YOU’VE almost certainly heard of Multan’s Nishtar hospital; as south Punjab’s largest public sector hospital, it is visited by thousands of patients every year. Even if you’re not familiar with the hospital, you will almost certainly have heard of an incident that took place in 2022, when a video went viral showing several corpses in various stages of decomposition left to rot on the roof of the hospital.

Some reports claimed that there were 200 to 500 bodies (in reality there were four), and there was furious speculation that these belonged to missing persons allegedly being disposed of with the collusion of hospital authorities. The truth, when it emerged, was less sensational and — in keeping with Pakistani realities — much more predictable.

The bodies were of the unclaimed and unidentified dead and were meant to be stored in special rooms. Instead, hospital staff had, in violation of SOPs, simply dumped them on the roof under the open sky. This was inhuman, shouted the government of the day, while pledging heads would roll. Investigative committees were constituted in classic Pakistani tradition. And in keeping with that tradition, nothing really happened.

And now in 2024, the hospital is once again in the news, and once again for all the wrong reasons.

Nishtar Hospital is once again in the news.

Following the death of a kidney patient, who undertook regular dialysis at the hospital, from HIV-related complications, it emerged that the three dialysis machines reserved for HIV patients had, in fact, been used for the dialysis of kidney patients who were free of the deadly blood-borne virus. The result? At least 30 kidney patients now have HIV, as reported in Asif Chaudhry’s comprehensive story in this paper last week.

By Oct 26, the hospital knew what had transpired, but reportedly tried — again in keeping with tradition — to hush it up. It only came out with the news once a person had died. Worse, when the news spread and patients went and got HIV tests at the hospital, reportedly the results turned out negative. When they went and had the same tests conducted at a private lab, they tested positive. From this, we can only conclude that either the hospital labs are ineffective or falsifying results. For those familiar with how Pakistan’s health system operates, neither possibility is implausible.

For those unfamiliar with the way dialysis is conducted, allow me to explain in light of my own experience as a person with a family member who regularly underwent this treatment: the patient is tested constantly; prior to every session, a comprehensive blood screening is conducted to make sure that the patient does not suffer from a disease, such as hepatitis C, that could contaminate the machines. It appears that this screening was either not conducted, or else conducted in such an unprofessional way that the results would count for nothing.

In addition, patients with renal failure or impaired kidney function are sometimes tested several times a week to make sure that their creatinine and urea levels are in control.

Now, consider this: while the hospital apparently learned of this disaster in October, we have no way of knowing how long this contamination had been in play or how many people have been infected beyond the 30 that have been reported. Those hapless patients would then have gone on to have regular blood tests and procedures which means that the circle of infection would have likely spread beyond themselves, not to mention that many of these would have gone on to expose others, such as spouses or sexual partners, etc to HIV, meaning that the spread may be exponential. Only now is the hospital attempting to track down those who may have been infec­ted, but it’s already too late.

In 2016, the exact same thing took place at Larkana’s Chandka Medical College hospital, where over 50 dialysis patients were infected with HIV. This only came to light when many patients who had undergone dialysis there later sought treatment at SIUT (which follows protocols to the letter), where the virus was detected. As with Nishtar, proper dialysis procedures had not been followed.

And of course, we all (should) remember what happened in Ratodero in 2019, when a local doctor who catered to low-income segments was accused of having inadvertently infected 282 adults and children with HIV through negligence and the unsanitary reuse of syringes and blood transfusion equipment. (The doctor himself was reportedly an HIV patient, having contracted the virus through a blood transfusion after a car accident.) Reporters who covered this story say that while he was certainly at fault, he was also used as a scapegoat to cover for what is in fact a systemic breakdown, as many of the patients he saw may have already been infected elsewhere. Our healthcare sector itself is sick, and no amount of committees is going to heal it.

The writer is a journalist.

X: @zarrarkhuhro

Published in Dawn, November 18th, 2024