Around 900 children under the age of 12 have tested positive for Human Immunodeficiency Virus (HIV) in Ratodero since April, and medical officials predict the number will rise after linking a pediatrician to dozens of cases and identifying other unhygienic practices in the city.
Muzaffar Ghanghro, a pediatrician who offered medical care to some of the poorest families in the city, has had his practices called into question since the HIV outbreak began. Early investigations from Pakistani medical officials revealed many of the children who tested positive for HIV previously received medical care from Ghanghro.
Imtiaz Jalbani, a father of six, told the New York Times that he became concerned when he saw Ghanghro rooting around in the trash for a syringe and did not want to be questioned.
“He said, ‘If you don’t want my treatment, go to another doctor,’” Jalbani said in an interview, adding that Ghanghro told him that treatment did not cover the cost of a new syringe.
“My wife and I had to starve ourselves to pay for the medicine,” he told the Times. By the time of the interview, four of Jalbani’s six children had contracted HIV, and two of them had died.
A similar story was reported by Gulbahar Shaikh, a 44-year-old local journalist who broke the story on the pediatrician. Shaikh told the Times that prior to his exposé, many parents in Ratodero were flocking to get their children tested due to a rumor concerning Ghanghro’s practices, and Shaikh himself became worried because his own children were treated by the man.
As it turned out, his 2-year-old daughter was also infected with the virus.
While it was initially reported that Ghanghro was posing as a doctor, he recently renewed his medical certificate and was hired as a general practitioner at a government hospital - even after being arrested and charged with reusing syringes.
Ghanghro has not yet faced a court, but he told the Times that he is innocent and has never reused syringes.
As the months have gone on, testing centers have been set up across the city, and the Times reported 1,112 cases of HIV have been confirmed in the 200,000-person city. Being that most of the new cases are amongst children, schools have begun segregating children based on their status.
Despite there being ways to treat the virus and make one’s viral load undetectable and untransmittable, Ratodero’s high illiteracy rate poses a problem for those uneducated on treatment.
If untreated, HIV leads to Acquired Immunodeficiency Syndrome (AIDS), during which the body’s immune system is so weak that a simple cold or infection can easily kill.
“My wife and I, fortunately, we are literate. We hug and love our daughter. But our relatives stopped touching her and are now reluctant to visit us,” Shaikh told the Times.
After months of investigations, medical officials are now saying that while the credible accusations brought against the pediatrician may parallel the stories of a large number of childhood HIV infections, there are some other unhygienic practices that have increased the likelihood of transmission across Pakistan - especially in poor areas such as Ratodero.
For example, many barbers reuse razors that may become contaminated and are not sterilized between uses. Similarly, dentists have been known to use reuse tools that remain unsterilized.
From 2010 to 2018 alone, the number of new HIV infections in Pakistan has risen from 14,000 to 22,000, and AIDS-related deaths have climbed from 1,400 to 6,400 during the same period, according to the Joint United Nations Programme on HIV and AIDS.
“Unless these quack doctors, barbers and dentists are not checked, the number of incidents of HIV infection will continue going up,” Dr. Imran Akbar Arbani noted to the Times. He went on to reveal that he knows of at least 35 children from the city who have died since April 25.
“In Pakistan, the government does not act unless there is a national uproar sparked by media coverage,” he argued, explaining why it was him who decided to inform Shaikh of his discovery of the trend - which ultimately lead to the journalist exposing his city’s plight.