The crisis of infectious diseases grows ever stronger in the country and Sindh is no exception. The latest figures show that dengue and Naegleria have claimed 15 lives each while rabies has killed 18 in the province this year alone.
Sindh Health and Population Welfare Minister Dr Azra Pechuho told SAMAA Digital on Tuesday how the government is handling the situation, what lessons they have learned and what their plans are for the future.
A much needed Infection Prevention and Control (IPC) Committee has been formed, said the health minister, whose task is to carry out baseline surveys in all public sector healthcare facilities, train medical and non-medical staff in the best infection control protocols and monitor whether those protocols are being adhered to.
“We used a checklist to evaluate different hospitals and found that most of our public sector hospitals were not scoring more than 80 out of a thousand,” said Dr Pechuho.
She explained that they scored points for having incinerators to dispose of waste, but lost many more for using them without proper protocols. None of the steps and stages of getting the biological waste to the incinerator were being followed.
Dr Pechuho says the outbreak of HIV in Larkana had alerted them of the urgent need to work on infection control.
So they had started by training professionals who would then train others and bring about a trickle-down infection control effect in the province. Thirty-five trainers have been certified so far who will return to their respective districts and train hospital staff from janitors and paramedics to nurses and doctors.
It will be a slow process but she believes they will see positive results in the long run.
To further strengthen infection control, committees will also be formed in hospitals themselves. These will look after not only waste disposal, but also monitor the use and sterilisation of medical equipment.
The main culprit behind the HIV crisis is the reuse of syringes, the health minister says. She has directed the central procurement committee to make the bulk of syringe purchases, around 80%, autolocked—in which the plunger is locked after a single injection.
“A committee on communicable diseases has also been notified to look at vector-borne diseases,” the provincial health minister told SAMAA Digital in response to a question on the dengue outbreak.
It will comprise infectious disease experts and be headed by health secretary Hafeezullah Abbasi. The World Health Organisation was supporting the initiative and the IPC cell will follow up with its trainers.
Dr Pechuho explained there had been more cases of dengue in urban areas, such as Karachi, as compared to rural districts because of the way freshwater was stored.
The mosquito that spreads dengue, Aedes Aegypti, breeds in stagnant freshwater sources. These include uncovered water tanks, water cisterns, flower pots, buckets and stagnant puddles of rainwater that hadn’t drained properly.
Compared to this, freshwater sources in rural areas were usually not stagnant.
“Even the dengue cases that have been reported in rural areas were from people who came from Karachi,” she added.
Spraying was being carried out, said Dr Pechuho, but it would not cover the inside of homes where people will have to take their own precautionary measures.
Similarly, Naegleria fowleri, the brain-eating amoeba that has claimed 15 lives so far, has also emerged as a Karachi-specific problem.
“Water is not chlorinated at the household level,” lamented the health minister, advising people to use chlorine tablets and avoid inhaling water through the nose until the issue of leaky pipes affecting chlorination was solved.
Lastly, she revealed that the recent cases of tetanus and diphtheria had occurred in children who were not immunised.
Three children have died of diphtheria while tetanus claimed two lives, reported The News on October 11.
“The EPI programme has not been strong in Karachi before. We’re working on strengthening it. I’ve ordered an investigation into the cases to find out who the vaccinators were,” she said.