KARACHI: While malaria is fast spreading in Sindh, the provincial health system is faced with another big challenge and all public and private sector hospitals are put on alert as cholera cases begin to take on the look of an outbreak in the province after around 150 cases of the waterborne disease are confirmed in Karachi.

The situation has set alarm bells ringing for the quarters concerned, who until the last week had been denying any such possibility.

The facts came through in an urgent communiqué sent to all district health officers (DHOs) from the director general of health asking them to ready hospitals under their authority and engage the local communities to combat the growing number of cholera cases.

The letter was sent after the health secretary took a “serious notice of the upsurge in cases of acute watery diarrhoea among children below and above the age of five years”.

Acute watery diarrhoea cases in children on the rise

The DG health wrote to DHOs: “Under the terms of International Health Regulations [IHR] 2005, cholera is one of 34 diseases which are mandatory to be notified. In this context, you are requested to notify any suspected case of cholera, confirmed cases of cholera and any death caused by cholera as per guidelines of IHR 2005.”

When contacted by Dawn, DG of health Dr Muhammad Juman Bahoto said that the health machinery across the province had been moved and apart from assuring better treatment facilities at hospitals, building up resources to meet any upcoming challenge and actively utilising all available resources, the officials concerned had also been asked to engage the community for a solution and result-oriented efforts.

“We have asked the DHOs, to engage and encourage community-based organisations, religious leaders, students and community members for support and sensitise the community to cholera,” he said.

“Regarding the immediate steps, we are making arrangements to establish control rooms as the health facilities and nominate the focal persons to share daily statistics of the cases. The supplies of oral rehydration solution/salts (ORS), zinc, IV Fluids, doxycycline, Trimethoprim / Sulfamethoxazole and relevant medicines and solutions have already been enhanced.”

The fresh alert and reaction came just after within a week as some 150 cases of cholera in Karachi alone sent ripples through the provincial health authorities. Earlier, the Sindh health establishment had brushed aside reports of cholera cases and upsurge in the waterborne diseases in any part of the province.

Many observers, however, see it as a deliberate attempt from certain quarters within the health department to hide the facts and real number of cases just to show ‘all good’.

Speaking to Dawn, Qasim Soomro, a Member of the Provincial Assembly (MPA) from Tharparkar and parliamentary secretary for health, doesn’t rule out this possibility, but believes that such attempts cannot be practiced at higher level and the system devised by the health ministry after so much capacity building doesn’t allow anyone to deceive or mislead the authorities on the top.

“The health minister held a meeting mainly to discuss diarrhoea and other waterborne diseases only a few days ago where she had discussed in details all possibilities,” he said.

“So I don’t think there’s any organised move to conceal the fact for any reason. The moment the situation came to notice of the authorities, measures were put in place, which would start making difference.”

Published in Dawn, April 30th, 2022