The HIV outbreak in a small town in Pakistan has grown to over 1,112 cases, and nearly 900 of those newly diagnosed are younger than 12. That’s nearly 1 out of every 200 residents of Ratodero, The New York Times reports, but officials believe the real number of HIV cases is much higher. In fact, not even a quarter of the city’s population has been tested.
When health officials began investigating the outbreak last spring, they said reused syringes and medical malpractice were to blame. Pediatrician Muzaffar Ghanghro, who served the poorest families, was found to be at the center of the outbreak. A father recounted to the Times that he watched the doctor rummage through trash for a syringe to use on his son. Four of the man’s children contracted HIV; two have died.
The doctor has been arrested and charged with negligence, manslaughter and causing intentional harm. He maintains that he never reused syringes. Because he has not been convicted, he was able to renew his medical license and now works in a government-run hospital.
Even if many of the HIV cases did result from Ghanghro’s malpractice, health officials say it is likely that many doctors reuse syringes. They are now looking at ways to revamp the country’s health care system.
“The only good thing about the outbreak has been that it laid bare the multiple flaws in the system that the government with support of U.N. agencies needs to address,” pediatrician Fatima Mir told the Times. “What the outbreak in Ratodero says about Pakistan’s health care is that infection control is poor or nonexistent. Pakistan’s health care system is now trying to integrate infection control as a formal part of the system. With the lack of infection control, this outbreak is not unexpected. What is unexpected is that this time, children are the main victims, and there are a lot of them.”
Health officials tell the Times that the country is facing a full-blown health crisis, noting that Pakistan and Afghanistan are the only two countries in the world that still report polio cases.
Arshad Altaf, a physician and HIV injection safety expert who has worked with the World Health Organization, wrote an opinion piece in CNN that further contextualizes the problems in Pakistan.
He says the typical Pakistani health patient believes that injections are part of regular treatment. Doctors frequently administer them in order to satisfy their patients, often resorting to reusing syringes.
He notes that the country has one of the highest rates of hepatitis C in the world and also sees regular outbreaks of hepatitis B. What’s different about the HIV outbreak in Ratodero, he writes, is that it has garnered international media attention. “Without a multipronged approach, enacted in the near future, Pakistan will continue to experience disease outbreaks,” he writes, “and many more people will be put at risk.”