Chikungunya might disable a million

Author: Abdul Khailque Ali and Zulfiqar Kunbhar

KARACHI: Khadija 40, a mother of five is sitting in OPD of Civil hospital waiting for her turn to be seen by Dr Abu Talib whom she has visited 3 times earlier this month. She is suffering from Chikungunia a viral disease which has crippled her totally. When it attacked me about a month ago I had severe pain in my entire body and joints. The pain in my soles was so intense that I could not even put my feet on the floor early in the morning, she told Daily Times.

Half of her family including her brothers’ sisters and her mother is also suffering from this disease. Half of the people in Lyari are going or have either gone through this ordeal, she further informed.

Zafar from New Chali who had been waiting to see the doctor for over three hours said that most of the people in the area are either undergoing the treatment or have gone through it during the last few months. I went to a doctor in our vicinity but he was asking for Rs 7,000 for the whole course, I did not have that kind of money so I have come to a government hospital to get treated.

Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain. Other symptoms include muscle pain, headache, nausea, fatigue and rash.

The virus is transmitted from human to human by the bites of infected female mosquitoes. Most commonly, the mosquitoes involved are aedes aegypti and aedes albopictus, two species which can also transmit other mosquito-borne viruses, including dengue.

There is no specific antiviral drug treatment for chikungunya. Treatment is directed primarily at relieving the symptoms, including the joint pain using anti-pyretics, optimal analgesics and fluids. There is no commercial chikungunya vaccine.

Chikungunya and other arboviral disease, are now spreading explosively in Karachi. According to The Lancet, a UK based medical journal, Chikungunya virus was found circulating in rodents in Pakistan as early as 1983. In fact, a few patients with chikungunya were also reported in Lahore during the 2011 dengue outbreak. The current outbreak is said to have started in the second week of November, 2016. Different health-care authorities in Karachi estimate the total number of patients to be in the millions.

The outbreak is linked with the deplorable sanitary system in Karachi. Open sewers and feculent morasses, which are breeding habitats for mosquitoes, can be found all throughout the city. Experts have urged the need to rid the city of stagnant water bodies, heaps of garbage and to raise awareness.

The irony of the matter is that most of the people affected belong to middle and lower middle class backgrounds since most of them are not facilitated with fly proofing in their houses.

Since the doctors do not know much about this disease most of them try to counter it with their own remedy. In the poor neighborhoods where most of the doctors are quacks the best cure is a drip added with painkillers and steroids. A course of 10 drips costing Rs 8,000 is offered to the patient without mentioning its ingredients. The poor patients who can hardly afford living are compelled to arrange the money so they can get out of the terrible pain they are in.

In better neighborhoods the doctors are trying to counter it with pain killers and some times the treatment takes months to heel.

The tragedy is that people who are being treated with steroids, and do not know anything about its consequences now have liver diseases within 2 to 3 years. Karachi is witnessing a large amount of people succumbing to Hepatitis at this time, informed Prof Tahir Hussain who has examined hundreds of these cases in the last few months.

The other issue is that around one third of the people who will eventually get out of this pain will acquire Rheumatoid Arthritis for the rest of their lives. This would be just like a disability, said Dr Pervaiz Anjum an orthopedic doctor who is treating patents with these symptoms after the attack. Most of the patients who have either week bones or are in their late years are forced into limited disability.

The Government of Sindh has done nothing to control this epidemic which has affected the lives of over two million people and the numbers are rising. All it needed was a little spray which could have eased the lives of so many, said Dr Zubair Choudhary who runs his own clinic in Orangi Town. I don’t treat people with drips and injections rather I try to convince them to get rid of this ordeal in a slow and safe way, but most of them don’t listen to me because they are in such a pain that they want relief fast .

Earlier about a month ago, a team of World Health Organisation experts comprising epidemiologists, entomologists and observers visited various chikungunya affected parts of city and called the government to take ‘radical’ measures to safeguard the city from increasing incidences of the disease. The team while calling for effective and integrated vector control interventions also highlighted the need to improve environmental conditions by removing piles of garbage and fixing sanitation problems.

Karachi is a mega city and what the current government has done nothing besides making tall claims. Controlling this epidemic was not a big issue at all, all it needed was little will and some spray on the huge heaps of garbage which this regime has totally failed to remove.

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