The gender divide: More men than women affected by hepatitis in Swat

Experts cite lack of treatment and diagnosis for women as the cause.

SWAT:

Across the provincial border in Swat, a surprising statistic shows that hepatitis has a far greater prevalence rate in men. However, as a doctors explain, that is only because women with the disease are rarely brought in for diagnosis, let alone treatment.

In the case of Amankot-native Sultan Mahmood, the disease cost him a job in Saudi Arabia. “I was not aware I had the disease until I went for a medical for a Saudi work visa. I lost my visa and a huge amount of money because of that,” he told The Express Tribune, adding that he probably got the virus from a used razor blade while shaving.

Most people in Swat get medical treatment from dispensers and unqualified practitioners because they charge less than certified doctors. Unfortunately, experts cite this as a major cause of the spread of virus.

Recently in Banjot village six children were administered expired measles vaccines, three of whom died, while the other three were listed as critical for an extended period of time. All of them actually had undiagnosed hepatitis.

Another native of the region, Asia Bibi, 24, also has hepatitis, but so do eleven other members of her family. “Extreme poverty and this disease have made our lives miserable,” she said. Her brother Adnan, 14, who has hepatitis C, cannot afford treatment.

Meanwhile, Asia’s sister, Nighat Bibi, got hepatitis during her pregnancy. Now her newborn also has it.

None of them have it bad as Khalida, Asia’s 50-year-old sister-in-law, who has had hepatitis C for the last 7 years and the disease is now in its incurable stage. “Doctors say the disease has reached my liver and it is completely infected,” she said, adding that she is losing large amounts of blood every day. “It has ruined our entire family,” she added.

Situation in Swat

Dr Fazal Akbar, an assistant professor at Saidu Teaching Hospital in Saidu Sharif, said that although no authentic research data is available regarding the prevalence of hepatitis in the Swat, he estimates that around 10% of the valley’s population is carrying the disease.

“Khwaza Khela, Amankot and Gut Peochar tehsils are the areas where most patients come from. A major factor in the spread of the disease is used syringes. In Swat, most medical treatment is done by unskilled practitioners who don’t bother to use fresh syringe for each patient,” he told The Express Tribune.

He also explained the gender imbalance in the number of diagnosed cases. “There is a lack of awareness among our people. They don’t get checkups, and the disease is often only detected when somebody is going abroad as a labourer and needs to undergo a medical,” he said, which also explains why women rarely, if ever, are tested for the disease.

Positive steps

Unlike the federal capital and Rawalpindi, Dr Akbar said that in Swat, the government has taken keen interest in controlling the disease and has provided a substantial amount of vaccines to local hospitals. However, “The main problem we are having is with the genotype 3A virus, which exists in 90% of patients in Swat.  Patients with genotype 3A cannot recover with common vaccines but need Peginterferon, which we don’t have,” he said. However, Dr Akbar was hopeful that request for an increased allocation of Peginterferon will be granted.

The doctor urged people to take precautionary measures and not go to unskilled and unqualified practitioners. “Everyone should make sure that brand new syringes are used for vaccination,” said another doctor. “Similarly, a new razor blade should be used whenever one goes for a shave,” he added.

Published in The Express Tribune, July 28^th, 2012.