Children pay the price in Pakistan’s mass HIV outbreak

A woman and her daughter, who are both HIV positive, walk outside their home in Subhani Shar village near Rato Dero, in southern Sindh province, Pakistan, on March 25, 2021. (AFP)
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Updated 14 June 2021

Children pay the price in Pakistan’s mass HIV outbreak

  • Pakistan’s largest HIV testing and treatment center was established in the rural town of Rota Dero in the wake of the disaster
  • Poor infection control is rife across impoverished Pakistan, where doctors often re-use equipment to cut costs

Rato Dero, Pakistan: Since his son was diagnosed with HIV during a mass outbreak in Pakistan among babies and children, hard-up Shahzado Shar has often been forced to choose between food and medicine.

His five-year-old was one of hundreds who tested positive in 2019 after a whistleblower doctor uncovered a scandal involving the re-use of needles in southern Sindh province.
The number of patients quickly swelled and two years later the figure stands at more than 1,500, according to data from the provincial health ministry.
Pakistan’s largest HIV testing and treatment center was established in the rural town of Rota Dero in the wake of the disaster, dishing out life-saving anti-retroviral drugs.
But affected families must cover further costs arising from the illness themselves.
“They tell us to go for further tests in private hospitals, but we don’t have sufficient money,” Shar told AFP, describing how his son continues to suffer from regular fever, abdominal and kidney pain.
Around 30 other children are also HIV positive in their small village of Subhani Shar, just a few kilometers from Rato Dero.
Pakistan’s public hospitals, located largely in cities, are often chaotic and inefficient, leaving rural families to rely on private clinics they can seldom afford that are often stuffed with unlicensed doctors.
At least 50 children have died since they were diagnosed, said paediatric specialist Fatima Mir, from Aga Khan University in Karachi, who has analyzed the data — though she had expected the number to be higher given the malnutrition and poverty among families in the area.
Authorities blamed a single physician — a popular child specialist in Rato Dero — for causing the outbreak.
Muzaffar Ghangro is currently out on bail, with court hearings repeatedly pushed back, much to the anger of many families.
He denies the charges laid against him, saying other doctors have pinned the outbreak on him because of his successful practice.


Poor infection control is rife across impoverished Pakistan, where doctors often re-use equipment to cut costs — out of necessity or greed.
The doctor who first exposed Sindh’s dirty needle scandal says little has changed since 2019.
“Things are as bad as they were at the time of the outbreak,” said whistleblower Imran Akbar Arbani, who called malpractice in the country “ruthless.”
Arbani took his data on the outbreak to local media after discovering an alarming number of babies with HIV in Rato Dero, where he has a private clinic.
He said authorities were quick to react at the time, but that discipline has since slipped.
“In the first three months, quacks and unauthorized medical practitioners were banned and their clinics were sealed, but they obtained clearance later on,” he said.
Rafiq Khanani, a doctor and the president of the Infectious Diseases Society of Pakistan, said regulations were ineffective or routinely ignored.
“The regulatory departments exist only on documents and in offices... practically, they are ineffective.”
In the wake of the scandal, the government banned the import of conventional syringes, insisting only on single-use auto-lock needles which cannot be re-deployed.
But a Sindh health official who did not want to be named told AFP that many doctors were circumventing the ban and still buying the cheaper models.


At Rato Dero’s HIV testing and treatment center, patients sit facing a television screen churning out health care advice in the local Sindhi language.
A frail 20-year-old man sits silently with his father, waiting for the results of rapid HIV test.
Paediatric specialist Fatima Mir said successful mass testing helped to identify victims of the crisis and slow down onward transmissions.
But Pakistan now has to go beyond the vital antiretrovirals and offer more rounded care to patients, Ayesha Isani Majeed, the head of the government’s National AIDS Control Programme, told AFP.
As the sun sets in Subhani Shar, a mother sits with her daughter draped across her lap, suffering another bout of fever.
Hakima Shar says she sometimes forgets to administer the drugs — which can control the virus and help prevent onward transmission — to her four-year-old, who often refuses to take them.
“We are very poor... I wake up with the sun and start working, so who else will give her the medicine regularly?” said the 25-year-old mother, who has also contracted the virus.
Many families had never heard of HIV, but now it dominates their lives.
“The government doesn’t provide us with antibiotics or multivitamins and we can’t afford to buy them ourselves,” she said.
“We are doomed.”


Pakistan issues fresh guidelines for Eid Al-Adha as COVID-19 cases rise

Updated 05 July 2022

Pakistan issues fresh guidelines for Eid Al-Adha as COVID-19 cases rise

  • Pakistan has had very few COVID-19 cases in recent months and did away with almost all precautions
  • In 24 hours, Pakistan recorded 653 positive cases, nearly double the number at the start of last Monday

ISLAMABAD: The National Command and Operation Center (NCOC), Pakistan’s federal pandemic response body, on Tuesday issued fresh guidelines for Eid Al-Adha, urging people to follow standard operating procedures (SOPs) as coronavirus cases rise across the country.

Pakistan has had very few COVID-19 cases in recent months and did away with almost all precautions.

But over the past 24 hours, the country recorded 653 positive cases, nearly double the number at the start of last Monday, according to NIH data. Over 162 people were reported to be in critical care.

 

“Eid UI Adha prayers should be organized in open spaces under stringent COVID protocols. In case of any compulsion to offer the prayers inside mosques, then all windows and doors should be kept open for ventilation / to minimize the chances of disease spread,” the NCOC said in a statement.

The body said up to three Eid prayers should be organized at a single venue with staggered timings to allow maximum people to offer prayers with COVID-19 protocols in place.

“All ulemas leading Eid prayers should be sensitised to keep sermons ... short so that people remain present in the prayer venues for a brief duration,” the guidelines said. “Efforts should be made to discourage sick, elderly and young children from attending Eid prayers.”

People without face masks should not be allowed to enter the prayer venue, the NCOC said, adding that prayer venues should have multiple entry and exit points and venue organizers should ensure the availability of hand sanitisers.

“It should be mandatory for all coming for prayers to use sanitisers before entering the venue,” the guidelines said.

“To ensure social distancing protocols, venue organizers to ensure prominent marking (6 feet apart) to allow sufficient space/distance between individuals. People should be encouraged to perform abulution at home before coming for the prayers and also bring their own prayer mats to the venue. Efforts should be made to sensitise people to refrain from embracing and handshaking after the prayer to avoid chances of disease transmission. There should not be any gathering at the prayer venue before the prayer and people should be asked to disperse immediately after the prayer.”

The NCOC said efforts would be made to promote and encourage central and collective sacrifices through various public, private and community organizations, while ensuring adherence to COVID-19 protocols of mask-wearing, social distancing and avoidance of crowds.
 


Pakistan approves imports in local currency from neighboring Afghanistan

Updated 05 July 2022

Pakistan approves imports in local currency from neighboring Afghanistan

  • The move is mainly aimed at buying coal to help ease energy shortages
  • Pakistan has shortage of forex reserves to buy LNG, oil in international market 

ISLAMABAD: Pakistan on Tuesday approved imports from neighboring Afghanistan in exchange for local currency, a move mainly aimed at buying coal to help ease an energy shortage.
The decision was taken in a meeting of Pakistan’s Economic Coordination Committee (ECC), a finance ministry statement said.
The ECC approved amendment in the Import Policy Order 2022 “to allow import of goods of Afghan origin against Pak Rupee” for a period of one year, it said.
The move is aimed at importing Afghan coal for Pakistan as it faces an energy crises due to a shortage of foreign reserves to buy LNG or oil in the international market to run its power plants.
Prime Minister Shehbaz Sharif announced plans last week to import coal from Afghanistan using local currency to save foreign reserves.
Islamabad has already announced an easy visa regime for Afghan nationals to help facilitate trade on both sides of the border. An Afghan finance ministry spokesman did not immediately respond to request for comment.
Customs duties from coal exported to Pakistan are a key source of revenue for cash-strapped Afghanistan. Sanctions on the banking sector and the cut in development aid since the Taliban took control last August year have severely hampered its economy.
No country has officially recognized the Taliban government, which has meant international financial assistance has dried up while Afghanistan faces a humanitarian and economic crisis.
The Afghan Taliban have lately stepped up coal exports to Pakistan to generate more revenue from its mining sector in the absence of direct foreign funding.
Kabul has raised duties on sales and increased rates recently.
Pakistan has also been facing an economic crises, with foreign reserves falling as low as hardly enough for 45 days of imports.


Media watchdog demands Pakistan ensure safety as two reporters killed in two days

Updated 05 July 2022

Media watchdog demands Pakistan ensure safety as two reporters killed in two days

  • Gunmen killed Ishtiaq Sodharo of Sindhi weekly Chinag in Khairpur district in Sindh province on July 1
  • Iftikhar Ahmed from Daily Express shot dead in northwestern Pakistani district of Charsadda the next day

ISLAMABAD: The International Federation of Journalists (IFJ) on Tuesday demanded the Pakistani government ensure the safety of journalists, days after gunmen killed two reporters within two days in two separate incidents.

Unidentified assailants killed Ishtiaq Sodharo, associated with the Sindhi weekly Chinag, in Khairpur district of the southern Sindh province on July 1. A day later, Iftikhar Ahmed, a reporter for the Daily Express, was shot dead in the northwestern Pakistani district of Charsadda. Police are investigating the motive behind Ahmed’s death, including personal enmity, while Sodharo’s wife has alleged he was killed on the orders of a local policeman. 

The IFJ condemned the murders and called on the Pakistani authorities to fulfil their international obligations under Pakistan’s constitution to safeguard press freedom.

“Pakistan’s government must take appropriate measures to ensure journalists’ safety and security, as required by law, and act to reduce assaults on journalists so that they may carry out their work without fear,” the IFJ said in a statement on its website.

Pakistan is considered a dangerous country for journalists who often have to face violence, legal cases, abductions, detentions and threats from both state and non-state actors. 

In May, the country fell 12 points on the World Press Freedom Index from 145 in 2021 to 157 in 2022.


Pakistan concludes Hajj flights, all 83,312 pilgrims arrive in Saudi Arabia

Updated 6 min 17 sec ago

Pakistan concludes Hajj flights, all 83,312 pilgrims arrive in Saudi Arabia

  • 34,453 pilgrims traveled under government scheme and over 48,000 through private operators
  • 52 flights have utilized the Route to Makkah immigration facility at Islamabad airport this year

ISLAMABAD: Pakistan’s director-general of Hajj in Jeddah said on Tuesday the country’s Hajj flight operation was complete and all 83,312 Pakistani pilgrims had arrived in Saudi Arabia. 

One of Islam’s five main pillars of faith, the Hajj was restricted over pandemic fears to only 1,000 people living in the Kingdom in 2020 and to 60,000 domestic participants last year, compared with the pre-pandemic 2.5 million pilgrims annually. 

This year, after Saudi Arabia lifted COVID-19 restrictions, the kingdom will welcome one million domestic and foreign pilgrims. A quota of 81,132 pilgrims was initially allocated for Pakistan this year, which was later increased by 2,000.

“Our Hajj flights have been completed and all 83,312 Pakistani pilgrims have arrived in Makkah,” DG Hajj, Abrar Ahmed Mirza, told Arab News over the phone from Makkah.

He said 34,453 pilgrims had traveled under the government scheme and over 48,000 through private operators.

“We are now giving them training on Hajj rituals which are starting from Wednesday especially preparing them for Mina, Arafat, and Muzdalifah where pilgrims from all over the world move at the same time,” Mirza said.

Haseeb Ahmed Siddiqui, the director of the Hajj Complex in Islamabad, said 52 flights had utilized the Route to Makkah facility at Islamabad airport this year. 

The Route to Makkah initiative allows pilgrims to fulfil all immigration requirements at the airport of origin. This saves them several hours upon reaching the kingdom since they can enter the country, having already gone through immigration at home. 

“17,077 pilgrims proceeded to the Kingdom under Route to Makkah project using 52 flights this year,” Siddiqui told Arab News.

Adeel Ahmed, a pilgrim from Rawalpindi, said he had no words to express his happiness at being selected for the pilgrimage.

“My name was not part of the first draft and I got a chance at the last moment,” Ahmed told Arab News. “I am unable to share my feelings and happiness as Allah has granted me this privilege to fulfill my dream.” 

Sumera Kiran, another pilgrim from Rawalpindi, expressed satisfaction with arrangements at the airport.

“The [Saudi] government and Pakistani authorities have done very good arrangements at the airport,” she said, adding that she had received her luggage at the hotel.


Pakistan central bank may raise rates by 125 bps to tame 13-year high inflation

Updated 4 min 33 sec ago

Pakistan central bank may raise rates by 125 bps to tame 13-year high inflation

  • The South Asian nation is wrestling with economic turmoil, a fall in reserves and a weakening currency
  • Another hike would increase government debt servicing costs as well as hurt industries, says an economist

ISLAMABAD: Pakistan’s central bank looks set to raise its key policy rate by 125 basis points at its review on Thursday, as it attempts to tackle 13-year high retail inflation, according to the median estimate in a snap poll of 10 economists and market watchers. 

The economists, analysts and senior professors surveyed were widely split on the quantum of increase by the State Bank of Pakistan (SBP), with views ranging from 50 to 200 basis points. 

Two respondents did not see a need for a rate increase. 

The central bank raised the benchmark interest rate by 150 bps in May, taking the total increase to 400 bps so far this year to counter rising inflation. 

The South Asian nation is wrestling with economic turmoil, a fall in reserves and a weakening currency. 

Data on Friday showed consumer prices in June leapt 21.3 percent from a year earlier, largely on account of a 90 percent spike in fuel prices since the end of May after the government scrapped costly fuel subsidies. 

With the current policy rate at 13.75 percent and inflation running well above, real interest rates in the economy have turned sharply negative. 

“The last monetary policy committee statement is proof that the State Bank of Pakistan is way behind the curve on anticipating inflation,” said Yousuf Nazar, an economist who writes for various publications and formerly with Citigroup. 

“Another hike would increase government debt servicing costs as well as hurt industries. 

It is not going to have much of an impact on exchange rate or overall demand,” he added. 

Most believed a hike was inevitable, given persistently high global energy prices, the abrupt ending of fuel subsidies as well as the need to control demand after SBP said in its last policy statement the economy had rebounded much more strongly than anticipated. 

“The overall policy mix is geared toward stabilization and demand management,” CEO of Macro Economic Insights Sakib Sherani said, adding that this will induce a sharp slowdown in the economy, possibly a recession, in the short run. 

But Fahad Rauf, head of research at Ismail Iqbal Securities, said he does not see the need to increase rates further. 

“The economy is already slowing down. The layoffs have started and are expected to increase further. 

Further cost pressures would only enhance the burden on industries and workers,” Rauf said. 

“The fiscal arm is working now, tough measures have been taken. SBP needs to wait for the results before further tightening,” he added. 

With Pakistan expecting a restart of the much-awaited bailout package from the International Monetary Fund after the country agreed on some tough economic policy adjustments to promote stability, the SBP’s decision is being closely watched.