No more a silent killer

Pakistanis are facing a multitude of health problems and foremost among them is hepatitis C infection. According to the 2007 national survey, 4.9% Pakistanis are infected. The estimated number could be around nine million.

There are a number of differences between hepatitis B and C. Besides the severity of health effects, foremost is the availability of a vaccine for hepatitis B whereas no vaccine is available for hepatitis C.

Fortunately, immunisation against hepatitis B is gradually increasing in Pakistan. The vaccine is provided for free at government centers for women and children and it can also be purchased privately at a cost.

The other differences are related to transmission routes. Hepatitis C is no more a silent killer. It often affects in the prime of a person’s life and has devastating impact.

As the world marks World Hepatitis Day on 28th of July, the collective effort that is being put in Pakistan to arrange treatment for patients suffering from hepatitis is remarkable.

Free treatment provided by the government as well as NGOs face challenges ranging from quality to regular supply of drugs or even getting into the treatment programme, like the CM’s Hepatitis Control Programme in Sindh.

The number of patients receiving treatment is certainly less than the number of people infected. This leaves us with the old adage, “prevention is better than cure.”

We need to address how Hepatitis C is spread. Most common is unsafe injections or unscreened blood transfusions. There are other modes such as unhygienic medical procedures, minor to major surgeries, ear piercing and reuse of blades. The virus can also be transmitted from mother to child as well. Tattooing is another cause but it is not very common.

Many healthcare practitioners, who are not even trained, prescribe injections to make money as it provides quick relief and works faster. In big cities, there are established centres where kits are available which can detect hepatitis C at its earliest stages. This is not the case in smaller towns and rural areas.

Today, there are three types of donor categories in Pakistan. First is the professional, the second is the family donor and the third is the voluntary blood donor. The third category is the safest but unfortunately its number is limited in Pakistan.

Provinces have a greater role and autonomy now post devolution, but there is also lack of coordination. The Ministry of National Health Services, Regulations and Coordination can take the lead here.

District and town health administration can play a key role. Unsafe injection practices must be addressed. Secondly, the use of technology such as auto-disable (AD) syringes should be introduced. This will help in curtailing the menace of reuse of syringes.

We can sensitize communities on the risks of unsafe injections and improve blood transfusion services, particularly beyond urban centres.

We need to promote voluntary blood donation. One way could be to educate the youth, especially in the age of terrorism and bomb blasts where blood is almost always required for the injured.

In a large and populous country like Pakistan, only collective efforts will work as the government alone cannot do this.

Published in The Express Tribune, July 28^th, 2014.

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