of any drastic or direct action against the management of the private hospital concerned.
It is up to the patient’s family members and Pakistan Steel, the company for which Abdul Naeem works and which
provides health cover to his family, to go to the police and lodge a case of criminal negligence, as there is no regulatory
law that authorises the health department to initiate any drastic action against the private hospital on its own, said the
source.An official of the department said that people’s concerns were growing over the quality of service and the practices
of private sector hospitals in the city and some other parts of the province, as there are no legal provisions for regulating
healthcare institutions and make them answerable for any negligence or unethical practices.
In recent months, the federal and provincial health ministers have repeatedly underlined the need for regulating the
business of private hospitals, clinics and diagnostic centres, pledging that the government will enact a set of laws
exclusively for the purpose very soon. Their efforts came amid growing public concern that no concept of patients’ rights
exists in the country.
However, no one in power seemed interested in providing relief to the public, said a source, adding that the maximum the
health department could propose to the Pakistan Medical and Dental Council (PMDC) or the Pakistan Nursing Council
(PNC) after receiving the inquiry report would be suspension of the registration of the doctors or nursing staff concerned,
as the case may be.
Negligence resulting in a patient’s death, unjustifiably high cost of treatment, excessive hospital charges or unnecessary
removal of a patient’s organ(s) are all tantamount to criminal acts and such complaints against hospitals’ managements or
medical and other staff are reported very often. However, the health department does not have the authority to lodge a
case with police, said a senior health official, requesting anonymity.
Hospitals sometimes enter into negotiations with the aggrieved party in cases of alleged malpractice, with offers made for
compensation to be paid in various ways. In the absence of any regulatory system, the official added, this seems to be the
most that could come from the inquiry report.
It was further learnt that an ordinance for accreditation and regulation of private hospitals was drafted by the health
department, vetted by the law department and finally endorsed by the chief minister about three years ago, but its
promulgation is still hindered by influential owners of hospitals and diagnostic centres.
Mr Naeem is currently admitted to a different hospital, where he has been taken off the ventilator. His doctors say that his
condition is “relatively good”.
(By Mukhtar Alam, Dawn-13, 05/07/2009)
CHK’s centre helps infected couples have HIV-free births
KARACHI, July 5: Happiness and gratitude filled the souls of Hassan and his wife Afshan when they celebrated the first
birthday of their son Usman recently. The day reminded them of the turbulent moments they had spent together, worrying
about the risks to their health as well as to their unborn child.
Both Hassan and wife Afshan, as well as their elder eight-year-old child, Alyan, are HIV positive. Fortunately, Usman,
however, was born HIV negative, after medical intervention.
“This ‘achievement’ could not have been possible if government support was not there. The cost of the required tests and
drugs is simply unaffordable for a person like me,” acknowledges Hassan, a schoolteacher and resident of North
Nazimabad.
The couple is all praise for the staff working at the Civil Hospital Karachi’s Centre of Excellence-Enhanced HIV/Aids
Control Programme, where they come for routine visits “We were not only educated about the disease and provided with
drugs free of cost, but were also given much-needed counselling. The encouragement of doctors lifted our spirits. This,
actually, helped us come out of the deep depression we had been passing through at that time after being ‘condemned’ for
conception and listening to negative remarks by a number of doctors,” they say.
Usman’s story
Recalling their ordeal, Hassan said he was the first in the family to be diagnosed with the infection. Though Afshan and
Alyan had no history of serious illness, Hassan had been ill for four years with various infections and had been losing
weight. Doctors failed to diagnose his illness and finally someone suggested a test for HIV/Aids. He was declared HIV
positive in January 2008.
According to Hassan, the family’s reaction was positive in the sense that nobody doubted his character. He, however, had
no clue to the source of the infection. Later, his wife and child were also found HIV positive. At that time Afshan was four
months pregnant.
A few doctors advised them to terminate the pregnancy, but they were unwilling. “I had got pregnant after a long time,
which had given me hope to end Alyan’s loneliness. I could never forget the memories of my second child who I lost to
pneumonia within a year of his birth. Perhaps he died of the HIV infection as I used to breast-feed him and the virus might
have passed on to my son from me,” recalls Afshan.
While the couple had a tough time trying to accept the painful facts about their lives, the indifferent attitude of medical
practitioners added to their woes.
“Devoid of any empathy and understanding of the disease, most doctors used to pose embarrassing questions. The
commonly asked one was why we opted for conception when we were HIV positive. It was hard to make them understand
that we had no knowledge about the deadly infection before conception,” adds Hassan.
After diagnosis at the centre, the entire family was put on an antiretroviral drug. The family suffered another set-back when
the lady doctor, who had earlier accepted Afshan for delivery at her hospital, refused to take her case upon knowing her
health status.
“The baby needed to be delivered through Caesarean section in order to reduce the risk of mother-to-child infection. The
CHK centre gave us the option to deliver the baby at Qatar Hospital in Orangi, but we wanted a facility nearer to our
home,” says Hassan.
After being refused service from some private hospitals, one private doctor finally agreed to come to their help and the
baby was delivered through an operation. Usman was born HIV negative.
“Though Usman’s health status is a great relief, we are greatly concerned about Alyan’s future, mainly because there is
little knowledge about HIV/Aids in society, which treats people with the infection as outcasts. We are refused treatment for
common ailments at health facilities. Those who do agree to treat us charge us exorbitantly. The government must do
something to alleviate our sufferings,” says Afshan.
More success stories
The CHK centre has six more cases to its credit in which HIV negative babies were born to HIV-infected couples in two
years. Only one mother was reported to have had a miscarriage.
About 515 people — of them 50 to 60 are women and 20 children — are registered with the centre currently running a
programme preventing parent-to-child transmission under the Sindh HIV/Aids control programme in collaboration with
Unicef. The total number of registered HIV/Aids patients in Sindh is 2,498 out of 5,237 HIV positive persons in the
country.
Considering the social stigma attached to HIV/Aids, no signboard has been put up outside the centre set up at the CHK.
“We know it’s not the right thing to do, but we also don’t want to embarrass visitors and try our best to ensure
confidentiality,” says Dr Azra Ghayas Abro, who heads the centre.
Sharing some facts about HIV/Aids, she said that most people remain asymptomatic for many years after initial infection.
However, an HIV-infected person is highly infectious during this initial period. After the virus causes progressive
deterioration of the immune system, increased vulnerability to infections may lead to symptoms.
Elaborating upon the mother-to-child infection risk, she said that the chances of HIV transmission reduced greatly if
antiretroviral drugs were given during pregnancy, labour and delivery. The drugs slowed down the reproduction of the
virus.
“Mothers are also advised to have Caesarean section for delivery as it minimises the risk of the baby’s contact with the
mother’s blood and body fluids. Also, they are advised not to breast-feed the baby,” she said, adding that the antiretroviral
drugs were needed to be taken for life. Irregularity can result in the development of drug resistance.
The infected couples were also advised the regular use of condoms and asked to plan conception on doctor’s advice. Dr
Abro lamented the lack of knowledge among doctors about HIV transmission and said that if general precautionary
measures were adopted, there was no risk of HIV transmission as was the case with other infectious diseases.
(By Faiza Ilyas, Dawn-13, 06/07/2009)
Doctor suspended over pregnant woman’s death, probe instituted
KARACHI, July 6: The Sindh health minister constituted on Monday a three-member inquiry committee to inquire into the
cause of the death of a pregnant woman at the Sindh government hospital, Liaquatabad, who allegedly died because of
doctors’ negligence. The young woman was expecting her first baby.
The health minister also suspended resident medical officer Dr Ayesha Zahidi, transferred the medical superintendent of
the hospital, Dr Shaheen Hasnain, and issued a show-cause notice to the head of the gynaecology department, Dr Salma,
over the death.
An additional secretary of the health department, Dr Shireen Narejo, gynecologist Dr Uzma Khalid and acting MS of the
hospital Dr Khalid Jameel are members of the committee.
Earlier in the day, relatives of the woman staged a protest demonstration at the hospital against the alleged negligence of
the staff. They claimed that the woman was having labour pains and died as the relevant staff did not attend to her
properly.
The woman, Shahida, wife of Furqan, living at Liaquatabad 8, was admitted to hospital on Sunday night. She had been
visiting the hospital for prenatal check-ups and was expected to deliver a baby in the last week of July, said a source.
The protesters said the woman in labour had been crying for hours during the night, but the doctors did not provide her
necessary treatment.
The protesting relatives and area people manhandled a couple of staff and staged a sit-in at the hospital.
Later, on a directive of the provincial health minister, Dr Sagheer Ahmad, senior officials including the secretary, special
secretary and a deputy secretary of the health department reached the hospital to calm the enraged people, urging them
to disperse as the health department had decided to investigate the matter.
Relatives claimed that the woman was brought to hospital well in time and it was the negligence of the hospital staff that
caused her death.
However, the doctors explained to the high-ups that the woman did not show symptoms requiring an emergency exercise
in the night and it was decided that a cesarean-section delivery would be done in the morning when senior doctors would
also be available.Dr Sagheer Ahmed also directed senior doctors in government hospitals to be regular and punctual for
prompt treatment of patients, particularly women and children, and improve the image of government hospital doctors,
said a handout.
(By Mukhtar Alam, Dawn-13, 07/07/2009)
Pakistan ranking high in incidence of HIV and AIDs
Pakistan now ranks high among countries with concentrated HIV and Aids epidemics as the incidence of the disease has
increased considerably in the last few years, remarked Director AMAL Foundation, Imran Rizvi.
Rizvi was speaking at a capacity building workshop themed “Women, children and HIV and Aids” held for media personnel
at the Karachi Press Club on Wednesday. Later, Dr Sikander Iqbal, Media Coordinator, Sindh Aids Control Programme
(SACP) shared various facts regarding the spread of HIV in Pakistan. He said “Approximately 5,600 registered HIV
positive people are currently present in Pakistan, out of which 2,500 cases have been reported from Sindh, while,
according to a report of World Health Organisation (WHO), an estimated number of 0.1 million patients living with HIV and
AIDS are present in Pakistan out of which 27000 are women.
Highlighting the high incidence of the disease in adolescents Rizvi said that 41.5 percent of men between the ages of 1549 have been found actively involved in commercial sex. Meanwhile, a large number of adolescents especially children
living on the streets in Pakistan are engaged in injecting drugs along with commercial and transactional intercourse which
leaves them vulnerable to HIV.
Speaking about the role of the media, Rizvi said that the world media has a greater role in influencing people. He also
urged the media personnel to play their role in eliminating the myths associated with the disease.
“Though the mass media has taken steps in the fight against aids” he said, “still a lot more needs to be done in this regard
with the help pf public service messages, publication of informative material about the disease and by dedicating airtime to
HIV and AIDS public service documentaries on different TV channels.”
Media should pressurise the government as well as civil society to take this disease seriously and try to acquaint the
masses with information,” he further stressed.
(The News-20, 09/07/2009)
Marble workshops wreaking havoc in Pak Colony
Residents of the Hasrat Mohani Colony, situated in the Pak Colony, consider ‘marble dust’ as destructive energy. The dust
which hangs over the entire area like a shroud is creating several problems for them. In a local clinic, a three-month-old
baby wails as the doctor makes a move to check her body temperature. After a brief check-up, the doctor pronounces her
to be a victim of a chest allergy. Like the child, the doctor himself has become a chronic allergy patient by working in the
dusty atmosphere.
A few miles down the road, Gul Afshan, a 40-year-old housewife living just opposite a small marble-cutting unit, takes big
gulps of air before talking, she told The News, “Thanks to the grinding and cutting marble work which is carried out openly
on the roads, I have been forced to live with asthma for the last 15 years. I can neither perform any household chores nor
can I go out to work. The dusty air has limited my visits only to the hospitals.”
The colony, housing 10,000 people, is home to several cutting and grinding warehouses which are operating noisily in the
residential premises, posing many health and environmental threats to the residents and the workers.
The grinder which is used to cut the round shapes of the marble slabs emits a great amount of marble dust. The workers
and inhabitants of these areas are prone to a disease called silicosis, in which the marble particles damage the cells of the
respiratory system and people feel difficulty in breathing. This can later lead to respiratory system failure eventually
resulting in the death of the patient. Also, the marble dust is one of the major causes for asthma, especially among
children.
Another environmental hazard which these marble-cutters pose is that when water is sprayed on the slabs (to ensure their
smooth cutting), the wastewater is routed to a series of settling tanks. A tanker then sucks the mixture from the tanks,
flushing it into the nearby river bed, choking and blocking it completely. It is to be noted that when the liquid is solidified, it
damages the fertility of a land. Another such problem is noise pollution which adds to the problems of the Colony.
Apart from the residents, the workers are the ones who are the most exposed to these hazardous conditions. Working
without a protective mask or equipment, Muhammad Ajmal said, “We don’t wear masks as it gets very hot around here
and we cannot breathe. Thus we don’t feel like covering our faces. But by working 12 hours a day, and earning just 4,800
per month.
While the grinding and cutting work is easily carried out on the streets, a proper system for disposal of the marble waste
doesn’t exist, and the marble waste lies on the roadside for several hours before it is picked up by the garbage vans and
that too just once in the day. This waste creates problems for the passers-by, the men who are eating on the roadside
dhabas, or the children playing on the streets. Another disturbing fact is that there are just 2-3 doctors in the area available
for the ailing colony. In this regard Doctor Naveed Khan said, “Every day I examine more than 100 patients all suffering
from chest allergies and respiratory problems, while 70 per cent percent of these patients are children. Many people
suffering from tuberculosis as well.”
The long-term solution what these residents are looking towards is that these units should be moved from the residential
area. Nooruddin, a ‘Pan’ owner had a suggestion in this regard, “We aren’t against the livelihood of the people who
constitute 45 per cent of the colony’s population; neither do we oppose their profession. All we want is that their smallscale industries should be moved away from the residential areas,” he concluded.
(By Rabia Ali, The News-13, 14/07/2009)
‘Doctor’s presence must during administration of injections’
KARACHI, July 15: The Pakistan Society of Anaesthesiologists has expressed concern over the administration of wrong
injections to patients, urging the government to ensure that all injections are administered under the supervision of
qualified doctors.
The demand was made at a joint press conference addressed by Prof S. Tipu Sultan, Dr Zia Akhtar and Dr Safia Zafar
Siddiqui, the office-bearers of the anaesthesiologists’ association, at the PMA House on Wednesday.
They expressed concern over a recently published news report that a 20-year-old student of an engineering university was
fighting for his life at a private hospital after a nurse administered him a wrong injection. However, they said this was not
the first incident of its kind; as many such incidents had occurred in public and private hospitals in the past. But,
unfortunately most of the cases were never reported, they added.
Explaining what actually happens in such cases, they said illegible handwriting of doctors, who prescribe injection
transamin to control bleeding, is sometimes misunderstood as injection tracrium by pharmacists. The latter is used by the
anaesthetist to paralyse all muscles of the body during surgery. Nurses mostly fail to cross-check the name of injection
before administering it in the absence of doctors. The wrong injection ultimately results into the patient’s death.
The anaesthesiologists said, “There is absolutely no other use of this drug anywhere else and no other person except a
trained and qualified anaesthetist is eligible to use this drug.”
They said in the university student’s case the drug used in place of transamin was acuron, which was exactly the same
drug as tracrium with a different brand name.
They said there were so many other cases in which the drugs prepared by different pharmaceutical companies were so
similar to each other in there packing and colour of their ampoules that it was difficult for a person with an ordinary
qualification to recognise and appreciate the difference.
The Pakistan Society of Anaesthesiologists was greatly concerned with the situation, they said, and suggested some
appropriate measures to stop this unnecessary loss of life.
They said no nurse in any case be allowed to inject any injection to the patient in the absence of a doctor. “It should be the
moral and legal responsibility of the doctor on the duty to give all injectable drugs to patient under their own supervision.”
They suggested that manufacturers and packagers of drugs must mark the drugs, having no ordinary use, in a way that
anyone could recognise them. For example, they should label it as “For O.T. Use Only” and adopt a specific colour coding.
It would certainly minimise the risk of administering wrong injections.
They further suggested that doctors should be careful while prescribing injection transamin, but if at all it was necessary to
prescribe this injection then there should be clear instructions like “to be injected by the doctor on the duty” along with the
prescription.
(Dawn-15, 16/07/2009)
Gastroenteritis epidemic in Landhi
Pipeline water samples ‘unfit for consumption’
KARACHI, July 17: City government officials have linked the epidemic of gastroenteritis in Landhi to the consumption of
contaminated water, which has been found “unfit for human consumption”.
About 750 men, women and children had reported to the medical emergency centres and nearby hospitals with symptoms
of gastroenteritis in the Samdani Town, located in Union Council No 5 of Landhi Town, on Wednesday and Thursday.
Following the outbreak, the city government’s executive district officer for health had ordered collection and test of water
samples from a worn-out pipeline of the Karachi Water and Sewerage Board in the area.
Talking to Dawn on Friday, Health EDO Dr A.D. Sajnani said 19 water samples were collected from the Samdani Town
area on Thursday and all were found contaminated with “high coliform density”.
The lab test of the samples confirmed that the samples contained E.coli at a high rate, he said, adding that health officials
had also collected water samples from surrounding areas for laboratory tests.
Following the reports about the outbreak of waterborne diseases, the Karachi Water and Sewerage Board dismantled the
faulty line which supplied water to hundreds of houses in Samdani Town, Future Colony and Mansehra Colony.
In a water testing exercise earlier this year, the city government’s health department had found about 31 per cent of the
water samples it drew from the Karachi Water and Sewerage Board sources and consumers’ underground storage tanks
unfit for human consumption. Of the 5,846 water samples collected, 1,790 were found to be contaminated with high
coliform density.
(Dawn-15, 18/07/2009)
Doctors’ protest
DISRUPTION in the delivery of basic services like healthcare can mean the difference between life and death. This
observation is underscored by the Punjab-wide doctors’ strike on Thursday when tens of thousands of patients, some of
them in serious condition, were unable to get essential medical attention because their would-be healers were out to make
their own woes heard. The strike did not come about all of a sudden. Doctors at government hospitals have been
protesting for the regularisation of their services and promotions for close to a year now. A few weeks ago, they had
threatened a ‘long march’ on the chief minister’s residence. They abandoned the idea after some influential personnel
promised that notifications would be issued in acceptance of their demands. By the look of things, the strike would not
have come to pass if the provincial government had not prevaricated on its commitments.
The provincial authorities should not have made pledges that would be difficult for them to honour. The government should
have instead told the doctors that regularisation and promotions require a lot of money which the authorities did not have
and that accepting some of their demands would mean bypassing the Punjab Public Service Commission. This would set
a bad precedent and further weaken the already beleaguered provincial services. Thus persuaded, the doctors might have
agreed to withdraw some of their more controversial and expensive demands. But the government has chosen to deal with
the issue differently by apparently trying to drive a wedge between doctors’ associations and obfuscating the issue. Official
media managers are insisting that the chief minister has already regularised the services of thousands of doctors while
‘summaries’ regarding their remaining demands are ready. These tactics will induce a sense of alienation and aggravate
the problem, making life even more difficult for patients.
(Dawn-7, 25/07/2009)
Substandard drugs
PUBLIC-sector hospitals in Pakistan are beset by many problem, not the least of which is their inability to provide all the
required medicines to patients. Another major problem they pose is that of the quality of the drugs that are being
dispensed. As the media has been reporting on and off, more often than not the drugs are substandard and administering
these to patients may well prove fatal. Even if they are not lethal they do nothing to ease the patient’s distress and can
actually aggravate the problem. At the root of this scourge is the government’s drug policy and inability to check
corruption. With the health budget not keeping pace with the escalating number of patients at government health facilities,
hospital finances in the public sector are in dire straits. As a result, hospital pharmacies are not well-stocked. Limited
resources allow them to provide only a few low-cost drugs. Patients are asked to buy their own medicines elsewhere.
That is bad enough. But what is worse is the corruption. Hospital pharmacists are known to sell their stocks to
pharmaceutical stores. Cases have been reported of people purchasing from these stores medicines with stamps
indicating that they are meant for use at government hospitals. In many cases these are replaced by substandard drugs at
the hospitals. If there is corruption at the health department’s level, then poor quality stocks are supplied to the hospitals
with money being siphoned off elsewhere. This problem needs to be addressed seriously if the poor – who regularly visit
government hospitals — are to derive some benefit from the healthcare the government has to offer. The least they should
be entitled to is attention from medical professionals, decent diagnostic facilities and life-saving drugs that are of good
quality and not stocked beyond the expiry date. The proposed health policy will hopefully address this issue.
(Dawn-7, 27/07/2009)
Parents of child with congenital scoliosis grapple with finances
Every time five-year-old Rumaisha Sohail looks at herself in the mirror, she asks her mother why her clothes dangle
loosely on her shoulders, why her body is tilted more towards the right, why she cannot stand or sit up straight, or why she
is shorter than children belonging to her age group.
A student of Kindergarten at a private school, Rumaisha is suffering from a rare disorder known as congenital scoliosis,
which is defined as the curvature of the spine as a result of the malformation of the vertebrae. In this disorder, the ribs and
the spinal vertebrae are poorly formed. This condition occurs at the time of birth, and girls are more prone to it than boys.
While Rumaisha was admitted to the hospital for her MRI and CAT scan, her father, Sohail Alam, spoke to The News
about her present condition, and what the child has been going through all this time.
“When Rumaisha was born, she had a cyst on her back which was diagnosed as meningocele and needed immediate
operation. At that time, I was living in Hyderabad and hence immediately brought her to Karachi, and got her operated
under the care of a specialist surgeon at a private hospital. However this was just the start of our miseries. Two months
later, we brought her to the same doctor again, because Rumaisha’s body was forming into a curve. After examination, the
doctor pronounced her to be a victim of congenital scoliosis, and told us that she can be only operated when she is fourfive years old as by that time her spinal cord and other organs would be fully developed. For the time being, the doctor told
us to make Rumaisha wear braces to prevent the abnormal growth that results from most vertebral malformations,” he
said.
However, the brace had no major effect, and with the passage of time, Rumaisha’s body started bending more towards
the right. Her physical growth was badly affected, and today she looks like a two-year-old instead of a five-year-old.
“Rumaisha gets tired very quickly while playing. She often complains of stomach aches and backaches, and often finds
herself out of breath. The curvature has taken a dangerous turn of 76 degrees, and needs immediate operation, otherwise
her heart, kidney and ribs will be damaged, and will stop functioning,” said Rumaisha’s grandmother, her eyes filled with
tears.
“For this complicated surgery, the surgeons have advised us to go abroad, and get her operated only by surgeons who
have had experience dealing with such patients. To do so, however, we need a whopping amount of US$80,000 to
US$250,000. If we cannot raise the money, we will have to leave everything in God’s hands, and pray that the doctors
here save her life,” Alam said.
(By Rabia Ali, The News-13, 29/07/2009)
Slaughter House: a picture of pitiful neglect
The Slaughter House area in Lyari Town, home for many sanitary staff, is a picture of pitiful neglect. In an irony of sorts,
many who keep the city’s environment clean find their own locality without any basic facilities, including those of access to
potable water, adequate sanitation, health and education.
The community, comprised mostly of minorities, is compelled to live in apathetic conditions, as choked sewerage lines
have almost inundated the vicinity. A small playground in the walled locality has now turned into a cesspool, further
compounding the miseries of the sanitary staff. Unfortunately, this situation has now become the norm.
The locality was established in 1940, long before the inception of Pakistan, by the then Karachi Municipal Administration to
accommodate the poor sanitary staff associated with the municipal administration. Low-cost quarters were awarded to the
poor, while a similar type of locality was set up at Moosa Lane in the same neighbourhood to accommodate Christians and
Gujrati-speaking Hindu families.
Earlier there were 5000 minority low-caste families living in the Slaughter House compound. Now, however, the law-andorder situation in the area has forced many families to migrate to other areas due to security reasons.
A local activist, who wished to remain anonymous, told The News that the area comes under the City District Government
Karachi (CDGK) administration but it does not have proper water supply, sanitation system, electricity or gas. He said that
many workers, after returning from work, carry water pots and plastic drums to neighbouring areas to fetch water.
He narrated that there was a primary school building built in the area before partition, but due to the lax approach of the
authorities concerned after partition, the building gradually collapsed. Now there is no teacher and parents are reluctant
send their children to school. Similarly, he said, a rich library with hundreds of new books of contemporary literature,
monthly magazines and daily newspapers, is now under the control of drug peddlers.
Many dwellers of the area meanwhile seemed unhappy with the Pakistan People’s Party (PPP) government, claiming that
it had failed to treat people according to its manifesto. Many eagerly await their share in the Rs1.5 billion development
package for Lyari, but there seems to be a general acceptance of the status quo — not many harbour much hope of
improvement, and living conditions are such that children of these sanitary staff would probably be compelled to adopt the
same profession.
Local activists believe that authorities-that-be seem ignorant of their problems. “We demand that our localities be added in
the list of Sasti Basti areas, where market items are available on the cheap, as announced by the president of Pakistan.”
They also demanded that the CDGK provide all basic facilities to the area, including potable water supply, health centre,
adequate sanitation, park and playground.
(By Jan Khaskheli, The News-20, 29/07/2009)
AUGUST
Recreational drug abuse an unseen killer
KARACHI, Aug 2: What started out 10 years ago as a bit of fun has now become the biggest challenge 25-year-old Sobia
(name changed to protect privacy) has ever faced in her life. Currently admitted to the KPT/ Karwan-e-Hayat Psychiatric
Care and Rehabilitation Centre, Keamari, she is undergoing treatment for drug addiction for the fifth time in three years.
The desire to overcome her addiction notwithstanding, she sees little hope for better prospects.
“I want to quit drugs for good and embark upon a career but my family does not support me,” she says bitterly. “My
parents want to kick me out of the house.” While admitting that drugs are part of the problem, she adds that “perhaps my
relationships with men irritate them”.
Sobia lives in the upper-class DHA locality and dropped out of school during her O-Levels. The drugs which she has been
using for recreational purposes since she was 15-years-old include hashish (charas), Ecstasy, Ketamine, cocaine,
Lysergic Acid Diethylamide (known as LSD or ‘acid’) and various methamphetamines.
Over the past decade or so, the use of these so-called ‘recreational drugs’ has become relatively common amongst the
elite of the city. Once viewed as a problem restricted to the economically-challenged sections of society, substance abuse
and drug addiction now appears to be a widespread phenomenon, although the substances in question vary.
“My father drinks alcohol and my brother is also hooked on these drugs,” says Sobia. “I ended up being addicted to them.”
The reason, she says, is not only because they are easily available but also because she and others like her command
sufficient financial resources. “I never paid for my drugs since I got them from either my brother or friends,” she tells Dawn.
“They could buy them quite easily.”
The world of which Sobia speaks is well-known to the Karwan-e-Hayat Centre. While most of the patients there are from
lower-income groups, the doctors in the rehabilitation department say that they also get patients from well-to-do areas,
and point out that recreational drug abuse is on the rise.
“There is no doubt that children from educated and well-off families are now getting more and more into drugs,” informs Dr
Sheema Nadeem, who works at the centre. “Initially, it is the result of peer pressure at parties where such drugs are used
openly. These substances — though greatly damaging in the long term — can momentarily provide boundless energy,
euphoria and an increased sexual appetite. But the initial high gives way to negative emotional and physical after-effects,
so many young people then turn to sedatives and anti-depressants.”
These observations are endorsed by Dr Uzma Ambreen, a psychiatrist who runs a clinic in Clifton. The doctor receives
about two dozen cases a month of patients from all over Karachi, who have a history of drug abuse and are aged between
13 and 26 years.
“Initially, the parents of such youngsters come to us citing some other problems,” she explains. “Generally, it is either a
decline in school grades or an inexplicable change in behaviour that forces parents to seek medical help for their children.
It is during the investigations that we come to know about the use of drugs.”
Usage condoned
Dr Ambreen believes that part of the problem is a shift in societal attitudes, particularly in the upper class, that now
condones alcohol and hashish as ‘acceptable’. With the use of these substances having been normalised, young people
have little reservations about experimenting with higher-class and more dangerous drugs. The choice of drugs appears to
depend on economic capacity. “Ecstasy and cocaine are expensive, so their use is restricted to the posh areas; but
hashish is cheap and is easily available everywhere,” she observes. “The victims of hard recreational drugs are usually
young people in elite co-education schools. Although I do get female patients, they are far fewer in number as compared
to males.”
At the Aga Khan University Hospital, Dr Ehsanullah Syed, a child and adolescent psychiatrist, also receives about 10 new
cases of teenagers with a drug history every month. “The use of recreational drugs is definitely increasing,” he says.
“Eighty per cent of such patients are boys, and the most commonly abused substances include alcohol, hashish — which
is usually smoked — and Ecstasy, which comes in the form of pills. Very often, parents remain unaware that their child is
taking drugs. Some parents fail to recognise the problem altogether.”
Drug facts
While heroin, cocaine and marijuana fall in the organic category, Ecstasy, methamphetamines, Ketamine and LSD are
synthetic drugs which are produced through chemical synthesis. Synthetic drugs are psychoactive substances produced in
laboratories, and as with most drugs, sustained usage may give rise to physical dependency or addiction.
Information gathered from various sources suggests that Ecstasy — commonly known as ‘E’ — is the most commonly
used amongst the synthetic drugs. Smuggled into the country and sold by dealers who meet their clients at pre-arranged
locations, pure Ecstasy and cocaine are often cut with other substances such as sedatives, in order to increase the
dealers’ profits. For the end-user, one pill of Ecstasy costs between Rs1,000 and Rs1,200 depending upon the type and
quantity of the contaminants.
Cocaine, which resembles a fine white powder, is usually adulterated with substances such as baking powder and one
gram of it costs between Rs12,000 and Rs15,000. Ketamine, an anaesthetic used in human and veterinary medicine, is a
prescription drug found commonly in drug stores.
“Each drug gives a different sort of high,” says Sobia. “With Ecstasy I feel happy and super-confident while LSD causes
hallucinations. These substances give more pleasure when taken with booze. Since I’ve been taking them for so long, I
now have a high tolerance level and have so far not experienced any side-effects.”
Indeed what the users often do not know is that these recreational drugs can cause serious and long-lasting damage.
Doctors say that Ecstasy, for example, is in some ways even more damaging than heroin since it can cause sudden
death. Taken as it is in the heated atmosphere of a party, it can lead to severe dehydration, high blood pressure and heart
or kidney failure. Frequent use of the substance can damage the brain cells and may affect memory. And after the high is
over, users often experience depression and find themselves taking more drugs to counteract that.
The physical effects of cocaine include constricted peripheral blood vessels, dilated pupils and increased temperature,
heart rate and blood pressure. The duration of cocaine’s immediate euphoric effects, which include hyper-stimulation,
reduced fatigue and mental clarity, depends on the route of administration.
“With an increasing number of heroin addicts, the trend of consuming recreational drugs among youth of well-to-do
families is worrisome. Though the government puts the total number of drug addicts in the country at five million, one can
say with confidence that this is pretty much an under-estimation and the actual number must be around 10 million,” says
Dr Ajmal Kazmi, who heads the Karwan-e-Hayat centre.
High relapse rate
The relapse rate of substance abuse patients is disturbingly high, sometimes going up to 50 per cent. Most doctors agree
that the major reasons for this are the lack of family support, and the lack of motivation on part of the drug user.
“Basically, the factors that led them towards drug abuse and addiction do not change,” Dr Ehsanullah Syed points out.
“Patients do not complete the full treatment and fail to report again after some time. In many cases, I feel that parents do
cooperate and are truly concerned, which is why they seek help for their children. But there are other social factors at play
that are, unfortunately, not under their control.”
According to the doctor, the substance abuse relapse rate at his AKUH clinic is as high as 50 per cent.
“Addiction is a disease,” says Wakeel Ahmed, a drug abuse counsellor at Willing Ways, a health facility that provides help
in dealing with addictions of different types. “Drug addiction is no different,” he comments. “Every drug has a different level
of addictiveness and the time it takes for a person to get hooked may vary. But once that happens, patients need not just
detoxification but also rehabilitation. And that is not possible unless the family is involved. The writ of the family has to be
restored and that is why we hold a series of sessions with the family before admitting a patient to the centre.”
Medical experts maintain that in the case of young and educated patients in particular, parents need to be much more
involved in and aware of their children’s activities. Early warning signals can come in the form of anything from behavioural
changes to demands for increased pocket-money. If these danger signs are missed, substance abuse can lead to serious
mental and physical damage, and even death by either suicide or accident.
(By Faiza Ilyas, Dawn-13, 03/08/2009)
Rs5,230 million projects for health sector
An amount of Rs5,230 million will be spent on 24 new and 49 ongoing health sector schemes during the current financial
year in order to ensure better facilities to patients throughout the province, Sindh Health Minister Dr Sagheer Ahmed said
on Sunday, while talking to a delegation of health professionals at his office.
Dr Ahmed said that Rs890 million will be spent on various preventive programmes and Rs1,862.787 million on teaching
hospitals. Six health department projects will be completed during the current financial year, including the master plan of
the Civil Hospital Karachi, the extension of the Sindh Government Hospital Saudabad, the establishment of the Breast
Cancer Centre at Sindh Government Hospital Liaquatabad, improvement of Skin Disease Hospital Karachi, the provision
of a library at Ghulam Muhammad Mahar Medical College, Sukkur, and strengthening and improving the Abbasi Shaheed
Hospital Karachi.
Dr Ahmed said that an Anti-Rabies Vaccine (ARV) and Anti-Snake Vaccine (ASV) Laboratory would be established at the
People Medical College Hospital, Benazirabad, at a cost of Rs200.330 million.
(The News-13, 03/08/2009)
Maternal, child health programme faces new risks
Inadequate and slow release of funds, expected changes in the local government system, a ban on the recruitment of
health staff and the lack of emergency obstetric and neonatal care (EmONC) at health facilities are some of the issues
which have adversely affected the National Maternal, Newborn and Child Health (MNCH) programme.
The delay in establishing district programme monitoring units (PMU) is also hampering programme activities. This was
revealed during the second joint annual review meeting of the MNCH programme, chaired by Sindh Chief Secretary Fazalur-Rehman.
The meeting was also informed that possible changes in the local government system posed a “new fiduciary risk” for the
programme, which required careful “mitigation strategies.”
The PC-1 of the programme, which is being funded by Norway, was approved in 2006-07 but relatively insignificant funds
were allotted to Sindh in 2006-08. Practically, during the financial year 2008-09 (first year of real implementation) the
programme has shown “good progress” within available resources, according to official sources and the documents
available with The News.
However, of the total initial allocation of Rs2,500 million for the financial year 2008-09, only Rs1,779 million were released
to the programme. The delay in release of funds was not only at the federal level but also at the provincial level, which
could be gauged from the fact that the health department Sindh had moved a summary for release of Rs161 million on
January 3, 2009 but till June 2, funds were not released.
Though these funds were non-lapsable as these were tied grants and eventually released to the programme, this issue
has resulted in “inadequate and unpredictable financing” of the programme and is also considered a risk to the donour
financing for the programme.
Availability of skilled human resource in hospitals and health facilities and the ban on recruitment of health staff in Sindh
was also noted with concern as it is affecting the overall performance of the health sector.
This is affecting not only the implementation of the MNCH programme but also the overall performance of the health
sector. Considering that MNCH programme was donor and federal government funded programme, it was suggested at
the meeting that there should be immediate lift on the ban on recruitment in Sindh.
It was stated that 12 district headquarter hospitals out of total 23 districts and 12 Taluka headquarter (THQ) hospitals out
of 57 THQ hospitals were providing EmONC services. Out of 108 rural health centres (RHCs), 48 RHCs were providing
basic EmONC.
In order to improve the state of affairs, the government has recently appointed 108 lady doctors and 108 lady health
visitors while 21 ambulances procured for health facilities. Besides medicines were procured last year, whereas
procurement of equipment is planned in current financial year.
Furthermore, the health department recently held a meeting with the Vice Chancellor LUMHS Jamshoro in which, he was
requested to attach post-graduate (PGs) with DHQ hospitals of Sindh where needed. It also approached head of College
of Physicians and Surgeons Pakistan (CPSP) regarding rotation of PG students in districts as a prerequisite for
examination.
Medicines and quality equipment for EmONC services was also being ensured in four districts namely Nawabshah,
Mirpurkhas, Larkana and Badin respectively. Provision of resuscitation protocols for labour rooms and newborn care has
also begun in 14 health facilities.
Recruiting gynecologists and pediatricians in remote districts, establishing neonatology units in hospitals, lifting ban on the
recruitment of healthcare providers along with strategy to ensure availability of health staff in hard to reach areas,
implementing PG students’ rotation to districts, imparting training of existing staff on anaesthesia, neonatology etc with
“surety bond”, developing minimum services delivery standards were some of the suggestions to reduce maternal and
infant mortality rate in Sindh.
It was also noted with concerns that district PMUs have not been properly established, without any operation team, it
would be difficult to implement programme activities effectively that may lead to wastage of meagre resources. Once
PMUs are established, they should work as an integral part of the district health management team.
(By Imtiaz Ali, The News-20, 05/08/2009)
Hospitals demand low power tariff
KARACHI, Aug 5: The Private Hospitals and Clinics Association (PHCA) headed by Sindh Minister for Sports Dr
Mohammad Ali Shah has demanded a separate electricity tariff structure for the city’s hospitals, clinics and healthcare
centres.
Dr Shah chaired a meeting of the association recently to discuss the issue and certain other matters.
It noted with concern that the Karachi Electric Supply Company was charging commercial rates from health care
establishments, pointing out that this increased the cost of treatment and the ultimate sufferers were patients.
The meeting suggested that the health care establishments should be provided electricity at a rate equal to that of the
residential consumers’ category or at somewhere between residential and commercial consumers categories.
In a communication issued after the meeting, the PHCA also urged the government to frame a set of laws for regulating
the private sector healthcare centres in Sindh.
There should be legislation to monitor the functioning of health care concerns with a view to improve the standard of
health care services, it said, adding that any monitoring body to be set up for the purpose should be a self-regulatory
authority and have representation of all stakeholders, both from the private and public sectors.
The meeting also rejected proposals of implementing the CDGK Private Hospitals Bylaws 2008, indicating that the
provincial government was in the process of setting up a regulatory authority for private health concerns.
It stressed the need for early declaration and implementation of the national health policy.
(Dawn-15, 06/08/2009)
Jang Forum on government hospitals
Minister lambasts govt departments over copy and paste mindset
Sindh Health Minister Dr Saghir Ahmed lambasted both the finance and planning, and the development departments for
their stereotypical “copy and paste” mindset, claiming that such an attitude in preparing successive health budgets hardly
leaves any room for reforms in the public health sector.
Addressing the Jang Forum on ‘Government Hospitals: Performance & Planning’ on Wednesday at Newport Institute of
Communication & Economics, the minister minced no words in conceding the official failures with regards to serving the
ailing with improved public health care. He said that this “failing streak” would not cease if such arbitrary treatment was
meted out while formulating budgets and bureaucrats superseded elected representatives. He regretted the fact that less
than one percent of the gross domestic product (GDP) was being spent on health. Dr Ahmed also urged the hosts of the
forum to invite officials from the finance and planning and development departments to participate in such a discourse
instead fooling the masses.
City District Government Karachi (CDGK) Executive District Officer Dr A.D. Sajnani defended the initiatives taken by the
government, claiming that the upgrading of existing health care infrastructure was direly needed to cater to the growing
number of patients seeking medical help from crowded and insufficient health facilities.
Upholding the CDGK’s position, Dr Sajnani said that the government had improved its health care facilities a great deal
while enabling its prime health outlet -Abbasi Shaheed Hospital (ASH) - to attend to an emergency every two minutes.
“The ASH has 1100 children in its paediatrics OPD, while the Karachi Institute of Heart Diseases (KIHD) is one of the best,
and we will replicate it in all 18 towns.” He said that the CDGK had planned different health care programmes, while every
town would have a secondary health care facility where consultants would diagnose what is being referred to them.
Civil Hospital Karachi Pediatrics Department Chief Dr Iqbal Memon, Pakistan Medical Association Karachi Secretary Dr
Samreena Hashmi, and Consumers’ Foundation President Huma Bukhari also spoke at the occasion.
(The News-14, 06/08/2009)
Newborn kidnapped from Civil Hospital
A day of happiness turned into a nightmare for one couple on Sunday after their newborn daughter was kidnapped from
the premises of Civil Hospital Karachi (CHK) by unidentified people.
Doctors at the CHK had conducted a caesarian operation of one Rukhsana w/o Mohammed Naeem at about 7am on
Sunday, following which she gave birth to a baby girl. After the succesful operation, Rukhsana was shifted to Gynecology
Ward No-3.
Learning that the operation had been succesful, Muhammed Naeem left for his work, leaving behind Rukhsana’s sister to
take care of his recovering wife. After some six hours, a couple visited Rukhsana while she was alone in her room and
enquired about her health and told her that she had given birth to a beautiful girl.
The same couple again appeared in the room after some time and told Rukhsana that her sister was sitting outside the
ward and she wanted to feed the baby.
Believing them, Rukhsana handed over the newborn to the couple who slipped away with the baby.
After waiting for an hour, Rukhsana called the attendants and doctors and asked about her baby, but they were unaware
of the situation. Meanwhile, the guard posted at the CHK Gynecologist Ward was also found to be missing, following
which the CHK authorities called the Risala police.
During the course of investigation, it was found that the standard procedure in place at the hospital did not allow any
patient or newborn to be released without a doctor’s slip. Hence, the the onus of the incident lay on the hospital staff, who
were allegedly found to be negligent of their duties. However, the police have gathered some clues and prepared sketches
of the suspected couple. Further probe is underway.
Mohammed Naeem had married Rukhsana about nine to 10 years ago and they have four daughters and a son. He is a
resident of Zia Colony, Korangi, and he sells plastic instruments, including plastic plates and bowls, on a push cart at
Korangi interchange for a living.
Taking note of the incident, Sindh Health Minister Dr Sagheer Ahmed has ordered a probe into the kidnapping of the
newborn from the premises of Civil Hospital Karachi.
On his directives, Provincial Health Secretary Syed Hashim Raza Zaidi rushed to the hospital and met the missing baby’s
father Naeem, mother Rukhsana and other relatives.
The health minister also directed the secretary health to inquire from ward’s duty guards, staffers and doctors as to how
outsiders managed to enter the ward and take away the baby.
The minister said that any employee or doctor of the CHK found negligent in this case would be punished according to the
law.
(The News-13, 10/08/2009)
Two cardiac emergency centres opened
KARACHI, Aug 11: Accompanied by City Nazim Syed Mustafa Kamal on Tuesday, Sindh Governor Dr Ishratul Ibad Khan
inaugurated two cardiac emergency centres in Shah Faisal and Landhi towns.
Each of the 50-bed centres will function as units of the Karachi Institute of Heart Diseases (KIHD), and will begin receiving
patients in their out-patient and emergency departments on Wednesday.
The governor also inaugurated a second mortuary of the city government in Landhi. The cold storage was completed
recently and has a capacity for 58 bodies.
Dr Ibad also visited the KIHD in Federal B Area, where a new building (KIHD Unit-II) was inaugurated by the city nazim
recently. The governor also addressed a public meeting in Landhi after the inauguration of the facilities there.
He said all credit for the development activities that took place in Karachi and the interior of Sindh during the last few years
went to MQM leader Altaf Hussain, who, according to him, had always motivated his party workers and leaders to work
selflessly and impartially.
“The development works carried out in Karachi during the last four years are in fact like serving the whole of Pakistan and
we feel pride in it,” Dr Ibad said, adding that he was satisfied that the city government had set an example of public service
by providing emergency healthcare facilities to the people near their homes.
Speaking at the gathering, City Nazim Syed Mustafa Kamal said there would be no U-turn in the journey of development in
Karachi. “The process of development will continue despite all odds,” he said.
Coming to the development of cardiac care facilities, he said the first five to 10 minutes were considered most important
for heart patients needing immediate medical aid, and nobody could afford delays in such cases.
In the past Karachi had only one cardiac care and treatment facility, but now “we have established four cardiac emergency
centers in different areas of the city to provide the facility of open-heart surgery, angioplasty and angiography on
subsidised rates.”
MNA Asif Husnain, DCO Javed Hanif and EDO (health) Dr A.D. Sajnani were also present during the inaugurations and
meetings.
(Dawn-13, 12/08/2009)
Medical waste
INCINERATION has been considered the best method of disposing medical waste. Hospitals in the federal capital have
been trying to procure this facility while those without it try to gain access to an incinerator at the nearest hospital. But a
recent report in this paper about the environmental shortcomings of the waste-disposal system in a leading private hospital
in Islamabad, which has recently procured two new incinerators, has drawn attention to a major drawback of incineration.
Although considered a hygienic method of disposing medical waste as compared to the practice of dumping it with
municipal waste, incineration releases toxic by-products, particularly dioxin and mercury, which are known to have harmful
effects on kidneys, the nervous system, brain, etc. In fact, according to WWF-Pakistan, incineration is fast becoming an
obsolete method of medical waste disposal in many developed countries because of this concern. Hence, many
healthcare facilities in the developed countries are moving towards the environmentally safer method of hospital waste
disposal known as autoclaving, a process of neutralising or sterilising potentially infectious medical waste prior to disposal
in the standard municipal solid-waste stream.
If our hospitals have yet to adopt this safer waste-disposal technique, our health, environment and municipal authorities
have also yet to develop a systematic approach to overall waste disposal that incorporates the safe disposal of medical
waste. A centralised healthcare waste-disposal system for Islamabad was under consideration two years ago. Under this,
medical waste would first be segregated at source and the hazardous waste was to be collected from all healthcare
facilities and transported to a landfill on the outskirts of the capital where it would be treated and disinfected before burial.
Until now, however, neither has such a system been put in place nor a proper landfill site developed. Unless this is done,
Islamabad’s healthcare facilities, with their toxic incinerators as well as unlined disposal pits, will continue to be a danger
to the environment and public health.
(Dawn-7, 17/08/2009)
Role of midwives, BHUs stressed in reducing maternal mortality rate
KARACHI, Aug 20: Underscoring the role of midwives and basic health units in reducing maternal mortality and morbidity,
women parliamentarians at a forum held here on Thursday vowed to ensure the strengthening of the midwifery and
nursing cadres and improved delivery of primary health services in the country.
Speaking as the chief guest and on behalf of about a dozen members of the national and provincial assemblies present at
the meeting on the issues of pregnant mothers, MNA Dr Azra Pechuho said that the government, which was already in the
process of formulating a national health policy, would certainly address the issues of mothers and children. She said
mothers and their children often fell victim to ignorance, improper guidance and inadequate healthcare facilities,
particularly in the urban slums and rural areas.
“We are aware of the issues behind a weak health delivery system and are recommending at the due forum not only the
quantitative and qualitative enhancement in the midwifery and lady health workers sectors and strengthening of
paramedical staffers at basic health units and rural healthcare centres, but are also recommending a system that
guarantees maximum deployment and retention of doctors, including the postgraduate doctors, at primary healthcare
units,” she said.
She also called for meaningful interaction between various ministries and wings of the government towards
implementation of a comprehensive health programme, which, among others measures, also gave due consideration to
maternal health, family planning, pre-marriage testing of couples, adequate vaccinations of mothers and neonatal
healthcare.
The discussion, organised by the United Nations Population Fund and the Pakistan Medical Association, was attended
among others by Shehla Reza (Deputy Speaker, Sindh Assembly), Humera Alwani, Rashida Panwar, Tauqir Fatima
Bhutto, Shama Mithani, Aisha Khuso and Kulsoom Begum.
Dr Sadiqa Jaffery, Dr Samrina Hashmi, Dr Shershah Syed, Dr Yasmeen Qazi and Dr Nighat Shah shared their
experiences with the parliamentarians and identified the weaknesses of the existing healthcare networks and medical
education system in the country. They also suggested some remedial measures.
‘30,000 pregnancy-related deaths every year’
It was said that every minute a woman in the developing world died due to treatable complications of pregnancy or
childbirth, and thus every minute a family was devastated. Had there been a reduced poverty level and a mechanism that
ensured that every pregnancy was wanted, every birth was safe, every young person was free of HIV/Aids and other
communicable diseases and every girl and woman was treated with dignity and respect, particularly those suffering from
obstetric fistula, the lives of surviving children could become safer.
The forum was told that about 30,000 young women died every year in the country because of pregnancy-associated
complications, while 375,000 women suffered every year from pregnancy-related complications, like depression, chronic
pelvic pain, loss of uterus, infertility, pelvic inflammatory diseases, vesicovaginal fistula and recto-vaginal fistula.
Over 80 per cent women delivered at home in the presence of unskilled birth attendants; on the other hand, in a majority
of secondary and tertiary healthcare centres, emergency obstetrical care was not available on a 24 hour basis. The
majority of basic health units and rural health centres were not functional.
The speakers also stressed the need for long-term planning to produce an army of competent and skilled midwives
receiving enough support during training and employment to reduce maternal death rates. Inclusion of emergency
obstetric care in the curriculum of medical colleges, nursing schools and paramedical training centres was also suggested
during the meeting.
Some of the discussants also took up the issue of abortion in the country. They noted that under certain circumstances an
induced abortion was allowed, “but [they are] frequently performed in a haphazard, slipshod, illegal, secretive or deceptive
manner by skilled and unskilled personnel under unhygienic conditions using crude instrumentation with consequences for
the lives and health of women involved”.
It was further noted that a number of gynecologists did not bother to give proper time to expectant mothers for natural
deliveries and resorted to exercise surgeries, which also affected the mother health adversely.
On the other hand, the absence of trained and competent doctors and staffers at the government establishments in the
vicinity of patients also created opportunities for non-qualified health practitioners to exploit and extend treatment on a trial
and error basis, which needed to be checked, said a parliamentarian.
Another MPA referred to her visit to Thatta, and held that pregnant mothers there had to suffer due to the absence of a
proper communication system between the so-called basic or maternity care centres and the tertiary health units for
consultancy and referral of cases. As such, a number of mothers-to-be died on their way to larger hospitals for want of
emergency care.
Other parliamentarians called for filling the vacant posts of doctors and relevant staff in the government sector. There was
also a suggestion that the work pertaining to maternal healthcare could be done more purposefully if the population
welfare institutions were also brought within the ambit of the health ministry and departments.
The UNFPA’s representative in Pakistan, Daniel B. Baker, said that his organisation’s support for running the fistula
centres in the country was being extended up to 2010, as it felt that such establishments were necessary for capacity
building of local health care providers to manage fistula patients individually and create awareness among the masses for
prevention of obstetric fistula.
(By Mukhtar Alam, Dawn-15, 21/08/2009)
Public hospitals’ service charges challenged in SHC
The imposition of service charges on medical facilities in public hospitals was challenged in the Sindh High Court (SHC)
on Friday.
Petitioner Mohammad Siddiq Kaladla (Advocate) submitted to the court that he came to know through media reports that
the Sindh Health Department had issued a notification on July 3, imposing service charges on X-Rays, ultrasounds and
other facilities, which was unjust and uncalled for.
Naming the Sindh chief secretary, health secretary and others as respondents, Kaladla submitted that the government is
responsible to provide health care to citizens under Article-38 (d) that guarantees that the State shall provide food,
clothing, housing, education and medical relief to all citizens. The counsel said that a large number of citizens who go to
public hospitals cannot afford expensive treatment, and prayed the court to direct the government to withdraw the
impugned notification. He also prayed the court to direct the respondent to take steps for providing life-saving drugs and
medical facilities to all hospitals.
After conducting preliminary hearing of the petition, SHC’s division bench comprising Justice Mushir Alam and Justice
Mohammad Athar Saeed, issued notices to the Sindh chief secretary, health secretary, Sindh advocate general and others
for September 2, and sought their comments.
Suspect remanded: Administrative Judge of Anti Terrorism Courts in Karachi remanded a suspect to police custody for his
alleged involvement in kidnapping and murder case.
Aurangzaib along with Ahsanullah, Amanullah and Ghulam Rasool are charged with kidnapping Shah Faisal from Sachal
area on August 14. Police alleged that the suspects took the abductee to Balochistan and demanded Rs. 10 million and
later reduced the amount to Rs.5 million. Police said that suspects received Rs. 70,000 for the release of the abductee but
later killed him. AJ Justice Maqbool Baqar, remanding the suspect to police custody till August 28, directed the
investigation officer to produce him on the next date of hearing.
Status quo ordered: SHC ordered status quo in a matter pertaining to the sale of a plot in DHA Phase-VII area and
directed the plaintiff to deposit the remaining amount before the Nazir of the court.
Plaintiff Chaudhry Abdul Ghafoor submitted that he purchased a plot in DHA area and obtained the possession by paying
90% of the amount but the defendant was not signing the sale deed and he was mala-fidely avoiding doing so. His
counsel Syed Haider Imam Rizvi submitted that permanent injunction may be granted in favour of the plaintiff as he has
paid almost 90% of the amount and willing to pay the remaining amount.
SHC’s single bench comprising Justice Maqbool Baqar, granting status quo on the lawsuit, directed the plaintiff to deposit
the remaining amount before the Nazir of the court.
(The News-14, 22/08/2009)
Sindh govt to spend Rs1114.229m on preventive health programmes
Sindh Minister for Health, Dr Sagheer Ahmed, announced that the health department would spend Rs1114.229 million on
preventive health programmes throughout the province.
Presiding over a meeting at his office on Tuesday, the minister said that an amount of Rs1074.229 million would also be
spent on eight ongoing schemes while Rs40 million had been earmarked for three new schemes of preventive
programmes.
The minister further wised up the meeting that the department has allocated Rs46.523 million for operational support to
the extended programme on immunisation (EPI) Sindh while Rs60 million each have been earmarked for tuberculosis and
roll-back malaria initiatives.
Elaborating the new schemes in preventive programme, he said that this included blood transfusion services at a cost of
Rs5 million, child survival programme in Sindh with Rs5 million and support to oral polio vaccine through Global Alliance
for Vaccines Initiative (Gavi) at a cost of Rs30 million.
According to an official communique, the minister was quoted, saying that prevention is better than cure which is the main
reason for emphasis on preventive programme. “Media have to play an important role in creating awareness amongst the
masses especially mothers regarding prevention.”
The health minister laments the high mortality rate of newborns and children under the age of five years in Pakistan,
compared to other parts of the world. “Sindh also has high child mortality rate for which MNCH programme has been
initiated in the province.”
The minister appealed to the mothers to get their children immunised against diseases and ensure their well-being. He
appeared satisfied with the stock inventory of the vaccines provided by the EPI to the government-run hospitals in this
regard.
(The News-14, 26/08/2009)
SEPTEMBER
SIUT is a philosophy of life, says Dr Rizvi
KARACHI: Pakistan's leading organ plantation expert and founder of Sindh Institute of Urology and Transplantation (SIUT)
Dr Adib Rizvi has said that SIUT is not just a building but a philosophy of life.
"Healthcare is the fundamental right of every newborn and not charity," said Dr Rizvi. "The difference should be clear and
not like the education sector where blue and yellow schools are separate, which is not fair."
A doctor is a friend of the patient and should guide him till he gets well.
"A doctor's duty is not limited to diagnose the disease and prescribe the medication, but he or she must follow the patient
in the treatment process, as everyone knows that majority of the patients in Pakistan are unable to buy medicines," he
said.
Addressing an Iftar party in his honour at Karachi Press Club organised by SUPPORT organisation, Dr Rizvi said that
most of the people are unable to pay the specialists, even a general practitioner (GP) charges about Rs 300 per patient
that is also unaffordable for majority of the people.
"When there is nothing to eat, vaccination is a luxury," said Dr Rizvi. He quoted an example that recently a man came from
Mardan with stones in both kidneys and when he started treating the man, he found amulets painted on his back and on
inquiry, the patient revealed that he was unable to go through the treatments, so he went to a local faith healer to get
these amulets painted on the hopes that he may get well.
While addressing the ceremony at KPC, former student leader and Democratic Students Federation (DSF) activist, Dr
Rizvi recalled the past that he regularly used to visit KPC to distribute DSF press releases. Talking to this scribe, Dr Rizvi
recalled the past that how he got the idea to establish such a mass level institute, he said that thanks to the flood that had
given him an idea to establish such an institute. "It was 1973 when torrential floods hit Sindh and I was visiting district
Thatta with some friends, when in village Chohar Jamali, under a bayan tree I found a mother scattering channas in the
mud before her hungry children and when I asked why she is doing so, she said that her children are hungry for the past
three days and if she handed the channas over to them they would eat them at once and ask for more so she was
scattering them in the mud so that it may take time for them to search and eat. After learning about that incident I came to
know that life is not just a bed of roses," he recalled.
SIUT, the largest public sector health organisation in the country, provides free, comprehensive and modern medical care
in kidney diseases and transplantation of different human organs. After being given autonomy in 1991, SIUT has treated
over 1 million patients and spent over a billion rupees on curing patients. SIUT treats 650,000 patients annually, majority
of these patients arrive from rural areas and all of them are treated free of cost at SIUT.
"With the passage of time, the healthcare facilities have increased along with the patients and diseases. In the past we
used to operate on a single patient every month, but now we operate on three patients everyday and on every organ
transplant case we have to spend Rs 200,000," he said.
SIUT started working in 1974 and the ever first organ transplant was held in 1980 and since then SIUT has conducted
2,800 cases of organ transplant. "In SIUT everyday 38 operations are conducted out of which two to three operations are
of organ transplants," he said.
(By Amar Guriro, DailyTimes-B1, 08/09/2009)
18 women die in Karachi free food stampede
KARACHI: Seventeen women and a 13-year-old girl were killed, and another 15 injured, during the free distribution of flour
and other supplies at a wholesale market on Monday.
Saddar Town Superintendent of Police Abdullah Sheikh said the incident occurred at a stall set up to distribute free food at
local philanthropist Iftikhar Muhammad Chaudhry’s warehouse. “Thousands of women crammed into the narrow lanes of
Khori Garden in Jodia Bazaar to take advantage of the offer. When the organisers felt the women was getting out of
control, they closed the door, causing a suffocating atmosphere,” said Sheikh. He said the panicking women then
attempted to leave at the same time, causing a stampede. However, local police official Hashmat Ali told AFP a private
security guard tasked with ensuring the women formed an orderly queue had baton-charged them, scaring them and
causing the stampede. “I have lost my little daughter,” cried Karima in hospital. “All I wanted was a bag of flour for my
family, but my greed lost me so gravely,” she added.
Their fault: Some bystanders claimed the women had brought the tragedy upon themselves by displaying impatience.
“The women were very undisciplined. It was not the organisers’ fault because the women were constantly trying to break
the queue,” said one female witness.
Prime Minister Yousuf Raza Gilani, President Asif Ali Zardari, Sindh Chief Minister Qaim Ali Shah and Muttahida Qaumi
Movement chief Altaf Hussain expressed their grief over the incident and ordered an immediate investigation. The Sindh
government also announced Rs 100,000 for each of the aggrieved families.
Case registered: South Zone Deputy Inspector General Ghulam Nabi Memon said the government had arrested
Chaudhry, who has been distributing food for charity for over 10 years. “A special team led by SSP Investigation Farhat
Junejo has been formed to probe into the incident,” Memon added.
(By Faraz Khan, DailyTimes-A1, 15/09/2009)
JPMC nurse dies due to alleged negligence of doctors
KARACHI: Rubina Habib would have never imagined that her death would be caused by something that she knew how to
do best for the last nine years of her life. Rubina was a nurse at Jinnah Postgraduate Medical Centre (JPMC).
She was a hardworking nurse and did all that she could to make her patients comfortable during the time they were
admitted to the hospital. No matter how many deaths she had seen in her life as a nurse, she would have not believed that
she would also suffer the fate of her patients, lying on the same bed as they do, during the last hours of her life.
Sadly, she did not die a natural death, after all a natural death at 28 is highly unlikely to begin with, but in fact she died due
to the negligence of the very people she was working with.
Rubina had everything going for her she had a stable job and was on a maternity leave for the past two months. For
understandable reasons she was to deliver her baby at the JPMC Maternity Ward.
However, fate had other plans for her as she died in the ward at around 2:00 am on Friday morning. The news spread like
wild fire and the nurses left their wards to protest against the negligence. The protest affected the routine of Pakistan’s
largest state-run hospital and several patients admitted in the hospital suffered because of the protest. As a part of the
protest, nurses blocked the main road outside JPMC, making it difficult for people to access the four major hospitals
located on that road, including JPMC, National Institute of Cardio Vascular Diseases (NICVD), National Institute of Child
Health (NICH) and the Kidney Centre.
When the nurses showed no signs of backing out of the protest, the JPMC administration called the members of the
Pakistan Nursing Council (PNC) but the council refused to respond to the hospital until they took action against the
doctors that were allegedly involved in the negligence. Following the PNC’s reply the hospital’s administration suspended
six doctors, two nurses and three postgraduates including Dr Reena, Dr Humera, Dr Devi Kumari, Dr Talat and Dr
Mehnaz. The hospital management issued a press statement signed by JPMC Acting Director Professor Ghulam
Mehboob, which stated that five doctors have been suspended and an enquiry has been ordered. However, not a single
name was mentioned in the statement. However on contact a senior member of the hospital management, on the
conditions of anonymity, said that a six-member committee comprising some senior members of the hospital
management, members of the PNC and doctors has been created which would issue a report within the next 24 hours
after which further action would be taken on the basis of the findings of the report.
The nurses were against the formation of an enquiry committee, terming it to be a delay tactic. A senior member of the
PNC said that the hospital management would never remove the staff involved in the negligence and said that instead of
the proper course of action the hospital’s management would announce a meager amount to compensate for Rubina’s life.
“We are ready to go to court to get justice for Rubina,” said Nursing Superintendent Irshad Abbasi.
He added that the issue just does not end at Rubina’s case as everyone who will be treated by the negligent doctors and
staff will be at risk. Rubina body was taken to her residence at Saeedabad and a large number of nurses attended her
funeral.
(By Amar Guriro, DailyTimes-B1, 19/09/2009)
Commemoration of World Heart Day today
NICVD running without any budget
KARACHI: Around 550 patients, admitted in Pakistan’s biggest state-run cardiac hospital, National Institute of
Cardiovascular Diseases, would observe World Heart Day today (Sunday) by bearing all their treatment expenses.
NICVD, which caters to about 0.7 million patients in OPD, ICU and other wards, is running without a single penny in terms
of annual budget. In the absence of a budget, NICVD’s administration has converted the state-run hospital into a
semiprivate hospital by charging hefty fees for different treatments.
“We are not getting a single penny in terms of annual budget for treating the patients. The federal government has
promised about Rs 500 million in the name of expenses grants, but we usually get only a third of the money,” said NICVD
Executive Director Professor Dr Khan Shah Zaman. Visiting NICVD on Saturday, this scribe found a huge signboard with
clear instructions that all the patients visiting the emergency must buy a token for Rs 100 before the checkups. “We
charge Rs 20 from the patients visiting the OPD and, if admitted, he or she has to pay Rs 300 as admission fees and then
we charge Rs 90,000 for angioplasty and these fees are lower than what the other private hospitals charge,” said Dr
Zaman.
Majority of the patients, who belong to a lower income stratum, suffer a lot. Among these patients, elderly Haji Abdul
Rahim was in tears because he could not afford to buy an injection that the doctors had prescribed.
Muhammad Jaffar, an ironsmith by profession, was admitted in the hospital for one month to receive cardiac treatment
and was allowed to go home on Saturday. “I spent Rs 80,000 during my stay and the doctors have prescribed more
medicines, but I am really unable to afford them,” he said. NICVD has failed to provide the patients with basic facilities
even after charging hefty fees. Several patients told this scribe that usually when new patients arrive in the hospital, they
are forced to sleep on mattresses spread out on the floor.
“We have 450 beds in all, but sometimes the number of patients exceeds, and since we can’t refuse any new patients, we
make arrangements on the floor,” Dr Zaman said. Experts stated that in South Asian countries, especially in Pakistan,
cardiovascular diseases have materialised on an alarming level and are rapidly becoming an epidemic. In Pakistan, the
situation’s gravity could be gauged from the fact that approximately 75 percent of the total cardiac patients die before
getting proper treatment due to absence of proper healthcare facilities.
Over 17.2 million people worldwide die annually from heart diseases and strokes, which are the world’s leading causes of
death. Workplace wellness programmes that encourage healthy diets, physical activity and discourage tobacco use have
been shown to be a cost-effective way to save lives and improve productivity. Federal Health Minister Mir Ijaz Hussain
Jakhrani declined to issue any statement on the matter. “Sahab does not talk to media persons,” said Munawar, Jakhrani’s
personal assistant.
(By Amar Guriro, DailyTimes-B1, 27/09/2009)
OCTOBER
Toxic water being used to cultivate vegetables
KARACHI: With the rise in population including the influx of people from other parts of the country, the citizens’ need for
milk, vegetables and other edibles has also increased manifold. Unfortunately, the wells of Damloti and Malir’s Memon
Goth had dried up some four years ago due to paucity of underground water and lack of rains in the past several years.
The city has lost around 70 percent of its sources of fresh fruits and vegetables.
Sukhan Nullah is one of the major sewage canals that have become readily available sources of water for vegetable
growers. These growers of Landhi and Korangi’s rural outskirts are completely dependent on the Sukhan Nullah’s sewage
water for their crops.
The green vegetables that are being produced using such water carry a bluish or purplish tint, while they have a typical
scent that differs from that of the actual vegetables.
The industry located in the vicinity of Sukhan Nullah has been dumping industrial waste, especially untreated waste
product of dyes, over an open area since long. The toxic waste has also changed the colour of the soil to blackish blue.
The towns of Malir and Gadap are the key providers of fresh fruits and vegetables in the city, meeting up to 45 percent of
the demand, while about a percent of vegetables are supplied by Manghopir and New Karachi’s rural outskirts.
Regrettably, the availability of potable water to the citizens is already in short supply, so it is not possible for the vegetable
growers to use 100 percent fresh water for agriculture, boosting usage of sewage water from major sewage canals and
highly toxic industrial wastewater for cultivation of easily-grown vegetables.
However, heavy floods in recent years have filled the underground natural water reservoirs and the wells of Damloti and
Memon Goth. But the time without water had forced the growers to sell their lands and thus a relentless process of
urbanisation eradicated agriculture on a massive scale. Following this, the growth of agricultural products was significantly
impaired and crops were spoiled. This situation was devastating for the citizens, while the local growers had also lost their
livelihood.
An expert on water-related issues and technology told Daily Times that the civil institutions of governments at provincial,
federal or city level have failed to control the open dumping of untreated industrial waste in sewage canals, which also
infects migratory birds and sea life, especially green turtles and fish found near shores.
Additionally, the cultivation of fruits and vegetables from the toxic water is extremely detrimental to humans and animals
alike, and cases of premature presbycusis and greying of hair, teeth and bone infections, gastric ailments and increased
risks of acquiring cancers have also heightened.
Former Executive District Officer (EDO) Agriculture Shabbir Ahmed Bhurt told Daily Times that using toxic water for
growing vegetables should never be allowed because there are now around 4,000 wells in Damloti and Memon Goth that
are filled with water, adding that during his tenure as the EDO, around 1,000 watercourses were constructed in those
areas, while only 91 watercourses were constructed from 1977 to 2004.
Bhurt suggested that there was a vast scope for agricultural industries in those areas.
(By Irfan Aligi, DailyTimes-B1, 04/10/2009)
Only 7 anaesthesiologists in govt hospitals in interior Sindh
KARACHI: There are only seven anaesthesiologists employed in 47 public sector hospitals in 23 districts of Sindh, except
Karachi, due to which the hospitals, despite having the facilities of operation theatres, cannot operate on patients, and in
some cases, the hospital administration has no other option except operating without the services of anaesthesiologists.
Daily Times learnt that in some hospitals in the districts of interior Sindh, the laboratory technicians carry out the
responsibility of an anaesthesiologist, which is equivalent to playing with the lives of the patients.
Anaesthesiologists are medical doctors trained in administering anesthetics and overseeing patients’ medical care before,
during and after surgery.
Medical experts revealed that 25 percent of the deaths in interior Sindh are caused by the absence of anaesthesiologists.
As per media reports, 23 people died in different hospitals of interior Sindh in the last two months because they could not
be operated upon in time.
Sources in the health department said that most posts of Grade 18 and above in different hospitals of Sindh were vacant
as doctors were showing hesitation to serve in these capacities, claiming that they do not want to live in those areas where
basic necessities of life were not available. “Whenever they are transferred to remote areas, they exert political pressure to
transfer their services to Karachi,” added the sources.
Indus Hospital Head of Anaesthesiology and Pakistan Society of Anaesthesiologist (PSA) President Dr Akhtar Aziz Khan
said that there was a shortage of anaesthesiologists not only in Karachi, but also in Sindh, adding, “The problem is that
very few youngsters opt for expertise in anaesthesiology. At the undergraduate level, students do not study
anaesthesiology, so they have no basic knowledge of the subject and no curiosity to study it further.”
He proposed the health department to create awareness among aspirant doctors regarding the issue.
PSA officials said that there were only 1,363 anaesthesiologists in the country, most of whom were serving in the armed
forces.
An anaesthesiologist, Dr Saeeda Hyder, claimed that 95 percent of the posts of anaesthesiologists were vacant because
of the unavailability of experts, quickly adding,
“However, most of the doctors even do not like to serve in the remote areas, where no facilities of life are available.”
When contacted, the health department officials denied commenting on the issue.
(By Fawad Ali Shah, DailyTimes-B1, 12/10/2009)
‘24% of country’s hospital beds occupied by waterborne disease patients’
KARACHI: Experts from different countries and officials of the Pakistani government, as well as international
organisations, have expressed concern over the alarming increase in the number of waterborne and diarrhoeal diseases
around the world. The increase is due to the limited access to safe drinking water and the lack of proper sanitation
systems.
Quoting data collected by international organisations, these experts disclosed that every day, diarrhoeal diseases kill
6,000 people around the world, out of which 5,000 are children. They said in Pakistan, 38.5 million people do not have
access to safe drinking water and 50.7 million do not have the facility of proper sanitation. These high statistics result in
more than 24 percent of Pakistan’s hospital beds being occupied by the people suffering from waterborne diseases.
Moreover, diarrhoea is the leading cause of mortality and second leading cause of morbidity among children under five
years of age.
Addressing the session of the first day of Aga Khan University’s National Health Sciences Research Symposium on ‘The
Impact of Water and Sanitation on Health: Our Problems, Our Solutions’, Pakistan government Health Director General Dr
Rashid Jooma said that the work being done on the water and sanitation sectors in Pakistan is not like that being done in
other countries, such as India, worsening the sanitation conditions.
Jooma said that the bad sanitation conditions are not only affecting human health but the environment too. He added that
the estimated cost of environmental degradation in Pakistan is Rs 365 billion per year, of which Rs 112 billion is caused by
inadequate water supply, sanitation and hygiene conditions.
Talking about the government’s response to these challenges, including legislation and policy, and initiatives for safe
drinking water, sanitation and hygiene, he said there are several projects in the pipeline and more is yet to be done. “One
example is washing hands with soap, which can reduce diarrhoea by 47 percent and is critical in the fight against polio,”
he said, adding that inter-agency cooperation and public-private partnerships to improve water supply and sanitation
programmes are necessary.
Senior Architect and Urban Town Planner Arif Hassan underlined the fact that over the last 50 years the government has
invested considerable money, including aid, in drinking water and sanitation programmes. However, these projects have
not been successful and have increased Pakistan’s foreign debt considerably. Some NGO projects have delivered positive
results but unless their methodology becomes a part of the official policy, planning and implementation procedures, they
cannot be successful to the extent required for servicing the growing demand for water and sanitation. In the past two
years, the government has legislated a sanitation and drinking water policy which, to be successful, will need to relate to
ground realities.
UNICEF Deputy Representative Luc Chauvin said that water and sanitation are keystones for economic development and
all people, including the poor, have the right to access drinking water and sanitation services. He said water, sanitation
and poverty are linked, as the diseases brought on by poor quality of drinking water and inadequate sanitation facilities
mean that people lose income opportunities and incur increased health costs. “Improving access to water and sanitation
will help reduce Pakistan’s health burden,” he said.
Aga Khan Program for Islamic Architecture at MIT Professor Dr James Wescoat said landscape planning has an
increasing role to play in helping expand household and neighbourhood water and sanitation solutions to rural and urban
areas. “Environmental design has played a vital role in linking water and health, from Mohenjo Daro to Boston,” he said.
Addressing the Symposium via the Internet from India, Dr Bindeshwar Pathak, founder of the Sulabh Sanitary Movement,
said low-cost sanitation technology is available and by adopting these technologies, any country can improve the
sanitation sector. Sharing his experience of introducing a two-pit pour flush toilet that uses only 1-1.5 litres of water, he
said that the technology is flexible and affordable and can be implemented at costs starting from USD 30, depending on
the quality.
AKU’s Dr Iqtidar A Khan said that in Pakistan 90 percent of water is used for agriculture and less than 10 percent for
drinking and sanitation. He said the water availability has fallen from 5,000 cubic metres per capita in the early 1950s to
less than 1,500 cubic metres today. Quoting the words of former United Nations Secretary General Kofi Annan, he said
that AIDS, tuberculosis, malaria and other infectious diseases will not be defeated until the battles for safe drinking water,
sanitation and basic health care are won.
(By Amar Guriro, DailyTimes-B1, 28/10/2009)
NOVEMBER
Pneumonia vaccine to become part of EPI in 2011
KARACHI, Nov 2: Medical experts said at a forum on Monday that the world’s leading child killer pneumonia could be
controlled through scaling up exclusive breastfeeding, vaccinations and effective management.
This disease affects children and families everywhere, but in the world’s 68 high-mortality countries, including those of
South Asia and sub-Saharan Africa, the severity of pneumonia episodes has been alarming. In these countries, about 98
per cent of the children’s deaths occur due to pneumonia.
Pneumonia kills more children under five than measles, malaria, and Aids combined. In Pakistan, the World Health
Organisation (WHO) estimates that one in every five children’s death is due to pneumonia.
Studies have shown that implementing pneumonia prevention and treatment interventions worldwide could save more
than one million lives each year and significantly reduce the burden on families and communities that must cope with
pneumonia-related illnesses and deaths.
Experts stressed the need for hastening action and tackling the number one threat to Pakistani children — pneumonia — if
the fourth United Nations millennium development goal of reducing child mortality was to be met.
The forum was jointly organised by public-and-private sector health institutions at the Aga Khan University as part of the
first World Pneumonia Day activities. The day was observed across the globe on Nov 2 to make the child advocates,
decision-makers in government and private sectors and political leaders move for, among other things, resources and
political will and prevent the avoidable deaths from taking place every year.
Dr Tariq Bhutta, chair of the National Immunization Technical Advisory Group, Pakistan, said that safe and effective
vaccines existed to provide protection against the primary causes of pneumonia, streptococcus pneumonia and
haemophilus influenzae type b (HIB) in children and it was heartening that the Hib vaccine had already been introduced in
the national immunization programme. He informed the audience that the pneumococcal vaccine would be included in the
Expanded Programme on Immunization (EPI) for Pakistan by Jan 1, 2011.
“The pneumococcal vaccine is at present available in Pakistan but remains out of reach for the majority of people due to
its exorbitant price,” he added, saying that the vaccine would be available free of charge at all EPI centres around the
country.
Calling for preventing pneumonic diseases, a noted pediatrician and child health expert, Dr Ghaffar Billoo, also a professor
at AKU, said that protection and treatment of children was equally important. Breastfeeding for the first six months along
with good nutrition and adequate hygiene could prevent many cases of pneumonia in children, he added.
He also stressed the need to recognise the signs of pneumonia such as fast breathing, wheezing and fever at the earliest
as timely healthcare with low-cost antibiotics could save lives.
Dr Bo Lindblad, professor emeritus, Karolinska Institutet, Sweden, Professor Iqtidar A. Khan, professor and interim
chairman, Department of Paediatrics and Child Health, AKU, also spoke on the occasion.
Dr Anita Zaidi of AKU presented early results from a large research study of pneumonia in children in Karachi, Hyderabad,
the Matiari district of Sindh and Jhelum in Punjab showing that the use of the Hib vaccine has reduced the incidence of
pneumonia cases in these areas.
She said that Hib had consistently been the leading cause of childhood bacteria meningitis in all regions including the
Asian where it was the leading cause of mortality in children under five. Surveillance showed meningitis incidences of 3076 cases/100,000 children.
According to her, the preliminary data from Hib vaccine impact study in the country showed that infants getting the Hib
vaccine had a lower rate of severe (X-ray-proven) pneumonia.
The ‘Global Action Plan to Combat Pneumonia’ which was released by the WHO and Unicef on Nov 2 was also discussed
during the AKU forum.
The two organisations have outlined a six-year plan for the worldwide promotion of a comprehensive set of interventions to
control the diseases. The countries have been urged to implement a three-pronged pneumonic control strategy.
The WHO and Unicef began laying the foundation of a global action plan for pneumonia control (GAPP) in 2007 and by
March, 2009 the 10-valent vaccine had been approved by them, which will cover about 86 to 88 per cent of the serotypes
responsible for the disease in the US and Asia.
(By Mukhtar Alam, Dawn-13, 03/11/2009)
First-ever World Pneumonia Day observed
‘Pneumonia kills more children than measles, malaria and AIDS combined’
KARACHI: Health experts of the Aga Khan University (AKU) have said that pneumonia is one of the most lethal diseases
in the world and it kills more children, under five years of age, as compared to other fatal diseases like measles, malaria
and AIDS, even if all three are combined.
As a part of the message on World Pneumonia Day, celebrated around the world on November 2, the experts said the
world’s leading child killer is not measles or malaria, but in fact pneumonia, which can be prevented by existing vaccines
or treated with inexpensive antibiotics. They also said that while the disease affects children and families everywhere, it
has the most impact in South Asia and sub-Saharan Africa, where 98 percent of all deaths occur due to pneumonia.
In Pakistan, the World Health Organisation (WHO) estimates that
one in every five child deaths are caused by pneumonia. This
disease must be tackled if the United Nations Millennium
Development Goal 4 for reducing child mortality is to be met.
In a statement issued by AKU Department of Public Affairs Media
Executive Fabeha Pervez, the experts at AKU said that safe and
effective vaccines exist to protect children from the leading causes
of pneumonia such as Hib and pneumococcal diseases.
“The Hib vaccine is already available and Pakistan was the first
country in South Asia to introduce the vaccine through its national
immunisation programme, including the pneumococcal vaccine,
which will be included in the Expanded Programme on Immunisation
(EPI) for Pakistan by January 1, 2011,” said Pakistan National
Immunisation Technical Advisory Group Chairman Dr Tariq Bhutta.
“As the pneumococcal vaccine is currently available in Pakistan, at
Rs 12,000, it is too expensive for most people. Under the EPI, the
vaccine will be available free of cost at all EPI centres around the
country. Resources should not be an excuse to avoid tackling this
problem,” said Bhutta.
Researchers at AKU are providing reliable estimates pertaining to how many children are affected by Hib and
pneumococcal infections in Pakistan, while demonstrating the highly positive effects of vaccinating children against
pneumonia. AKU Department of Paediatrics and Child Health (DPCH) Professor Dr Anita Zaidi presented early results
from a large research study of pneumonia in children in Karachi, Hyderabad, the Matiari district of Sindh and Jhelum in
Punjab, showing that use of the Hib vaccine has reduced the incidence of pneumonia cases.
Besides preventing the disease, protecting and treating children is equally important. “Breastfeeding the baby for the first
six months of its life, along with good nutrition and hygiene can prevent many cases of pneumonia” said AKU DPCH
Professor Dr Gaffar Billoo. He also stressed on the need to recognise the signs of pneumonia, which include heavy
breathing, wheezing and fever, since providing timely health care with low-cost antibiotics can save lives.
Sweden Karolinska Institutet Emeritus Professor Dr Bo Lindblad highlighted that organisations from around the globe have
joined hands to urge governments to fight pneumonia. The first steps for this fight are outlined in the Global Action Plan for
the Prevention and Control of Pneumonia, released by the WHO and UNICEF today, to mark the first World Pneumonia
Day.
AKU DPCH Professor and Interim Chairman Iqtidar A Khan, delivering the closing remarks, further said that new vaccines
can only have their full effect on reducing pneumonia related deaths, if efforts are stepped up by parents, doctors and the
health officials of all districts to make sure every child receives a full course of vaccines.
(By Amar Guriro, DailyTimes-B1, 03/11/2009)
Health cover for schools
AT a time when the very future of our schools is so bleak, it appears almost crass to write about the need for introducing a
school health programme in Pakistan. But, as pointed out by an observer, diseases take a heavier toll than bomb blasts.
Hence they should not be ignored.
Besides we have been warned that the war we are engaged in will be of long duration. Life must then go on — as will the
cycle of health and disease. And both — school safety and students’ health — must be provided for.
Last week, a seminar in Karachi on the ‘Impact of water and sanitation on health’ would normally not have caught my
attention, given that this issue has been talked about endlessly with no worthwhile result.
Nevertheless, hidden in the outpouring of words that such gatherings produce, was a one-line statement that came like a
bolt from the blue.
One didn’t expect it as learned experts were pontificating on the advantages of clean water and sanitation. Prof Rasheed
Jooma, director general of health, who was the chief guest on the occasion, casually mentioned that the federal health
ministry “might revitalise the school health programme”.
One fervently hopes that it does. Dr Jooma would earn the gratitude of millions of parents if he translates his words into
reality.
Few would recall that at one stage the government had introduced a health programme for school students. Needless to
say it never got off to a good start and is now virtually dead. If the government thinks it worthwhile to revive this project, it
certainly deserves to be commended and no delay should be brooked.
One hardly needs to emphasise the close link between health and education, something that is universally recognised.
One reinforces the other. A child in good health can apply himself to his studies better. His school attendance record is
good, and being alert and energetic the student can be expected to perform better academically. Besides, health
education must start early in life to have an impact.
The ideal approach therefore is to link the two sectors where linkages are available. This could be done by introducing a
strong school health programme, especially in public-sector institutions, which account for 87 per cent of primary-level
enrolment in the country. Students in these schools have modest means and are often denied adequate healthcare.
The government would do well to look into some programmes that NGOs have adopted to give some health cover to their
students. Some of them are doing very well.
Take the case of the Garage School in Neelum Colony, a low-income locality in Clifton, Karachi. Set up by Shabina in
1999 with a handful of children on its rolls, this school has expanded over the years. Today it has over 300 students.
Shabina adopts an incremental approach. Initially she was providing rudimentary healthcare on an ad hoc basis. This has
now been formalised and expanded to include students and their families as well.
Since February, Dr Aniqa Khan has been holding a clinic on the school premises thrice a week in the afternoon. The
students of the school as well as their families receive coverage free of cost. This might even involve expensive surgery
and hospitalisation which is provided through the network of health facilities and consultants which Dr Khan has created
through personal contacts
The most recent beneficiary of this arrangement was Kainat, a five-year-old who suffered from a serious congenital heart
problem. Three weeks ago, Kainat underwent delicate cardiac surgery at a leading hospital in Karachi. Funds were raised
for the child as an appeal went round on the Internet with the hospital also providing concessionary rates.
When the school admits new children all of them undergo a medical check-up so that any serious condition can be
detected — that is how Kainat’s case came to light. Any child who feels unwell is encouraged to visit Dr Khan with his
parents not just to obtain medicines but also to receive counselling on health awareness. The doctor has periodically
arranged group discussions with the community on health, hygiene, lifestyle, diet and family planning.
The health clinic has begun to make an impact. Absenteeism in class has decreased and the health of the children has
improved. Adopting the preventive approach, Shabina gets donors to pay for the vitamins, iron and calcium pills she hands
to the children every morning, costing over Rs21,000 a month. When a donor is available, they also get fruit, eggs and
milk to supplement their diet. Dr Aniqa Khan treats other families in Neelum Colony whose offspring are not attending the
Garage School for a nominal fee.
It all appears to be so simple and doable. One hopes the health ministry will study this model and adopt it. Why should it
be left only to the NGOs and other individuals committed to education and health to think outside the box? The
government with its greater resources should be the one taking the initiative to introduce a programme of this kind. The
Global Competitive Index places Pakistan at the lower rungs of health-related indicators. The recently announced National
Education Policy speaks vaguely of providing health services and food in schools but one will have to see if the authorities
are serious about it.
What is needed is a holistic approach to the child’s education. He is a part of his family which lives in a community. Until
an effort is made to reach out to them and integrate the classroom with the social environment, no education project can
succeed. If primary healthcare were to be integrated with education — schools can form the nucleus — it will be possible
to reach out to the community. This will considerably reduce the load on tertiary healthcare institutions.
(By Zubeida Mustafa, Dawn-7, 04/11/2009)
Too many cooks spoil the Sobhraj Maternity Home?
KARACHI: The Sobhraj Maternity Home (SMH), which has also been declared as a historical building, is in a pitiable state
due to different bodies governing its affairs at the same time and paucity of funds; however, a recent development has
brought a glimmer of hope for the health facility.
Located near Burns Road, a densely populated and congested residential old area of the city, the SMH was established in
the pre-partition era in 1928 and was upgraded in 1975 with an extension to the outpatient department facility.
However, the poor state of the health facility could be attributed to the fact that it has remained under different
administrative controls at the same time.
The defunct Karachi Municipal Corporation, the City District Government Karachi Health Group of Offices and the Sindh
Council of Unified Group have been claiming the administrative control of the SMH, while the annual CDGK budget for
2009-10 has allocated a very petty amount of funds for it.
The 120-bedded SMH, with around 350 OPDs per day, has an old nursing teaching faculty, which has been upgraded to
18-month course with a main focus on midwifery consisting of a batch of 25 students.
The lack of necessary funds has cause severely hindered the smooth functioning of the SMH. There are 10 incubators in
the SMH for the neonates but unfortunately five are out of service due to technical faults there are no funds for their repair.
A major problem at the SMH is that there are only a couple of anesthesiologists available only from 8am to 2pm. The lack
of anesthesiologists during other hours is addressed with the help of private anesthesiologists. Patients in need of surgical
measures have to pay two different fees i.e. Rs 600 during from 2pm to 8pm and Rs 800 from 8pm to 8am.
Although, the CDGK Health Group of Offices has completed the interviews of doctors, the required number of doctors for
the SMH is yet to be approved and budgetary allocations are also yet to be revised.
However, it has been learnt that following the efforts of the SMH Medical Superintendent Dr Anwar Khwaja, the hospital is
due to undergo major upgrading with the help of some concerned philanthropists in the city.
The SMH would have a new building covering an area of 45,000 square yards that would be equipped with latest
diagnostic tools and machines. The number of medical consultants would also be increased at the SMH.
(By Irfan Aligi, DailyTimes-B1, 05/11/2009)
High blood pressure leading cause of death across the globe
Researchers at the Aga Khan University on Thursday said that high blood pressure (HBP) is the leading cause of death in
high and low income countries. Quoting a research conducted from 1990 to 1994 by the National Health Survey of
Pakistan, one in every three people over the age of 45 suffers from high blood pressure.
The doctors said that despite convincing evidence, low blood pressure reduces the chances of death, heart problems,
strokes and kidney disease. Blood pressure control rates remain poor in most developing countries. In Pakistan, poor
health literacy, unhealthy lifestyles and a lack of awareness contribute to the high blood pressure problem, which is further
compounded by a poorly regulated and disorganised health care system.
“The strategy proposed by our trial is simple and can easily be integrated into the existing health care system of Pakistan
and many other developing countries: one general practitioner training session per year coupled with health education at
home by trained community health visitors,” said Dr Tazeen Jafar, Professor of Medicine and Community Health Sciences,
AKU, the leading investigator on the study.
“This is encouraging because it provides hope of success if similar strategies are implemented in other countries facing
the pandemic of high blood pressure and associated morbidity and mortality.” The study, launched in 2003 and funded by
the Wellcome Trust, UK, is based on a two-pronged approach. Community health workers were trained to provide
knowledge on the harmful effects of hypertension and to share options for non-medical interventions to prevent and
control blood pressure and heart diseases.
“We talked to families about weight loss strategies, the need to exercise, how to quit smoking, how to reduce salt and
saturated fat intake, and to increase the amount of fruit and vegetables in their diet. In some cases, this was quite new for
certain communities. “We saw that patients in groups receiving both health worker care, as well as updated physician
care, had the greatest improvement in blood pressure,” said Dr Jafar. “These results can help develop a cost-effective
strategy to prepare a sustainable and implementable nation-wide blood pressure control programme.”
(The News-14, 06/11/2009)
High blood pressure reaching epidemic proportions in country
KARACHI: The researchers of the Aga Khan University (AKU) have found that high blood pressure is turning into an
epidemic in the country, and it could only be controlled by training the physicians and by providing healthcare education to
people in their homes through community health workers.
The AKU researchers, after conducting a lengthy technical research, also found that reduced blood pressure over the long
term can lead to a one-fifth decline in deaths from heart disease in urban populations. The study that was carried out for
about two years and was funded by the Wellcome Trust, UK and based on a two-pronged approach.
Over 1,300 40-year-old individuals with high blood pressure were chosen from 12 urban communities in Karachi. The
subjects for this study were selected from New Karachi, Rehmani Garden, Aurangabad, Korangi, Saghir Centre,
Villayatabad, Saudabad, Safoora Goth, Orangi Town, Liaqatabad, Ramswami and Bhutta Village and were divided into
clusters.
One group was assured to receive home-based health education from community health workers and other group was
referred to trained general practitioners.
Also there were those who received both these options, while a fourth control group received no intervention.
These groups were regularly examined over a two-year period. “We saw that patients in groups receiving both health
workers’ care, as well as trained general practitioners’ care, had the greatest improvement in blood pressure,” said Dr
Tazeen Jafar, AKU professor of medicine and community health sciences, and the lead investigator on the study.
He said these results could help develop a cost-effective strategy to prepare a sustainable and implementable nation-wide
blood pressure control programme.
High blood pressure is the leading cause of death in high and low-income countries. According to the National Health
Survey of Pakistan, conducted from 1990 to 1994, around 21.5 percent of the urban population over 15 years of age - that
is one in every three people over the age of 45 years - suffers from high blood pressure.
Despite convincing evidence that lowering blood pressure decreases death and disability from heart disease, strokes and
kidney disease; blood pressure control rates remain poor in most developing countries.
In Pakistan, poor health literacy, unhealthy lifestyles and a lack of awareness contribute to the high blood pressure
problem, which is further compounded by a poorly regulated and disorganised health care system. The AKU study shows
that existing infrastructure can be used to provide cost-effective and implementable solutions to tackle a growing
pandemic in the region.
“The strategy proposed by our trial is simple and can easily be integrated into the existing health care system of Pakistan
and many other developing countries: one general practitioner training session per year coupled with health education at
home by trained community health visitors,” said Dr Jafar. “This is encouraging because it provides hope of success if
similar strategies are implemented in other countries facing the pandemic of high blood pressure and associated morbidity
and mortality.”
Community health workers were trained to provide knowledge on the harmful effects of hypertension and to share options
for non-medical interventions to prevent and control blood pressure and heart diseases. “We talked to families about
weight loss strategies, the need to exercise, how to quit smoking, how to reduce salt and saturated fat intake, and to
increase the amount of fruit and vegetables in their diet. In some cases, this was new knowledge for the communities. In
other cases, all they needed was advice on changing their lifestyles,” a participating health worker explained. The
education was delivered at three-monthly intervals to match the frequency of visits by government lady health visitors.
(By Amar Guriro, DailyTimes-B1, 06/11/2009)
Legislation to curb quackery, fake drugs stressed
KARACHI, Nov 7: As quacks and producers of fake medicines rake in money at the cost of people’s health and life, health
officials say they are unable to curb quackery and production and sale of spurious drugs because they do not have
necessary legal support.
Sources in the provincial and district governments said a successful operation against quacks and dealers of fake
medicines could not be carried out in districts and tehsils across the province as the authorities had failed to make “some
small but important amendments” in the existing rules needed to launch prosecution in court over violations of the Drugs
Act, 1976, and the Allopathic System (Prevention of Misuse) Ordinance, 1962 or related laws.
From time to time, health officials have been expressing their inability to help safeguard the public against quacks,
incompetent health providers and sellers of spurious and unregistered drugs. But after the Supreme Court’s Aug 27, 2009
verdict in the case of a one-and-a-half-year-old girl, who was needlessly amputated at a health facility in Punjab, they have
started reviewing the legal provisions again.
An SC bench, comprising Chief Justice Iftikhar Muhammad Chaudhry and Justices Ghulam Rabbani and Jawwad S.
Khawaja, while ordering concentrated efforts by the federal and provincial health authorities against quacks and dealers of
fake medicines had also issued instructions to the drug courts to early dispose of cases and action against the violators of
the drugs act.
The SC order said that the federal and provincial governments in conjunction with the Pakistan Medical and Dental
Council (PMDC) must note that enjoying healthcare facility was the public’s right to life under Article 9 of the constitution
and it could not be denied to the them on account of unauthorised medical practitioners functioning throughout the
country.
The EDO (health) of Faisalabad and others EDOs (health) of all districts throughout the country, according to the SC
decision, should submit reports about violation of the Drugs Act, 1976 and the Allopathic System (Prevention of Misuse)
Ordinance, 1962 or related laws, within two months, to the registrar of the SC, who would compile them province-wise and
submit them to the members of the bench for their consideration in chambers.
The allopathic system ordinance, which envisages measures, among other things, against a person pretending to be a
doctor or persons other than registered medical practitioners performing surgical operations, says that no prosecution
shall be instituted under the ordinance except by an inspector appointed under the drugs act or by a person empowered
by the provincial government in this behalf.
It is learnt that both the Sindh health department and the PMDC have started consulting EDOs and are seeking proposals
for the implementation of the SC verdict.
The special secretary (health) of the province also held a meeting for the purpose recently, a source said.
During the meeting, Karachi’s EDO-Health Dr A. D. Sajnani said that there was a need to make amendments in certain
rules, particularly in the wake of the devolution of power and implementation of the SLGO, 2000, for taking action against
quacks.
There is also a need to empower the health EDOs to seal any clinic/ dispensary/ maternity home or any other place used
for diagnosis, treatment or rehabilitation of patients if it is run by a person not qualified/ registered with the PMDC.
Similarly, the drug inspectors getting salaries from the district governments, or the EDOs, be allowed to order the sealing
of a health institution or premises which keep or use stocks of spurious drugs.
According to a source, the EDO (health) of Karachi has also requested the provincial health secretary to empower the
relevant EDOs to prosecute the violators of the drugs law.
Some officials suggested that it should also be inserted in the law that the local police assist the relevant field officers
during their actions against quacks, spurious and unregistered drug manufacturers and sellers and a mechanism for interprovincial coordination be developed against groups engaged in producing and dealing in fake medicines.
A field officer told this reporter that his team in a recent operation against an unregistered drug seller in Hyderabad had
learnt that medicines branded by foreign countries, including the United Kingdom, India and China, were being prepared
and sold in the country.
(By Mukhtar Alam, Dawn-13, 08/11/2009)
1.5m Thalassemics unaware of their condition
Thalassemia is a painful disease and currently there are 1.5 million patients suffering from it who are completely unaware
about it, said Mohammed Iqbal, president of the Iqbal Thalassemia Care Centre (KITCC) Trust on Saturday.
Addressing the inaugural ceremony of the KITCC Trust that saw a number of political figures coming forth with their
support for the organisation, Iqbal further explained the illness to the audience. “There are two types of Thalassemia,
minor and major. The minor one is a blood irregularity and doesn’t require any medicine but if two people having
Thalassemia minor get married then their children may be born with Thalassemia major which is not curable and is a life
long process of pain and misery for the family,” he explained.
“The disease spreads because of intermarriages and most of the victims are Baloch, Pathan, Memon and other such
communities where intermarriages are common. As a result, the disease is carried from generation to generation,” he
added.
S M Muneer, Patron-in-Chief of the KITCC Trust lamented how the government was always there when passing a bill but
when it came to actually providing financial security to welfare organizations, it did not seem to have time. “We know that
there are other more important issues for the government to deal with but health care is equally important, and needs
concerted effort as it is teamwork and can’t be done in isolation,” he said.
Sindh Minister for Health Sindh, Dr Sagheer Ahmed, reiterated the same and added, “It’s high time we stop supporting a
cause verbally and instead show that we actually aim to do something about it. We need the state to come forward as it’s
a long-term process.” He also stressed the need to bring forth laws in which married couples would be asked to go for
blood tests in order to avert the risk of Thalassemia.
In the end, Speaker Sindh Assembly and Acting Governor of Sindh, Nisar Ahmed Khuhro, said that the Sindh Assembly
had passed a resolution in October 2009 according to which it would be mandatory for the youth to go through tests before
marriage so that the disease could be investigated upon. Senator Abdul Haseeb Khan also spoke.
(The News-14, 08/11/2009)
Children in city’s 2nd largest slum battling with diarrhoea
KARACHI: Viral diarrhoea has gripped the city’s second largest slum settlement, Machhar Colony and children are falling
victim to this deadly disease.
The reasons for this outbreak include a lack of proper sanitation system, a huge open
drain running in the centre of the colony and absence of clean potable water.
The health experts working in the colony have declared this an emergency situation and
said if the government does not take any immediate safety measures, the condition
could worsen. They also warned that the disease might spread in other parts of the city.
“Since last week, diarrhoea has become epidemic in the colony and children are dying,”
said Dr Aisha Siddique, a young lady doctor at Mother and Child Heath Centre, which is
run by a non profit and non government organisation Concern for Children Trust (CFC).
She said that she receives 60 patients everyday, but since the spread of diarrhoea, the
majority of the patients visiting the centre are children.
“A child in almost every home is suffering from diarrhoea in this colony, which has a
population of about 0.7 million,” said Dr Siddique. She said that there are about 72 clinics
working in different areas of the colony and almost every clinic is receiving large
numbers of children with viral diarrhoea.
Located in the backwaters of Karachi Port, just off the edges of the Arabian Sea, Machhar Colony is the second largest
slum settlement after Orangi Pilot Project and is home to approximately 0.7 million people of different ethnic backgrounds
and nationalities including Biharis, Burmese, Bangladeshis, and Afghans. As the colony is illegal on government records,
therefore it is suffering from a lack of basic facilities such as clean drinking water and proper sanitation.
“There is no water supply system in the colony, therefore the people get water from other localities through a network of
plastic pipes, and you can see these pipes are spread amongst the garbage on the surface of the main sewerage drain
passing from the middle of the colony, Dr Siddique explained. “Sometimes when the garbage catches fire, these pipes are
burnt resulting in sewerage water getting mixed with drinking water causing the spread of diseases” She said that the
practice is common in the colony, but the reasons for the diarrhoeal disease as well as its spread need to be ascertained
through a study.
Official data from different international organisations reveals that in Pakistan, 38.5 million people lack accesses to safe
drinking water, and 50.7 million lack access to improved sanitation, due to which 25 percent of the total hospital beds in
Pakistan are occupied by the people suffering from waterborne diseases.
The study further reveals that diarrhoea is the leading cause of mortality and second leading cause of morbidity among
children under five years of age.
“Due to poverty, there is almost one patient of tuberculosis in every house in the colony, besides this typhoid fever, viral
fever and other diseases are also common, but this recent diarrhoeal epidemic could be very fatal if certain measures are
not taken,” said Dr Siddique.
(By Amar Guriro, DailyTimes-B1, 09/11/2009)
Awareness to contain disease urged
Diabetes kills 89,000 a year in Pakistan, say experts
KARACHI, Nov 9: Pakistan will have the fourth largest population of diabetic patients in the world by 2030 if the country
fails to check the rate at which the disease has been spreading.
According to an estimate of the International Diabetes Federation, about 89,000 deaths of men and women occur every
year in the country because of diabetes-related complications.
These were the views of senior health experts at a ‘diabetes awareness walk’ organised by the National Institute of
Diabetes and Endocrinology (NIDE) on the Ojha campus of the Dow University of Health Sciences on Sunday.
The walk was part of programmes being organised to observe World Diabetes Day on Nov 14.
The theme of World Diabetes Day launched by the International Diabetes Federation (IDF) and the World Health
Organisation (WHO) is “diabetes education and prevention”. The day marks the birth anniversary of one of the discoverers
of insulin in 1922 — a life-saving substance given to diabetic patients.
According to World Health Organisation statistics of 2005, more than 180 million people worldwide have diabetes and the
number is likely to more than double by 2030, if the condition is left unchecked.
Almost 80 per cent of diabetic deaths occur in low- and middle-income countries, according to the report, experts say.
A good number of people, including faculty members of the university, students and diabetic patients, participated in the
walk.
The director of the NIDE, Prof Zaman Shaikh, said that diabetes was a serious threat to public health and the leading
cause of blindness, limb amputations and cardiac problems worldwide.
Quoting the IDF estimates, he said that some 285 million people worldwide would live with diabetes in the year 2010 and
the figure was expected to reach 438 million by 2030.
The South-East Asian region was worst affected and it had about 58 million people suffering from diabetes and their
number could reach about 101 million by 2030, registering an increase of about 72 per cent, he said.
Prof Shaikh said that Pakistan had a diabetes prevalence rate of about seven per cent in the entire population which was
an alarming situation.
If steps were not taken, the figures would multiply to an extent that by 2030, Pakistan would become the fourth leading
nation in the world in terms of people having diabetes. He said that diabetes treatment was expensive and to combat the
problem, all sections of society must act together under the IDF motto “Unite for Diabetes”.
Prevention strategies, he said, were the most important and for this lifestyle changes, including regular exercise and
dietary changes, could be of the utmost importance.
That could help control blood sugar and prevent the complications in the long term, he said.
Prof Zeenat Ayub also spoke.
A free blood sugar screening and body mass index test was also arranged.
(Dawn-15, 10/11/2009)
Administrative wrangle leaves police hospital in tatters
The ongoing onflict over the administrative control of the Police Welfare Hospital, Garden, between the Police and Sindh
Health Department, is posing the policemen difficulties, Additional Inspector-General (AIG) Shahid Hayat told The News.
Constructed in 1945, the Police Welfare Hospital gets its funds from the Home and Health Departments, while the latter
also recruits doctors for the hospital.
And that’s where the problem starts, as the patients, all of them policemen, complain that there are no doctors to attend to
them in the hospital, and as a result, they are referred to government hospitals.
“What’s the use of their getting salaries from the hospital when these doctors don’t bother to show up at all?” asks Hashim
Khan, a constable.
Hayat seems to have an answer to that as he says that on May 2005 they had signed a Memorandum of Understanding
(MoU), with the Health Department and Sindh government respectively which stated that the police department will be
controlling police hospitals in Karachi and Hyderabad and in a letter to the Secretary, Health, he had asked the Health
Department to take back the doctors recruited by them “as they are not adding anything to the hospital.”
However, the Secretary, Health, did not entertain this demand, stating that it was in complete violation of the rules and as
for the notification for the handing over of the hospital, it was issued in 2007. “The only good thing that came out of it is
that the doctors have stopped coming as we have categorically told them not to,” says Hayat.
The Secretary, Health, was out of country when contacted for comments.
Moreover, a budget of Rs35 million is allotted to the police department in Karachi which comprises a task force of 35,000
which leaves seven rupees per policeman.
“We can’t even get a Disprin strip for this amount”, says Hashim Khan, and adds that no matter what the high-ups do it’s
ultimately the constables who face a hard time.
Meanwhile, the welfare hospital is being reconstructed by the police department but without any financial help from the
government. “We are taking help from the other sources this time and have amb itious plans to see our project through, no
matter what people say,” asserted Hayat.
(By Saher Baloch, The News-13, 14/11/2009)
Where health is a birthright
WHILE validating the Transplantation of Human Organs and Tissues Ordinance 2007 in the form of a bill, the National
Assembly paid rich tributes to Prof Adibul Hasan Rizvi and the Sindh Institute of Urology and Transplantation (SIUT),
Karachi. They deserved the recognition they received — belatedly though — from our lawmakers.
What has been achieved through the transplantation law, that had to be validated under a Supreme Court judgment, is
something momentous. It was the good name of the country and the medical profession that was at stake.
If the law is implemented transparently and due vigilance is exercised Pakistan should be able to shed the stigma it had
acquired as the kidney bazaar of the world. We had earned the reputation of being the spot where a foreigner with endstage kidney failure could buy an organ from the poorest of the poor and have it transplanted by hiring the services of a
local urologist who had sold his conscience to the devil. This was demeaning beyond belief.
No argument to support the practice — it did have its advocates after all — had any moral justification. The monetary
transaction involving hundreds of thousands benefited a handful of individuals whose bank accounts grew fabulously.
The donor, whose poverty was used as an excuse to vindicate his decision to sell his kidney, received peanuts that did not
help him repay his debts while he ended up with new health problems caused by poor post-operative care.
The recipient who was supposed to be the main beneficiary found himself suffering from the after-effects of surgery done
hastily and clandestinely.
The new law will therefore be welcomed because it provides the legal framework to curb this shameful practice. The
impact of the ordinance promulgated two years ago had already begun to be felt. It is Dr Rizvi’s success in getting this law
enacted that is the news of the day. The law had many enemies. It had been in the works for 15 years. Its adoption now
signifies the victory of an idealist against big money.
Our experience tells us that where entrenched vested financial interests making illegal profits are involved in Pakistan, it is
nigh impossible to dislodge them. The system works in their favour.
Then how could one frail-looking man with a shock of white hair take on the organ traffickers? It became apparent that he
had a will of steel. There were risks involved and one of the profiteers even claimed before the court that the factor at work
in the case was “business rivalry”.
The simple truth is that for Prof Rizvi practising medicine is not a business. He gave up his private practice in 2000 and the
SIUT does not charge a penny from its patients.
A man of moral convictions, Dr Rizvi practises what he preaches. He has not forgotten his Hippocratic Oath or the leftist
leanings he imbibed during his student days, notwithstanding the sweeping advent of the market in this age of capitalism.
Hence social justice continues to be close to his heart and is the lynchpin of his professional and personal life.
A sceptic may ask, so what? That is what they all claim. But pay a visit to the SIUT and see for yourself. Prof Rizvi
welcomes visitors any time — that is how I discovered the place when I was investigating some health facilities that were
raising donations through public walks.
Those were pre-SIUT days when Dr Rizvi’s kingdom was the urology ward of the Civil Hospital, Karachi. It was in March
1991 that the Sindh Assembly adopted an act that created SIUT as an autonomous institute. This gave SIUT the space it
needed. By then even the parent hospital had imposed service and bed charges on its patients.
It is not just the impeccably clean environment of the place, the skill and expertise of the doctors and the staff that
impresses one. It is the compassion and humanity in the operation of the institute that attracts well-wishers and there is no
dearth of them.
The decisive factor that has turned the tide in favour of SIUT is that in a country where only the rich are entitled to
healthcare, the institute has proved that the poor can also be given the gift of health with dignity and compassion. Dr Rizvi
never tires of saying, health is the birthright of every citizen and it is a deplorable system under which the rich get health
cover and the poor are left to die.
That is why at SIUT all are equal before the cashier. All services provided to any one who enters its portals are free of cost
— be it antibiotics for renal infection or the expensive transplantation surgery and the anti-rejection drugs one has to take
for life.
True, there are a few other health centres in the country working for the poor who are provided free treatment. But they
restrict their intake of patients. Some require the ill to get an appointment. Others shut their doors when the magic number
of patients has been registered.
At SIUT the flood of patients keeps rising. In 2009 (until Nov) 650,000 patients received treatment for which the institute
spent Rs1.2bn. Since 1985 2,740 patients have received kidney transplants. But most importantly no questions are asked
about one’s economic status. One doesn’t have to prove one’s poverty to be entitled to free treatment. According to Dr
Rizvi, a person’s self-esteem should never be offended.
It is therefore not surprising that even our MNAs who adopted the bill in a bipartisan spirit had to acknowledge the
greatness of the cause Dr Rizvi espouses. The public is constantly paying him a tribute by making donations that account
for double the budgetary allocations SIUT receives from the government, although it is a public-sector utility.
Unlike many others, Dr Rizvi’s brand of medical ethics does not allow him to collect funds from the public to run SIUT and
then slap high charges on his patients as many are doing in the name of philanthropy.
(By Zubeida Mustafa, Dawn-7, 18/11/2009)
Recent dengue deaths cause alarm
KARACHI, Nov 23: Two more dengue patients died at the Abbasi Shaheed Hospital last week amid an alarming increase
in the cases of the mosquito-borne disease, which has so far claimed the lives of eight persons in the city.
The two latest victims, a man and a woman, died after a week-long treatment. Both patients were in their thirties and lived
in two localities of Orangi Town.
Thirty-six-year-old Khadija, one of the latest victims of the mosquito-borne disease, was admitted to Abbasi Shaheed
Hospital (ASH) on Nov 15 with a history of high-grade fever and bleeding, said Dr Shakeel Mullick, the official in charge of
the provincial dengue surveillance cell. He said that it was the third case in which a dengue patient died in the hospital.
She was tested positive for dengue at the ASH where she died on Nov 21, he added.
Khadija, a housewife and resident of Sector 1-D Orangi Town, was taken to hospital after she had been suffering from
fever for one week. She left a husband, three daughters and a son.
Confirming another death of dengue, Dr Mullick said that Mohammad Afzal, a resident of Qasba Colony, was admitted to
the ASH on Nov 7.
The 35-year-old patient was also tested positive for dengue and he died on Nov 16.
He said that the latest two cases brought the total number of dengue-related deaths in the city this year to eight, an exact
double of the last year’s death figure.
Earlier, the Civil Hospital Karachi had reported two deaths while the Ziauddin University Hospital, the Liaquat National
Hospital, the Aga Khan University Hospital and the Abbasi Shaheed Hospital reported one death each till Oct 19.
A total of 14 new patients thought to be suffering from dengue were admitted to two hospitals in the city till Monday
morning. Of them, 13 patients were admitted to the Abbasi Shaheed Hospital alone.
The number of outgoing patients is 28.
According to the provincial dengue surveillance cell, the numbers of dengue-suspected patients, including children and
women, reached 1,162 during the year. Of them, 713 (61.35 per cent) patients were tested positive.
From September an alarming increase in the cases of dengue patients is being witnessed in the city. Till Sept 9, all the
hospitals had received only 84 patients tested positive for dengue, but the figure jumped to 403 patients in a short span of
six weeks. Also till Sept 9, only one dengue-related death was reported in the city.
The city was first hit by a dengue epidemic in 2006. The outbreak that persisted for six months affected 4,750 people and
claimed 50 lives. The following year, 22 patients died of dengue fever in the city. In all 2,600 cases were reported to the
major hospitals of the city that year. In 2008, the disease claimed four lives in the metropolis and the total number of
patients also came down. This year, eight deaths due to dengue have been confirmed by the health authorities.
Since the number of dengue positive cases has increased by 75 per cent during the last one month (from about 400 till
Oct 23 to about 710 till Nov 23), experts once again warned the public in general and youths in particular to take
precautionary measures and avoid exposure to mosquitoes.
Dr Rafiq Khanani, the president of the infection control society Pakistan, said that dengue incidents would start subsiding
by the end of November and almost stop in December with a drop in temperature.
He, however, said that the city government should reactivate its fumigation campaign to avert an outbreak of dengue.
As many as 49 dengue-suspected patients are still under treatment in various hospitals of the city.
(By Mukhtar Alam, Dawn-13, 24/11/2009)
Over 50pc women die in child birth
Over 50 per cent of women in Pakistan die during child birth as a result of lack of blood in their body. Most women do not
understand the implications of this problem due to which child bearing gets difficult.
Doctors expressed their concern at a seminar, organised by the Asia Lab Diagnostic Centre in collaboration with Haji
Saeed Welfare Trust, on Tuesday. The seminar was organised to understand the factors and proper treatment regarding
this disease which creates major complications for a woman.
“Ten per cent of deaths during childbirth occur because women do not have enough blood in their bodies,” says Dr Zafar
Baqayi.
Dr Aziz Khan Tank said, “If we want to develop the concept of safe mother and child than promoting awareness among
women is necessary. Irregular menstruation, marrying at a young age, not taking proper nutrition and less space between
deliveries, are the main factors which make it difficult for the body to create blood.”
The doctors stressed that women need to take care of themselves by taking ample steps to maintain their diet by eating
food that helps in making blood for the body.
(The News-13, 25/11/2009)
DECEMBER
Sex workers vulnerable to Aids despite increased awareness
KARACHI, Nov 30: A prostitute born and brought up in the city’s Napier Road red-light area, Shumaila never heard about
HIV and Aids until recently. Today, she carries condoms but clients refuse to wear them.
“None of us were aware of the danger of Aids looming over us for years but now we all know and can avoid it,” said the tall
29-year-old who lives in a Victorian-style building in the heart of the neighbourhood.
Shumaila’s awareness — rare among the county’s sex workers — is thanks to the Gender and Reproductive Health
Forum, a local charity that runs a UN-funded programme in Napier Road teaching prostitutes about the perils of HIV/Aids.
“So far we have provided hundreds of thousands of condoms to sex workers in the last two years, which have saved them
from being infected with the lethal virus,” said Mirza Aleem Baig, who runs the forum.
Karachi, one of the biggest Muslim cities in the world, has up to 100,000 female sex workers, according to data gathered
by Pakistan Society, a local welfare organisation.
“This is 20 per cent of their overall population in Pakistan. Lahore comes next with 75,000 sex workers,” Saleem Azam,
head of the charity, says.
Prostitution may be illegal but it has prospered in an increasingly Islamised Pakistan, where an economic downturn and
spreading poverty have forced women and men onto the streets to meet the rising cost of living.
Shaheena, 38, is a home-based sex worker. She is a skilled paramedic but seldom finds a permanent job.
“So I opted to enter this business on the side,” she told AFP, veiling her face to hide her identity. “I have siblings, cousins,
nephews and nieces who don’t know about my second profession. So I don’t want to identify myself to embarrass them.
“But it’s a question of survival as none of my relatives support me with money. They are all too stretched themselves,” she
said.
Azam says more than 60 per cent of Pakistan’s prostitutes work from homes or ply the streets, while the elite serve
wealthy clients from kothikhanas (houses or rooms) in plush neighbourhoods.
This year’s annual UN report on Aids said while the epidemic in Asia appears to be stable overall, HIV prevalence is
increasing in some parts of the region, such as Bangladesh and Pakistan.
A survey published in the report said 60 per cent of female sex workers and 45 per cent of their male clients in Karachi
and Lahore do not know that condoms can prevent transmission of HIV.
Of those that do, few protect themselves.
“The number of our clients who agree to wear a condom is very small. Female condoms are not available, which can save
us more effectively,” said Nasreen, another prostitute in the Napier Road area.
“I can’t carry condoms in my purse on the street as we’re vulnerable to the police and could be arrested if they find them,”
said Afshan, 29, who walks the city’s busy streets looking for clients.
The most recent survey conducted by the National Aids Control Programme (NACP) in 2006 said only 18 per cent of sex
workers reported always using condoms.
The UN report estimates that around 96,000 people, or 0.1 per cent of the population, live with HIV in Pakistan. The
government says only 5,000 people are infected.
The NACP says the disease is spreading among high-risk groups, especially drug users, who mostly inject and use dirty
needles, raising fears the virus could spread quickly from addicts to prostitutes.
In 2006, Pakistan said HIV/Aids prevalence among female sex workers was around 0.02 per cent, but independent bodies
put it much higher. “It is at least 15 per cent,” said Azam.
“They are totally at the mercy of their clients. Most of their clients refuse to wear condoms,” he said.
“In Pakistan, this business is illegal, thus there is no law to seriously tackle the issue and save precious lives. Yet a wayout is desperately needed on humanitarian grounds.”
Baig said he had identified an HIV-positive sex worker a few months ago and tried to help her with treatment and a new
job but she left because her colleagues considered her a blot on their business.
“Now, no one knows where she is and what she is doing,” he said.
(Dawn-15, 01/12/2009)
Deaths due to ‘medical negligence’ cause alarm in KU
KARACHI, Dec 1: The recent deaths of a senior teacher and another employee, allegedly due to medical negligence, have
caused strong discontent among Karachi University (KU) teachers who are now openly condemning the administration
and accusing it of playing with the lives of employees by turning a blind eye to their health.
There is no uniform policy and the entire ‘system’ is being run either to benefit selective individuals or to penalise those
who oppose the administration, they say.
“The Karachi University is the biggest in the country and also stands prominently among the educational institutions of the
region. Then why such apathy towards those who have made it what it is today?” asks Prof Dr Abid Husnain, president,
Karachi University Teachers Society (Kuts).
The teachers’ society, he said, was actively engaged in discussions with the administration these days to improve the
standard of medical facilities and bring reputable private hospitals on the university panel.
According to Dr Husnain, all major private hospitals, which were on the university panel a few years ago, no more
entertain KU employees due to delayed payments on the part of the university’s accounts department.
“In this situation, there is no option, but to rely on two small private hospitals on the university panel with questionable
services,” he said.
Cases ‘mishandled’
Asrar Ahmed Siddiqui, an assistant professor who taught at KU’s general history department for 25 years, died on Nov 14
after suffering a massive heart attack a day earlier. Immensely popular among students, Mr Siddiqui was known for his
dedication and commitment.
Teachers who had remained closed to Mr Siddiqui while he was being treated in private hospitals over the past two
months were unanimously of the opinion that his case was ‘mishandled’ by doctors.
“There is no doubt that his case was mismanaged. Doctors failed to diagnose the actual cause of his illness and kept the
relatives in the dark till the end. Incorrect diagnosis led to further complications and, finally, took his life,” commented Prof
Dr Jameel Kazmi of KU’s geography department.
More than two weeks have passed, but the university administration is still clueless about what exactly happened with Mr
Siddiqui. An inquiry had been ordered into the incident on Nov 16 by the vice chancellor at a condolence meeting held for
the late teacher. No comprehensive report has been submitted as yet.
And, while, some administrative concern has been shown on Mr Siddqui’s case, the death of Asghar Ali, a typist at the
science dean’s office, has gone almost unnoticed.
Reportedly a patient of high blood pressure, Ali (32) had worked on the campus for over 10 years. He collapsed in his
office some time back in the morning and was immediately taken in the KU ambulance to a private hospital. The hospital,
which was earlier on KU’s panel, allegedly refused to entertain the patient and demanded payment of cash in advance.
“We managed to get a bed for him only after handing over some amount to the staff. However, he remained without proper
treatment for hours and finally died late in the evening,” a KU employee who accompanied Ali to the hospital said.
Navin Ghulam Haider, an assistant professor at Pakistan Studies Centre, KU, told Dawn about another case of medical
negligence concerning Baqar Ali (around 40 years of age), a gardener who worked at PSC for 17 years and died a few
months ago.
Baqir, according to Haider, did not have any life-threatening disease and was primarily diagnosed with jaundice in the
beginning of this year. Later, he off and on went to a private hospital on the university panel and was also admitted for
some time.
“I went to see him in the hospital quite a few times. There was no specialist at the hospital and only one doctor was
looking after all cases. He refused to share the case details with me, saying that only relatives could be informed about
them. This was just an excuse to hide his incompetence since he knew that Baqar’s relatives were not educated enough
and couldn’t question him,” said Haider, adding that the hospital’s ICU was looked like a picnic spot.
Baqir remained on different medication for five months and finally died, apparently due to kidney failure, she said.
“One day he came and had itching all over his body. When I asked him about this, he told me that the doctors said it was
because of some reaction of the medication. On his last days, he was administered 40 bottles of blood while he was
bleeding from the mouth,” she said.
Haider claimed that the doctors had not told the patient at any stage for five months that he had any serious illness.
Visit to the clinic
A visit to the KU clinic revealed that it served as nothing more than a small dispensary. The building was in a poor state
and didn’t have facilities for basic investigation. Teachers who had been visiting the clinic complained that the ‘rift’
between two male doctors was affecting patients’ interests.
“The university has made the junior doctor in charge of the hospital. This has created differences between the two and
often causes problems for patients because both male doctors are not even on talking terms with each other,” one of them
said.
At present three doctors, including one lady doctor, are available at the clinic. A male doctor lives on the campus while
there is no resident lady doctor despite the fact that almost half of the teachers on the campus and 75 per cent students
are women.
Criticising the ‘laid-back’ attitude of the university administration towards health issues concerning its employees, Dr S.M.
Taha, an associate professor at the general history department, said it was ironic to see that a university with 3,000-plus
staff did not have any pharmacy with life-saving drugs.
“We don’t have any emergency numbers available. This is especially worrying in the case of female teachers living
independently on campus,” he said.
Voicing their concern over the lack of resources, teachers demanded that the number of doctors and paramedics be
increased and their appointments made on merit.
They also said the university should properly publicise medical rules, besides revising its reimbursement rates every year
in accordance with the rise in inflation. They also showed concern about what they called ‘deliberate delays’ in the
reimbursement of medical bills.
Talking to Dawn, Dr Nadeemuz Zaman, official in charge of KU clinic and acting senior medical officer, claimed that the
clinic was equipped with all basic facilities. However, a request for provision of ultrasound and an x-ray machine had been
pending with the administration for years, he said.
About Asrar Ahmed Siddiqui’s death, he said he was not looking after his case and did not know the details.
“We have requested the hospitals where he went for treatment to provide us with details of his record and are waiting for
the reply.”
Regarding Asghar Ali’s case, he claimed there was no problem in hospital admission. “It was a case of brain hemorrhage.
There was no medical negligence involved and every type of assistance was provided to him.”
Dr Nadeem declined to comment on Baqar Ali’s death, saying that perhaps Dr Abid Hassan, the other doctor at the clinic,
dealt with that case.
(By Faiza Ilyas, Dawn-15, 02/12/2009)
No AIDS awareness
THE surest way to lose a battle is to deny it is taking place. This may just be happening where HIV/AIDS is concerned in
Pakistan. The World Health Organisation estimates that the number of people infected with the deadly virus has exceeded
125,000 in the country; the official figure, however, has not crossed the 5,000 mark for many years. The groups
immediately at risk are injected-drug users and sex workers, where high levels of risky behaviour combine with limited
awareness. A survey published in this year’s annual UN report on AIDS said that 60 per cent of female sex workers and
45 per cent of their male clients in Karachi and Lahore were unaware that condoms can prevent the transmission of HIV. A
survey conducted by the state-run National AIDS Control Programme in 2006 conceded that only 18 per cent of the
respondent sex workers reported using condoms. Even where awareness exists, sex workers — particularly children —
usually lack the power to negotiate safe sex. Male child prostitution is estimated to be the most common form of sexual
exploitation in the country, with nearly 20,000 child sex workers in Lahore alone.
HIV is on the rise in Pakistan, and this situation must be recognised and addressed. Due to practices such as the
inadequate screening of blood for transfusions and unsafe surgery such as organ removal and dentistry, the virus is
spreading in a society that is already characterised by poverty and illiteracy. Pakistan cannot afford to underestimate the
consequences of HIV/AIDS spilling into the general population: this has happened in parts of Africa, and it is frightening. A
massive awareness campaign is urgently needed, combined with efforts to combat poverty, drug abuse and unsafe
medical practices. Unless the societal attitude towards this stigmatised virus changes, Pakistan may find itself facing an
epidemic, with appalling consequences.
(Dawn-7, 02/12/2009)
Untold story of abortion
ACCORDING to the Pakistan Demographic and Health Survey 2006-07, the country’s population growth rate has fallen to
1.9 per cent from a record high of 3.7 per cent per year in the 1960s.
The survey also gives the total fertility rate (the average number of children a woman would have if she went through her
entire reproductive period, 15-49 years) as 4.1 which has been reduced considerably from 5.4 in 1990.
The population welfare authorities are naturally pleased with these results. But a veil of silence shrouds some more
statistics related to reproductive health. It has been left to the National Committee on Maternal and Neonatal Health
(NCMNH) to shed light on the unpleasant realities of the demographic sector in Pakistan.
Releasing the findings of a survey conducted with the cooperation of the Guttmacher Institute, New York, in 2002, the
NCMNH disclosed the other day that an estimated 890,000 induced abortions were performed in Pakistan that year. Since
abortion is severely stigmatised in our society women are reluctant to talk about this issue. Many of them do not even seek
professional help. A large number have their pregnancy terminated clandestinely by untrained, back-alley midwives.
Inevitably this leads to complications that place a heavy load on the healthcare system. Thus in 2002, 197,000 women had
to be hospitalised for post-abortion complications and a tenth of them died of sepsis, excessive bleeding and other
abortion-related disorders. These maternal deaths are only one aspect of the picture. It is not known how many women
suffer from infertility, long-term disabilities and the economic costs of poorly performed abortions.
While such surveys scientifically confirm what has generally been known, the need of the hour is to look into this matter
seriously rather than hush it up or condemn the women who are driven to seek recourse to abortion. The plain fact is that
every abortion performed is a story of failed contraception. The DHS places the unmet need for contraception at 25 per
cent. In other words one in four women is saddled with an unwanted pregnancy which she could have avoided had she
had access to reliable birth control methods.
The question that has intrigued demographers is how Pakistan’s population growth rate has been falling when
contraceptive prevalence has not increased proportionally. The NCMNH and Guttmacher fact sheet answers this question
succinctly. “The disconnect between low contraceptive use and a relatively small average family size suggests that women
are relying on abortion as a method of controlling their fertility.” Unsurprisingly, the more backward a province the lower its
contraceptive use and the higher the abortion rate.
As is generally the case in issues related to reproductive health, the problem is rooted in the poor status of women in our
society. This time one cannot even blame the law, the prevailing myths notwithstanding. The abortion law as amended in
1990 to better conform to Islamic teachings is quite liberal. In fact, no one has been known to have been prosecuted under
this law.
The problem lies in the policy that denies many women easy access to contraceptive cover. Strangely, men have been
absolved of all responsibility in family planning matters. As a result the onus of finding a solution rests on women, and their
stories are heart rending. At the NCMNH meeting Dr Saadiah Pal presented a number of case studies of women who
opted for abortion, some of them dying in the process. But could they be blamed? One who was pregnant for the 12th time
was the sole breadwinner of the family and her husband was a drug addict. Another had eight children and was a beggar.
And the stories went on.
These are the stories the population welfare department should be listening to. The gynaecologists and obstetricians are
familiar with them as they have to bear the brunt of abortions that go wrong. They know what is needed and this was
reiterated at the meeting mentioned above. Their recommendation to show the way forward was, “Prevent unintended
pregnancy to reduce abortions. Ensure availability of quality family planning services. Increase health and population
budget to six per cent of GDP.”
These words sum up in a nutshell what is missing in our population programme that is not making any headway. There is
a total absence of political will especially at the highest level and an utter failure to comprehend how basic a slowdown of
population growth rate is to the success of our economic development. The strategy adopted to achieve the goal of
replacement level birth rate by the year 2020 is also counter-productive.
As is our wont, a National Population Commission, headed by the prime minister, and four provincial population councils
have been announced. But not much is heard of them.
The population strategy focuses entirely on women who now understand the importance of planning their families. But the
cooperation of men is not being enlisted. What better proof is there of missing male participation than the data for
contraceptives? In January 2009 the use of condoms fell by 18.6 per cent as compared to January 2008, when in the
same period overall contraceptive use registered an increase.
The government speaks of cultural sensitivities, unaffordability of contraceptives and the marked preference for a male
child as hampering progress in achieving population goals. Mercifully, the negative role of religious leaders has not been
advanced as a major factor because as confirmed by the experts at the NCMNH meeting the clergy is no longer a
vociferous opponent of family planning. But it still has to emerge as a staunch advocate as it has in other parts of the
Muslim world.
Dr Sadiqua Jafarey, president of NCMNH, is spot on when she observes, “Many Pakistani women are paying with their
health — and even their lives — to avoid births they cannot afford or do not want.” She also believes that the maternal
mortality rate can be drastically reduced if women are helped to avoid unintended pregnancies.
(By Zubeida Mustafa, Dawn-7, 02/12/2009)
HPV prevalence among Karachi women low: study
KARACHI, Dec 3: A population-based survey of HPV (human papillomavirus) which is a sexually transmitted infection and
carries a major risk of causing cervical cancer has found its prevalence very low in a densely populated locality of
Karachi.
Over 900 women residing in Orangi participated in the survey, a collaborative project of Aga Khan University Hospital
(AKUH), International Agency for Research on Cancer (IARC) based in France and Sindh Government Qatar Hospital
(SGQH), Orangi.
The study — the first large-scale population-based survey on HPV infection in Pakistan — will be published soon. It found
the HPV prevalence in Orangi at less than three per cent.
Dr Syed Ahsan Raza, a senior instructor and epidemiologist at the AKUH who was the principal investigator of the survey,
described the findings as “striking” given the fact that the HPV prevalence in Karachi was lower not only than what it is in
the other countries surveyed by the IARC, but also compared to the neighbouring Asian countries — Nepal (8.6per cent),
Tamil Nadu, India, (17 per cent), China (15-18 per cent in three provinces) and 10 times lower compared to the high-risk
areas in Asia and Africa (35 per cent in Mongolia and 51 per cent in Guinea).
“The HPV prevalence (in the Karachi locality) was found to be even lower than what it is in Iran and Algeria. It is difficult to
explain the actual reasons for this difference. However, the extent of sexual promiscuity in those areas, perhaps, could
provide some insight into the reasons,” says Dr Raza.Results from Karachi, he said, had to be interpreted cautiously
compared to the rest of the country. “In fact, there were some suggestions of slightly higher prevalence among non-Urdu
speakers. However, given the fact that the survey was conducted in one of the largest cities of Pakistan and in an area
where there is representation of different ethnic groups, it is reasonable to believe that the HPV prevalence is not as high
as seen in other parts of Asia.”
For the survey, a group of midwives was initially trained to go door-to-door and create awareness about cervical cancer in
order to convince women to participate in the survey. The midwives were also trained in carrying out gynaecological
examinations at the Qatar Hospital.
A census of 10,000 households was done to collect name and age of every woman resident of the locality. Due to certain
socio-cultural constraints, however, unmarried women were not included in the study.
Cervical samples were obtained from women between the age of 15 and 59 years from May 2007 to March 2008. The
HPV type testing was performed on samples at the Vrije University Medical Centre, Amsterdam.
HPV burden
One of the most common STIs (sexually transmitted infections), the HPV infects the epidermis and mucous membranes of
humans. Approximately, 130 HPV types have been identified. About 30 to 40 HPV types are typically transmitted through
sexual contact. Some sexually transmitted HPV types may cause genital warts.
According to the study, cervical cancer is the third most commonly reported cancer in women after breast and oral cavity
cancer. At the moment, no cervical screening programme exists in the country nor is there any data on HPV infection in
the general population. Little information is available on HPV-associated cervical cancer in the country.
The study points out that the public awareness programmes on STIs in Pakistan in the past have been hampered by the
social restriction attached to discussing female sexuality. Even in high-risk groups, women are hesitant to undergo regular
gynaecological examination or medical check-ups, it says.
Findings
According to the findings, a total of 17 different HPV types were identified. HPV was 2.8 per cent overall with 22.7 per cent
and 2.2 per cent among women with and without cervical abnormalities, respectively.
Significant associations with HPV positivity were observed in a working woman having two or more than two sexual
partners, an age difference of 10 and above with husband, extramarital affairs of husband and his absence from home
more than seven nights a month.
Higher HPV was also found among illiterate women (as compared to women who reported secondary education); and
women who were separated or divorced (compared to married women in monogamous marriages).
HPV prevalence was relatively constant across all the age groups. HPV 16 was the most common type.
The proportion of women using any kind of contraceptive was 43.4 per cent. There was no suggestion of higher HPV
prevalence among younger women.
Fourteen per cent of women in the study were working women and three-fold elevated risk of HPV positivity was seen in
90 per cent of those women who were either employed as factory workers or were domestic workers.“The low prevalence
of HPV infection is consistent with a country of low cervical cancer risk,” it concludes.
According to Dr Raza, the findings of very low prevalence in Karachi will help decide whether or not to prioritise cervical
cancer prevention programmes in Pakistan where the burden of other infectious diseases is very high.
(By Faiza Ilyas, Dawn-13, 04/12/2009)
KIHD awarded status of teaching institute
KARACHI: The Karachi Institute of Heart Diseases (KIHD) has been awarded the status of a teaching institute.
A College of Physicians and Surgeons Pakistan team, after reviewing the pros and cons of the KIHD, permitted the
institute to initiate a four-year postgraduate diploma course in specialised cardiac medicine and surgery.
On the occasion, City Nazim Mustafa Kamal said the KIHD was the
second institute after National Institute of Cardiovascular Diseases
(NICVD) to be affiliated with the CPSP and it would open new
avenues in the field of research and treatment of patients with heart
diseases.
Kamal said the CDGK spent more than Rs 400 million to upgrade,
modernise and extend the KIHD, and the institute was equipped with
modern machineries worth Rs 100 million. The KIHD pioneered the
use of high-tech equipments such as ‘256-Slice Multi-slice CT
Angiography’ in Asia as only the John Hopkins University of the
United States was using it.
Kamal said the KIHD was the second largest hospital in public sector with all departments and facilities under one roof and
a vision to provide access to modern diagnostic and treatment facilities to the citizens at cheap rates.
Kamal added that despite a tremendous financial deficit, the CDGK ensured provision of dedicated medical services to
ailing citizens at highly subsidized rates like angiography for Rs 3,500, angioplasty with stents for Rs 35,000 and cardiac
bypass surgery for Rs 50,000. While other heart institutes in the city were charging Rs 30,000, Rs 250,000 and Rs
300,000 for the same procedures, respectively.
Kamal further said the Sindh Medical Technology Faculty has also recognised the KIHD for Cardiac Medical Technology
Training and the KIHD Teaching Institute would start a three-year diploma course to train cardiac medical technologists.
He added that the KIHD would also establish a nursing teaching institute at the same venue.
Talking to Daily Times, KIHD deputy executive director Dr Siraj said the CPSP visited the KIHD on Oct 19 for inspection
and issued a letter of approval on Dec 2 to approve the KIHD’s affiliation from Oct 19. The KIHD Academic Council has
started preparations to invite students who have completed their first year to enrol at the KIHD for diplomas.
Replying to a question, Dr Siraj said it was the city nazim’s special efforts that enabled the KIHD to keep offering heavy
subsidies to patients amid a crucial financial deficit. He added that the KIHD had performed 1,000 angioplasty procedures,
10,000 angiographies and 100 heart bypass surgeries since Dec 2008. He further said the salaries of the teaching
personnel would become a tedious job, however, the KIHD was already prepared and the new expenses would be met by
curtailing other non-development expenses until allocations were made in the forthcoming annual budget.
(By Irfan Aligi, DailyTimes-B1, 04/12/2009)
Mysterious disease strikes children in coastal areas of city
KARACHI: A strange disease has spread in the coastal belt of Karachi paralysing the lower limbs and some times the
arms and other body parts of the victims, the majority of whom are children.
Earlier, there was an outbreak of a similar disease in Achhro Thar
(White Desert) of district Sanghar and other areas of the Tharparkar
desert. Now this disease has taken its toll in the Rehri Myan Goth in
Bin Qasim Town, where office-bearers of the Pakistan Fisher Folk
Forum (PFF) claim that there are about 200 victims, most of them
children.
The residents of the area told this scribe that the victims of the
disease are first afflicted with fever for a few days and then their
lower limbs and sometimes the arms and other body parts are
completely paralysed. Though this disease remains unidentified,
geologists contend that it is caused due to the consumption of
fluoride-contaminated underground water. Experts have also
expressed fear that the disease could engulf the entire coast of
Sindh. The victims mostly blood-related, and in some cases, there
are around six patients in the same family.
Muhammad Hussain, a resident of Rehri village, is a fisherman who has braved many cyclones in the Arabian Sea during
his fishing voyages, but is completely helpless to do anything for his four children, who have been paralysed. His three
sons, Nazir, Dilbar and Mubarak, and a daughter Hajira, were normal, but they suddenly feel victim to the disease.
“My first child developed a fever one day and within a week, he was paralysed,” he said narrating his woes. “First we
thought it’s weakness due to the fever, but later we realised his lower limbs were paralysed.” He took his children to
several doctors and also sought the help of faith healers, but all went in vein. Sami Memon of the PFF said his
organisation has compiled a list of the victims’ names and most of them are children. “We have a list of about 173 children
affected by this disease, but there are several other victims whose names we could not collect,” he said.
According to the PFF list, some of the victims include fisherman Esa, who is suffering the same ailments following the
paralysis of his four daughters Fatima, Sheraan, Bhaan and Ameer Bano; Aamnat, daughter of Ismail; Hyder Ali, son of
Allah Dino; Ibrahim, son of Mehmood; Hussain, son of Hassan Ali; Nazia, daughter of Ali Hussain, Mohammad Noor’s son
Moosa and daughters Hawa and Nadia; Hakeem, son of Abdullah; Azam, son of Umar; Usman, son of Ismail, and Abdul
Hussain, son of Ahmed Ali.
When this scribe contacted Sindh Health Minister Dr Sagheer Ahmed for his comments on this issue, he was not
available, however his PRO said the issue does not come under the jurisdiction of the provincial health department, and
the CDGK EDO (health) might be the right man to contact. When this scribe asked him how this matter that concerns the
lives of so many children does not come under the jurisdiction of the Sindh government, he suggested contacting the
provincial health secretary.
But that proved to be anything but useful as Sindh Health Secretary Hashim Raza Zaidi simply refused to comment on the
issue. This wasn’t surprising since the health department avoiding talking to media personnel over such issues has
become a routine practice. CDGK Health Group of Offices Executive District Officer Attur Das Sanjnani claimed that the
issue was nothing more than media-created hype. “There are just four children of a family residing in Ibrahim Hyderi
whose lower limbs have been paralysed,” he said.
“We have conducted a complete survey of these areas and found that the disease is hereditary and for such diseases,
there is no treatment even in advanced countries.” The residents of the area told this scribe that since the creation of
Pakistan, the people living in the coastal belt of the city are yet to receive basic facilities such as healthcare, educational
institutes and above all drinking water supply schemes.
“Most of the residents of Ibrahim Hyderi, Rehri Goth and others areas of the coastal belt of the city are consuming the
underground water, but no one knows about the quality of this water,” said PFF’s Sami Memon.
“It could possibly be the increasing level of fluoride in the underground water that has caused this mysterious disease,”
said renowned geologist and faculty member of the Department of Geology, University of Karachi, Prof Dr Shahid
Naseem. Dr Naseem has visited about 400 small villages of district Umerkot and other parts of Tharparkar to acquire
water samples for laboratory testing.
According to his findings, the underground water had high levels of fluoride. Earlier, this scribe reported the outbreak of a
similar disease in Achhro Thar in district Sanghar where around 17 people had dead in only one village and several others
were paralysed.
“The disease has not only spread in Karachi, but perhaps spread along the entire coast of the province and also in
Balochistan up to Iran, as we have received reports of the same disease affecting people in Quetta and a small village on
the Iranian border,” Dr Naseem said.
“We have to conduct a detailed survey of the coastline to learn more about this disease.” Dr Naseem said arsenic
contamination was first reported in Punjab, but now the problem has moved on to Sindh. “The contamination of
underground water with both arsenic and fluoride could possibly be the cause of this disease, but only a detailed survey
can confirm this,” he said.
(By Amar Guriro, DailyTimes-B1, 05/12/2009)
WHO team visits Rehri affected with mysterious disease
KARACHI: A three-member team of the World Health Organisation (WHO), headed by Dr Soomar Khoso, visited the
homes of the children suffering from paralysis of the lower limbs, after the news of a strange disease affecting the people
of Rehri Myan Goth in Bin Qasim Town.
Though the Sindh government has not taken any action yet, the news has spread like wildfire and a WHO team rushed to
the area to meet with the families of the children.
Talking to this scribe, one of the WHO members disclosed that they were not allowed to talk to the media. However,
confirming the authenticity of the news, the WHO official was unable to give an estimated number of victims suffering from
the disease.
“We have met the families, taken firsthand knowledge of the victims and would send the reports to Islamabad so that
WHO could plan better treatment of the victims,” said the official and added, “I feel the disease could have resulted from
pregnant women not getting quality healthcare and being deprived of nutrition and potable water, but only the final report
would be able to shed proper light on the situation.”
However, water
this disease.
experts
said
fluoride
and
arsenic
contamination
could
be
a
possible
reason
of
Daily Times had previously reported that a mysterious disease had gripped the coastal belt of the city whereby 200
people, majority of them children, had been affected with paralysis of the lower limb.
On contact, Provincial Health Minister Dr Sagheer Ahmed said he had no knowledge of the situation, adding that he would
call a press conference on the issue after talking with the officials of the concerned departments. However, until the filing
of this report, he was unavailable for further comment.
Earlier, the minister’s PRO had claimed the issue did not come under the jurisdiction of the provincial health ministry,
suggesting contacting the health department of the City District Government Karachi.
When contacted, Adviser to Sindh Chief Minister Sharmila Farooqi said that after coming to know about the situation
through the media, she had visited the affected area and constituted a committee, headed by Provincial Secretary Health
Hashim Zaidi, who would visit the area on Monday.
The vast coastal belt of the city, where historical settlements are located, are deprived of basic facilities, including
healthcare and potable water supply.
Daily Times had previously disclosed that more than 200 children had fallen victim to this disease in Rehri Myan Goth.
(By Amar Guriro, DailyTimes-B1, 06/12/2009)
Karachi is home to 10 million drug addicts
There are some 10 million drug addicts in Karachi, and about 50 million in the entire country, according to Anti-Narcotics
Force Pakistan statistics. Poverty, unemployment, depression and an overall feeling of hopelessness are the main causes
of substance abuse, which is forcing millions to use drugs on a daily basis.
To address this issue, Pakistan Medical Association (PMA) held a press conference on Wednesday, and asked the
government as well as parents, to take preventive measures against this rapidly increasing threat.
Former PMA Secretary-general Dr Qaiser Sajjad said that the basic responsibility lies with parents and teachers as they
are more responsible in ensuring that childen get an interactive environment at home and school, where they can openly
discuss problems without fearing a punishment. He said that most of the drug users suffer from inferiority complex and in
order to hide this weakness they use drugs. “Sometimes kids use drugs just to get famous in school or to be accepted by
a popular group which gives a tremendous boost to their confidence.”
Moreover, Dr Sajjad pointed out that a drug in any form (heroine and marijuana) is the cheapest item in our country and
one which is readily available at every nook and corner of Karachi. Drugs are sold at a price of Rs150, through which the
investors earn around 75 million a year “which is threatening to our country’s stability and welfare.”
However, Dr Younus pointed out the mistakes in awareness campaigns of some organisations as well “who forget in their
enthusiasm what they are actually promoting and how a person might interpret the campaigns message.” He gave an
example of a NGO that promoted the use of clean and unused needles for Injecting Drug Users (IDU). “What are we
implying here; keep on using drugs but in a safe manner?”
Both the speakers spoke about the deteriorating condition of primary heath care and the instability that is rampant in the
country at large because of which it is difficult to choose which problem to counter first. “It is basically our own indifferent
attitudes,” said Dr Sajjad, “we keep on neglecting an issue unless it gets much bigger and as a result becomes difficult to
handle.”
The speakers urged the civil society at large and the government in particular to take notice of issues which are vying for
their attention, “concerted efforts are needed not just from the government but also from the people of our country as it’s
been quite a while they woke up from their slumber,” Dr Naveed said at the end of the conference.
(The News-20, 10/12/2009)
Swine flu alarm as Sindh seeks help from centre
KARACHI, Dec 10: Following information that the swine flu virus (H1N1) has hit the city in a big way and is also making its
presence felt in other parts of the province, the Sindh health department has decided to seek technical support from the
federal government and international health agencies for diagnostic, treatment and protective arrangements against the
contagious disease.
Dawn has learnt that on Thursday patients, including several pregnant women, were rushed to a private hospital on
suspicion of having contracted swine flu.
The hospital has already tested nasal/throat (nasopharyngeal) swab samples of 121 persons at its lab which is said to be
observing the protocol of the Centre for Disease Control, US, said a senior doctor at the hospital, adding that she was
concerned about the health of the infected women.
The hospital has said that of the 121 persons, 21 have been tested positive for swine flu.
While the federal health ministry has designated the Jinnah Postgraduate Medical Centre (JPMC) as the focal hospital for
attending to travellers flying into the city from abroad who are suspected of carrying the swine flu or A (H1N1) influenza
virus, the provincial health department has allocated a portion of the existing isolation ward of the Civil Hospital Karachi for
the admission, antiviral treatment and observation of any patient thought to be suffering from swine flu.
A source in the CHK said that over 20 samples collected from patients suspected of suffering from swine flu were sent to
the National Institute of Health in Islamabad for confirmation of the disease in recent months but none was declared
positive.
The secretary of the provincial health department, Syed Hashim Raza Zaidi, who chaired a review meeting on swine flu on
Thursday, said that 21 suspected cases had been reported in Sindh and only four were confirmed positive for the H1N1
virus by the NIH.
The meeting agreed that polio surveillance officers of the World Health Organisation already working across the districts
should be incorporated for the surveillance of swine flu. It also approved the WHO/CDC protocol for nasopharyngeal swab
sample collection and its subsequent dispatch to Islamabad.
It was decided that viral transport media (VTM) – or swine flu test kits – should be made available at all the major hospitals
in Sindh for the immediate collection of samples from patients thought to be suffering from swine flu and their confirmation
from the NIH in Islamabad.
It was also decided that the national programme on Influenza-A would be approached for a further supply of VTM to the
province.
The participants of the meeting decided that all the public sector hospitals, including the JPMC and the National Institute of
Child Health, should be taken on board and their representatives should be invited to the meeting to strengthen the
surveillance system against swine flu.The meeting decided to ensure immediate reporting to the Influenza-A Swine Flu
Cell, which is run by the Sindh health department, all suspected cases of swine flu by all the major hospitals of the city.
Dr Shakeel A. Mullick will be the focal person of the newly established cell and will be available on his cellphone (03212420780) for the reporting of suspected cases or confirmed cases.
The focal person has also been assigned the task of arranging training sessions in small groups to prepare master trainers
to understand SOPs for the viral disease and further disseminate information for follow-ups at all levels. The first training
session will be held at the CHK on Dec 15.
The meeting also decided to ensure availability of Relenza for the patients who showed resistance to the already
distributed Tamiflu capsules at all the major hospitals in Sindh. The meeting also discussed the establishment of an
Influenza-A lab at the CHK.
The swine flu virus was declared a pandemic by the WHO about six months ago. The virus has infected thousands of
people in over 30 countries and also caused a considerable number of deaths.
Swine flu, according to experts, is a highly contagious, acute respiratory disease of pigs that is also transmitted to human
beings. The symptoms of the H1N1 virus are similar to those of seasonal flu and include fever, cough, sore throat, runny
or stuffy nose, body aches, headache, chills and fatigue.
Experts suggest that people should often wash their hands with soap and water, especially after they cough or sneeze,
and they should also avoid touching their eyes, nose or mouth as germs spread this way. Infected people should stay
indoors for a week or so and other people should not come in direct physical contact with them.
The chairman of the Infection Control Committee at the Aga Khan University Hospital, Dr Bushra Jamil, said that her
hospital which started attending to patients thought to be suffering from swine flu in June was currently receiving a
disproportionate number of severely ill pregnant women who were suspected of having contracted swine flu.
Discussing the issue of swine flu in mothers-to-be, she said that a pregnant woman who thought she had flu should call
her doctor right away to see if treatment with an antiviral medicine was needed. She added that pregnant women had had
higher rates of hospitalisation with suspected swine flu virus than the general public.
About six per cent of confirmed H1N1 2009 influenza deaths in the US have been in pregnant women.
She suggested that pregnant women try to avoid close contact with sick people. Speaking about treatment for mothers-tobe, Dr Bushra said that H1N1 flu was treated with antiviral drugs such as Tamiflu (oseltamivir) or Relenza (zanamivir).
She said that at the moment no reports suggested that these drugs caused harm to pregnant women or to their unborn
babies. She added that antiviral medicines could be taken at any stage of pregnancy.
Although the specific H1N1 vaccine was not available in Pakistan at the moment, pregnant women had been earmarked
as one of the initial target groups to receive the 2009 H1N1 monovalent vaccine as soon as it became available, she said.
(By Mukhtar Alam, Dawn-13, 11/12/2009)
Medical negligence
THE president’s call for an effective plan to deal with the rising cases of medical negligence is timely. Given the numerous
incidents being reported every other day of people dying at the hands of ill-trained medical professionals who lack
knowledge, competence, professional integrity and commitment, it is time to address the problem. At least nine such
cases have been reported in the press since September from all over the country. Many of them have provoked public
protests testifying to the growing awareness of patients’ rights. On occasions when an independent enquiry has been held
medical negligence was established as in the deaths of an MNA at PIMS, Islamabad, a three-year-old girl at the Doctors
Hospital, Lahore, and a former cricket captain’s wife. Hence the president is right to instruct the health ministry and the
PMDC to devise standard operation procedures to check such cases. That can be done immediately by adopting WHO’s
standard guidelines for hospitals.
The problem lies with the implementation as experience has shown. It is significant that the performance of all hospitals —
be they in the public or private sector — is questionable. All cases of alleged medical negligence exhibit typical
characteristics. The doctor responsible is found to be unqualified for the work he was assigned. Many doctors in the
public-sector hospitals have been running a private practice, displaying indifference towards their patient’s suffering, thus
provoking a strong reaction from the patients’ relatives. These are issues that cannot be addressed by the SOPs the
president has called for. They have a direct bearing on the wider health policy that has been in the works for years now.
The quality of medical education, the failure to inculcate a sense of professional ethics in medical graduates and the
freedom given to government doctors to run private practices can only be addressed at a national level within the
parameters of a health policy. It may be added that the health policy should focus on improving the quality of services,
facilities and motivation of the professionals at government hospitals. Private facilities would then have no choice but to
improve their working or perish.
(Dawn-7, 11/12/2009)
Young UTP dies in hospital
KARACHI, Dec 10: A young undertrial prisoner facing theft and illegal arms possession charges died in the Civil Hospital
Karachi on Thursday.
He was arrested by the Ferozabad police only two weeks ago and was remanded in judicial custody with multiple head
injuries and fractured bones, officials said.
The mysterious death of 32-year-old Abid Francis Masih shocked the family, who alleged that the Ferozabad police had
on November 23 booked the father of two children only for not paying them bribes after he was caught riding a motorbike
without registration documents.
“My son was an electrician,” said Beenish Masih, the mother of deceased Abid. She was among other family members
protesting against the police when they came to receive the body at the Civil Hospital Karachi. “He was returning home
when he was caught by the police, and later we came to know that my son was facing robbery charges.”
She said she firmly believed that her son was severely tortured by the Ferozabad police. To support her claim, she pointed
to Abid’s body which bore several visible marks of bruises.
However, Orangzeb Khattak, the SHO of the Ferozabad police station, rejected the allegations.
“We arrested him with illegal arms. He was also accused of theft and robbery,” he said in a brief response to Dawn’s
queries. He denied any use of torture on the accused.
However, Raja Mumtaz, the deputy superintendent of the Central Prison, had different facts to share.
“When we received Abid on Nov 26 under court orders of judicial custody, he was badly injured,” he said, putting a
question mark over the Ferozabad police’s claim. “He had injuries on the head as well as on other parts of the body. We
treated him in our (prison’s) hospital for a few days.”
However, he said, Abid failed to respond to treatment, and the jail authorities moved him to the Civil Hospital Karachi on
Dec 7, where he was being treated in the neurology ward.
“Since the accused was injured, we felt all was not well with him. We also conducted Abid’s medico-legal examination
when he was received in jail from the Ferozabad police,” added deputy superintendent Mumtaz. The same exercise was
repeated at the Civil Hospital after Abid’s death. However, doctors said the report of the medical examination was
reserved and would take time to conclude.
Tow motorcyclists die
Two young motorcyclists died in separate road accidents on Thursday, police said.
The first incident was reported within the remits of the Shershah police station, where a 25-year-old motorcyclist was hit by
a fast-moving dumper.
“The victim has been identified as Shafi Muhammad, who was hit by the dumper near the Pankha Hotel, and the driver
sped away,” said an official at Shershah police station. “He was a resident of the Lyari area and was returning home from
work. His body was taken to the Civil Hospital for medico-legal formalities. Since the family has been busy in his burial, we
are waiting for their response before registering an FIR.”
In the other accident, a fast-moving motorcyclist was killed when he rammed his motorcycle into an electric pole near the
Karsaz flyover, police said.
“Eyewitnesses told us that he was riding the motorcycle at more than an average speed and lost its control when he was
near the Karsaz flyover,” said an official at the New Town police station. “He was taken to the Jinnah Postgraduate
Medical Centre by some passers-by. He died during treatment in the JPMC. We have shifted the body to the Edhi morgue
after legal formalities, where it lies unidentified.”
(By Imran Ayub, Dawn-13, 11/12/2009)
52pc women suffer abuse during pregnancy
Eminent gynecologist and former Secretary-General of the Pakistan Medical Association (PMA), Dr. Shershah Syed, has
said that the vast majority of women in Pakistan suffer physical and verbal abuse even during pregnancy.
“In a survey we conducted at Government Qatar Hospital, Karachi, it was found that 52 per cent of the pregnant women
complained of physical and verbal abuse,” he told a seminar held at PMA House on Thursday.
The seminar was held to mark the International Human Rights Day under the auspices of National Organisation for
Working Communities. He said the situation was not different in other parts of Pakistan.
Dr. Syed said women in Pakistan were physically and verbally abused when they most needed care. This happens
because women in Pakistan have not been granted basic rights as yet, he said.
“Women’s rights are human rights,” he said. “Forty-nine per cent of Pakistan’s population comprises women but they don’t
enjoy basic human rights. In such a situation how can we ensure any progress in Pakistan society,” he said.
He said 60 women die in Pakistan in every two hours and 600 become invalid and this was happening in a country whose
leaders most loudly boast of having made the atom bomb. He said as many as 30,000 young women die in Pakistan every
year because of complications during pregnancy. He said Pakistan does not need a “strong army;” it needed a healthy
population. He said it was high time to form a broad-based alliance to fight for primary education to every child, since only
education could ensure a vibrant and sane society. He said terrorism was flourishing in the country due to illiteracy and
poverty. He said strangely enough no terrorist has ever been punished by a court of law in Pakistan.
Dr. Tauseef Ahmed Khan, Professor of Mass Communications at the Federal Urdu University, Karachi, said a society
could not flourish unless and until it ensured Human Rights. He said previously, the common man did not enjoy any rights
but with the advent of industrialisation came education but whatsoever education was available then was mainly confined
to men. He said it was after the industrial revolution that people learnt how to fight unitedly.
The word “people” was coined, carrying the connotation of the largest segment of society, the commonfolk, and with it
came the idea of basic Human Rights,” he said. Thereafter, came the idea that it was the responsibility of the State to
ensure provision of basic Human Rights to the people, he said.
He said it was after World War II that people realised the importance of peace and United Nations came into being. He
pointed out that despite the fact that Pakistan was a signatory to different UN Conventions; its rulers were not ready to
accord basic Human Rights to its people.
He said it was a fallacy that the state could be strengthened through massive spending on defence and it was high time
that the social sector was given a priority and spending was made in health and education sector.
Mahnaz Rahman, a woman’s rights activist hailing from the Church World Service (Pakistan-Afghanistan), said women’s
role was of immense importance for creating peace.
As mothers women were keen to get their children educated and for that purpose, peace was essential, she said.
She said access to clean drinking water, education, health, a place to live and a healthy environment were the basic
human rights. She said there couldn’t be justice in a society unless there was peace.
She said women in Pakistan performed double duty. They worked in offices, factories and fields and they also cooked and
reared their children. She said terrorism was the main problem in Pakistan and it was an outcome of grave injustices.
“Children in Madrassas are brainwashed and converted into suicide bombers but this has nothing to do with our religion
since Islam preaches love and harmony and respect for all religions,” she said.
Trade union activist Nawab Ali said that the judiciary always seems to serve the interests of the State. He said the state of
industrial worker in Pakistan could be gauged from the fact that he was paid only Rs 5,000 a month. He said a ban had
been imposed on child labour and it was a good step but since the vast majority was suffering from abject poverty and
there was dearth of schools, these children were only adding to the force of street children.
Elvis Stephen, a spokesman of minority community said when women and children in Pakistan were suffering from acute
problems, one could guess about the existential situation of minorities.
Trade union leader Fareed Awan said Pakistan had no sense of direction even after 62 years of its existence.
He said Pakistan could not claim to be a sovereign state since decisions about this country were made abroad.
Awami Party Convener Hasan Nasir said only struggle at the grassroots level could ensure Human Rights. He said unless
the basic character of the state was changed, basic rights to the people could not be ensured.
Muthahida Qaumi Movement (MQM) leader Talat Sultana said MQM was against terrorism and stood for peace. Umar
Abbas of the National Organisation for Working Communities said that the right to form a union was the basic right of a
worker and since people don’t enjoy basic rights in Pakistan, we witness so much violence and terrorism.
(By Shahid Husain, The News-19, 11/12/2009)
1st swine flu death confirmed in city
KARACHI: The first death by swine/H1N1 flu in Karachi has been confirmed by the National Institute of Health (NIH)
Islamabad. According to sources at Liaquat National Hospital (LNH), Syed Amir Ali, 34, resident of Gulshan-e-Maymar
was admitted in LNH on November 28 with high-grade fever, body ache, flu and some respiratory problems.
He died a week ago in the hospital and his blood samples, which were sent to NIH for examining, confirmed that he was
suffering from H1N1 flu. As per Ali’s heirs, he had never travelled abroad, which is why they did not believe he was
suffering from swine flu.
Meanwhile, Sindh Health Minister Dr Sagheer Ahmed ordered a meeting on Thursday to formulate strategy for combating
possible cases of swine flu in Sindh.
Health Secretary Hashim Raza Zaidi presided over the meeting, which decided to ensure immediate reporting by all major
hospitals for suspected cases of swine flu to the Influenza-A (swine flu) Cell in the Health Department and that Dr Shakeel
Malik, the focal person, should be informed about suspected cases at 0321-2420780.
Zaidi informed the meeting that at present, 21 suspected cases were reported in Sindh and four were confirmed with
positive H1N1 virus by NIH Islamabad.
It was also decided that training sessions in smaller groups would be arranged by the focal person to prepare master
trainers for understanding the standard operating procedure for swine flu and for providing further information. The first
session would be held on December 15 at Civil Hospital Karachi.
It was further decided to furnish isolation wards at all major hospitals in Sindh for receiving positive cases of swine flu and
discharging them by following the WHO/CDC Protocol and all the staff paramedics/medics, when advancing to the
Medical/ ENT/Chest and Paediatric wards, should take all preventive measures, such as wearing gloves and masks to
reduce chances of spreading the infection.
It was agreed that WHO’s Surveillance Officers already working in the districts for Polio Surveillance should also be
incorporated for the surveillance of swine flu and approved WHO/CDC Protocol should be followed for sample collecting
and dispatching them to NIH Islamabad.
Ensuring availability of Relenza, a drug that can be used for patients who show resistance with the already distributed
Tamiflu capsules, and availability of Viral Transport Media to collect samples for swine flu was also agreed upon.
It was further agreed that all Town Health Officers should initiate an extensive campaign with the media’s involvement for
creating awareness about the disease and that all public and private hospitals should be taken on board for strengthening
the surveillance system.
Civil Hospital Medical Superintendent Dr Saeed Qureshi said a resistance had been seen against Tamiflu in certain
patients and for these patients, Relenza had to be procured in all the major hospitals in Sindh. He also said the InfluenzaA lab is under construction at Civil Hospital Karachi with the assistance of WHO/CDC and its equipment would be
provided by NIH Islamabad.
(DailyTimes-B1, 11/12/2009)
Four more test positive for swine flu
KARACHI, Dec 14: Swine flu cases reported in the city rose to 28 on Monday as the Sindh health department recorded
four more lab-confirmed cases from a private teaching university’s diagnostic laboratory.
At least 79 people in the country have been tested positive for swine flu, which has so far claimed nine lives, officials said
on Monday.
The provincial focal person for swine flu, Dr Shakeel A. Mullick, said on Monday evening that the Aga Khan University
Hospital had reported samples of four more persons, a man and three women, positive for swine flu.
However, the health authority at Islamabad knew of only five of the positive cases reported in Sindh so far.
A doctor at the AKUH told Dawn that on average two to three persons suspected of suffering from swine flu had been
visiting the hospital in recent days. None of them have been admitted to hospital for any management, said the doctor,
adding that at present only one patient found positive for swine flu was admitted and receiving intensive care at the
hospital.
The federal health ministry’s director-general, Dr Rasheed Jooma, told Dawn from Islamabad that till Monday the National
Institute of Health had tested 260 samples, out of which 56 were found positive for swine flu, and nine people had died of
the disease. The NIH Islamabad had so far tested five samples received from Sindh as positive with no death, he added.
He, however, could not give details of the ninth swine flu death in the country.
In all, according to an NIH report finalised on Monday noon, 23 patients have been tested positive for swine flu in
Islamabad, 17 in Punjab, five in Sindh, nine in the NWFP/Fata, one in AJK.
The nine deaths caused by swine flu are: one in Islamabad, four in Punjab, two in the NWFP/Fata, one in AJK and one
that of an Afghan national.
On the other hand, AKUH sources claimed that the hospital’s laboratory had tested samples of 27 males and females of
age ranging from six to 60 years positive for the disease, of which one patient, who was sent to a nearby hospital for
treatment, died about a week back.
The NIH data did not mention any death in Sindh, which could mean that the one death so far known to have taken place
in Karachi had not been reported to Islamabad either by the AKUH or the Sindh health department.
An AKUH source said that the hospital laboratory had stopped sending samples of patients suspected of suffering from
swine flu to the NIH. Initially, the lab sent some samples tested positive by it to the NIH which reconfirmed all of them, the
source said, adding that the AKUH lab was also of international standard and as such the executives felt that there, after a
second confirmation by the NIH, remained no reason for sending the swine flu positive samples to Islamabad.
Giving details of the new positive cases as received from the AKUH, Dr Mullick said that they were of a 23-year-old man
from Punjab and three women, aged between 24 and 50 years.However, he did not specify the residential areas or history
of the patients in question, saying that the AKUH had not forwarded complete information to the swine flu control cell of
the health department.
He said the study of the positive cases reported so far in Sindh indicated that people in their 20s were the worst affected.
He further revealed that a woman reportedly suffering from the flu for the last one week and admitted to the Sindh
Government Services Hospital was being shifted to the isolation ward of the Civil Hospital Karachi for further surveillance
and supportive care. The samples from the patient had been drawn for onward transportation to the NIH, Islamabad, for a
swine flu virus test, Dr Mullick added.
(By Mukhtar Alam, Dawn-13, 15/12/2009)
‘Ill-equipped’ govt hospitals get swine flu medicine
KARACHI, Dec 11: Senior health officials working amid a swine flu alarm in the city have put their faith in antiviral
medicines being provided to them, ignoring their health facilities’ lack of capacity for a fully-fledged treatment of patients
reporting with a severe infection of the H1N1 virus.
Sources added that 35,000 Tamiflu tablets would be supplied to at least seven large hospitals run by the Sindh and city
governments within a couple of days. However, the preparation of isolation wards in public sector hospitals for treatment
and management of patients complaining of severe respiratory problems and chest infections would not be done anytime
soon.
These hospitals would not be able to establish such wards with ventilators required exclusively for swine flu treatment.
The federal health ministry’s Director-General Dr Rasheed A. Jooma told Dawn on Friday that the swine flu death toll in
the country had risen to eight. The deaths have been reported from Peshawar, Lahore, Karachi and Faisalabad, according
to him. The National Institute of Health (NIH) in Islamabad, he said, had informed him that 37 persons were positive
among the 190 tested for swine flu so far.
Pointing out that there had been a rise in swine flu cases being reported in Karachi, he insisted that the virus had been
carried by someone coming from abroad.
The focal person on swine flu for Sindh, Dr Shakeel A. Mullick, said that the NIH had so far confirmed five swine flu cases
in the province. Four of the patients had already tested positive by the Aga Khan University Hospital (AKUH) laboratory
while the other one was deported from Oman and quarantined at the federal health ministry facility near Karachi airport.
Dr Mullick said that the total number of cases tested positive at the AKUH was 21 and they included both male and female
patients. He said he would now further reconcile the AKUH swine flu data with the NIH results given so far in the case of
Sindh.
A note of caution
In reply to a question, he said that physicians should prescribe Tamiflu tablets only when a patient had contracted swine
flu and not just to preempt it. At a time when the NIH had confirmed 39 swine flu positive cases in the country, people
must protect themselves by considering their own personal hygiene and ensuring cleanliness, besides taking extreme care
while touching and using everything that could be infected, he said.
Executive Director of the Jinnah Postgraduate Medical Centre Dr Salim A. Kharal said that his hospital did not have any
isolation ward at all, but after receiving alerts about the possibility of a swine flu outbreak in the city, he had ordered the
utilisation of the old cancer ward, opposite the eye department, as a temporary isolation ward. The ward would have a
capacity for 10 to 12 admissions at a time, he added.
He said that at a time when the JPMC was already running short of ventilators, it would not be possible for it to spare this
facility for a swine flu patient reporting at the hospital. “What we can give to the patient is Tamiflu and some supportive
care only,” he admitted. He said the JPMC would surely request the federal government for allocation of a huge amount
needed for an ideal isolation ward that could meet the criteria laid down by the Centre for Disease Control, US.
A similar response was given by the medical superintendent of the Abbasi Shaheed Hospital, Dr Mashhood-ul-Zafar
Farooq. He said that the hospital could utilise the isolation ward established earlier for dengue patients if swine flu patients
needed to be admitted. The isolation ward, however, did not have ventilators, he conceded.
Talking about the CHK’s preparedness for a swine flu outbreak, its additional medical superintendent Captain Dr Liaquat
Sheikh said that the hospital had in all 16 beds in its isolation ward out of which four were reserved for swine flu patients.
However, he added, the ward did not have ventilators. If needed, the facility could be diverted to it from the surgical ICU
and neurocoma emergency facilities, he said.
A ventilator used for swine flu patients could not be used for other intensive-care patients without autoclaving and
sterilisation, said Dr Kharal, who is also a senior microbiologist.
Sindh Health Minister Dr Sagheer Ahmad had stated last month that his department would send a summary for a special
budgetary grant for the procurement of at least 16 ventilators to be provided to the government teaching hospitals in the
province on a priority basis. According to a source in the health department, the summary has since been sent to the chief
minister and approval still is awaited.
A senior CDGK health officer, Dr Aslam Pervez, told Dawn that Tamiflu tablets received by Health EDO A.D. Sajnani from
the provincial government had already been delivered to the CHK (10,000), Saudabad hospital (2,000), Qatar hospital
(4,000), Liaquatabad hospital (2,000) and Korangi hospital (3,000). The New Karachi hospital and the Abbasi Shaheed
Hospital would get 4,000 and 10,000 tablets, respectively, in a day or so, he added.
(By Mukhtar Alam, Dawn-13, 12/12/2009)
Overdose of negligence
The death of three-year old girl Imanae Malik, due to alleged criminal negligence shown by the staff of a private medical
hospital in Johar Town Lahore has shaken every individual. According to the statement of the father, the girl, the only child
of her parents, was brought to the facility called Doctors Hospital for treatment of a burn on her hand. The emergency staff
present at the scene administered her three injections to soothe the pain that proved lethal, to quote the statement.
This is not the first case of its type where medical negligence has cost a patient
his or her life, or resulted in a permanent disability. But what is different this
time is the course of events that followed. In the past, the standard response
would have been a protest launched by the aggrieved family, followed by
suspension of the accused and initiation of a probe into the incident -- and in
most cases a strike called by the doctors' community against their
"victimisation".
Within days a victim's family, already reeling from grief, would get fed up with
the tedious process of appearing before inquiry committees, recording
statements and withdrawing their complaints.
The general perception about the logical outcome of the inquiry into Imanae Malik's death was not much different from
this. But what followed is totally different from what was expected. The way the government has conducted inquiries, the
administrative machinery has conducted raids on the hospital and made arrests is something unheard of in the past.
No doubt the initiative taken by Imanae's parents, judicial activism and the role of media had a lot to do with the fate of this
case. The question pertinent at the moment is whether this incident will be treated as an isolated case or will it lead to
formulation of standard guidelines and practices and penalties in case they are violated again.
Pakistan Medical Association (PMA)-Equity Group President Dr Saghir Baloch is of the opinion that the accountability
mechanism is already in place. He tells TNS that the case of Imanae Malik does not fall in the category of professional
negligence. "It is a case of criminal nature as the administration of Doctors Hospital had deputed a non-technical and nonqualified person to treat emergency patients."
Dr Baloch says the Doctors Hospital administration is being taken to task for the reason that it committed a crime by
allowing an unqualified person to play with the lives of patients. He says had the injections been administered by a
specialist doctor, PMA would have held a proper inquiry and given a chance to both the accused and the aggrieved to
establish their point.
The council has taken action against several negligent doctors including a professor of surgery who had no option but to
leave the country, he says, adding: Pakistan Medical and Dental Council (PMDC) does not favour accused doctors in
inquiries.
Dr Baloch says the negligence of a doctor has to be proved before a penalty can be imposed. On the other hand the
accused is not liable to punishment if he is able to establish that he committed the act in good faith, he says. He tells TNS
that PMDC has even asked for postmortems in certain cases. Similarly, it can ask for medical records related to cases in
questions from hospitals that are bound to keep it updated.
Dr Baloch suggests that professors of government medical colleges should be barred from practicing in private hospitals.
"It is a common practice that they hire the staff of government hospitals, including house officers, for their private hospitals
on lower salaries. These staffers are overworked and disinterested. They have no option but to obey their bosses," he
adds.
The assertion of Dr Baloch holds weight as Imanae's father has also stated that Sandip Kumar who administered the
wrong injection (Pavulon) to his daughter -- It seems he was not aware of what he was doing for he was drowsy at the
time. The report issued by the Punjab government's inquiry committee states: (constitution of committee members)
"Injection Pavulon is used for induction of anaesthesia for those patients who are to be put on ventilators during
operations; it was criminal to use it in case of a three-year-old child suffering from simple burn. In fact this drug is used for
relaxation of respiratory muscles; hence administration of this drug was not at all justified."
As the outcry on the incident gained momentum, Doctors Hospital had to hold its staff responsible for the death.
The announcement made by the in-house inquiry committee of the hospital stated: "This enquiry has shown gross medical
negligence on the part of on-call pediatric doctor, Sandip Kumar in the treatment of this youngster. Following this initial
enquiry, all the involved doctors even remotely associated with this case have been suspended. All relevant hospital
records and above mentioned enquiry report has been given to the Investigation Officer of Johar Town Police Station.
Since police is investigating, any further comments on this may jeopardise an independent enquiry."
Another practice that should be checked, says Dr Baloch, is the non-supervision of house officers in emergency wards. He
says, under the rules, house officers have to be supervised by senior doctors and are barred from even writing a
prescription till they have six-month experience -- "Unfortunately, fresh house officers are treating serious patients in
emergency wards."
Former Additional Prosecutor General Punjab and ex-member Punjab Bar Council Nasiruddin Khan Nayyar Advocate tells
TNS that negligence is culpable under the law. "Indemnity is only for acts done in good faith by applying maximum care
and caution," he says.
He adds surgery is an act done in good faith and is different from criminal assault for the reason that extreme care is taken
with the main purpose to cure the patient. So, even the acts done in good faith without taking extreme care are culpable.
Nayyar says a surgeon who starts an operation without administering anaesthesia to a patient is guilty of professional
neglect. Similarly, if a patient under the influence of anaesthesia leaves the room without doctors' permission and suffers
an injury then both the doctor and the patient are responsible.
Commenting on a decision by a District Consumer Court in which an accused doctor was asked to pay hefty
compensation to an aggrieved patient, he says, the ruling is not binding on other courts. "Till the time a superior court does
not interpret this law and categorise medical doctor as a service provider there will be no binding effect on other courts.
The scope and extent of a law is defined by the superior courts and the process may take decades to complete."
Punjab health department spokesman Additional Secretary Dr Mushtaq Ahmed Salariya tells TNS this case is different in
a sense that the aggrieved family has not given up. He says the family, which has returned recently from abroad, is wellaware of the rights of patients and liabilities of medical professionals in case of criminal negligence. "The way they
highlighted the issue and involved the mass media and other means of communication to spread the word made it
impossible for the hospital management to hush up the affair."
In response to a question, Dr Salariya says this time the doctors' community also refrained from opposing the move as it
was very difficult for them to trivialise the issue. "It's hard to tell someone, who has lost a dear one, to forgive the culprits."
He says the same doctors who had joined hands to protest against the proposed Punjab healthcare bill did not take it as
an assault on their fellow professionals.
Dr Salariya is hopeful that this particular case will raise awareness among masses about their rights and warn negligent
medical practitioners of dire consequences if they do not treat their patients seriously. He says many inquiries launched in
the past could not go beyond a certain point as the aggrieved families withdrew in the middle, terming the incident a will of
God.
He also rejects allegations that the Doctors' Hospital administration is politically victimised by the Punjab government.
"Had it been the case, Dr Faiza Asghar, the managing director of the hospital, would have been removed from the
chairpersonship of Child Protection Bureau. She is still holding the post which was awarded to her by the previous
government," he adds.
(By Shahzada Irfan Ahmed, The News-24 Encore, 13/12/2009)
Govt doubts AKUH swine flu results
Even after four new cases of swine flu were confirmed by the Aga Khan University Hospital (AKUH) on Monday, taking the
number of swine flu patients to 27, government officials appear to doubt the test results of the said hospital by repeatedly
counting the five cases confirmed by the National Institute of Health (NIH) in Islamabad.
Dr Shakil Mullick, Focal Person, Sindh Surveillance Cell, says that only those figures will be considered “national figures”
which are both confirmed and proven by the NIH or by the World Health Organization (WHO). Dr Sagheer Ahmed,
Provincial Health Minister in his recent speech on the issue, also spoke along the same lines.
“It does not matter to us at all whether the government accepts or denies the results. The test samples were taken to
ensure whether the AKUH can provide facilities in case of an outbreak of swine flu,” said Dr Bushra Jamil of the Infection
Control Committee, AKH.
She said that either the government does not want to create panic among the masses or it might be that “they do not have
the required facilities to give to its people.” Dr Jamil says that the Aga Khan Laboratory has been sending the test results
of infected patients from June “and our job is to keep on providing them, hoping that the situation does not get worse.”
She says that so far the cases the hospital has received are “mild ones”, majority of them being out-patients, and can be
treated with paracetamol and other medicines to suppress the pain and fever. One patient, a doctor, is in the Intensive
Care Unit (ICU) of the hospital. So far, the high risk group includes pregnant women, children under five and people
having some chronic illness.
Meanwhile, doctors and experts complain that the plans of the Health Ministry are quite “theoretic” and nothing substantial
has come thus far. The doctors say that there’s only one Influenza Surveillance Laboratory in the country and that too in
Islamabad, as a result of which the process to test samples is really slow. On condition of anonymity, a senior doctor said,
“The government will not openly accept the number of people confirmed positive for swine flu as they do not want to do
anything about it unless there is a severe outbreak.”
(By Saher Baloch, The News-13, 16/12/2009)
Two women test positive for swine flu
KARACHI, Dec 18: While the provincial health authorities are still debating the status of swine flu reports released by a
private teaching university hospital, two more female patients have been declared infected with the swine flu virus.
Dawn has learnt that one of the patients was under treatment at the Sindh Government Services Hospital while the other
patient was being given intensive-care treatment at a private hospital in Defence.
Releasing details about the first patient of swine flu being treated at any government hospital, Health Minister Dr Sagheer
Ahmed told newsmen on Friday that a 47-year-old nurse from Karachi, the sixth patient of swine flu in Sindh, had been
tested positive and confirmed by the National Institute of Health (NIH) in Islamabad.
He said that the patients’ samples were sent to the NIH for confirmation and so far four male and two females had been
tested positive for swine flu. He said swine flu, which is similar to seasonal flu but has the higher rate of transmission, is
dangerous but curable and can be avoided by adopting precautionary measures. The isolation wards in all major hospitals
should be equipped with required machines to facilitate the patients, he added.
The latest figure of swine flu cases confirmed by the NIH, which is owned by the provincial health minister and the health
secretary, however, included four cases that had already been tested positive by the Aga Khan University Hospital
laboratory during the last three weeks.
Although the AKUH lab had tested some 30 samples positive for swine flu since June, all of them are not included in the
national or provincial data of swine flu. Top health officials are of the view that since the private sector lab was not
recognised by WHO they had no choice but to wait till the time all the samples are evaluated by the NIH and declared
positive for the virus.
About the second patient, a medical officer from a private hospital confirmed that the female patient was about 23 years
old and was being treated at the hospital for over one week. “However, the private lab told us only on Thursday that the
swab specimen of the patient, who is in a critical condition and receiving treatment in isolation, has been found positive for
swine flu,” the doctor added.
He said that the paramedics had also been cautioned as far as protective measures were concerned.
According to internationally observed epidemiologic criteria, a swine flu patient may have a history of travel to any state or
country where swine flu cases were reported or he or she has been in contact with persons infected with the virus in the
seven days prior to their illness onset. Nasopharyngeal swab specimens are preferable for laboratory testing.
About the nurse whose specimen has been found positive for swine flu by the NIH, the official in charge of the swine flu
surveillance cell of the Sindh health department, Dr Shakil Mullick, said that the sample was drawn from the paramedical
staff of the Service Hospital on Dec 15, but it was intimated only this morning that the sample was positive for swine flu.
Following the confirmation, the nurse, who appears normal with no major swine flu symptoms, had now been admitted to
an isolation ward of the Services Hospital for the prescribed treatment of swine flu, he added.
Commenting on the existing trend of swine flu incidents in the city, the secretary of the provincial health department, Syed
Hashim Raza Zaidi, said that cases reported so far were mild in nature with negligible death rates and as such there was
no cause for public alarm.
However, he said that there was standing advice to doctors and paramedical staffs performing duties in the ENT, chest
and medicine departments of hospitals to observe all precautionary measures while handling patients thought to be
carrying the swine flu virus and to wear required protective gloves, masks and gowns.
About the tracking of the patients found positive for swine flu by the private university lab, the secretary said that the
department had the contact addresses or telephones numbers of the patients and it could go for their inspection as well.
“However, I am told by the AKUH that it was already having a track of the patients tested positive at its lab,” the secretary
maintained.
(Dawn-13, 19/12/2009)
Paralysed children of Rehri Goth
‘Controversial’ WHO report irks parents of victims
KARACHI: The controversial report issued by the World Health Organisation (WHO) about the mysterious disease that
caused paralysis of lower limbs in more than 200 children in Rehri Goth, irked the parents of the children and they decided
to protest against it.
Around 200 children of different age groups living in Rehri Goth along the coastal belt of the city were reported to be
affected with a mysterious disease causing lower limb paralysis.
After media reports of these affected children, a three-member team of the WHO, headed by Dr Soomar Khoso, visited the
area and held meetings with 17 afflicted children.
Talking to this scribe one official of WHO Sindh on condition of anonymity, as officials are strictly bound not to talk to
media persons on-record, confirmed the news that WHO has issued the said report.
Disclosing details of the report, he said that multiple reasons have been cited as the cause of the disease.
“Some of the children are afflicted with genetic disorders, others have Vitamin D shortage and a few were affected with
severe fever causing lower limb paralysis,” he said.
On a question he confirmed that no blood samples were taken to diagnose the actual cause of the disease. “The report
was issued on the basis of physical appearance and medical history,” he said, adding that only three samples of tap-water
in the area were sent to the WHO laboratory in Islamabad that rejected the presence of fluoride, arsenic and other
chemical contamination, however, biological contamination was detected in the water samples. The report also states that
close-kin marriages could also be one reason behind the disease.
However, as per local residents, the majority of the population is consuming underground water, and according to the
water-quality experts’ fluoride and arsenic contamination in aquifers could be a reason for the diseases, but WHO has not
taken the samples of the underground water.
Similarly, Vitamin D deficiency among fisher folk is also debatable because medical experts say they not only have high
fish intake, but also spend long hours under the sun, both known sources for Vitamin D.
The parents of the children reacted severely over the report, “We reject genetic disorder to be the reason as most of the
children got this disease at the age of 16 and we suppose that the report was issued only to get rid of the patients.
Therefore, we are thinking we will protest against WHO at Karachi Press Club,” said Hussain, a fisherman and father of
four affected children. Talking about the close-kin marriages, he rejected saying it is not an isolated practice pertinent only
to this colony but happens throughout Sindh and other parts of Pakistan. “We demand the government of Pakistan and
WHO to go through the detailed medical examination of these children and then start treating them,” he concluded.
(By Amar Guriro, DailyTimes-B1, 19/12/2009)
Expectant mother dies of swine flu
KARACHI, Dec 19: A pregnant woman admitted to a private hospital became on Saturday the second known person in the
city to die of swine flu during the last two weeks.
The woman, reportedly in the second trimester of pregnancy, was admitted to the National Medical Centre in the Defence
Housing Authority about a week back and kept in the ICU for supportive care. She was included in the list of the 30
patients tested positive for swine flu (H1N1) by the Aga Khan University Hospital (AKUH) till Dec 17.
The official in charge of the swine flu surveillance cell of the Sindh health department, Dr Shakil Mullick, said that the
woman was 25 years old and she died at around 11am on Saturday. “I have been told by the hospital that the patient had
no contact history,” he said.
About a female nurse admitted to the Sindh Government Services Hospital after being tested positive for swine flu by the
National Institute of Health in Islamabad on Friday, the official said that she was well. In the given situation, however, he
cautioned the people that they adopt precautionary measures even while suffering from seasonal flu and consult
physicians.
On Dec 10, the chairperson of the infectious control committee at the AKUH, Dr Bushra Jamil, had said that her hospital,
which started attending to patients thought to be suffering from swine flu in June, was also receiving a disproportionate
number of severely ill pregnant women who were suspected of having contracted swine flu.
A medical officer from the NMC said on Saturday that the pregnant woman was admitted to hospital on Dec 12 and had
since been getting Tamiflu. She had a weak immune system and was already undergoing some other health
complications.
He said the deceased patient lived in the PECHS and was expecting her first baby.
The paramedical staff and doctors who treated her had also been prescribed Tamiflu as a precautionary measure, the
doctor said in reply to a question.
Experts say that pregnant women, even if they are healthy, are at a high risk of hospitalisation and death from swine flu. A
well-considered analysis has shown that pregnant women are more likely than the general public to develop severe
disease after infection with the pandemic H1N1 swine flu virus, said a senior doctor, adding that such women were four
times more likely to be hospitalised, with an unusually high death rate.
With the latest death, the number of deaths caused by swine flu in the city became two, while the total number of patients
tested positive for swine flu, either by the AKUH or NIH, reached 32.
Speaking to Dawn, the director-general in the federal health ministry, Prof Rashid Jooma, said on Friday that in all, 76
people had been tested positive for swine flu by the NIH in the country, while the number of deaths was nine.
The DG’s figure on swine flu does not include the deaths taking place in Karachi and 26 cases found positive for swine flu
by the AKUH laboratory.
In reply to a question, he said that about two million protective vaccines against swine flu would be available in the country
under the Expanded Programme on Immunisation in mid-January. The initial recipients of the vaccines would be pregnant
women and the medical and paramedical personnel handling swine flu cases at hospitals across the country, he added.
(By Mukhtar Alam, Dawn-13, 20/12/2009)
Ship-breaking activities
Workers face health hazards
KARACHI, Dec 20: While thousands of Karachiites visit the Gadani beach on the Balochistan coast for its majestic beauty,
most are likely completely unaware of the murky undercurrents of life in what they consider to be a prime picnic spot —
thousands of labourers work in perilous conditions, often for a pittance, at Gadani’s ship-breaking yards, while the
government ignores their plight, Dawn has found.
Investors, most of them based in Karachi, operate ship-breaking operations on over 120 plots of land taken on rent from
the Balochistan Development Authority (BDA) and individuals at Gadani, employing thousands of local labourers.
The workers do the often dangerous work of extracting ferrous and non-ferrous metals, steel pipes and valves, electricity
cables, machinery and wood from derelict ships. Fires and accidents are common, while the air is polluted, often causing
breathing problems for them.
Speaking to Dawn, several labourers and management staff members alike stressed that it was vital that something be
done to improve both working and living conditions for those associated with the ship-breaking businesses.
There is no government agency to monitor and evaluate the operations of these businesses, and the provincial
environmental watchdog is doing nothing to monitor the environmental impact of ship-breaking at Gadani. There are no
health and safety standards for the dismantling and recycling of materials and metals, and this is having an impact on both
plant and marine life in the area.
Labourers and senior staffers say that if the government wants to preserve the beach and to promote recreational
activities in the area as well as maintain the industries here, it will have to formulate and enforce some safety and
environmental standards, as well as engage in social uplift activities in the villages. The rights of labourers in the shipbreaking yards need to be protected, they added.
Once ‘world’s largest ship-breaking yard’
Gadani, situated about 50 kilometres northwest of Karachi in Lasbela district, has been known for its ship-breaking yards
since the late 1970s.
In the 1980s, Gadani was described as one of the largest ship-breaking yards in the world, with more than 30,000 direct
employees, but competition from newer facilities in India and Bangladesh lessened its output and, in later years, it shrunk
to producing less than a fifth of the scrap it produced two decades ago.
There has been an upsurge in demand, however, since December 2008, and at present there are 10 small and medium
sized ships (including cargo ships and oil transporters) beached at Gadani for dismantling and recycling.
Ship-breaking involves beaching the vessel at the yard, removing bunkers (fuel, diesel and lubricant), transferring lubricant
and oil to a tanker for onward shipment, removing stored and loose items, removing wood and finally dismantling the
actual ship. This final stage includes the dismantling of machinery from the deck and engine room, and the cutting of the
hull with gas torches.
Normally, each ship requires a workforce of 100-150 non-skilled labourers, cutters, cutter’s assistants/helpers, crane
operators, forklift/front wheel loader operators, winch operators, supervisors and fitters. They will work for between two
and three months.
Health, environmental impacts
During the dismantling process, various gases are given off, while a good deal of liquid and solid waste is also generated.
Oils and chemicals are extracted, while garage waste, sewage and domestic waste are also created.
According to experts, the process of extracting parts of the ships structure and its components for reuse produces
potential releases to the environment due to insufficiencies in preparatory processes prior to the dismantling. There is also
an inability to collect, remove and secure hazardous substances on board due to a lack of equipment, training and
procedures, they add.
For example, blowtorches are extensively used to extract metal from the ships, but there is no heed paid to the large
amount of fumes, smoke and particulates (including manganese, nickel, chromium, iron and lead) being generated.
Emissions from the metal cutting process are also likely to contain air pollutants that may have toxic effects on workers.
A visit to Gadani revealed that neither owners nor government agencies are working to put into place any sort of protective
measures for the labourers.
Further, the petroleum products found in a variety of tanks and drums are having an adverse impact on the environment,
in addition to the primary danger to workers of handling oil and fuel without proper fire safety procedures.
Local police say that four deaths took place in 2000, while workers frequently report injuries and minor burns. Several
have slipped off ships from a great height, suffering head injuries.
Working ‘without any protective gear’
“You can see us working with our bare hands, without any eye protection, masks, headgear or gloves, on the ship and
outside on open plots loaded with toxic materials, while the air is filled with hazardous gases as well,” said a labourer, his
concerns echoed by others.
“We have to remove insulation stuck to steel and aluminium without protective clothes and masks. Most of the time,
welders and cutters prefer to burn the last remnants of fuel/diesel oil sludge on shore instead of removing them by
pumping, which ultimately make the atmosphere unbearable,” they continued.
“We are working with no periodical health checks, which is a matter of great concern to us,” added another labourer. “We
are inhaling the air without knowing its quality and the impact on our internal organs.”
There are practically no health facilities for the exclusive use of these labourers, who at present number about 6,000.
“We do not have any social security schemes, government clinics or ambulances functioning in the vicinity of the shipbreaking yards or any first-aid facilities in the yards,” said a member of the managerial staff at one of the yards, adding
that even private facilities in the area are neither equipped nor staffed by adequately trained personnel.
Though a couple of plot-holders claimed that they had made adequate arrangements for the housing of workers at their
plots, with proper drinking water and sanitation facilities, labourers could be seen going to open places outside their work
premises when nature called. The sewerage wells or tanks are not built in line with scientific and environmental
requirements, which is a source of contamination for subsoil water.
An administrator claimed that workers found their jobs financially rewarding, and that the workers (mostly from the NWFP,
Punjab and Balochistan) have now stopped travelling to the United Arab Emirates in search of work.
A survey revealed that the workers receive Rs350 to Rs500 for a long day of work, including a couple of overtime hours,
and are forced to live five or six to a small room, with no facilities for pastimes outside of their work.
About the fitness of vessels and the material these possessed, a manger said that since the vessels beached at the shipbreaking yard were ocean-going vessels coming after an anchorage at KPT, there was no room for terming them faulty,
anti-environment or marine ecology shattering ships or declared unwanted by western or European ship-breaking and
recycling industries.
‘Ship-breaking not a source of pollution’
The chairman of the Pakistan Ship-Breakers Association, Deewan Rizwan Farooqui, said that ship-breaking activities at
Gadani had slowed down as the market demand for scrap had shrunk. At present, he said, work was occurring only on 2022 plots. “Ours is a labour-heavy activity, without consuming water or electricity, and adds billions to the government
exchequer, but the industry is failing to get the required attention from the government.”
He denied that ship-breaking activities along Gadani were a source of pollution at any stage. Recently, members of the
World Bank and French diplomats have also visited us and expressed their satisfaction over our processes, he added.
“I can say without any fear of contradiction that ship-breaking operations at Gadani are much better than what is done in
India and Bangladesh, as far as number of accidents and levels of pollution are concerned,” he claimed.
However, independent observers have stressed the need for monitoring the industry to bring about improvements in the
overall environment of the Gadani beach and its nearby population centre, as well in the occupational safety of thousands
of workers engaged in the ship-breaking.
The environmental protection agency of Balochistan and the BDA should play a proactive role for the development of a
mitigation and environmental management plan to avert any long–term negative impacts on the local community or
physical and biological environment of the Gadani beach area.
The director-general of the Environmental Protection Agency, Balochistan, Mohammad Ibrahim, told Dawn that he had
recently taken over as EPA chief, but had started reviewing the environment situation along the Gadani beach.
As a signatory to the Basel Convention, which also imposes some obligations for ship-breaking , Pakistan is required to
ensure an environmentally sound management for dismantling of ships, he said, adding that he had conveyed his
concerns to the federal environment ministry and EPA, and requested for the provision of necessary equipment and
capacity building of the provincial environmental agency to assess the level of reported air pollution and marine ecology
degradation in the ship-breaking area.
“We are also setting up our regional office at Hub, which will enable the employees to have frequent visits to the shipbreaking area and take remedial measures,” the DG said.
(By Mukhtar Alam, Dawn-13, 21/12/2009)
Five test positive for swine flu in Karachi
KARACHI: Five more persons, including two children, were found infected with the H1N1 swine flu virus in the city on
Monday, taking the number of swine flu positive patients having reported to private and government hospitals to 37 since
June.
The new cases have been tested by the Aga Khan University Hospital, whose 23 samples have been verified by the
National Institute of Health, Islamabad, and declared positive for swine flu so far. In addition to the AKUH, government
sector hospitals had also sent two samples from patients, which were found positive for swine flu by the NIH.
An AKUH staffer said that following the instructions of the federal and provincial governments, the hospital had sent 19
samples and all of them had been found positive.
The official in charge of the provincial swine flu surveillance cell, Dr Shakeel Mullick, said that a three-year boy, who was
included in the list of five latest cases declared positive by the AKUH laboratory, was still admitted to the university
hospital for intensive care.
The other four were females aged between 10 and 26 years, he said, adding that in all the six patients of age ranging from
5 to14, 16 patients aged from 15 to 24, 12 patients from 25 to 49 and two of 50 and 60 years had been found positive for
swine flu either by the AKUH or the NIH.
He said the NIH had till Monday tested 25 cases received from Sindh, including 23 sent by the AKUH. Only two patients
are still admitted to the AKUH. Two deaths caused by swine flu had earlier been recorded.
So far, 13 females, 17 males and seven children had been infected by swine flu, he said further.
The infected patients from Karachi are resident of Clifton, Civil Lines, Gulshan-i-Fatima, Dhoraji, Karimabad Colony,
Garden, F. B Area, Nazimabad, PECHS, North Nazimabad.
The patients normally reported to the hospitals with fever, cold, cough and body ache, while a couple of them were also
rushed to hospitals with respiratory distress and pneumonia.
In the meantime, senior physicians at a seminar on swine flu, held at the Karachi Medical and Dental Centre on Monday,
maintained that there was no imminent danger of a swine flu pandemic in Pakistan.
The government, however, had proactively braced itself to counter any critical situation relating to H1N1 as the disease
transferred rapidly from one person to another and, therefore, it was necessary that all precautionary measures were
taken, they added.
(Dawn-13, 22/12/2009)
25,000 swine flu vaccines provided to hospitals: EDO Health
About 25,000 swine flu medicines have been provided by the City District Government Karachi (CDGK) to major hospitals
as well as those run by the city government, said Health Executive District Officer (EDO) Dr A.D. Sajnani on Monday at a
seminar held at the Karachi Medical & Dental College to discuss the phenomenon of swine flu.
Sajnani said that thus far, 10 thousand tablets of Tami Flu, the preventive drug, have been provided to both the Abbasi
Shaheed Hospital (ASH) and Civic Hospital Karachi (CHK), while Qatar Hospital and Sindh Services Hospital have also
been given 4 thousand and one thousand tablets respectively.
He said that Jinnah Hospital was also being provided with 10 thousand tablets, adding that the medicines have been
provided free of cost so as to ensure that citizens could be saved from the affects of this virus.
The EDO said that necessary precautionary measures have already taken by the CDGK on the directives of City Nazim
Mustafa Kamal, who has also instructed that instead of sending specimens to Islamabad to test for the virus H1N1, all
necessary arrangements should be made for testing at the pathological laboratory of ASH and Leprosy Hospital.
Sajnani further said that the city government was trying to inform citizens about the virus and is affects through banners
and distributions of leaflets. He said that the information about swine flu and precautionary measures can also be received
from the city government toll free number 10800-12012.
Sindh Health Secretary Syed Hashim Raza said that swine flu is a kind of common seasonal flu caused by the new virus,
H1N1. The virus has attacked people across the world, and was rapidly transferring from one person to other.
Other speakers at the seminar said that there is no imminent danger of a swine flu pandemic in Pakistan; however, the
government has proactively braced itself to counter any critical situation relating to H1N1 as the disease transfers rapidly
from one to other person.
Thus far, nine citizens have died and 76 are reported to have contracted the deadly virus in Pakistan. Two citizens of
Karachi have lost their lives to the disease, while 26 are reported to be carrying symptoms.
The seminar was addressed by Professor Salimullah and KMDC Principal Dr Waqar Kazmi, among others.
(The News-13, 22/12/2009)
Another expectant mother dies of swine flu
KARACHI: Another pregnant woman has died of swine flu (H1N1), health authorities confirmed on Tuesday.
This brings the number of deaths blamed on the virus in the city to three. Sindh health secretary Syed Hashim Raza Zaidi
told Dawn that the 21-year-old woman was expecting a chid and she died at a private hospital about four days ago.
This was the second known death of a pregnant woman due to swine flu in Karachi, he said, adding that she had tested
positive for swine flu at an Aga Khan University laboratory.
He said that the AKUH laboratory had showed a total of 42 cases positive for swine flu in the city till Tuesday.
Mr Zaidi said that in view of the emerging cases of swine flu and related deaths, the health department would hold another
meeting of medical superintendents, town health officers and other stakeholders on Wednesday to devise a strategy for
more rigorous awareness campaigns and discuss prevention and cure of the disease.
The official in charge of the swine flu surveillance cell of the Sindh health department, Dr Shakil Mullick, said that the
AKUH lab found another seven samples positive for swine flu on Tuesday.
The sample for swine flu test of the second deceased pregnant woman was also included in the newly tested patients, he
said.
In the meantime, a couple of staffers of the private hospital — Health Care Hospital — also said that the woman’s death
took place some four days back due to swine flu.
However, they refused to say anything further on the issue, saying that the ‘administrator’ was the right person to talk on
the subject.
Despite repeated attempts, this reporter could not contact the administrator.
When a senior health official in the health department was asked about the attitude of private hospitals, he said that they
were required to report at the earliest to the health department about the swine flu patients they treated.
Dr Bushra Jamil, head of the infectious control committee of the AKUH, said that patients thought to be suffering from
swine flu were still coming to the hospital.
A couple of such patients had been admitted to the hospital on Tuesday, she said, adding that the majority of the
confirmed and suspected swine flu patients were teenagers and people in their 20s.
She said that she had come to know through other medical professionals that a few other private hospitals were also
treating patients tested positive for swine flu.
Late-reporting or hiding of facts from the government caused difficulties in tracking swine flu cases and setting relevant
strategies, she said.
In the meantime, doctors working at Sindh Government Hospital Korangi-5 organised a seminar on swine flu to raise
awareness about the disease.
The medical superintendent of the hospital, Dr Abdul Wahid Rajput, told the participants of the seminar that people with flu
symptoms should stay at home, avoid crowds, and take leave from work or school until the disease was no longer
transmittable.
The head of the chest unit of the hospital, Dr Shakil Siddiqui, said that asthma sufferers were more at risk of swine flu.
‘When this virus attacks the respiratory tract, it can take a turn for the worse,’ he said.
He asked such people that instead of feeling panicky, they should take their asthma control medicines properly and should
cover their nose and mouth with tissue paper when they cough and sneeze and throw the tissues into the dustbin after
using it.
Dr Nayyarul Islam said that coughing, sneezing and even touching any surface containing the virus could spread it.
‘Swine flu in human beings is most contagious during the first five days of the illness,’ said the physician, adding that in
certain cases, particularly involving children, the duration could prolong to 10 days.
He said the diagnosis for the infection could be made by sending collected specimen, during the first five days of ailment,
for an analysis.
(By Mukhtar Alam, Dawn-13, 23/12/2009)
Rehri children suffering from genetic disorder
KARACHI: The Sindh health minister with a team of senior paediatricians paid a visit to a poverty-ridden locality of the
metropolis, Rehri Goth, on Wednesday to get first-hand knowledge about the reports that children of the area had become
victim of some mysterious ailment.
As a result of the visit, four children of Rehri Goth, aged between four and 10 years, were rushed to the Civil Hospital
Karachi, where doctors would evaluate them clinically for treatment.
The head of the paediatric ward-II in the CHK, Prof Iqbal Memon, told Dawn that one of the children was admitted to the
intensive-care unit while others were admitted for evaluation and treatment for severe weaknesses, including nutritional
weaknesses, anaemia and slow growth.
There had been reports about Rehri Goth, a neglected population of about 30,000 people in Ibrahim Hyderi, that it was
haunted by some mysterious diseases.
Health Minister Dr Sagheer Ahmed and his team of doctors visited the locality to know whether it was an outbreak of some
disease or something else that made the area children sick.
The minister and his team met and interviewed several persons, who had gathered along with their sick children at a
house in Khalifa Para, Rerhi Goth.
Later, he told newsmen that there was nothing mysterious behind the children’s ailment.
He said the children were the victim of genetic disorder, rickets, muscular dystrophy, thalassaemia and other diseases due
to ignorance of their parents and the overall environmental and unhygienic conditions.
He said he had interviewed parents and saw the children along with a team of senior doctors, who were of the view that
the disorders could have been averted provided the families had the opportunities for any improved education, health and
financial resources.
‘However, it is never too late and the government will help these families of fishermen,’ he added.
The health minister said that a camp would be set up again at Rehri Goth on Thursday to ascertain the exact number of
children affected by genetic disorders or inherited diseases.
Some independent social and health workers told Dawn that though the disease problems in children existed for last many
years, it could be highlighted only in recent months.
‘We need free ambulance service and free physiotherapy for our affected children,’ said some parents. ‘The government
should ensure the establishment of fully-fledged health-care centres with doctors and equipped with machines and
medicines in our vicinity and other coastal areas as well,’ they added.
Health Secretary Syed Hashim Raza Zaidi, Dr Iqbal Memon, Dr Zulfiqar Bhutta, Dr Abdul Majid, Dr A. D. Sajnani, Dr
Saeed Qureshi, Prof Juned Ashraf accompanied the health minister.
The medical superintendent of the CHK, Dr Qureshi, said that a team of doctors had already visited the area and asked
the NGOs working in the area to ask the families concerned to bring their children to the CHK for clinical investigations,
but no positive development could be noticed.
Dr Iqbal Memon said the affected children were suffering from mental retardation, nutritional weakness, muscular
dystrophy, vitamin D resisting rickets, genetic brain dystrophy and infections. ‘I am afraid that a couple of children also
suffer from bone dysphasia,’ he said.
Dr Bhutta of the Aga Khan University said that such diseases were also common in other villages, which were facing
pathetic health and education infrastructure, across the province and the country. This could be attributed largely to interfamily marriages and there is a need to educate parents on the subject, he added.
Meanwhile, the health minister said in a press release that the treatment and physiotherapy would be provided to all the
sick children of Rehri Goth.
(By Mukhtar Alam, Dawn-13, 24/12/2009)
Cause of Rehri Goth child paralysis remains contentious
Contrary to the recent findings of an international health organisation, a team of doctors from the Infection Control Society
(ICS) has concluded that contaminated water cannot be ruled out as a causative factor for the rampant child paralysis in
Rehri Goth.
This revelation from the ICS, which is a non-governmental organisation working on health issues, comes in the wake of
recent reports from an international health organisation, which had concluded that contaminated water could not have
caused paralysis among children in Rehri Goth. While conceding that the water in the area was contaminated, the
organisation had categorically cited Vitamin-D deficiency and genetic factors as the essential culprits.
Dr Azra, who was part of the five-member ICS team, told The News that according to her team’s findings, there are
multiple reasons for the disease found in children in the coastal locality. She said that they had initially thought that these
cases of paralysis were related to polio, but they were wrong.
Dr Azra linked poverty and lack of health facilities with the problem, and said that the team believed that due to lack of
awareness, people did not take their children to hospitals once the symptoms of the disease appeared. As a result, the
problems multiplied, leading to paralysis. She added that the ICS team has taken blood samples and conducted other
tests for further analysis in order to suggest proper treatment.
Doctors in the ICS team detected a host of causes for the disease among children, and said that they could not overlook
the negative impacts of lack of sanitation, contaminated water and deadly chemicals flowing into the nearby sea.
Meanwhile, a Pakistan Fisherfolk Forum (PFF) spokesperson told The News that they have approached the ICS team to
set up emergency centres for the rehabilitation of the victims, especially those who the team thinks need immediate
treatment. He said that the ICS team agreed to the PFF’s proposal and such centres will be established soon.
The PFF has also received information from the Illyas Jat locality in the same neighbourhood, where at least 15 children
are said to be suffering from similar symptoms. The fisherfolk forum has formed a team which will visit all neighbouring
coastal localities to ascertain the prevalence of the disease.
The PFF spokesman said that they have already highlighted the issue of increasing marine pollution, but the “ignorant
authorities” are not taking this seriously.
Meanwhile, residents of the area have appealed to the provincial government to look into the matter sympathetically and
diagnose the real causes of the disease which has caused immense panic in the entire coastal zone of Karachi.
(By Jan Khaskheli, The News-20, 24/12/2009)
Skin diseases hit coastal areas of city
KARACHI: A large number of people living in the coastal areas of the city, majority of them children and women, are
suffering from various skin diseases such as scabies, ectoparasite skin infection and eczema due to polluted water and
lack of hygiene.
The residents of these areas are mostly poor fishermen, and according to a local non-governmental organisation, Kalachi
Social Viable Association (KSVA), the skin diseases have spread on a vast scale in coastal areas such as Rehri Goth,
Ibrahim Hyderi and other areas of Bin Qasim Town.
The organisation has estimated that 1,218 children of 720 families in Ibrahim Hyderi alone have been inflicted with skin
diseases. Their initial findings reveal that water pollution and lack of hygiene could possibly be the cause behind the
outbreak of the diseases, while a lack of proper state-run healthcare facilities in these areas has worsened the situation.
“Every third adult and second child in Ibrahim Hyderi is suffering from a skin disease and it seems that outbreak is
spreading rapidly,” said Dr Taju Nisa Farooquie alias Farah, a doctor at a medical centre run by KSVA.
“Most of the skin disease patients are poor and cannot afford proper treatment, thus their family members also become
affected,” said Farah, who attends around 100 patients daily, majority of them suffering from skin diseases.
This scribe visited several affected families and observed that the diseases have reaced epidemic levels in some areas.
A teenager fisherman Imran Dhorai, resident of Kariyani Paro of Ibrahim Hyderi, was born with rashes on his skin.
The rashes became so severe that as he grew up, almost all of his body became covered with strange patches.
The disease rendered him unable to continue his profession as a fisherman and he had started working as a mechanic in
an auto garage. The disease also destroyed his social life as he feels strange while mingling with his peers and also feels
that he would never get married. “Sometimes, I can’t even sleep...during summers I feel as if my body is on fire and in
winters, scaly pieces of skin shed from my body that feels unbearable,” he told this scribe with teary eyes.
He consulted several doctors and also visited hakeems. He even went to take a bath in natural hot water fountain in
Manghopir that is believed to heal skin diseases, but all went in vain.
The disappointed fisherman even resorted to consulting faith healers, but even that did not work.
Another fisherman blamed the increasing sea pollution for the situation and said the pouring of untreated highly toxic
effluent directly into the sea has created the problem.
He backed his claim by saying that hundreds of industrial units in the Korangi Industrial Area release effluent directly into
Arabian Sea through the Korangi Nullah.
Dr Ashok Kumar, who also works at the KSVA medical centre, said there is a lack of proper hygiene in these areas, and
this could be one of the reasons behind fungus infections.
“Most of the residents in these coastal areas are fishermen and therefore lack of hygiene and polluted water could be the
reason behind the skin diseases.”
Bin Qasim Town Town Nazim Jan-e-Alam Jamot said there are several families afflicted with skin diseases in his town.
“There are state-run hospitals in these areas, but they lack medicines and proper funding,” he said.
“We are arranging a medical camp in Ibrahim Hyderi for immediate relief of patients,” said Kiran Jamot, a KSVA officebearer.
Sindh Health Minister Dr Sagheer Ahmed said his department has arranged two camps in Ibrahim Hyderi for the patients.
(By Amar Guriro, DailyTimes-B1, 24/12/2009)
‘Mysterious’ ailment
THE mystery surrounding Rehri Goth’s children has apparently been solved. Reports had emerged of ‘mysterious’
ailments afflicting the children of this impoverished fishing village on the outskirts of Karachi, following which Sindh’s
health minister visited the locality with a team of senior doctors on Wednesday to ascertain the facts. What emerged was
that the reasons behind the children’s illness — poverty, ignorance, hereditary diseases, unsanitary living conditions —
were not so inexplicable after all. Four of the children were admitted to the city’s Civil Hospital where they will be treated
for nutritional weaknesses and anaemia. Talking to the media, the health minister enumerated a nightmarish list of
debilitating ailments the children are suffering from. He blamed the parents’ lack of awareness and the area’s unhealthy
environment for the children’s condition. The minister added that the disorders could have been averted if the families had
access to health and education facilities as well as financial resources.
The government’s promise to help this community is commendable but the problem needs to be tackled on a wider scale.
The residents’ demand for a free ambulance service as well as proper medical facilities needs to be met immediately, not
only for this locality but for all the city’s far-flung settlements. This holds true not only for Karachi but the rest of the country
as well. In a metropolis where many can avail of five-star medical treatment, it is sheer injustice that pockets exist where
people do not have access to the basics of life, such as clean water, sanitation facilities and proper housing. And as the
children are also suffering from disorders reportedly due to marriages between close relatives, perhaps the government
can launch an awareness campaign about the risks inherent in such unions.
(Dawn-7, 25/12/2009)
Secrecy over swine flu data
KARACHI, Dec 24: Federal health ministry officials were not updating their counterparts in Sindh on the increasing
number of swine flu cases and on strategies needed to curb the disease, said sources in the Sindh health department.
Till Thursday, Sindh has reported 52 positive cases of swine flu and this had been confirmed by the National Institute of
Health (NIH), Islamabad, and the Aga Khan University Hospital (AKUH).
Although there is no update from the federal health ministry, a source estimated that about 40 to 45 per cent of the total
swine flu positive cases detected in the country were from to Sindh.
It has been learnt that there is no formal communication from the federal government to the Sindh government on swine
flu data, sources said that under a policy some stakeholders were trying to hide the details of such cases in order to avert
criticism of senior health managers across the country for their failure to move in the right direction at right time.
When Sindh Health Minister Dr Sagheer Ahmad was contacted by Dawn, he said that he did not know about the national
focal person on swine flu so far, but the director-general in the federal health ministry on request had told him on
December 22 that 110 swine flu cases had been confirmed by the NIH, out of whom 39 were of Sindh.
He said that he had asked the DG to ensure that the national comprehensive data paper should be posted to his office
daily, but that did not happen. He further said that much had been heard about the swine flu preventive vaccines, but no
information was being shared officially by the federal health ministry.
Sindh had reported 52 swine flu cases and a close coordination between the ministry and the federal health department
was needed, he added.
Replying to a question he said that since a majority of the cases sent by the AKUH to Islamabad had been rechecked and
confirmed positive for swine flu by NIH, there was no use of denying the private hospital’s findings.
“We now own the AKUH findings and include them in the overall provincial data for swine flu,” he said.
The focal person on Swine flu in the Sindh Health department, Dr Shakil A. Mullick, said that he too had been calling the
people at the helm in Islamabad, but to no avail.“What I have been told by NIH people about three days ago was that
Sindh had reported 25 cases positive for swine flu,” he added.
Giving the latest city situation on swine flu, Dr Mullick said that no new patient was tested positive for swine flu by the
AKUH on Thursday, while the number of patients admitted for swine flu treatment at two private hospitals remained five till
Thursday.
A maximum of four swine flu positive patients had been hospitalised at AKUH, he added.
“Sindh has reported so far three deaths, but I am not sure whether these had been included in the national data or not,” he
said in reply to a question.
A couple of senior health ministry personnel at Islamabad were also contacted by Dawn, but they failed to provide any
update on swine flu.
There was no response from the cellular phones of the federal health secretary and the director general of health, despite
repeated attempts.
However, people in the Sindh health department and district government said that they badly felt that the federal
government should turn up and the health bosses from Sindh should come to Karachi and join them in tracking the swine
flu virus, which was not the indigenous virus, particularly when a majority of patients did not have any contact history or
foreign travel history.
Late on Thursday night, the national manager on Influenza Control Programme, Dr Arif Zaka, said that the federal health
minister, federal health secretary, DG health Islamabad and he were being provided a daily report on swine flu by the
NIH.NIH informed that 114 cases had been found positive for swine flu, with ten deaths till Thursday; he said, but failed to
give any breakdown of the cases reported countrywide or the number of Sindh cases and observed that the executive
director of NIH was the best person to be contacted in this regard.
(Dawn-15, 25/12/2009)
KIHD launches training in cardiac technology
The Karachi Institute of Heart Diseases (KIHD) has launched training in cardiac technology under a three-year diploma
programme, after its recognition from the College of Physicians and Surgeons Pakistan (CPSP). Earlier, a special team of
CPSP comprising of senior cardiologists inspected KIHD and declared it an appropriate institute for cardiac teaching in
cardiac technology. The institute will also be equipped with a cardiac nursing institute.
This was stated by KIHD Executive Director Dr Abdus Samad while addressing the launching ceremony of diploma in
cardiac technology.
Dr Samad said that a nursing institute will soon be added in the present set up of KIHD while the medical and surgical
wards will also be started soon.
EDO Health Dr A.D Sajnani said that it has been an honour for the KIHD and the City District Government Karachi that the
institute has been recognised for cardiac teaching. He said that despite of facing worst financial constraints City
Government has managed to fulfill all requirements of its hospitals and medical institutes. KMDC Principal Dr Waqar
Kazmi said that the establishment of a cardiac institute was a big achievement of the city government. He said that the
institute has been equipped with latest machinery that was not available even at private hospitals in Pakistan.
Renowned cardiologist Professor S.M Rab said that Karachi was a big city and one cardiovascular institute was
insufficient for the requirement of the heart patients from every nook and cranny of the city. He said that the institute was
in fact like a dream come true for the people and it would surely serve the ailing humanity in a big way.
He advised students to take their studies seriously and set up new examples of excellence in this profession. He said that
present was an era of latest technology and must have to equip ourselves with the latest technology. The completion of
the second phase of the KIHD has so far cost Rs600million.
(The News-19, 25/12/2009)
Rehri Goth child paralysis
Camp established to assess, treat disease
After a wave of mysterious disorders affecting the children of Rehri Goth, Sindh Health Minister Dr Sagheer Ahmed has
ordered the establishment of a camp in the area to assess and treat the ailing children.
A team of doctors from the Civil Hospital Karachi visited Ibrahim Hyderi and met the children of Jam Punnoh to evaluate
their condition.
Reports regarding a mysterious disease plaguing the residents of Rehri Goth, had been circulating in the media with no
particular cause coming forth. Dr Ahmed visited the area with a team of doctors on Wednesday to find out the real cause
of the disease. After interviewing several people in the area the minister later told media persons that the ailment is not
mysterious. Rather it is a “genetic disorder” including other diseases like, thalassemia and muscular dystrophy. Dr Ahmed
said that the disease is a result of unhygienic conditions in the area and ignorance of the parents.
The team of doctors, who were present with the minister, was of the view that due to lack of financial resources, education
and health facilities the disease had spread so much in the area but said that it’s still not too late as the government will
help the families of those infected.
(The News-19, 25/12/2009)
Two more die of swine flu in Karachi
KARACHI: Two more patients, including a young man, have died of swine flu, taking the death toll caused by the dreaded
virus in the city to five, health officials said on Friday.
Ironically, the two men, who were admitted to the hospitals for treatment during the last eight days, were declared positive
for swine flu by the National Institute of Health, Islamabad, after their deaths.
An official of the health department told Dawn that one of the patients was given treatment and supportive care at the
Ziauddin Hospital, North Nazimabad.
The focal person for swine flu surveillance in Sindh, Dr Shakil Mullick, said that the number of patients tested positive for
swine flu in the city reached 55 since June last. He added that so far swine flu claimed five lives.
Of the 22 males and 33 females detected positive for swine flu, two children are still admitted to two private hospitals, he
added.
Giving details about the latest casualties caused by swine flu, Dr Mullick said that a 70-year-old male patient, a resident of
North Nazimabad, was admitted to a private hospital on Dec 19 with the history of a respiratory tract infection. He died on
Dec 22, while the result of his swab sample was awaited by his consultants and medical staff.
About the other death, which took place at the Civil Hospital Karachi, the focal person said the patient was a 30-year-old
man from Mawach Goth. He had diabetes with its complications, and was admitted to the CHK on Dec 17. He died on Dec
19.
Answering a question by this reporter, Dr Mullick said that relatives and paramedics coming into contact with or handling
patients, later declared positive for swine flu, should be monitored for symptoms of the virus. If they show symptoms for
flu, they should be given necessary treatment at the earliest, while samples should also be collected from them for swine
flu tests as precautionary measures, he added.
Experts say that swine flu in humans is most contagious during the first five days of the illness and as such the diagnosis
for the infection could be made by sending collected specimen during the first five days of ailment for an analysis.
Besides the two belatedly declared swine flu deaths, there had been three deaths, including two of pregnant women, in
December. The total number of cases detected positive for swine flu in the city reached 31 as the Aga Khan University
Hospital found another positive case in its laboratory on Friday.
However, provincial health officers did not know how many of the confirmed reported cases reflected in the consolidated
national figure of swine flu patients and deaths.
In the meantime, 36 awareness camps were established on a permanent basis at different spots in the 18 towns by their
respective health administrations to create awareness about swine flu. The special secretary of the health department
visited at least four such camps in Gulshan-i-Iqbal and Jamshed towns during the day.
A swine flu cell has also been established at the Sindh Government Children Hospital, North Nazimabad town. At a
meeting presided over by the MS of the hospital, Dr Asif Zaman, it was decided that the cell would comprise an OPD and
an isolation ward. Parents visiting the hospital with children are also being given awareness handbills and other
information on swine flu. Dr M. A. Waheed will be the focal person of the cell, said a press release.
Another camp was established by Town Health Officer Dr Ashraf Saeeduzzaman in Keamari, where people were told
about coughing etiquettes and the time when to suspect any person for the disease or rush him to hospital. Dr Ahmad
Hasan, Zahida Hussain Shah and Saleem Sardar of the Ahsas Trust also spoke to the gathering at the camp and
answered various questions.
(By Mukhtar Alam, Dawn-13, 26/12/2009)
75pc govt hospitals still using obsolete rabies vaccine
KARACHI, Dec 25: The government and the media have not yet given due priority to rabies that claims thousands of lives
every year in the country.
One major reason of this high mortality is the fact that the government has not developed any strategy to address this
serious public health issue.
Official apathy can also be gauged from the fact that 75 per cent of the public sector hospitals are still using the old
vaccine which has been found ineffective in many cases and declared obsolete by the World Health Organisation two
decades ago.These points were highlighted by Dr Naseem Salahuddin, head of the department of infectious diseases,
Indus Hospital, at a public awareness programme held at Aga Khan University auditorium on Friday.
Introducing the disease, Dr Salahuddin said that rabies was hundred per cent fatal and, at the same time, hundred per
cent preventable.
“That means that if signs and symptoms of the disease appear, there is no treatment possible and the disease has always
proved fatal.
“Rabies is transmitted to humans from infected mammals and is caused by a virus. An infected animal has the rabies virus
in its saliva and can transmit it to anyone through its bite. After the bite, the virus can spread into surrounding muscles and
then travel up nearby nerves to the brain. Dogs are the most common carrier of the rabies virus,” she said, adding that the
virus could be transmitted to livestock or cats or other mammals by the bite of a rabid dog.
The symptoms could take days, weeks, months or even a year to appear, depending upon the load of the virus transmitted
and the proximity of the wound to the brain, she said, adding that almost half of the victims were children.
“Before the virus could reach the brain and symptoms appear, the patient needs to be administered immediately the rabies
immunoglobulin and the tissue culture vaccine (TCV), depending upon the nature of the bite. Once the virus reaches the
brain, the infection becomes fatal,” she explained.
About the disease prevalence, she said that although no scientific data was available, it was said that between 2,000 and
4,000 people died of rabies while 150,000 cases of dog bite cases were reported annually in the country.
The modern rabies treatment, she said, was costly, but effective. The vaccine cost, however, could easily be reduced by
adopting the intramuscular method of injection.
“This can reduce the cost by one-fifth and the quantity of the dose required for one patient can also be decreased in this
way,” she said. She advised that pet dogs must be vaccinated against rabies.
About the first aid in case of a dog bite, she said that the bite must be washed thoroughly with soap and then an antiseptic
should be applied. Proper washing of the bite could reduce 30 per cent chances of rabies infection, she said.
Referring to the lack of interest on the part of the government over the issue, Dr Salahuddin said that it must discontinue
the use of obsolete vaccine, import good quality tissue culture vaccine, make sure its availability at all public sector
hospitals, train health experts and take steps to control stray dogs’ population in a humane way.
Speaking on tetanus, Dr Mohammad Wasay of the AKU said that Pakistan had a high mortality rate due to the disease
which, although was dangerous, could easily be prevented.
“It can cause death and disability. The life of a child born in unhygienic conditions is specially at risk. This risk can be
prevented if mothers are administered the vaccine which is inexpensive and easily available,” he said, adding that every
person must take the full vaccination course.
On the subject of encephalitis, Dr Saad Shafqat, assistant professor of neurology at the AKU, said it was inflammation of
the brain tissues.
“The symptoms included fever, mental disorder and seizures. It could cause death and disability,” he said.
“There are different types of viruses which cause the disease. The virus that is transmitted to humans by a mosquito bite is
common in India and Pakistan. The disease is also called Japanese encephalitis. It is generally seen after a spell of rain,”
he said.
(By Faiza Ilyas, Dawn-15, 26/12/2009)
Unhygienic conditions prevail in Lyari
KARACHI, Dec 25: The streets of Lyari Town littered with trash and garbage heaps along the roads have become a
serious public health concern, creating unhygienic conditions in many parts of the locality.
Residents of the area have told Dawn that they have drawn attention of the authorities concerned towards the unhygienic
conditions in their areas several times.
However, no government functionary was taking up the matter seriously, they said.
They said that poor cleanliness was posing a serious threat to public health and expressed the fear that if urgent steps
were not taken, any epidemic could break out in the area.
They said that the worst situation existed in the surrounding areas of Kara Bhai Karimji and Shah Waliullah roads where
garbage was being dumped on roads because no municipal rubbish dumps existed in the area.
Area people blamed the inefficiency, negligence and mismanagement of municipal officials concerned for the poor
situation.
When Dawn spoke to local officials, they cited shortage of funds, lack of necessary equipment and staff as some of the
main reasons for poor garbage collection and disposal system.
A survey of the locality showed that the disposal of garbage remained a serious problem in some parts of the town as over
the years most of the municipal rubbish dumps had disappeared because of encroachments and land-grabbing activities
of a powerful mafia.
This resulted in the emergence of many illegal garbage dumps in the area.
In the absence of any proper municipal rubbish dumps, people began dumping waste on roads and footpaths.
The local people said that mafias had raised multi-storey buildings on places where municipal rubbish dumps stood with
the connivance of municipal officials.
Residents and community leaders were of the view that the present system had totally failed to deliver and the poor
sanitation had become a major problem for the people.
The situation is getting worse in Nawabad, Daryabad, Khadda, parts of the Baghdadi and Shah Union Council areas
where sanitary workers are not performing their duties regularly.
(Dawn-15, 26/12/2009)
Investing in health
IT is quite clear that the country’s health provision services are under tremendous pressure. In the rural areas surrounding
Islamabad, for example, over 400,000 people are dependent on just three rural healthcare centres and a dozen basic
health units. Established decades ago and managed by the administration of the Islamabad Capital Territory, these
centres should have had facilities that kept pace with the growing number of patients coming in for treatment. Instead,
even the collective annual grant for the units has not been increased in years. This means that on average a sum of Rs11
is annually available for each patient from the resources accessible to these health units. These meagre funds are also
meant for additional exercises such as periodical insect-spraying and annual anti-allergy camps.
Equally disturbing are the implications for health centres in other rural parts where access to and the efficient working of
an area’s medical centre can mean the difference between life and death. Besides the inaccessibility of medical centres
other problems encountered by patients include the scarcity of medicines and facilities to treat any but the most common
of ailments and the dearth of qualified doctors and medical staff. There is an urgent need, therefore, to not only increase
the number of health centres and BHUs in the rural areas, but also to improve their performance. In addition to increased
funding, this requires setting up reliable supply lines for medicines, providing incentives to doctors and paramedical and
nursing staff to work in these areas, and inculcating in them a sense responsibility and compassion towards the patients. A
sick population is an unproductive one and puts more pressure on the country’s already stretched resources. It is high
time that Pakistan invested in the health needs of its citizenry, particularly those in the rural areas.
(Dawn-7, 28/12/2009)
Residents of coastal villages suffer for lack of healthcare
KARACHI, Dec 27: Jobless and financially-strapped Khuda Gunj, the father of four children and a resident of a coastal
village, suffered another setback when he had a serious motorbike accident.
One day when he was heading homewards in the evening, he fell from his motorcycle and received multiple injuries on a
leg.
His friend riding pillion got cuts and bruises on his face and fainted. Luckily, some passers-by helped them and took them
to their homes in Mubarik Village, an old settlement of fishing community situated in Keamari Town and very much part of
Karachi.
Here, they remained without any first aid for almost an hour and 30 minutes. And the reason was that the only healthcare
facility in the village had been closed down many years ago and no transport facility or ambulance service was available to
take them to Mauripur, which is a 45-minute drive from Mubarik Village. It was the nearest place where medical services
could be available.
After hectic efforts, some relatives hired a truck which took the injured to Mauripur where they had to be treated at a
private clinic because there was no government-run hospital in Mauripur as well.
“Most of the primary healthcare facilities in the town have been shut for many years. A few which do function here, open
only for some hours in the morning and are facing a lack of staff, facilities and medicines. People in remote villages,
especially women, older people and children, face a grave risk of death and disability in medical emergencies,” Khuda
Gunj tells Dawn.
This entire episode cost his friends Rs3,000 — a big burden on their meagre resources.
Still, they failed to get an X-ray of the injuries because there was no such facility available at the clinic nor they could
afford it.
The miseries of the inhabitants of coastal villages are compounded by the fact that there is no government-run hospital in
the entire Kaemari Town, which has a population of about 672,000 people.
What Khuda Gunj and his friend faced in the medical emergency, however, is not an isolated incident.
According to Dr Shershah Syed, practising at the government-run Qatar Hospital in Orangi and president of the Society of
Obstetricians and Gynaecologists of Pakistan, the situation in the rest of the country is not much different.
“Eighty to 70 per cent basic health units (BHUs) and 50 per cent rural health centres (RHCs) in the country are nonfunctional, mainly because of a shortage of staff. The country is facing an acute shortage of midwives, paramedics and
nurses who are the backbone of any primary healthcare system. The country produces one nurse against eighty doctors
and only one doctor is available for 2,300 people.
“And, more seriously, there is no training in place at the public-sector institutions to train doctors as primary healthcare
physicians,” he says.
The problem, however, doesn’t end here.
Dr Syed points out that quality training of medical practitioners is also a critical issue.
Elaborating this aspect, he refers to a Unicef survey report according to which about 95 per cent of midwives in the
country get diploma training certificates without handling a single case of delivery.
“The survey was conducted in the late 1990s. But, ironically, it is difficult to challenge its findings even today,” he asserts.
Health experts believe that an efficient primary healthcare system must provide services for 24-THE Mubarak Village
dispensary which has been lying closed for years.—Fahim Siddiqi/ White Star hour emergency, obstetric care, first aid,
immunisation, maternal and infant care, school health service and family planning.
Painting a grim picture of the nation’s health, the Pakistan Medical Association annual report 2007 states that the overall
health situation has not changed in Pakistan for the past many years, though government funds for the health sector have
been increased.
“An army of nurses and paramedics are required to run the 10,000 primary healthcare centres and 800 hospitals in the
country with a population of 160 million. No government has ever made a comprehensive health policy to produce these
professionals and provide a respectable career structure for them.
“The government initiative to produce community midwives in the absence of trained tutors would not produce competent
health workers. It would be another waste of resources like the dai training programme in the past,” it says
Dr Shershah says that the lion’s share of the meagre health budget goes to tertiary care hospitals meant for specialised
treatment and 15 per cent is spent on primary healthcare which is set up to attend to 90 per cent of the patients. This
reflects the government’s misplaced priorities, he adds.
In the absence of an efficient primary healthcare system, it is not surprising to see that a large number of patients daily
reporting at the city’s tertiary care hospitals.
“At the Civil Hospital Karachi, around 18,000 women reported for gynaecological/obstetric emergencies this year. Of them,
only 8,000 were admitted. That means that the emergencies of 10,000 women could be treated at primary healthcare
centres if they were adequately equipped with facilities and manpower,” says Dr Farah Abdul Bari, managing the CHK
gynaecology/obstetric department.
Explaining these ‘mild’ emergencies, Dr Bari said that women reported with different problems, including severe vomiting,
diarrhoea and false labour pains.
“Those with false labour pains simply refuse to go home, saying that they are too poor and could not afford to go home
and return at the time of delivery,” she said.
“As is the case with other public sector hospitals, the CHK faces an acute shortage of staff and resources and the
employees work under stressful conditions. If primary healthcare facilities were properly equipped, it would definitely
reduce burden on tertiary care facilities and improve the working of their staff,” she adds.
(By Faiza Ilyas, Dawn-13, 28/12/2009)
Karachi endures the return of epidemic diseases in 2009
The year 2009 was a year of flu outbreaks and of ‘mysterious illnesses’ which caused concern and panic among the
people and demanded more groundwork as well as concerted efforts from doctors and health officials.
Mostly year ends are used to take a retrospective look towards achievements and setbacks of the year and senior doctors
and experts are of the view, that health wise Pakistan has not moved forward at all and most importantly “it seemed as if
health is not on the priority list of the government,” said Dr Samreena Hashmi, General Secretary of Pakistan Medical
Association (PMA) Karachi.
Dr Hashmi said that for the major part of the year, the health authorities were seen grappling with issues related to disease
and infection. She says that if we focus on preventive measures 50% of our work will be completed “as these are the main
burdens we need to understand first as they are linked with the health and prosperity of a common man.”
DENGUE FEVER: Since January 1 2009 till the December 19, 1355 people were suspected of being infected with the
dengue virus in Karachi, out of which 830 were confirmed positive whereas 9 people died due to Dengue Shock Syndrome
(High fever and bleeding) which created quite a stir. The fears of increasing number of patients was calmed by doctors at
a press conference held at Jinnah Post Graduate Medical Centre (JPMC) in which they said that the existing trend can not
be considered as an epidemic unless they receive more than 20 cases from one area. However, they said that dengue is
not a contagious disease and could be controlled by providing platelets to the patients. The patients complained that the
cost of a platelet was around Rs3,000 to Rs8,000 which they can not afford.
Doctors are of the view that the cases pertaining to malaria and dengue continue to increase, partly because of global
climatic changes and partly as a consequence of failure of control programs at community level.
Dr Samreena Hashmi, says that on a government level there’s no policy and if there is it is not being implemented at all.
SWINE FLU: In late April of 2009, Margaret Chan, Director General World Health Organization (WHO) declared “a public
health emergency of international concern” when the first two cases of swine flu were reported in the United States
followed by a hundred of cases in Mexico afterwards. This declaration created concern among many countries to take
ample measures in order to avert the danger of a swine flu pandemic. Health officials in Karachi and the government did
brace themselves up to counter the disease by putting up thermal scanners at the Terminal 1 and 3 of the old airport at
star gate. However, the Quaid-e-Azam International Airport, which receives thousands of passengers every day from
different parts of the world, was not equipped with thermal scanners.
The first case of swine flu was reported in June, when a girl of 17 years was detected with the virus. According to her
family, she had not even traveled abroad even. From June to November, 11 cases of swine flu were reported in Karachi
and most of them were out patients at the Agha Khan University Hospital (AKUH).
In December, AKUH Laboratory tested 24 people positive for swine flu and the doctors said that all of the patients have
not traveled from Karachi in recent times. The health authorities rejected the figures by declaring that only those figures
will be considered authentic which are confirmed by the National Institute of Health (NIH) in Islamabad.
From the month of June till December 72 people have been confirmed positive for swine flu, with six people dead.
Dr Bushra Jamil, of the Infection Control Committee at the Agha Khan University Hospital (AKUH) says that the spread of
infections like H1N1 was facilitated because of contagiousness of the organism and extensive air travel to and from the
country.
POLIO: The year also saw a return and increase in polio patients. The disease which was said to be eliminated from the
country still poses a threat. “Eighty two children are still infected in our country, among them 11 are from Sindh (including
5 from Karachi), Punjab (16), Balochistan (9) and a whopping 64 cases in NWFP. According to a report of WHO, the
disease will keep on spreading unless and until the living conditions of the people are not made better and will be a threat
even for those countries who have protected themselves, as it spreads by shaking hands and using the same utensils
again.
HIV/AIDS: A UN report titled ??? revealed on December 2 that 6,000 cases of Human Immunodeficiency Virus
(HIV)/Acquired Immune Deficiency Syndrome (AIDS) are registered in Pakistan; the actual number of people suffering
from the disease, however, could be in millions. The report further stated that because of lack of proper screening facility
in Pakistan it is therefore hard to assess the accurate number of patients suffering from AIDS. The major reasons for the
increase include the absence of a system to check HIV positive people, indiscriminate transfusion of blood, growing rate of
drug addicts and the trend of not using protection while having a sexual intercourse.
LGH gets Rs 1b package: Also, a development package of Rs 1 billion was allocated to the Lyari General Hospital, which
was taken as a good sign by the locals for the improvement of the area. Construction work on a medical college by the
name of Shaheed Mohtarma Benazir Bhutto Medical College also started but it witnessed a lot of setback as the
inauguration date for the medical college had been changed twice and the sources involved in the project said that so far
admission as well as registration process has not started.
(By Saher Baloch, The News-19, 31/12/2009)