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Since his son was diagnosed with HIV during a massive outbreak of infants and children in Pakistan, Shahzado Shar has often been forced to choose between food and medicine.
In 2019, his 5-year-old son was one of hundreds of people after a whistleblower doctor revealed the scandal of repeated needle use in southern Sindh.
According to the provincial Ministry of Health, the number of patients has increased rapidly. Two years later, the number has exceeded 1,500.
After the disaster, Pakistan’s largest HIV testing and treatment center was established in the rural town of Rotadro to provide life-saving antiretroviral drugs.
However, the affected families must bear the additional expenses incurred due to the disease.
“They told us to go to a private hospital for further examinations, but we did not have enough money,” Schal told AFP, describing how his son continued to have frequent fever, abdominal pain and kidney pain.
In the small village of Subhani Shar, just a few kilometers from La Todro, about 30 children were also infected with HIV.
Pakistan’s public hospitals are mainly located in cities and are often chaotic and inefficient, leaving rural families to rely on private clinics that they rarely can afford, which are often crowded with unlicensed doctors.
Fatima Mir, a pediatrician from Aga Khan University in Karachi, analyzed the data. She said that since the diagnosis, at least 50 children have died.
Mill said that given the malnutrition and poverty of families in the area, she expects this number to be even higher.
Authorities accused a doctor-a popular children’s specialist in La Todro-for causing the outbreak.
Muzaffar Ghangro is currently on bail, and court hearings have been postponed repeatedly, which has made many families angry.
He denied the allegations against him, saying that other doctors blamed him for the epidemic because of his successful practice.
The doctor who first exposed the Sindh dirty needle scandal said that there has been little change since 2019.
“The situation is as bad as it was when the epidemic broke out,” said the whistleblower Imran Akbar Arbani, who called the country’s malfeasance “relentless.”
Abani brought his data about the epidemic to the local media after he discovered an alarming number of HIV babies in La Todro, where he owns a private clinic.
He said the authorities reacted quickly at the time, but the discipline has declined since then.
“In the first three months, quack scammers and unauthorized doctors were banned, and their clinics were blocked, but then they got permission,” he said.
Rafiq Khanani, president and doctor of the Pakistan Institute of Infectious Diseases, stated that the regulations are ineffective or often ignored.
“Regulatory departments only exist in files and offices… In fact, they are invalid.”
After the scandal, the government banned the import of traditional syringes and insisted on using only disposable auto-locking needles and cannot be redeployed.
But a Sindh health official who asked not to be named told AFP that many doctors are circumventing the ban and are still buying cheaper models.
At the HIV testing and treatment center in Rato Dero, patients sit in front of a TV screen and make health care recommendations in local Sindhi.
A frail 20-year-old man sits quietly with his father, waiting for the results of a rapid HIV test.
Pediatrician Mill said that successful large-scale testing can help identify the victims of the crisis and slow down the spread.
But Pakistan must now go beyond important antiretroviral drugs to provide patients with more comprehensive care, Ayesha Isani Majeed, head of the government’s national AIDS control plan, told AFP.
When the sun set in Subanishar, a mother sat on her lap and her daughter had a fever again.
Hakima Shar said that she sometimes forgets to give her 4-year-old child these drugs-these drugs can control the virus and help prevent further transmission, which she often refuses to take.
“We are very poor… I started working as soon as I was in the sun. Who else would give her medicine regularly?” The 25-year-old mother said that she was also infected with the virus.
Many families have never heard of HIV, but now it dominates their lives.
“The government does not provide us with antibiotics or multivitamins, and we cannot afford them ourselves,” she said. “We’re fucked.”
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