The information surfaced on a reporter’s WhatsApp group: eight young children had been infected with HIV, allegedly at the Kulsum Bai Valika hospital in Karachi, and two had died. Every reporter was busy calling their Sindh government contacts for confirmation and details. Being 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 claimed?
It took me a while to reach the Valika hospital in SITE which sits at the top left of Karachi’s map. This is where all our big soft drink factories are located next to textile factories. Pathan Colony is a katchi abadi with tall thin buildings across the hospital, accessed through a hole in the wall by 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 in charge of the hospital, Chief Medical Officer Mumtaz Shaikh. I mentioned the rumors of at least 18 HIV positive children. “We don’t all read the news,” he told me. “And we don’t believe all the news.” Of course I thought. How stupid. He wouldn’t be open to me.
Interview with the hospital manager
The MS, however, goes on to say that at 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 warned the Sindh HIV program on October 22 that all hospitals have standing orders to deal with epidemic diseases. Within 24 hours screening teams came to SITE. According to the MS, 35 people sitting in the OPD that day were tested and found negative.
The hospital also had to tell its watchdog, 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 MS because he had just shown me the letter. It says six to eight children tested positive, I tell him. Not 2.
Shaikh closed the file. “They were not inpatients,” he replied. “They were people from outside the hospital, from the area.”
Translation: Eight children have HIV. Two may be dead. Six may 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 employee in MS’s office, but he also refuses to share any information. “It would spread panic. People will be ostracized,” he said.
I try to tell him I don’t want names. Just talk. Just a confirmation.
“All I can tell you is that the CDC site is here,” he says, handing me a pamphlet with an address. “You go here, but they won’t tell you anything.”
Neighborhood watch
Pretty deflated, I go outside to the parking lot to think about what to do next. Fortunately, I notice a man talking to the CDC worker and hang back until he is alone. He introduces himself as Irshad Khan, the local elected representative of Pathan Colony’s Union Council 1. He also happens to be the chairman of SITE Town’s health committee. He has a big file of papers.
Irshad Khan has been chasing the authorities since August, when the first diagnosis appeared. “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 quite commendable. He has got the grassroots political party workers to form a committee to work on the issue. There is someone from ANP, PTI, Jamaat-e-Islami and PPP.
The city representatives asked Valika to hold a seminar where hospital staff, people from Pathan Colony and grassroots organizations spoke about HIV. People learned that it does not spread through touch.
Dr. Arman, the pediatrician everyone knew, was there. Now he has been transferred to Landhi, I am told.
In the absence of real information, rumors have circulated in the colony. I have shared videos of hospital waste being carried in bins. The neighborhood 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 was on MQM turf, they would have set fire to this hospital. 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 branch, rejects the explanation that small clinics are to blame. “These people put it on the quacks,” he says, mentioning a news channel that came to provide coverage. “But when we go to the clinics, we buy our own injections from outside. There are quacks all over Pakistan, not just here. So why is this happening to children who came to Valika?”
The good news, I’m told, is that since the cases came to light, Valika’s drug and syringe shortages have ended. Bad news: There is still a shortage of staff. There are still not enough beds for the children.
The real cost
The political workers take me deep into the neighborhood 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 what happened, they had no test results to show me that HIV had actually been detected. A maulvi sahib told them that the child had HIV. And I wonder why these families have no way of knowing what happened.
One of the mothers, a factory worker’s wife, herself had to go to Indus Hospital as her husband could not miss the daily wage work. She went alone with her sick child. She later told the neighborhood committee that the journey alone cost her Rs 12,000.
I hear about Sahil’s niece: 14 months old, admitted to Valika with a fever that would not break. She had it for 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 on Dow. They were all negative, thank God, he said.
What about the child who shared a bed with his niece, I ask. She was sent to Patel hospital.
Akhtar Ali’s niece was born in Valika and was always treated there because her father, a factory worker, was registered with the Benazir Mazdoor card that entitles him to 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 continued to drop. On September 11, she tested HIV-positive.
Her mother claims she saw hospital staff using the same syringe on several children.
The baby was tested at a Ziauddin hospital laboratory and now she is receiving ART treatment at Civil hospital and has gained 2.5 kg. Her parents and siblings tested negative.
This has happened before
After the Ratodero outbreak, since 2019, HIV testing has been expanded across Sindh and there are over 30 ART centers, almost one per district.
When hospitals find positive cases, they file “zero reports” with the government. These patients then go to the government-run ART centers because the treatment is expensive. The government provides it for free through the National AIDS Control Program.
The government is testing the patients again according to a WHO protocol.
But in Pathan Colony, I am told by the men of the committee that some HIV-positive children have just been taken home and are not receiving treatment. If true, this is alarming. But I have no way to confirm.
“Because this is a chronic disease, people think it only happens sexually,” says Prof. Fatima Mir, the pediatric HIV expert at Aga Khan University. “So parents think, ‘We haven’t 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 figures. “We’re screening,” is all he could say. “Whatever cases come up are moved to ART centers and are processed.” 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 only one reason. The commission keeps shutting them down; they appear elsewhere. Another risk is infected blood. Families ask relatives to donate instead of paying for screened blood, he says. The donor may have hepatitis or HIV.
He gives another clue: “When a child is infected, it shows up at least six months later.” So this could mean that the children who allegedly tested positive at Valika hospital and were only treated there because it was on their father’s panel were infected months earlier.
I learn that SHCC met Keamari Deputy Commissioner Tariq Chandio and they will team up with SSP Keamari and DHO to inspect public and private hospitals in a district-wide crackdown on unqualified practitioners.
Meanwhile, the neighborhood committee says that people are scared and want more information. They collect their own data because no one else will, but proper clinical tests and assessments can only be done by the government.
