Containing the AIDS crisis

Home to the Indus Valley Civilization, the city of Larkana has once again come under the shadow of the AIDS health hazard. In 2019, reports claimed that as many as 500 children were affected when they tested positive within twenty-four hours. The spreading of this disease at such an alarming rate does spell limitations by the health care system that has never been implemented in the city. According to the research titled ‘Factors associated with HIV infection among children in Larkana District, Pakistan: A matched case-control study, in December 2019, 881 (4·0 percent) of 21,962 children screened for HIV had tested positive. The same study interpreted that the predominant mode of HIV transmission in the outbreak was parenteral, probably due to unsafe injection practices and poor blood safety practices.

The health experts, doctors, and practitioners must converge on a platform to not only fight to prevent AIDS from spreading, but also eradicate this menace from Pakistan. A full-fledged strategy must be put in place to counter the spreading of this disease. General practitioners across Pakistan need training and systems support in reducing injection use and in providing safe injections and transfusions only when necessary.

HIV/AIDS cases have been showing a decreasing trend across the world. Unfortunately, in Pakistan, there has been an 84 percent increase in cases from 2010 to 2020. Reports suggest that nearly 200,000 HIV/AIDS cases are currently active with thousands being reported every year.

In April 2019, parents began sharing about an episode of fever among their children. By mid-April, nearly fifteen children were tested for HIV. According to the Deputy Commissioner, Larkana, Muhammad Nauman Siddique, “Recognising the seriousness of this issue, local officials shortly thereafter set up a healthcare camp where children and their parents could be screened for the virus. 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 raising questions about how so many children became infected.”

After the outbreak, World Health Organisation along with UNAIDS and UNICEF worked to develop a response unit in Larkana. This included free testing and acting against hazardous clinics.

According to Maria Elena F. Borromeo, UNAIDS Country Director in Pakistan, “We need ongoing work with national and international stakeholders to effectively address the critical gaps in preventing new HIV infections and to guarantee the health and well-being of all people living with HIV in Pakistan so that the country is not left behind in the effort to end AIDS.”

According to another report, a majority of those affected with HIV/AIDS in Larkana are workers working in the red light area or are users of drugs. A report by Mehran Welfare Trust states that there are 200 to 250 transgender, 200 male, and 100 females working in the red light area. Nearly 500 drug users use drugs that they inject themselves with syringes. The data also reveals that nearly 15 percent of red light area transgender workers and 18 percent of drug addicts who use second-hand syringes are either HIV-infected or suffer from AIDS.

Lack of professionalism is also leading to the spreading of this disease. While the private and public hospitals, clinics, and medical centres in the metropolitan areas of the country take precautionary methods when using medical equipment, the same cannot be said for those operating in remote areas. Doctors and healthcare providers do not follow precautions when it comes to using sterilized equipment. Using contaminated equipment also leads to blood-borne diseases including Hepatitis B and C.

The Provincial Health Ministry has established a special task force for this. The Sindh Health Care Commission (SHCC), along with the teams from WHO has also pointed out healthcare practitioners conducting unauthorized medical activities. Accurate insight in this regard was shared during a health seminar where experts claimed that nearly 65 percent of the patients with HIV/AIDS were not willing to continue with their treatment. They cited the difficult attitude of their healthcare providers as the primary reason.

Education and awareness are perhaps the most important aspects when dealing with a medical problem. An awareness campaign at the national level must be initiated to inform the people about HIV/AIDS, how it is contracted, its symptoms, and treatment. This will reduce the impact of the dishonour that is associated with the disease. People also does not tend to openly discuss this disease. Having a conversation about HIV/AIDS, even with a doctor, is not encouraged. This perception should change so the doctor-patient interaction should flourish leading to constructive decision-making.

A medical emergency can arise at any time. Those residing in the city can avail the services of the clinics and hospitals. However, the residents of villages and rural areas need to travel long distances before arriving at a medical facility. There is a dire need to establish medical units across remote areas ensuring that medical staff is present to prevent any medical emergency. The same should be practiced across metropolitan and adjoining areas. This should be accompanied by a clear strategy. Doctors must be trained so that they can perform their duties with diligence. The authorities should provide them with proper medical equipment that is available in large quantities so each item including syringes, wipes, gloves, masks, and tissues, among others, are discarded after using them once.

All these measures should be put in effect on an emergency footing so that the scourge of AIDS can be snuffed out as early as possible.

The writer is a fiction writer, columnist and an author