The information appeared in a WhatsApp group of journalists: Eight young children had been infected with HIV allegedly in Karachi’s Kulsum Bai Valika hospital and two were dead. All the journalists were busy calling their contacts in the Sindh government to get confirmation and details. Since I am new to health reports, 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 Valika hospital in SITE, which is located at the top left of the Karachi map. This is where all our big soft drink factories are located, along with the textile factories. Pathan Colony is a katchi abadi with tall, thin buildings just opposite the hospital, accessed through a hole in the wall next to the petrol pump.
When I went to Valika on a Tuesday afternoon, the government hospital was very quiet, which I found strange because it offers free treatment to registered factory workers and their families.
I went up to meet the person who runs the hospital, Medical Superintendent Mumtaz Shaikh. I mentioned the rumors about at least 18 HIV positive children. “We don’t read all the news,” he told 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 head of the hospital
However, the MS goes on to say that first there were two boys, one from Banaras and another from Pathan Colony. Both positive. They were immediately sent to the Indus and Civil hospitals.
Valika alerted the Sindh HIV program on October 22 that all hospitals have standing orders to deal with epidemic-causing diseases. Within 24 hours, detection teams arrived at SITE. According to MS, 35 people sitting at the OPD that day were tested and tested negative.
The hospital also had to inform its monitoring 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. He left the MS because he had just shown me the letter. He says between six and eight children tested positive, I tell him. No 2.
Shaikh slammed the folder shut. “They were not admitted patients,” he replied. “They were people from outside the hospital, from the area.”
Translation: Eight children have HIV. Maybe two are dead. There may still be six out there, somewhere, with HIV.
Sindh’s HIV program is part of the Communicable Disease Control or CDC. I met a young CDC staff member at the MS office, but he also refuses to share information. “It would spread panic. People would be ostracized,” he said.
I try to tell him that I don’t want names. Just numbers. Confirmation only.
“The only thing I can tell you is that the CDC is here,” he says, handing me a pamphlet with an address. “Come here, but they won’t tell you anything.”
neighborhood watch
Rather discouraged, I walk out to the parking lot to think about what to do next. Fortunately, I see a man talking to the CDC staff and I stay behind until he is alone. He introduces himself as Irshad Khan, the local elected representative of Pathan Colony Union Council 1. He also happens to be the chairman of SITE Town’s health committee. He has a thick file of papers.
Irshad Khan has been harassing authorities since August, when the first diagnosis emerged. “We asked Valika for the list, but they don’t give it,” he said. They told the hospital the committee could help by gathering other people in the area for testing.
Irshad has done something quite commendable. He has gotten the rank and file workers of the political party 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 would talk about HIV. People learned that it is not transmitted by touch.
There was Dr. Arman, the pediatrician everyone knew. Now he has 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 thrown into garbage cans. The neighborhood committee has begun collecting its own data. There are ten cases.
Akhtar Ali, a political worker, says: “These people, the hospital staff, are rude. If this hospital was in MQM territory, they would have set it on fire. We have really controlled the people in the area. Nobody wants to come here.”
Usman Ahmed, president of Pathan Colony’s Jamaat-e-Islami chapter, rejects the explanation that small clinics are to blame. “These people put it on the healers,” he says, naming a news channel that came to provide coverage. “But when we go to clinics, we buy our own injections from abroad. There are quacks all over Pakistan, not just here. So why does this happen to children who come to Valika?”
The good news, I’m told, is that since the cases emerged, the shortage of Valika medications and syringes has ended. Bad news: Staff shortages persist. There are still not enough beds for the children.
The real cost
The political workers take me to the neighborhood where they introduce me to a young man who says his niece died of HIV. You just gave an interview to a vlogger. He offers to introduce me to the other family whose son had also died.
But when I met with the family and asked the mother what had happened, they did not have any test results showing that HIV had indeed been detected. A maulvi sahib told them that the boy had HIV. And I wonder why these families have no way of really knowing what happened.
One of the mothers, the wife of a factory worker, had to go to the Indus hospital herself because her husband could not miss daily wage work. She went alone with her sick son. He later told the neighborhood committee that the trip alone cost him Rs 12,000.
I have heard about Sahil’s niece: 14 months, admitted to Valika with a fever that did not subside. He had it for three, four days. Two children from his neighborhood tested positive for HIV. One was in the same bed as his niece.
Sahil didn’t trust Valika’s lab, so he had the entire family tested at Dow. They were all negative, thank God, he said.
What about the boy 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 for the Benazir Mazdoor Card, which allows him to receive 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, he tested positive for HIV.
His mother claims she saw hospital staff using the same syringe on several children.
The baby was examined at the Ziauddin hospital laboratory and is now undergoing ART treatment at the Civil hospital and has gained 2.5 kg. His parents and siblings tested negative.
This has happened before
After the Ratodero outbreak, since 2019, HIV testing has expanded across Sindh and there are more than 30 ART centres, almost one per district.
When hospitals find positive cases, they submit “zero reports” to the government. These patients then go to government-run ART centers because the treatment is expensive. The government provides it free of charge through the National AIDS Control Program.
The government is retesting patients according to a WHO protocol.
But in Pathan Colony, the men on the committee told me 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 corroborate it.
“Because it is a chronic disease, people think it only happens sexually,” says Professor Fatima Mir, a 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 tell me afterwards
I managed to reach Dr. Zulfiqar Ali Dharejo, deputy director general of the CDC, but he did not share any confirmed figures. “We are examining,” is all he could say. “Whatever cases arise, they will be moved to ART centers and treated.” Valika cases are being registered at the Indus hospital.
Dr. Ahsan of the Sindh Health Care Commission added that “people think they are charlatans when you say HIV.” But charlatans are only one reason. The commission continues to close them; appear in other places. Another risk is infected blood. Families ask their relatives to donate rather than pay for blood tested, he says. The donor could have hepatitis or HIV.
And he gives another clue: “When a child is infected, it is noticeable at least six months later.” So that could mean that the children who supposedly tested positive at Valika hospital and were only treated there because it was on their father’s panel, became infected months earlier.
I learned that the SHCC has met Keamari Deputy Commissioner Tariq Chandio and will be partnering with SSP Keamari and the DHO to inspect public and private hospitals in a district-wide crackdown on unqualified professionals.
Meanwhile, the neighborhood committee says people are afraid and want more information. They are collecting their own data because no one else will, but only the government can do proper clinical testing and evaluation.
