Patients struggle to buy tetanus vaccines

Victims injured during a traumatic accident are rarely in a stable state of mind to process the unfolding events once they reach the emergency department of a hospital. Yet, as an artificial shortage of the tetanus vaccine plagues the country's healthcare sector, trauma patients and their caregivers would have to momentarily cast aside their hazed consciousness and investigate the availability of the life-saving medication.

One such family was that of Ramiz, a courier rider in Karachi, whose son was injured while playing cricket with his friends on the road outside his house. "Since my son's wounds were bleeding pretty badly, we had to rush him to the nearby clinic, where we were told by the doctors to bring a tetanus injection. After searching several medical stores, we were finally able to find an injection, which was sold to us at an inflated price of Rs500," said Ramiz, who urged the government to address this issue and ensure the injection's availability at fair prices.

Like Ramiz's son, Kashif Khan, a labourer at a private company in the port city, had to seek emergency care when two rusty nails punctured his right leg during his routine industry work a few days ago. "Once I was taken to a private hospital for first aid treatment, the tetanus injection was not available. After extensive searching, I was finally able to buy it for as much as Rs800 per vial," lamented Khan.

Muhammad Salim, the owner of a local medical store in Karachi revealed that the tetanus injection, a crucial, life-saving medicine, had been short in supply since April. "Until four months ago, this injection was sold for Rs40 to Rs50. However, the recent shortage of the injection in the market has caused the price to rise to Rs800. Only 80 per cent of the stores are selling the injection, that too at arbitrary prices," shared Salim.

The situation was quite similar in Lahore, where Mahmood Ahmad, in charge of a leading medical store chain, revealed that despite the Drug Regulatory Authority of Pakistan (DRAP), fixing the price of a pack of 10 tetanus injections, marketed under the brand name of Amital, at Rs718, the medication was being sold in the black market for prices as high as Rs1,500 to Rs2,000.

"Two big distributors have established their monopoly and are selling the injection privately at high prices. Moreover, the medicine distributors in Lahore, the largest market in the city, have the injections in stock, but they are selling them only to a few medical stores at high prices. Surprisingly, a long time has passed but no action has been taken by the government to curtail the black marketing and artificial shortage of the essential drug," claimed Ahmad.

Miles away in the country's northern half, Shahid Khan, a medical store owner in Peshawar informed that since the past one and a half months, the supply of the tetanus vaccine had been halted by manufacturing companies. "Although a few medical stores have a limited stock available, they are selling the vaccine for thousands of rupees even though it usually costs barely a few hundred bills. Therefore, patients in need of the vaccines are forced to buy them at high prices since public hospitals do not have the required stock," confirmed Khan.

According to Dr Pir Ghulam Nabi Shah Jilani, an expert in emergency health management, the tetanus vaccine was a mandatory medication for any patient, who had sustained injuries during an accident since it created the antibodies needed to combat a toxin-producing bacterium called Clostridium tetani, that could damage the nervous system.

"Although tetanus is preventable, it is very dangerous. Early symptoms include muscle spasms, particularly in the jaw and neck, difficulty eating, and painful tightness in the muscles around the lips and abdomen, as well as seizure-like spasms and breathing problems. If not treated in time, this muscle stiffness can spread to the whole body and, in severe cases, can lead to death," warned Dr Jilani.

Speaking to The Express Tribune on the matter, officials regulating the supply of drugs at the federal and provincial level stated that steps were being taken to address the partial shortage of tetanus vaccines in the country.