Russian roulette with health
The writer is a Howard Hughes Medical Institute professor of biomedical engineering, international health and medicine at Boston University. He tweets @mhzaman
On a crisp morning in late January last year, I got lucky. The road from my hotel to Bhains Colony in Karachi did not have much traffic. It only took us an hour to get there. Passing through heaps of garbage, we were greeted by a veterinarian — the only one who was a government employee — at his office located inside an old animal hospital, built during the Raj days and crumbling from within. The veterinarian had a small house nearby, in equally dilapidated condition. Sanitation and hygiene are not particularly the strong suit of this part of Karachi.
Though I had read up quite a bit about cattle colonies in Pakistan, I did not realise how poorly the entire system is governed. Well, almost. The business part runs like clockwork. The middlemen, agents, trucks and transporters deliver the milk to the city with immaculate punctuality. But as we went from one farm to another, the situation went from bizarre to unbelievable. It was a regulation-free zone. The government vet was proud of coming up with his own concoction of drugs to treat the sick animals because existing drugs no longer worked. He told us he kept changing the formula without any basis because after a while his cocktails became impotent. We met farmers who paid unqualified pharmaceutical agents hefty sums of money (all under the table) to inject their cattle with the latest drugs meant for humans. We saw the blood of the sacrificed animals transported to the nearby poultry farms and given as high-protein blood meal to the chickens. We saw farm boys, as young as 10, working with cattle, injecting them with oxytocin to produce milk on demand. Some boys had a quota on how many buffalos they had to inject in an hour.
None of this is a secret. People who have visited Bhains Colony will tell you stories far more graphic. People who work there will share their experiences of regularly mixing antibiotics with food. Those who deal with the business side will say the government has always been complacent and complicit. This is about money and business, not public health or wellbeing of farm animals.
As we get closer to Eidul Azha, maybe it is worth reflecting how our farm animals are treated, what they are fed, and what in turn, are we feeding ourselves. Data from poultry and cattle farms in Punjab and Sindh suggests that, right behind China, we are among the worst offenders in the world of having antibiotics in animal feed (in mass of antibiotics per kilogram of meat). The regulatory agencies have their hands full and their minds empty. When I inquired, I found no one knew who was in charge of regulating animal feed. The presence of high amounts of antibiotics in the feed are now a given. No farmer has ever been fined for injecting toxic cocktails of hormones or antibiotics in his herd. The national action plan on curbing antibiotic use is gathering dust in a file cabinet somewhere at the NIH.
So why is this relevant today, and why does it matter? It matters because antibiotic resistance in Pakistan is an understudied problem — one that continues to undermine our health infrastructure to the point of collapse. Many of our antibiotics do not work because of resistance. Because how we handle our animals helps create superbugs. Because right on the heels of Covid-19, antibiotic resistance can pack a knock-out punch for vulnerable patients. Also because we are creating a monster that is unlikely to be contained with our meagre resources, and will likely go well beyond our borders. Most importantly, it matters because we can change course. We need stricter laws on antibiotic use, oversight and awareness. We should not be playing Russian roulette with our health, wellbeing and economy.
Published in The Express Tribune, July 14th, 2020.
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