Posted on: November 5, 2019 at 8:43 pm

Back in April of this year, it was reported that there was a surge in human immunodeficiency virus (HIV), among Pakistani children, in a small town called Ratodero. Ratodero is home to some of Pakistan’s most impoverished residents.

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A local television journalist there by the same of Gulbahar Shaikh broke the news, whose own two-year-old daughter has tested positive for the virus.

Children began getting fevers with unknown causes that weren’t responding to treatment [1]. Soon, HIV would be revealed as the cause. In fact, 82 percent of cases during this outbreak include children under the age of 15 years old [2].

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This is the first time that children have been victims of HIV in Pakistan on such a large scale, with 1,112 confirmed cases, and nearly 900 of them are children under the age of 12 [1].

Dr. Muzaffar Ghanghro, a pediatrician who was one of the cheapest physicians to see in the city, was arrested and charged after parents said he reused syringes on their children.

However, public health officials are saying that the cause of this outbreak is more complicated than one doctor allegedly using unsanitary medical practices to treat children. 

Pakistan Has the Fastest Growing AIDS Epidemic in the Asia Pacific Region

The accusations against Dr. Ghanghro—who has been released on bail despite Pakistani laws that he can’t be due to the nature of his crime, and has since renewed his medical license and is practicing at a different hospital—are alarming.

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One man, Imtiaz Jalbani, told The New York Times that his six children were treated by the doctor. Four of them are now HIV positive, and his youngest two—a 14-month-old and a 3-year-old—have already died. Mr. Jalbani says during one appointment, he saw the doctor looking in the trash for a used needle for his six-year-old son. 

When Mr. Jalbani objected, he says, the doctor said that if he didn’t want treatment he would have to go somewhere else, and that Mr. Jalbani was too poor to pay for an unused syringe.

Another parent, who has three children that are now HIV positive, told Reuters that she saw the doctor apply “the same drip on 50 children without changing the needle.”

Pakistan has the fastest growing AIDS epidemic in the Asia Pacific region, with a 369 percent increase in AIDS-related deaths since 2010, according to the Joint United Nations Programme on HIV and AIDS (UNAIDS) [3], [4].

Dr. Ghanghro says he’s innocent and has never reused syringes. But he’s not the only one suspected to be using unhygienic practices contributing to the spread of the virus.

What’s Causing Such a Vicious Outbreak?

In addition to doctors reusing syringes on patients, the World Health Organization (WHO) has identified risk factors contributing to the HIV outbreak in Pakistan, including [2]:

  • Unsafe IV injections during medical procedures
  • Unsafe child delivery practices
  • Unsafe practices at blood banks
  • Poorly implemented infection control programs
  • Improper collection, storage, and segregation and disposal of hospital waste

Besides doctors, some dentists treat patients with the same tools without cleaning them, and even barbers will reuse razors on multiple customers. Unhygienic practices such as these in Pakistan are suspected to be causing the country’s high HIV rates.

Unfortunately, these practices—particularly in poor areas of Pakistan—are likely to be much more common than health officials realize. 

Pakistan authorities have been shutting down the clinics of unqualified doctors and illegal blood banks in May (about 900) [3]. However, some locals say that some of these condemned clinics have already reopened.

Since testing is still ongoing—and only 36,000 of Ratodero’s 225,000 residents have been tested for HIV—authorities suspect the number of infected people could be much higher [1].

Global Response to the Concentrated Epidemic

WHO classifies Ratodero’s outbreak of HIV as a concentrated epidemic. But The New York Times reports that at least 35 children have died from HIV since the end of April, when the epidemic first gained global attention. 

The United Nations International Children’s Emergency Fund (UNICEF) is renovating a pediatric HIV treatment center at a hospital in Ratodero, so children can get treatment less than 10 kilometers away [5].

But Dr. Imran Akbar Arbani, a doctor in the area who originally told Mr. Shaikh, the journalist, of the outbreak while notifying authorities, says that unless these people—including doctors, barbers, and dentists—are left unchecked, rates of HIV will continue to rise. 

In addition, there appears to be a lack of awareness about the virus, as illiteracy rates are high in Ratodero, and many people are afraid that HIV can be contracted through touch.

Mr. Shaikh told The Times that his daughter—who had also been treated by Dr. Ghanghro—has been shunned by relatives and peers alike—at school, the infected children are kept apart from the uninfected. However, his daughter is responding well to treatment, after he and his wife sold all her jewelry and borrowed money to afford it, but Shaikh says children from very impoverished families won’t be so fortunate. 

What Can You Do?

Globally, HIV rates are declining. But in Pakistan, new infections have increased. The Times reports that only 10 percent of people thought to be HIV positive in Pakistan are being treated. Pakistan is almost entirely dependent on international support both for testing of HIV and treatment of the virus [6].

Clearly, more intervention is needed in Pakistan’s healthcare system. The Global Preparedness Monitoring Board has already said the world is not equipped to handle a disease pandemic, and that viruses and diseases are more likely to spread in areas that are impoverished or use unhygienic practices, which often go hand in hand [7].

Until something changes, Pakistan will rely on international efforts to improve its healthcare, curb disease rates, and prevent children from being victims of syringe reuse. You can donate to organizations such as UNICEF and UNAIDS that are fighting to get these children treatment and put a stop to unsafe medical practices that, in the end, have the potential to affect us all.

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Jenn Ryan
Health Expert
Jenn Ryan is a freelance writer and editor who's passionate about natural health, fitness, gluten-free, and animals. She loves running, reading, and playing with her four rescued rabbits.

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