Rotadero’s Children – Victims of the State’s criminal indifference?
For the hundreds of mothers to young toddlers in the Rotadero area of Larkana in southern Sindh province, the years ahead will be far from the usual anticipation of small milestones in their children’s lives.
Instead they will with bated breath, watch time pass preparing to battle yet another infection afflicting their children or desperately hoping that life allows them another chance.
It is reported that 761 persons in Rotadero are infected with HIV, 604 of whom are children mostly under the age of 5 years. Some have already succumbed to the virus or other secondary infections contracted as a consequence. Others suffer their ordeal alone, ostracized by their communities and awaiting treatment promised by the Sindh Government.
The Government of Sindh has been in a frenzy searching for explanations for the incidence of the disease especially among children, pointing fingers to deflect responsibility and scrambling to coordinate an effective response to the epidemic. According to a World Health Organization (WHO) team of experts the ‘re-use of injection needles and syringes’ and ‘unsafe practices of blood transfusion’ could be among the primary causes of the HIV outbreak in Larkana.
Local officials agree that the recent surge of HIV cases amongst children is on account of the widespread re-use of syringes by unregulated and unregistered ‘quacks’ posing to be medical doctors. AIDS is not new to Larkana. An outbreak of the HIV virus was first reported here in 2003 amongst injecting drug users (IDUs) and again in 2016 when several patients receiving renal dialysis treatment at a local hospital contracted the disease due to ineffective screening procedures and unsafe blood transfusions.
The recent epidemic (and its possible causes) should not then be so startling for the Government of Sindh, which arguably could have prevented the outbreak through effective and timely planning and coordination.
A blame game is now underway. The Sindh Health Care Commission failed to effectively crack down on quacks engaged in dangerous practices- the likes of which have led to the recent epidemic in Rotadero. The Sindh AIDS Commission, established through statute in 2013, failed to monitor and implement the AIDS Control Programme, which in turn failed to conduct requisite HIV/AIDS screenings in the province, often on account of lack of equipment. In all eventuality, the failure is that of the Government of Sindh.
It is my opinion that the Sindh government can be blamed for a criminal indifference to and disregard of the value of human beings, in particular children’s lives, and of its obligation to accord due protection to human life through proper regulation, planning and the provision of basic health care. Rotadero is not the first such instance of criminal indifference in Sindh.
The pressing demand now is the timely provision of treatment to those hundreds infected with HIV in Rotadero. According to the recent preliminary report of the WHO, 53% of HIV infected persons in Rotadero are still awaiting treatment.
Sahar Zareen Bandial
The government of Sindh already bears on its conscience the death of nearly 500 children in Tharparkar last year on account of malnutrition, and must be held accountable for its continued complicity in the loss and devastation of several lives.
The pressing demand now is the timely provision of treatment to those hundreds infected with HIV in Rotadero. According to the recent preliminary report of the WHO, 53% of HIV infected persons in Rotadero are still awaiting treatment. The Sindh Government is confronted with fast depleting stocks of antiretroviral therapy medicines (critical in controlling multiplication of the virus), which are projected to last only until mid-July.
The financial resources required to effectively control the epidemic – USD 1.5 million – are beyond the capacity of the provincial government. The WHO has committed only a small proportion of the amount. The Government of Sindh must immediately procure required medication and funding, and in line with WHO recommendations introduce systematic screening of HIV in the affected areas, conduct awareness campaigns, link HIV patients with available treatment sites and train health workers on management of HIV cases.
Sindh is not alone in its (failed) battle against HIV. 455 people with HIV/AIDS are reported to have died in Dera Ghazi Khan, Punjab last year due to lack of treatment facilities. The largest outbreak of HIV occurred last year in Jalalpur Jattan, Punjab where the Punjab AIDS Control Programme registered 750 positive cases of HIV. An increasing number of HIV cases are currently being reported in Faisalabad, Chiniot, Sahiwal, Jhang and Nankana, though government authorities are allegedly hushing up figures to avoid criticism.
According to the National AIDS Control Programme 165,000 people in Pakistan are living with HIV/AIDS out of whom only 24,331 are registered with government authorities and a meagre 17,149 are receiving treatment. The national and provincial AIDS control authorities should openly acknowledge the incidence of the disease and commit their resources to address the current epidemic, and through awareness campaigns and meticulous screening bring infected persons under the treatment net to avoid further transmission and outbreaks while adopting a zero-tolerance policy towards quackery.
This is their most basic obligation to us and to our children.
