World Pneumonia Day: Caution is better than cure, say health experts

Doctors say govt-sponsored immunisation may not tackle pneumonia spread.

ISLAMABAD:

While Prime Minister Gilani, in his message on World Pneumonia Day, noted with “satisfaction” that a highly efficient vaccine is being introduced in Pakistan, those fighting the disease say the real cause seems to be going unaddressed.

Poverty, say health experts, is what is leading to the spread of pneumonia in children in Pakistan where one in four child deaths are attributed to the disease.

“Most children [suffering from pneumonia] come from slum areas and have contracted the disease either by sleeping very close to people already suffering from pneumonia or through exposure to cold because they slept on a cold floor or walked barefoot on it,” says Dr Qaiser Shehzad Humayun, senior child specialist at Rawalpindi’s Holy Family Hospital. Dr Humayun is also critical of the efficacy of the government’s expanded programme on immunisation, which the prime minister said will prevent 65% of pneumonia cases that occur in Pakistan.

“The EPI does not include vaccines against HIB (Haemophilus Influenzae Type B) and pneumococcal infections, the two leading causes of childhood pneumonia,” he says, adding that the EPI is also so pricey that it is unaffordable for many.

To control the spread of pneumonia, he recommends meticulously maintaining personal hygiene through hand-washing and ensuring a balanced diet.

But while Dr Humayun said that most cases come to him during winter, Dr Jan Alam Aurakzai, who operates his private clinic in a suburb of Islamabad, says he receives cases year round. “In a majority of the cases, mothers of these children are domestic workers and do not have the time to collect woods or leaves to burn in order to heat water to wash their babies,” he says.

A number of cases, many of which result in deaths, are solely linked to poverty. “Due to lack of proper medical facilities in the area and financial constraints, some parents usually avoid taking their children to hospitals. This delay usually results in death,” he says. “In many cases, malnourished mothers give birth to babies with a weak immune system, making him or her vulnerable.”

But tackling pneumonia is tougher than simply ensuring preventive measures and proper, timely treatment as hospital-acquired pneumonia is rampant among elderly patients.

“Not maintaining enough space between beds of two patients, unhygienic conditions in wards and frequent visits by attendants can also cause pneumonia in someone already under treatment at a hospital,” points out Dr Fareedullah Shah, senior physician at Polyclinic Hospital Islamabad.

Dr Shah cautions that hospitals should ensure that medical staff and every attendant visiting a patient wears a mouth mask, gloves and has properly washed hands.

Strengthening current systems, says the World Health Organisation, can make treatment more accessible for more families.

“In Pakistan, community health workers can identify and treat most children with pneumonia at home with simple antibiotics. This can make treatment much more accessible for families and help government make the most of limited resources,” says Dr Shamim Qazi, WHO’s pneumonia expert.

(With additional input from APP)

EDITED BY ZAINAB IMAM

Published in The Express Tribune, November 12^th, 2011.