HIV in Sindh’s villages

According to Health-line, a health information web sitewhile there is no cure for human immunodeficiency virus, getting a quick diagnosis and early treatment can slow the progression of the disease and significantly improve the quality of life. A 2013 study found that people with HIV might have a near-normal life expectancy if they start treatment before their immune system is severely damaged.

The recent surge in detection of HIV-positive cases in several villages of Sindh has exposed the weaknesses of the healthcare system in the province where people have been fighting the debilitating disease. On May 9, a shocking news report revealed that as many as 225 out of 5,000 people screened by the Sindh AIDS Control Programme during the first 10 days of blood screening in Taluka Ratodero of the Larkana district were identified as HIV-positive. Of the 225 affected people, 180 are children and 45 adults.

On the same day, it was reported that a total of 517 people were tested in the Shikarpur villages of Dakhan, Pir Bakhsh Thaheem and Sarang Shar. In Dakhan alone, eight children were identified as HIV-positive. The children are between the age of four months and eight years.

Moreover, data gathered by the People’s Primary Healthcare Initiative found that of the overall 140 confirmed HIV-positive cases until March 2019, 30 had surfaced on May 6 during the day-long blood tests of 230 people in the villages of Massu Bhurgari and Hatri rural union councils of Hyderabad. Many among the affected are children.

It is said that the Sindh government has been pressuring the local health officials to not share data about the detection of new cases with the media. The facts and figures about the devastating disease should not be hidden as the situation already has become very bad. Every day, new cases are being detected, and among many patients the disease has reached the final stage. Children brought for the screening have been dying at the camps, which the Sindh AIDS Control Programme has established at Ratodero after an outbreak of HIV-positive cases there.

Reportedly, the Sindh health department has outsourced around 53 per cent of its health facilities. The PPHI owns about 90 per cent (1,135) of the basic health units , a considerable number of rural health centres, and a number of Taluka hospitals in the province. In the last three years, the PPHI has been paid 21 billion rupees. The sole purpose of outsourcing these health establishments was to provide quality healthcare services to the villagers. The startling health conditions prevailing in rural areas make it clear that the organisations paid huge amounts have not provided the people with access to quality healthcare services. But, sadly, the Sindh government, to date, has not bothered to have the PPHI’s performance evaluated by a third party.

The ever-growing medical quackery in rural areas has been playing havoc with lives of people for decades, but the government has not acted responsibly to check and stop that. This gross negligence on the part of government is responsible for the recent surge in HIV-positive cases.

Groups of people such as men who have sex with men, hijra sex workers, female sex workers, and thousands of people in direct sexual contact with these groups, drug pushers and truck drivers are considered high-risk populations for HIV. But in the recent surge in HIV in Sindh’s villages, 80 per cent of the affected people are children. Quackery is said to be the only cause behind the sudden outbreak as quacks reuse syringes for patients. The reason why people go to quacks for treatment is government’s failure to organise a healthcare system for poor people living in the rural areas of the province.

According to an estimate, there are 600,000 quacks in Pakistan providing primary and basic healthcare to poor people in rural areas. They not only treat minor diseases but also some of the most complicated ones such as cancer and liver and renal failures. People prefer quacks over qualified doctors and hospitals as they are cheap, easily available and attentive to their patients. They customise their method of treatment in accordance with the suitability, requirement and demand of their patients.

According to a report of the National Health Services, there were an estimated 155,000 HIV-positive patients in Pakistan in 2018. Of the total 150,000 HIV-infected people, 5,000 were in Balochistan, 15,000 in Khyber Pakhtunkhwa, 75,000 in the Punjab and 60,000 in Sindh. This shows that now Sindh has the highest number of HIV-positive patients in the country. The current outbreak of the damaging disease has made Larkana the most affected district in Pakistan.

Before the outbreak of HIV may develop into full-blown cases of Acquired Immune Deficiency Syndrome, the Sindh government should pay immediate and proper attention to the crisis. Primary and secondary levels of health facilities must be made available and accessible to all people in the rural areas of the province.

The writer is a freelancer