Viral hepatitis is Sindh’s silent killer

Author: Inayat Ali

Viral hepatitis is the eighth most frequent cause of mortality across the globe. According to Wold Health Organisation’s global data, 330 million people worldwide have been infected by hepatitis B and C. Out of these 20 million people will die between 2015 and 2030. In this grim picture, Pakistan and Egypt are two major contributors; 80 per cent of the world’s hepatitis patients live in these countries. In Pakistan, approximately 18 million people have been infected with hepatitis. Almost 400 people die of the disesae every day. Given the gravity of the situation, there is a demand to declare a hepatitis emergency.

The ominous crisis appears to have been a product of structural violence resulting from an imbalance of economic, political and institutional powers. The Sindh province seems to be worst hit in this regard. As much as 35 per cent of the province’s population is estimated to be carrying the silent killer. The virus is now seen to be responsible for every fifth death in the province. So far the disease has spared no one in terms of age and gender. Some of its preys have been quite young.

Most hepatitis patients remain unaware of the infection until it is at its final stage. Following the diagnosis, most of them think they have become a burden on their family. Many patients get desperate and start looking. Many approach opportunistic ‘healers’ like quacks and fake pirs for a miraculous recovery. Such healers exploit the already fragile patients. Some patients abandon their homes and find shelter at some shrine to pray for their health. Word of mouth plays a pivotal role in creating such options. Shrines full of patients suffering from diverse deadly diseases seem to some people the last resort as they wait for an imaginary recovery.

I personally know about a person in his late-30s who is fighting for his life. He is on a government-provided treatment. Due to poverty, he cannot afford the recommended food. He painfully replies to questions related to food, and begs every visitor for supplication. Now and then his family takes him to local ‘doctors,’ and pirs for healing.

Pakistan and Egypt are two major contributors; 80 per cent of the world’s hepatitis patients live in these countries

Therapeutic injections, syringe reuse, surgery, inappropriate sterilisation of invasive medical devices, blood transfusion, hospitalisation and sharing of razors have been the frequent sources of infection. Underdeveloped areas and the poor are more vulnerable to the disease.

A poor person has no choice except to visit a barber or a dentist or a quack who uses unsterilised instruments. The rich can afford to visit a fancy salon, a reputable doctor or a highly equipped health facility.

It is unfortuante that many of the people affected by the disease and their famlies have no good understnding of the mechanism that drives the epidemic. They are thus unable to avoid more infections. Many of them have no idea of their rights and see a free mosquito net or a BISP card as a favour.

The Pakistan Peoples Party has ruled the province for a long time. Its leaders must be held accoutable for their omissions. The party and government leaders must reflect upon their policies. A thorough analysis of the current practices and the vision of the future is necessary.

As the captain of the ship at the federal level, the Pakistan Tehreek-i-Insaf must deliver on its promises and prove its critics wrong.

The crises and the challenges require a prompt economic and political reimagining of power and resources to bring long-term and successful solutions at the federal and the provincial level. This project cannot be delayed without further calamity.

The writer is a PhD scholar at the University of Vienna, Austria. He can be reached at: inayat_qau@yahoo.com

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