The information surfaced on a reporter WhatsApp group: Eight small children had been infected with HIV supposedly at Kulsum Bai Valika hospital in Karachi and two were dead. Every reporter was busy calling their Sindh government contacts to get confirmation and details. Since I am new to Health reporting, I decided to go to the area’s Pathan Colony to see if I could find any parents who might know how this happened? Was there any connection with Kulsum Bai Valika Hospital as people were claiming?
It took me a while to reach Valika hospital in SITE, which sits to the top left of Karachi’s map. This is where all our big soft drink factories are located next to textile mills. Pathan Colony is a katchi abadi with tall skinny buildings right across the hospital, accessed through a hole in the wall at the petrol pump.
When I went to Valika on a Tuesday afternoon, the government hospital was really quiet, which seemed strange to me because it offers free treatment to registered factory workers and their families.
I went upstairs to meet the person who runs the hospital, Medical Superintendent Mumtaz Shaikh. I mentioned the rumours about at least 18 HIV-positive children. “We don’t read all the news,” he said to me. “And we don’t believe all the news.” Of course, I thought. How stupid. He wasn’t going to be open with me.
Interviewing the hospital chief
The MS does go on to say, however, that first, there were two children, one from Banaras and one from Pathan Colony. Both positive. They were immediately sent to Indus and Civil hospitals.
Valika alerted the Sindh HIV program on October 22, which all hospitals have standing orders to do with epidemic-causing diseases. Within 24 hours, screening teams came to SITE. According to the MS, 35 people sitting in the OPD that day were tested and emerged negative.
The hospital had to also tell its watchdog authority, the Sindh Healthcare Commission, and asked it to send officers to shut down small clinics run by fake doctors and barbershops in the area.
But wait. I stop the MS because he had just shown me the letter. It says six to eight children tested positive, I say to him. Not 2.
Shaikh snapped the file shut. “They were not admitted patients,” he retorted. “They were people from outside the hospital, from the area.”
Translation: Eight children have HIV. Two are perhaps dead. Six might still be out there, somewhere, with HIV.
The Sindh HIV program is part of the Communicable Disease Control or CDC. I meet a young CDC staffer in the MS’s office but he also refuses to share any information. “It would spread panic. People will be ostracised,” he said.
I try to tell him I don’t want names. Just numbers. Just confirmation.
“All I can tell you is that the CDC place is here,” he says, handing me a pamphlet with an address. “You go here, but they won’t tell you anything.”
Neighbourhood watch
Rather deflated, I go outside to the parking lot to think about what to do next. Luckily, I notice a man talking to the CDC staffer and hang back till he is alone. He introduces himself as Irshad Khan, the local elected representative for Pathan Colony’s Union Council 1. He also happens to be the chairman of the SITE Town health committee. He has a fat file of papers.
Irshad Khan has been hounding the authorities since August, when the first diagnosis surfaced. “We are asking Valika for the list, but they are not giving it,” he said. They told the hospital that the committee could help by gathering the other people in the area for testing.
Irshad has done something pretty commendable. He has gotten the grassroots political party workers to form a committee to work on the issue. There is someone from the ANP, PTI, Jamaat-e-Islami and PPP.
The town representatives asked Valika to hold a seminar where hospital staff, people from Pathan Colony and grassroots organizations spoke about HIV. People learned it doesn’t spread through touch.
Dr Arman, the paediatrician everyone knew, was there. Now he’s been transferred to Landhi, I am told.
In the absence of real information, rumors have been circulating in the colony. I have shared videos of hospital waste being carried out in dustbins. The neighbourhood committee has started collecting its own data. They count ten cases.
Akhtar Ali, a political worker, says: “These people are rude, the hospital staff. If this hospital were on MQM turf, they would have set this hospital on fire. We have really controlled the people of the area. No one wants to come here.”
Usman Ahmed, the president of Pathan Colony’s Jamaat-e-Islami chapter, rejects the explanation that small clinics are to blame. “These people put it on the quacks,” he says, naming a news channel that came to give coverage. “But when we go to the clinics, we buy our own injections from outside. There are quacks across Pakistan, not just here. So why is it happening to children who came to Valika?”
The good news, I am told, is that since the cases surfaced, Valika’s medicine and syringe shortages have ended. Bad news: Staff shortages persist. There still aren’t enough beds for the children.
The real cost
The political workers take me deep into the neighbourhood where I am introduced to a young man who says his niece died of HIV. He has just given an interview to a vlogger. He offers to introduce me to the other family whose child had also died.
But when I met the family and asked the mother about what happened, they did not have any test results to show me that HIV had indeed been detected. A maulvi sahib told them the child had HIV. And I wonder why these families don’t have any way of really knowing what happened.
One of the mothers, a factory worker’s wife, had to go to Indus hospital herself as her husband could not miss daily wage work. She went alone with her sick child. She later told the neighbourhood committee that the travel alone cost her Rs 12,000.
I hear of Sahil’s niece: 14 months old, admitted to Valika with a fever that wouldn’t break. She had it three, four days. Two children in her ward tested HIV-positive. One was in the same bed as his niece.
Sahil didn’t trust Valika’s lab, so he had the whole family tested at Dow. They were all negative, thank God, he said.
What about the child who shared the bed with his niece, I ask. She was sent to Patel hospital.
Akhtar Ali’s niece was born at Valika and was always treated there because her father, a factory worker, was registered with the Benazir Mazdoor Card that makes him eligible for free treatment at a SESSI hospital. The baby was one year old when she developed a persistent fever in April. She was treated for five months and her weight kept dropping. By September 11, she tested HIV-positive.
Her mother claims she saw hospital staff using the same syringe on multiple children.
The baby was tested at a Ziauddin hospital lab and now she is receiving ART treatment at Civil hospital and has gained 2.5kg. Her parents and siblings tested negative.
This has happened before
After the Ratodero outbreak, since 2019, HIV testing has expanded across Sindh and there are over 30 ART centers, almost one per district.
When hospitals find positive cases, they file “zero reports” to the government. These patients then go to the government-run ART centers because treatment is expensive. The government provides it free through the National AIDS Control Program.
The government tests the patients again according to a WHO protocol.
But in Pathan Colony, I am told by the committee’s men that some HIV-positive children were just taken home and are not getting treatment. If true, this is alarming. But I have no way of corroborating.
“Because this is a chronic illness, people think that it happens only sexually,” says Prof. Fatima Mir, the paediatric HIV expert at Aga Khan University. “So parents think that, ‘We have not done anything like this, so how did this happen to my child?'”
What some officials later tell me
I managed to get through to Dr. Zulfiqar Ali Dharejo, the Deputy Director-General of the CDC, but he did not share any confirmed numbers. “We are screening,” is all he could say. “Whatever cases are surfacing are being shifted to ART centres and being treated.” Cases from Valika are being registered at Indus hospital.
Dr Ahsan of the Sindh Health Care Commission added that, “People think quacks when you say HIV.” But quacks are just one reason. The commission keeps shutting them down; they pop up elsewhere. Another risk is infected blood. Families ask relatives to donate rather than paying for screened blood, he says. The donor could have hepatitis or HIV.
He provides another clue: “When a child is infected, it shows at least six months later.” So that could mean that the children allegedly testing positive at Valika hospital and only being treated there because it was on their father’s panel, were infected months earlier.
I learn that the SHCC met Keamari Deputy Commissioner Tariq Chandio and they will team up with the SSP Keamari and DHO to inspect public and private hospitals in a district-wide crackdown against unqualified practitioners.
Meanwhile, the neighbourhood committee says that people are scared and want to get more information. They’re gathering their own data because no one else will but proper clinical testing and assessments can only be done by the government.
