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Doctors in a Pakistani city are struggling to cope with the increase in the number of patients infected with HIV, the virus that causes AIDS, with nearly 700 cases registered since April, for most children.
Health officials suspect that the epidemic is linked to the reuse of syringes and needles and poorly screened blood transfusions.
"For me, it was impossible to imagine," said Nazeer, remembering the day a doctor said that his 16-month-old daughter had been tested positive for HIV.
"I told him," you laugh with me, how can she get HIV? "He said at his home in Ratodero, 480 km from Karachi, the capital of the southern province of Sindh.
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His daughter is undergoing treatment, he said, adding that he did not know how she had been infected.
Health authorities said that since April 25, in Ratodero, 681 people were HIV-positive, including 537 children.
More than 21,000 people were tested for HIV at the only Ratodero screening center in a government hospital. Others have been tested in private clinics.
"I have identified the tip of the iceberg. That could be thousands, not hundreds, "said Dr. Imran Akbar Arbani, who runs a clinic in the district town of Lakarna.
About 60% of Ratodero patients have been infected with reused needles and syringes or with blood transfusions that have not been screened for HIV correctly, said Dr Sikander Memon, program manager for the fight against HIV. AIDS in the province.
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Police and doctors conducted an initial investigation and discovered that 123 HIV-positive patients had been treated by a doctor before the infection.
Dr. Muzaffar Ghanghro was arrested on April 30 and charged with involuntary murder, police said.
"The negligence and carelessness of Dr. Muzaffar Ghanghro have been the main reason for the spread of HIV at a later stage," said the investigation team in a report.
Reuters was not allowed to contact Ghangro in prison and could not contact his lawyer.
Imtiaz, a worker, said that he had taken his three children to Ghangro because there was no pediatrician in town. All three were infected with HIV.
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"He applied the same drip to 50 children without changing the needle," he said.
"Sold all my valuables"
There are some 163,000 HIV and AIDS patients in Pakistan, of whom only 25,000 are enrolled in provincial and federal AIDS programs, said Zafar Mirza, a health advisor to Prime Minister Imran Khan.
At the request of Pakistan, the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) sent a team of experts to the region. They should go to Ratodero on Friday.
"They will conduct a proper investigation into the place of this outbreak," Mirza told reporters. "I hope that in the coming weeks we will know the reasons."
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The government has ordered 50,000 HIV test kits and is setting up three treatment centers. Adult patients are receiving antiretroviral drugs and medicines have been ordered for the children, Mirza said.
The Ratodero cases highlight the deplorable health care situation in Pakistan, a country of 208 million inhabitants where nearly one-third of the population lives on less than $ 3.20 a day and where many People can not afford medical tests or expensive drugs.
Few families can afford adequate treatment for HIV, which usually involves regular trips to Karachi.
"I sold all my valuables for treatment. Now I can not afford to buy medicine in Karachi every month, "said Tariq, who lives in a village near Ratodero.
Tariq, his wife and daughter are HIV positive and a nephew tested positive this month. He does not know how they got infected.
"There are 16 cases of HIV in our only village. Nobody came to see our plight, "he said.
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PakistanHIV / AIDSHIV epidemic
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