KARACHI: It is neither terrorism nor natural disasters but the unavailability of safe drinking water which leads to the highest number of deaths in Pakistan. The discharge of untreated industrial waste, poor sewerage system, agriculture run-off and unplanned urbanisation have downgraded water quality in Pakistan, depriving almost two-thirds of over 200 million Pakistanis of potable water, says a Pakistan Medical Association (PMA) report released on Thursday.

The report sheds light on the health challenges the country faced in the year 2020 and highlights flaws in the government strategy.

It begins with the Covid-19 pandemic, its impact on the whole world and how people in Pakistan responded to it.

“Unfortunately, despite our regular warnings regarding coronavirus nobody acted upon our advice. Even the public has never followed the preventive measures seriously and the government also seems to be failing in implementing SOPs.

“Now the second wave is proving to be more lethal and deadlier as the virus has mutated itself and has become more transmissible and more infectious. It has been observed that people are not getting fully recovered even after being declared negative,” it says.

Safe water remains a dream

One of the most pressing and fundamental health challenges the country faces, the report states, is the non-availability of clean, safe drinking water.

‘Hepatitis B and C are several times more lethal viral diseases than the coronavirus infection and resulting in around 300 to 325 deaths daily’

“It is estimated that, in Pakistan, 30 per cent of all diseases and 40 per cent of all deaths are due to poor water quality. Diarrhoea, a waterborne disease, is reported as the leading cause of death in infants and children in Pakistan while every fifth citizen suffers from illness and disease caused by the polluted water,” the report says.

On the country’s failure to address the issue of poor water quality, it cites the outbreak of XDR-typhoid, which affected people, particularly children, in thousands in Sindh.

“It is a serious water-borne infection caused by the bacterium Salmonella Typhi that spreads through contaminated food and water. The germ has developed resistance to common treatment mainly due to the extensive, unnecessary use of antibiotics.”

The association regrets that polio remains endemic to Pakistan despite over 100 rounds of vaccination carried out in the past decade. “Our anti-polio programme has deteriorated; in 2018 polio programme seemed to be on the brink of eradicating wild poliovirus transmission but unfortunately during the year 2019 as many as 117 cases were reported and in 2020 the tally of polio cases reached 83.

“This shows that we have not improved much. This is very unfortunate that the International Monitoring Board (IMB) observed that there is a lack of political unity behind polio resurgence in the country.”

About government performance vis-à-vis hepatitis, it says an estimated 15 million people are infected with hepatitis B and C while thousands of new patients are being added every year due to lack of prevention, testing and treatment resources as well as poorly screened blood transfusions, improperly sterilised invasive medical devices and unsafe injections.

“Hepatitis B and C are several times more lethal viral diseases than the coronavirus infection and resulting in around 300 to 325 deaths daily in Pakistan, while Covid-19 is causing far fewer casualties than viral hepatitis. PMA believes the main reason for the rising number of hepatitis C cases in Pakistan is the presence of a large number of quacks.”

The association also raises alarm over the growing number of HIV/AIDS patients in the country, which currently stands at 183,000.

“The ratio of spread of HIV/AIDS cases in Pakistan is 57 per cent, similar to the Philippines, which is very alarming. Out of the big number of estimated positive cases, only 25,000 cases are registered. This shows our poor performance. There is a dire need to increase testing capacity to check HIV/AIDS patients.

“The HIV and hepatitis B and hepatitis C are mostly spread through reuse of injection syringes, unsafe blood transfusion and mishandling of hospital waste.”

Published in Dawn, January 1st, 2021