74th polio case
Earlier this month, Pakistan confirmed its 74th case of the wild poliovirus type 1 (WPV1) in 2024. Out of three poliovirus variations, wild polio types 2 and 3 have been completely eradicated from the world while wild polio type 1 exists only in Pakistan and Afghanistan. It is gravely dismaying that Pakistan is still having to deal with never-ending cases of the poliovirus, despite repeated countrywide vaccination attempts. Most of the cases have been recorded in the Shikarpur district of Sindh, while Khyber-Pakhtunkhwa only has 1 reported case. The Health Department of Sindh needs to take stricter measures to ensure the safety of its residents and make polio vaccinations easily accessible throughout the country.
Sadia Rauf
Turbat
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Express Tribune
21-04-2025
- Express Tribune
Underqualified doctors head public hospitals
The qualification requirements for job postings ensure that only those applicants possessing the bare minimum academic skills necessary to lead the organization or department towards success in its field of work are considered for the position. Therefore, when the Health Department of Sindh starts appointing underqualified health officers to management level positions, perhaps it is no surprise that the current state of public health in the province is on the brink of collapse. Prior to 2022, the heads of hospitals and health centers across the province were appointed from Grade 20 general-cadre doctors. However, following a high court order, the provincial health department issued a notification stating that future appointments would be made from Grade 20 doctors holding a Master's in Public Health (MPH) degree. According to the Sindh Health Management Service Rules 2022, the Director-General of Health Services, Additional Director-General of Health Services, Deputy Director-General of Health, District Health Officers (DHOs), Medical Superintendents and Additional Medical Superintendents must be appointed from the health management-cadre of Grade 20 officers. However, currently, the health department is unlawfully making appointments of underqualified Grade 19 officers on the basis of political influence and favoritism. An officer from the Health Department of Sindh, speaking on the condition of anonymity, revealed that Grade 19 general-cadre doctors were serving as DHOs across 28 districts in Sindh. According to sources of the Express Tribune, the Sindh Government Saudabad Hospital was previously headed by Dr Pir Ghulam Nabi Shah Jilani, a senior Grade 20 officer from the health management-cadre. Later, he was replaced by a junior Grade 19 officer, Dr Agha Amir from the general-cadre. This decision disrupted the hospital's administrative affairs, making it difficult for patients to access medical treatment. An officer at the Sindh Government Saudabad Hospital revealed, on the condition of anonymity, that an illegal blood bank was operating in the public health facility, while complaints about the unavailability of medicines for patients were also rampant. Similarly, at the Sindh Government New Karachi Hospital, a Grade 19 general-cadre doctor was serving as the Medical Superintendent, despite the position requiring a Grade 20 doctor. Similar was the situation at the Sindh Government Qatar Hospital and Sindh Government Ibrahim Hydari Hospital. Likewise, Grade 19 general cadre doctors have been appointed to other important management level positions in Korangi, District South, District West and Jamshoro. "The Health Management Cadre Rules 2022 state that Grade 20 health management-cadre officers, who have obtained a Master's in Public Health or Hospital Management after completing their MBBS, should be appointed as hospital heads. These officers are capable of developing effective strategies to control the spread of diseases in their districts. Throughout the year, people in the province are at risk of some viral disease," said the officer from the health department. Dr Akram Sultan, a public health expert, opined that the appointment of inexperienced administrative officers to management positions in hospitals was one reason why the health problems facing countless people in rural Sindh remained unresolved. The DHOs and hospital heads serve as the custodians of health. However, health officers seem to be making no effort to eradicate diseases or plan for the future. Therefore, even though billions of rupees are allocated annually for public health, hospitals in rural Sindh still lack facilities for treating complex diseases, forcing patients to travel to Karachi for treatment. Hence, it is crucial to appoint officers who can develop effective strategies to prevent diseases and establish a healthy society," informed Dr Sultan.
Express Tribune
14-04-2025
- Express Tribune
City tops polio vaccine refusal cases
Federal Health Minister Mustafa Kamal said on Sunday that his ministry had issued guidelines for the prevention of the polio virus across the country but emphasised that that eradication of the virus from environment was the responsibility of authorities working at grassroots levels. Talking to media persons after chairing a meeting with the officials of anti-polio in Karachi, Kamal stated that the new phase of anti-polio campaign would commence from April 21. He urged the parents to get their children immunised against the polio virus for the healthy and better future of their children. Kamal revealed that there were 44,000 polio vaccine refusal cases in the country, out of which 34,000 were in Karachi, including 27,000 in the city's East District alone. "Out of them, 15,000 refusals were reported from Urdu-speaking parents and 10,000 from Pashto speaking families in the city," he said. Refuting the perception of polio vaccination's side or negative effects as rumours, he said that the anti-polio vaccination was totally safe and the parents should get their children vaccinated. He added that the vaccination was purchased by Unicef and it handed over by them to the government. The new anti-polio vaccine was announced, as officials said that environmental surveillance detected wild poliovirus in sewage samples from 20 districts of the country, though the data suggested a decline in overall virus circulation. According to the Regional Reference Laboratory for Polio Eradication at the National Institute of Health (NIH), 60 samples were collected from 51 districts. Of these, 25 tested positive for wild poliovirus type 1 (WPV1), while 35 others showed no presence of the virus. The samples that confirmed the presence of WPV1 came from Dukki, Kech, Khuzdar, Lasbela, Loralai, Nasirabad, Pishin, Quetta, Usta Muhammad, Bannu, Kohat, Lakki Marwat, Peshawar, South Waziristan Lower, Bahawalpur, Bahawalnagar, Dera Ghazi Khan, Lahore, Multan, and Rahim Yar Khan districts. Samples from Islamabad, Gilgit, Rawalpindi, Swat, Sahiwal, Nowshera, and others districts tested negative, pointing to improved control measures in several areas. "The trend shows a decline in positive samples and a reduction in virus circulation in many areas," an NIH official said. Pakistan has reported only six polio cases so far in 2025, down from 74 in 2024. Officials credit improved immunisation drives since September last year. "Repeated vaccination strengthens immunity and helps stop the spread," the official added. (WITH INPUTS FROM APP)
Express Tribune
05-04-2025
- Express Tribune
Non-existent health regulation plagues Sindh
In 2005, the last health policy was formulated in Sindh, which concerned the prevention and control of communicable and non-communicable diseases, improvement of maternal and child health, control of malnutrition, establishment of a district health system, regulation of private medical institutions, improvement of medical education, establishment of school health service, and control of illegal use of medicines. After the 18th Amendment, the formulation of a health and drug policy came under the purview of the provincial government. Unfortunately, however, despite the passage of 20 years, the Health Department of Sindh has not been able to formulate a new health policy. During this time, the people of the province have consistently been plagued by infectious diseases and seasonal epidemics including chikungunya, crimean-congo hemorrhagic fever, malaria, dengue, HIV-AIDS, hepatitis, tuberculosis and Covid-19. Although trillions of rupees are released annually for the vertical programs of the Health Department, the lack of a health policy in the province is a clear reflection of the poor coordination among the stakeholders in the public health sector. According to Dr Ikram Sultan, Former Director of Health Karachi, the failure of the government to devise a health policy meant that the Health Department was running on an ad hoc basis, and no targets could be set for the elimination of diseases from the province. "Under a health policy, a time frame is set for the elimination of various diseases and then at the end of the year, the targets are reviewed to see what percentage of the disease has been controlled. Unfortunately, the people of Sindh are forced to live under the influence of various viruses every month and throughout the year. Establishing a healthy society has become a dream. Until or unless, data of diseases is made available, no target can be set for their treatment and eradication," said Dr Sultan, who went on to add that there was no drug policy in Pakistan either. On a separate note, Dr Greesh Kumar, a health expert highlighted the fact that in the absence of a health policy, the infrastructure of hospitals and primary health centers running under the Health Department was also severely affected. "Conversely, public health problems have worsened due to which the pressure of patients at large teaching hospitals has become unmanageable. Therefore, often times patients do not get proper medical attention," revealed Dr Kumar. According to a survey conducted by The Express Tribune, there is no centralized system for collecting data of patients and diseases across various government hospitals. At present, there is a Health Secretary in Karachi, Director of Health Karachi and other district hospitals however, the second important secretariat of the Health Department is established in Hyderabad, which is named the Director General of Health Sindh. The surprising part is that in order to attend the meeting held in the DG office, the staff members have to travel to Hyderabad, which wastes time and fuel. On the other hand, no steps are being taken to improve the healthcare services and facilities at hospitals running under public-private partnerships. Where on the one hand there is a dearth of modern technology, on the other hand the Health Department is constantly facing a shortage of medical staff. Furthermore, there is a lack of government-level training to adapt the staff to modern requirements while no medical research centers are available to address health problems at the primary level. Hence, a strong health policy is essential for the establishment of a healthy society. Not only will a health policy expedite the eradication of diseases but it will also improve the overall public healthcare system in Sindh.
