PMA beholds 2019 a year of steep decline for health in Sindh

Province found itself in the grip of myriad diseases amid govt negligence, highlights report by PMA

KARACHI: Sindh's health sector seemed to be on a downward spiral as the province found itself grappling with a plethora of epidemics and disease outbreaks in 2019, a statement issued by the Pakistan Medical Association (PMA) on Tuesday underlined.

In addition, PMA Secretary General Dr Qaisar Sajjad pointed out that absence of quality doctors in Sindh has worsened the already crumbling state of the health sector.

Speaking with particular reference to Karachi, he said that the city continued to have only three tertiary care public hospitals for many years and had not witnessed the construction of a new one. As a result, the burden on the three public facilities had grown manifold, in the backdrop of exponential population growth, he added.

Dr Sajjad also observed that medical practised in Sindh were directed towards curative care than preventive care, which had led to the outbreak and spread of various diseases, as stated in the annual report issued by PMA.

Polio

According to PMA's annual report, polio persisted in Sindh despite multiple measures being taken for polio vaccination in the province over the past decade. In the report, PMA has quoted the International Monetary Board that has declared that the efforts to eradicate polio from the country had fallen victim to "political football". The medical body has also pointed towards the lamentable increase in the number of polio cases, only within a year's time, ruing the fact that the crippling disease was on the brink of elimination just about a year ago. In 2018, 12 cases of polio were reported in Pakistan but the figure drastically soared to an astounding 117 in 2019, the report stated, adding that of the cases reported in the previous year, 19 were from Sindh.

The report attributes polio resurgence in the country to lack of political unity.

Dengue

Dengue too reared its ugly head in the country during 2019, with around 50,000 cases of the potentially fatal fever being reported from across Pakistan. According to PMA, the swell in the number of dengue cases is indicative of authorities' negligence and near complete lack of efforts to curb the disease.

HIV   

Sindh found itself in the grip of the deadly HIV virus, when reports of a massive outbreak of the disease in Rato Dero, a taluka in Larkana District, made headlines in 2019. As many as 895 cases of AIDS have been reported from Rato Dero alone over the past year, of whom 754 are children and 141 adults, the reported stated, adding that from April, 2019 to November, 2019, around 37,558 people underwent screening for HIV in Larkana, of whom 1,195 tested positive.

Congo fever

The report also concludes that Karachi was hardest hit by the Crimean-Congo Hemorrhagic Fever (CCHF) in 2019, with the disease claiming as many as 20 lives in the city.

Hepatitis

Indicating towards the rise in the number of hepatitis B and C cases in the country, the report identifies the lack of preventive measures and test and treatment facilities, poor screening of blood used for transfusion, improperly sterilised invasive medical equipment and use of unsafe injections as factors contributing to the rapid spread of the diseases. It further mentions that according to a report by the World Health Organisation, presence of quack doctors too has largely contributed to the prevalence of hepatitis in the country.

Drug-resistant typhoid

In 2019, cases of drug-resistant XDR typhoid in Sindh were numbered in thousands, the report mentions and identifies the extensive use of antibiotics as the main reason behind the surge in the number of XDR typhoid cases.

Recommendations

According to PMA, measures need to be taken to curb environmental pollution in order to ensure the eradication and control of various diseases imperilling the lives of the citizens. The medical body has mentioned in the report that no steps have been taken to reduce environmental pollution despite the Sindh High Court issuing orders thrice for the relevant authorities to work towards this purpose.  The report laments that the laws pertaining to environmental conservation and preservation, including the Prohibition of No Smoking Law, 2002, are not being implemented.

The medical body has also called for providing security to doctors and paramedical staff and establishing more hospitals, as it expressed regret that the relevant authorities seem to remain unmoved despite PMA's frequent requests made in this regard.

Echoing Dr Sajjad's views, PMA, in its annual report, has stressed the need for investing more resources for preventive care than curative care. Though, nothing has been done in this regard, the report mentions, adding that consequently, various diseases have taken a toll on the residents of Sindh. It is pointed out in the report that the occurrence of 60% diseases can be prevented just by ensuring the provision of clean drinking water to the citizens.

Besides, PMA has raised concerns over the lack of vibrology laboratories in the province, as well as in Pakistan, and miniscule funds being allocated to the health sector.

The report states that proper planning, political will, increase and proper allocation of funds to the health sector and taking consolidated preventive measures can bring about a significant improvement in the health care delivery in the coming year.

Published in The Express Tribune, January 1^st, 2020.