The recent reports on HIV infections in Larkana have created an alarming situation. It is, thus, necessary to shed light on the context and the actions taken in this regard. There is no denying to the fact that it is a sensitive health issue. This is why the investigation carried out in this respect needs to be highlighted.
The first case of HIV/AIDS in Larkana was reported on the night of April 24, 2019. The HIV virus was found in 15 children of 2-8 years of age. Recognising the seriousness of this issue, the very next day a healthcare camp was set by the district administration and HIV/AIDS Control Programme to provide targeted screening of children, who were found with the HIV virus, and their parents. In addition, a circular was issued to encourage the rest of the people to get the screening done. The results of the screening within the first few days were shocking. The tests revealed that the parents of the HIV-positive children were HIV negative, that is they did not have the HIV virus.
The next day the Sindh Healthcare Commission and the HIV/AIDS Control Programme of Sindh starting addressing the matter on a priority basis. In the light of the screening results that had revealed the parents to be HIV-negative but the children to be HIV-positive and the reasonable assumption that the children, aged 2-8 years were not sex workers, that the chances of getting the virus from a dental checkup were low, it was conluded that the children were likely exposed to the virus through unsafe circumcisions or through injection by infected syringes. Possible causes included clinics run by quacks, use of a single syringe for multiple patients, and use of the same drip set for multiple patients. It was in the light of these possibilities that the entire vicinity was interviewed about their healthcare routine. They were also asked about the healthcare centres they visited in case of any ailment.
There have been 23 arrests, 61 unsafe clinics have been sealed and warnings have been issued to 29 healthcare centres
The district administration, district police, Sindh Healthcare Commission, Sindh Blood Transfusion Authority and Sindh AIDS Control Programme had already been active since the first HIV case was reported. Hence, some radical steps were taken to address this issue without any delay. Free healthcare camps were set in the surroundings and the screenings were done by qualified doctors. A crackdown was launched on the barber shops where stale shaving tools were used; on the quacks, doctors’ clinics and maternity homes which were unauthorised, run by the unqualified staff and were not practising basic hygiene requirements. These steps were taken in the wake of considering all such malpractices as serious criminal negligence which put a patient’s life at risk.
In order to further facilitate people in this regard, an HIV Paediatric Centre, for the first time, was set up for a free of cost registration, testing and provision of lifelong medicines. The period of healthcare camp for free screening was extended in Ratodero. Seminars and free consultation sessions were also held and were quite helpful. These sessions identified that a stigma was attached with being an HIV-pro and therefore, the patient would be reluctant to seek medical aid and that the traditional methods of circumcision were unsafe.
This HIV/AIDS case scenario certainly raised a need to ensure the use of autolock syringes, to establish well-equipped labs for conducting necessary medical tests before blood transfusion which are supervised and operated by well-qualified doctors and staff. Barbers’ association has also been notified and warned to ensure the use of disposable or at least sterilized tools. Beside this, awareness sessions on HIV/AIDS have been conducted on local FM radio and small committees comprising of lady health workers have embarked on a door to door campaign to increase awareness about AIDS in the affected areas and the outskirts as well. Another campaign has been launched to use autolock syringes and a media campaign has been launched to remove the stigma attached with the HIV/AIDS.
The support of the Government of Sindh is forthcoming in this respect. It has ensured a seamless provision of the medicines and the necessary equipment. Moreover, the international healthcare partners including the UNICEF and the WHO have provided the screening kits to speed up the testing procedure. Also, there have been 23 arrests, 61 unsafe clinics have been sealed and warnings have been issued to 29 healthcare centres. Further crackdown is underway.
The Paediatric Association and Pakistan Medical Association are, nonetheless, requested not to politicize what is primarily a public health issue. Their cooperation with the district administration, in order to create awareness, would be highly admired. The supply of Anti Retro Virus (ARV drugs) has been ensured and further initiatives have been taken to improve disease surveillance and proper disposal of hospital waste.
The social and the print media are also requested to ensure the privacy of the patients and not to sensationalize the issue. The district administration realizes the severity of this healthcare issue. It has actively been working to ensure preventive measures are taken to stop such cases in future as well as to provide complete treatment to the reported cases.
The writer is an officer in the Pakistan Administrative Service. He is currently serving as the Larkana deputy commissioner
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