The information surfaced on a journalist’s WhatsApp group: eight young children were allegedly infected with HIV at Kulsum Bai Valika Hospital in Karachi and two died. Every journalist was busy calling their contacts in the Sindh government for confirmation and details. As I am new to health reporting, I decided to go to the Pathan colony in the area to see if I could find any relatives who might know how this happened? Was there a connection with Kulsum Bai Valika Hospital, as people claimed?
It took me a while to reach Valika Hospital on SITE, which is on the top left of the Karachi map. This is where all our major soft drink factories are located, next to the textile factories. Pathan Colony is a katchi abadi with tall, skinny buildings right opposite the hospital, accessible through a hole in the wall at the petrol pump.
When I went to Valika on a Tuesday afternoon, the government hospital was really quiet, which seemed strange to me because it provides free care to registered factory workers and their families.
I went upstairs to meet the person who runs the hospital, Medical Superintendent Mumtaz Shaikh. I mentioned the rumors of at least 18 HIV-positive children. “We don’t read all the information,” he told me. “And we don’t believe all the news.” Of course, I thought. How stupid. He wasn’t going to be open with me.
Interview with the head of the hospital
The MS however goes on to say that initially there were two children, one from Banaras and one from Pathan Colony. Both positive. They were immediately sent to Indus and Civil hospitals.
Valika alerted the Sindh HIV program on October 22, that all hospitals have standing orders to combat epidemic diseases. In less than 24 hours, screening teams were on site. According to the MOH, 35 people sitting at the OPD that day were tested and found negative.
The hospital also had to inform its supervisory authority, the Sindh Health Care Commission, and asked it to send officers to shut down small clinics run by fake doctors and hair salons in the area.
But wait. I stop the MS because he had just shown me the letter. It says six to eight kids tested positive, I tell him. Not 2.
Shaikh closed the file. “They were not admitted patients,” he retorted. “They were people from outside the hospital, from the neighborhood.”
Translation: Eight children are HIV positive. Two may be dead. There may still be six people out there, somewhere, with HIV.
The Sindh HIV program is part of the Communicable Disease Control or CDC. I meet a young CDC employee in the MS office but he also refuses to share any information. “It would cause panic. People would be ostracized,” he said.
I try to tell him I don’t want names. Just numbers. Just a confirmation.
“All I can tell you is that the CDC headquarters is here,” he said, handing me a flyer with an address. “You go here, but they won’t tell you anything.”
Neighborhood Watch
Rather deflated, I go out to the parking lot to think about what to do next. Luckily, I notice a man talking to the CDC staffer and I stay back until he is alone. He introduces himself as Irshad Khan, the local representative of Union Council 1 of Pathan Colony. He also happens to be the chairman of the SITE City Health Committee. He has a big file of papers.
Irshad Khan has been harassing authorities since August, when the diagnosis was first revealed. “We ask Valika for the list, but they don’t give it,” he said. They told the hospital the committee could help by rounding up other people in the area for testing.
Irshad has done something quite commendable. He convinced political party activists to form a committee to work on this issue. There is someone from ANP, PTI, Jamaat-e-Islami and PPP.
City officials asked Valika to organize a seminar where hospital staff, Pathan Colony residents and grassroots organizations would talk about HIV. People have learned that the disease is not spread by touch.
Dr. Arman, the pediatrician everyone knew, was there. Now he has been transferred to Landhi, I was told.
In the absence of real information, rumors circulate in the colony. I shared videos of hospital waste disposed of in trash cans. The neighborhood committee has started collecting its own data. They have ten cases.
Akhtar Ali, a political worker, said: “These people are rude, the hospital staff. If this hospital was on MQM land, they would have set fire to this hospital. We have really controlled the people of the area. Nobody wants to come here.”
Usman Ahmed, president of the Pathan Colony Jamaat-e-Islami chapter, rejects the explanation that small clinics are to blame. “These people blamed the charlatans,” he said, citing a news channel that provided coverage. “But when we go to clinics, we buy our own injections from outside. There are quacks all over Pakistan, not just here. So why is this happening to the children who came to Valika?”
The good news, I am told, is that since these cases surfaced, the shortages of medicines and syringes in Valika have ended. Bad news: the staff shortage persists. There are still not enough beds for children.
The real cost
The political workers take me to the neighborhood where I meet a young man who says his niece died of HIV. He just gave an interview to a vlogger. He suggested that I introduce myself to the other family whose child had also died.
But when I met the family and asked the mother what had happened, they had no test results showing me that HIV had actually been detected. A maulvi sahib told them that the child was HIV positive. And I wonder why these families have no way of really knowing what happened.
One of the mothers, the wife of a factory worker, had to go to the Indus Hospital herself because her husband could not miss his daily paid work. She left alone with her sick child. She later told the neighborhood committee that the trip alone had cost her Rs 12,000.
I hear about Sahil’s niece: 14 months old, admitted to Valika with a fever that would not go away. She had it for three, four days. Two children from his parish tested HIV positive. One of them was in the same bed as his niece.
Sahil didn’t trust Valika’s lab, so he had the whole family tested at Dow. They were all negative, thank God, he said.
What about the kid who shared the bed with his niece, I ask. She was sent to Patel Hospital.
Akhtar Ali’s niece was born in Valika and has always been treated there because her father, a factory worker, was registered on the Benazir Mazdoor card which allows him to benefit from free care in a SESSI hospital. The baby was a year old when she developed a persistent fever in April. She was treated for five months and her weight continued to drop. On September 11, she tested positive for HIV.
His mother claims to have seen hospital staff use the same syringe on several children.
The baby was tested in a laboratory at Ziauddin Hospital and now she is receiving ARV treatment at the Civil Hospital and has gained 2.5 kg. His parents, brothers and sisters tested negative.
This has already happened
After the Ratodero outbreak, since 2019, HIV testing has expanded across Sindh and there are more than 30 ART centers, almost one per district.
When hospitals find positive cases, they submit a “zero report” to the government. These patients then go to government-run ART centers because the treatment is expensive. The government provides it free of charge through the National AIDS Control Program.
The government is retesting patients according to a WHO protocol.
But in Pathan Colony, the men on the committee tell me that some HIV-positive children have just been taken home and are not receiving treatment. If true, it is alarming. But I have no way of corroborating.
“As it is a chronic disease, people think it only happens sexually,” says Professor Fatima Mir, pediatric HIV expert at the Aga Khan University. “So parents think, ‘We didn’t do anything like this, so how did this happen to my child?'”
What some managers tell me later
I managed to reach Dr. Zulfiqar Ali Dharejo, deputy director general of the CDC, but he did not share any confirmed figures. “We are screening,” was all he could say. “All cases that surface are referred to ART centers and treated. » Cases of Valika are being registered at Indus Hospital.
Dr Ahsan, from the Sindh Health Care Commission, added: “People think of quacks when you talk about HIV.” But charlatans are only one of the reasons. The commission continues to close them; they appear elsewhere. Another risk is infected blood. Families ask their loved ones to donate rather than pay for tested blood, he said. The donor could have hepatitis or HIV.
He gives another clue: “When a child is infected, it is visible at least six months later.” This could therefore mean that children who tested positive at Valika hospital and were only treated there because they were on their father’s panel, would have been infected months earlier.
I hear that the SHCC has met Keamari Deputy Commissioner Tariq Chandio and they will team up with SSP Keamari and the DHO to inspect public and private hospitals as part of a district-wide crackdown on unqualified practitioners.
Meanwhile, the neighborhood committee says people are afraid and want more information. They collect their own data because no one else will, but the proper clinical testing and evaluation can only be done by the government.
