Polio eradication still a distant goal
KARACHI, Jan 1: In terms of the eradication of polio, for Sindh it is a matter of so near and yet so far. The province was close to controlling the virus in 2005 when there were only five cases.
In 2007, however, 11 confirmed polio cases were reported from five different districts, including Karachi. Although the provincial government and the international health organisations working in Pakistan for the eradication of polio have been claiming since 2005 that “the coming year will be a polio free year,” this hope has not so far materialised.
In the last week of October 2007, there were eight confirmed polio cases in Sindh. The number increased to 11 in a mere month or so, said Dr Farhat Jafri, the focal person for polio eradication at the Expanded Programme on Immunisation (EPI), Sindh. Explaining the situation, the doctor told Dawn that cases had been detected at the Kambar district, which experienced an influx of people from across the provincial border in the wake of the flood.
On Feb 17 last year, the project director of the EPI Sindh, Dr Salma Kauser Ali, said that only two confirmed and one contact polio cases had been detected in the province during the first two months of 2007. Keeping this number and the overall performance and targets achieved in Sindh, she had said, polio appeared to be on the verge of eradication.
Compared to 40 polio cases in 2006, Pakistan recorded a total of 24 cases in 2007. The percentage of the cases in Sindh in terms of the total number reported in the country increased from 30 per cent recorded in 2006 (when Sindh reported 12 cases), to 46 per cent in 2007.
Interestingly enough, relatively low numbers of cases were reported from the provinces that are considered the sources of the transmission of the virus to Sindh. During 2007, four cases were recorded in the NWFP, two in FATA and seven in Balochistan.
Asked about this, Dr Jafri said that the higher number of polio cases recorded in Sindh could be because the provincial surveillance system had improved and because it was possible to verify cases in comparison to Balochistan and the NWFP.
Challenges mounting up
Experts believe that the challenges in Sindh are mounting up. To ensure the interruption of the transmission of the virus, the province will have to carry out targeted vaccination campaigns and possible outbreak response campaigns in addition to national immunisation and special immunisation days, they told Dawn.
The chairman of the Expert Review Committee on Polio in Sindh, Prof Iqbal Memon, said that the province had come a long way in controlling polio since 1994 and should not be discouraged. “Our progress may be slow but we should not give up and we must continue to pursue our goals,” he said. “Sindh is now nearer to achieving a polio-free status than ever before.”
According to Dr Memon, who is a specialist in paediatrics, steps needs to be taken to increase the rate of routine vaccination, as, according to him, the overall 40 to 50 per cent coverage of the children less than one year was not satisfactory.
Furthermore, he suggested, in order to ensure an increase in routine immunisation, it should be made compulsory for parents to produce vaccination cards while enrolling their children in primary schools.
“In certain inaccessible areas such as parts of Jacobabad, Dadu, Larkana, Ghotki, Shikarpur and even Karachi, polio teams are hindered in their operation by physical constraints or social taboos,” he pointed out. “Media, political and social figures can play an important role in raising awareness amongst communities and countering misconceptions about the quality and side-effects of polio vaccines administered to children under five years of age during various national and special immunisation campaigns.”
Dr Memon told Dawn that amongst the misconceptions was that the vaccine affected human fertility and said that irrespective of their financial status, parents ought to wholeheartedly accept the vaccinators who came to their very doors.
According to another EPI Sindh official, Pakistan was one of four countries — the others being India, Afghanistan and Nigeria — which were close to eradicating polio. He told Dawn that in many cases, polio is reported to have originated in other countries such as Afghanistan, and then have been transmitted to Pakistan. He added that EPI workers were finding it difficult to reach remote areas of the province bordering Balochistan.
The EPI official suggested a review of the current communication strategy and the development of province/district specific plans with the involvement of local partners to check the spread of the virus.
During 2007, five polio cases were reported in Kambar, two in Karachi and Jacobabad each, and one case each in Khairpur and Thatta.
(By Mukhtar Alam, Dawn-17, 02/01/2008)
Another dengue patient dies
KARACHI, Jan 2: A patient suffering from dengue fever died at a private hospital on Tuesday, in-charge of the Dengue Monitoring Cell Dr Shakeel Mullick confirmed on Wednesday. He said a 23-year-old resident of Ancholi Society, Federal B Area, died at the Aga Khan University Hospital, leading the dengue-related death toll to 23.
According to Dr Mullick, the number of dengue patients brought to various government and private hospitals during the last five months or so has risen to 2,922. Nine of such patients are still under treatment at various hospitals in the city, he added.
On Nov 15, the tally of dengue patients was recorded as 2, 498.
(Dawn-18, 03/01/2008)
Damage causes health dept to put off anti-polio drive
KARACHI, Jan 2: Offices of the Sindh health department and various public sector health care facilities were destroyed in the wake of widespread violence that erupted after the assassination of PPP chairperson Benazir Bhutto on in Rawalpindi on Thursday last and continued on the following two days.
Talking to Dawn on Wednesday, Director-General of the health department Dr Hadi Bakhsh Jatoi said that a chain of cold storages meant for preservation of vaccines in Larkana was among the destroyed facilities. He said that the massive destruction has prompted the health department to postpone the special anti-polio campaign in certain districts, including Larkana and Kambar. The campaign was to cover these districts in the first half of this month.
“Not only that we will now need a fresh sizable consignment of vaccines, but we will have to mobilise the field staff, vaccinators and volunteers again, besides rescheduling the campaign programme,” he said.
Dr Jatoi has been gathering information from EDOs (Health). In the light of initial reports, and his talks with health officials, he said that the damage was substantial and health offices and institutions needed to be compensated in order to revive the operation. Dr Jatoi said that communication system meant for coordination among the EDOs’ offices in 20 districts had been destroyed and extensive damage to computers and official records reported.
At least 16 vehicles, 25 computers and 30 microscopes, as well as office records, had been set on fire or destroyed by rioters at the directorate of DG health, Hyderabad, which also houses directorates of TB and malaria control and the coordination office of the hepatitis control programme.
According to Mr Jatoi, rioters also ransacked and torched the Services Hospital, Hyderabad. Some unused ambulances parked at the hospital were damaged and taken away.
“Restoration of the telecommunication system on a priority basis is necessary to revitalise the EDOs’ offices,” said Mr Jatoi.
(Dawn-18, 03/01/2008)
New law gives autonomy to public hospitals
KARACHI, Jan 2: The Sindh government has decided to reduce its control over health institutions in the public sector and offered them autonomy to operate under a board of governors so that they can provide quality and affordable health care to all sections of society, officials said on Wednesday.
The BOG, whose establishment is stipulated in an ordinance promulgated recently, may be formed separately in the case of hospitals with or without training centres or teaching hospitals across the province and will act as the principal governing body.
It will also be responsible for the administration and management of the health facility being run by it.
The ordinance titled “The Sindh Health Institutions (Establishment and Management) Ordinance, 2007” was given approval by Sindh Governor Dr Ishratul Ibad Khan on Dec 27 with effect from Oct 24, 2007.
The ordinance says that government may, by notification in the official gazette, apply this ordinance to any health institution or teaching hospital functioning immediately before the commencement of this ordinance.
Also, the government may, by notification in the official gazette, establish such numbers of health institutions as it may deem fit, while the health institution shall be a body corporate, having perpetual succession and a common seal, with power to acquire and hold property as prescribed and may, by its name, sue or be sued.
The chairman of the BOG will be appointed by the Chief Minister. The provincial health secretary, medical superintendent of teaching hospital, vice-chancellor nominated by the government, principal of a medical college nominated by the government, shall be official members and four non-official members nominated by the government from among the philanthropists, distinguished businessmen and NGOs would be in the board.
The health institutions shall be responsible for providing training, health care facilities to people and perform such other functions as may, from time to time, be assigned to it by the government.
The Board shall appoint persons possessing qualifications on terms and conditions as may be prescribed by rules to be made to carry out the purpose of the ordinance.
The persons serving in a health institution in any capacity immediately before the commencement of the act in question, notwithstanding any law or terms and conditions of their service, stand transferred for service to the BOG on such terms and conditions as may be prescribed by rules, said section 6(1) of the ordinance.
However, the terms and condition should not be less favourable than the terms and conditions admissible to them immediately before their transfer. The employees transferred to BOG will continue to be the employees of the government and may be transferred to government by the Board unless observed in the service of the Board.
There shall be a fund, to be known by the name of the Board, which shall vest in the Board and to which shall be credited all sums received by the institution.
The government may order financial, medical and managerial monitoring through a third party nominated by the government and paid for by the BOG and the Board shall comply with the directions which may be issued by government on the report of the third party.
All persons acting or purporting to act in pursuance of any provision of this ordinance shall be deemed to be public servants within the meaning of section 21 of the PPC, 1860, the new ordinance emphasised.
(Dawn-19, 03/01/2008)
Health dept requires Rs120m for repairs
KARACHI, Jan 4: The Sindh health department will need about Rs120 million for the refurbishment of various government-run health facilities, hospitals and health offices set ablaze, looted or ransacked recently across the province under the cover of protests over PPP chairperson Benazir Bhutto’s assassination, said sources in the department.
The department was provided on Thursday with information about the damages or losses caused to public sector healthcare facilities in 19 districts of the province.
A report received from the director-general of health services, Sindh, had no estimates about damages caused to facilities in the other seven districts. “Perhaps basing on informal reports, the DG has forwarded to the department details of buildings and equipment and vehicles torched or destroyed by hooligans, without financial evaluations,” said an official, adding that that could be due to the absence of communication with the offices concerned.
Provincial health minister Fauzia A. Lari told Dawn the details of the damages and destruction would be placed before the provincial cabinet as well so that the federal government could be requested for a special allocation of funds for the restoration and refurbishment of the health facilities on a priority basis.
Answering a question, she said the Sindh health department would not base only on the first report of losses, but would also constitute a team of officials to survey the affected facilities, confirm the reported damages and recommend measures to overcome new challenges.
The DG said in his report said that damages of Rs27 million had been caused to the office and properties of the director-general of health services in Hyderabad, which also housed the TB Control Programme and the Malaria Control Programme.
At the DG health complex, two offices were completely burnt, 16 vehicles were burnt or damaged and 30 computers with all accessories were taken away. Besides, refrigerators, typewriters, photocopiers, medicines and vaccines were also stolen or destroyed.
At the Services Hospital, Hyderabad, three ambulances were completely burnt. The loss has been estimated at Rs3.2 million.
Another big damage, evaluated at Rs21 million, was done in Tando Mohammad Khan. The main store of the EDO health, a rural health centre, three basic health units, a store of the malaria control programme, EPI district store and two ambulances of a healthcare centre were damaged.
In Khairpur district, the cost of damages has been estimated at Rs14.4 million. Buildings of a number of rural health centres and basic health units and mother/child health centres, along with furniture, records, lab materials, ambulances and relevant vehicles, instruments/equipment and furniture of BHUs and RHCs and residential buildings of medical staff were destroyed.
Damage to MCH centre, including equipment, furniture, machinery, burning of a medical officer bungalow and partial damage to an ambulance have been reported from Tando Allahyar.
Badin district suffered a loss of 11 vehicles, damages to the EDO health office, an RHU and a BHU, while three ambulances, five pickups and the taluka hospital of Rohri were destroyed in Sukkur district.
From the remaining districts, including Umerkot, Jacobabad, Mirpurkhas, Naushehro Feroze, Thatta, Hyderabad, Nawabshah, Kamber, Larkana and Shikarpur, damages or loss to various rural health centres, basics health units, EDO offices, vehicles, ambulances, hospitals, residential blocks, equipment and stores have also been reported.
Health officials considered the losses as the worst blow to the available health sector infrastructure and operational facilities, which were already faced with a shortage of trained manpower, doctors, administrative staff and diagnostic equipment and medicines.
While the estimate of losses in terms of money in cases of some districts is yet to be completed, the DG has calculated a loss of Rs88 million so far, an official said, adding that damages in the remaining districts were likely to be worth Rs30 million.
(By Mukhtar Alam, Dawn-17, 05/01/2008)
Construction work on five cardiac centres completed
The City District Government Karachi (CDGK) has completed the construction work on five modern cardiac care centres in suburban areas, mainly katchi abadies, at an estimated cost of Rs.01 billion to provide better cardiac treatment facilities to poor and low income residents of such settlements.
All these centers are expected to start working in the current year.
The heart disease institute at Shah Faisal Colony would cost Rs 180 million, while a similar center at Landhi would cost Rs 140 million. CDGK is also establishing a cardiac hospital in Korangi at a cost of Rs 130 million and another heart disease institute at the Asia’s biggest katchi abadi Orangi Town at a cost of Rs 70 million. Besides, an amount of Rs 400 million is being spent on the up-gradation and extension of Karachi Institute of Heart Diseases in Federal B Area, including the construction of a four-storey modern building within the boundary wall of the institute.
After the completion of construction work on these buildings, preliminary measures would be taken for the procurement of machinery and deputation of staff at these hospitals, while theses buildings would soon be handed over to the medical superintendents concerned so that they could provide instant medical aid to poor people in the area.
(The News-13, 05/01/2008)
Organ donation makes a ‘world of difference’
IN only 2006 50,000 people died of end-stage organ failure in Pakistan. According to an estimate, every 10 minutes someone dies waiting for a life-saving organ transplant. The near and dear ones of all these people said that if their son, daughter, brother, sister had received organs, they might have lived longer.
Two months back an ordinance on cadaveric organ donation was promulgated and exactly two weeks later hundreds of notables signed donor cards in a campaign organised by the Sindh Institute of Urology and Transplantation, Karachi.
They wished that after death their organs should be donated and transplanted to persons in need to save their lives.