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HYDERABAD: The recent upsurge of HIV-positive cases in a single taluka in Larkana district has painted a gloomy picture of the health system in Sindh, where many organizations are fighting HIV and other diseases, but situation has become alarming.
Larkana is considered the political capital of the ruling Pakistan People's Party (PPP), and a growing number of these evils only weakly reflect its high claims of good governance. This situation calls for an in-depth audit of the health system and its related aspects.
Conditions at the primary and secondary levels of health facilities are enough to cause concern.
Just a few years ago, nearly 100 people out of 13,600 people with measles died in seven districts of Upper Sindh after the failure of the Expanded Program on Immunization (EPI) to reach the required immunization coverage. .
Editorial: Without immediate and appropriate attention, the emergence of HIV can turn into a full-fledged AIDS
In addition, quackery appears to be the main cause of the current HIV epidemic in Larkana, in the form of reused syringes for patients.
So far, 128 people have been tested positive for HIV in Larkana
If community-based screening is done elsewhere, such as in the villages of Hyderabad district (140 cases of HIV-positive since last year) by the Primary Health Care Initiative (PPHI), the number of HIV case will increase.
The Minister of Health of Sindh, Dr Azra Pechuho, in his recent policy statement to the Sindh Assembly, declared that it was difficult to "detect HIV for everyone" in the province. .
She revealed that the district of Hyderabad was another high-risk area of HIV / AIDS in Sindh. In the beginning, Dr. Sikandar Memon, head of Sindh's AIDS program, said that there were 10,000 HIV cases in Sindh.
Police investigation in progress
In Larkana, a doctor who tested positive for HIV himself was arrested. He was accused by Larkana's deputy commissioner of "having infected 15 children," but Dr. Masood Solangi, director general of health services, challenged DC's statement and called the doctor "mad."
A case has been registered against the said doctor, but there is no indication as to whether the children were infected by him. As of May 3, 128 out of 3,383 people were HIV positive in Larkana, showing that the disease remains prevalent while the health authorities are in denial.
In response to a request from DIG Larkana, Irfan Ali Baloch, three senior professors – two from Dow University and one from the Sindi Institute of Urology and Transplantation (SIUT) – were invited to assist the police in a investigation against the doctor retained.
The DIG, however, rejected the claim that the arrested doctor was "crazy". "We found it normal," he told Dawn.
Organizations such as the Sindh Blood Transfusion Authority (SBTA), the Sindh Healthcare Commission (SHCC) and the AIDS Program are apparently working in isolation. "We need to expand the scope of screening to other districts," said a SBTA official.
The Sindh Health Care Commission (SHCC) is a relatively new structure that became operational only last year. He has prepared a roadmap on how to ban quackery in addition to improving the quality of health care in the public and private sectors. He sealed 41 clinics and issued 100 notices for dubious practices in Larkana.
"Over the past 70 years, we have not had access to health care data. We have planned the geo-mapping of public and private health facilities in Sindh through a questionnaire. His trial will begin in Karachi in mid-May, "said Dr Minhaj Qidwai, head of SHCC.
He added, "There is a" rent seeking behavior "among Sindh doctors. The tendency of doctors to outsource their premises to dispensers leads to an increase in quackery. The registration of doctors will be re-checked by the Pakistan Medical and Dental Council. "
The task of SBTA is to reduce unsafe blood transfusions through unregistered blood banks. However, in recent years, he has failed to make himself felt until he is led by Dr. Zahid Ansari. The authority had even refused to operate transfusion centers funded by Germany in Sindh.
Dr. Dur-e-Naz Jamal is now at the helm. She traveled to Larkana on HIV-positive cases and closed some unregulated facilities.
The AIDS program has not been able to reduce the burden of HIV and does not provide accurate statistics on the disease, which could otherwise allow the government to fight AIDS, otherwise it would reach proportions epidemic in Sindh.
Government outsources health facilities to 53%
According to one estimate, the health department of Sindh subcontracted about 53% of its health facilities. PPHI has about 90% (1,135) of Basic Health Units (BHUs). A substantial number of rural health centers (CRS) and taluka hospitals are outsourced. The Department of Health occupies practically tertiary level, district hospitals and dispensaries.
According to some information, blood test kits recommended by the World Health Organization (WHO) were not used, even in privatized health facilities.
"No third-party assessment has been conducted with respect to the UHWs so far directed by PPHI to determine the qualitative changes it has caused. More facilities are privatized to other entities. The government paid 21 billion rupees in three years to PPHI. Why are we committed to privatizing our health infrastructure? Asked the Secretary General of the Pakistan Medical Association (PMA), Pir Manzoor.
The government has even outsourced one of four Jamshoro-funded regional blood centers (RBCs), funded by Germany, to a private party. This is despite the fact that the University of Medical Sciences and Health of Liaquat (LUMHS) had asked the Sindh government to entrust it with the center for safe blood supply. But the government declined the offer.
The same RBC provides blood (packaged cells) to one patient for 2,800 to 3,000 rupees, which is about 400 pc more than the current cost of 700 rupees of LUMHS for the same blood.
As part of the German funding, four RBCs were to be set up in Sukkur, Jamshoro, Benazirabad and Karachi. With Rs. 1.7 billion in financing, Sindh received Rs 637 million. Other provincial governments used it in public sector universities.
"I think that soon the health department of Sind will not exist more than on paper because we will have nothing to do," commented a source of health.
He added that during the privatization of services, the much talked about change in the provision of quality health care was still a distant dream.
Posted in Dawn, May 5, 2019
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