Hepatitis is increasing in Pakistan despite efforts by the government as well as by the non-government organisations (NGOs) working for decades to eliminate the disease from the country. We spend only a miniscule fraction of the budget on health, and, therefore, cannot spend much on vaccination against polio and hepatitis.
First, we need to assess the reasons for the spread of hepatitis and then develop a formal action plan. The most important reasons for the spread of the infection are lack of education, use of a syringe for several patients by doctors and nurses, barbers using infected instruments, through sexual contact, and from mother to baby at birth.
An NGO has been working on hepatitis for the last few years in and around Gharo, which is a locality housing the underprivileged. People there have been living with practically no access to healthcare. The NGO has done screening of more than 2,387 people and found 397 to be reactive. Out of 192 positive cases, 146 were treated; 106 completely treated and the remaining still under treatment.
One of the key modes of transmission is from mother to baby at birth. Therefore, there has to be a programme to prevent the transmission soon after the delivery. For this, lady health visitors and midwives may play an important role. They must be aware of pregnant women in their area and their expected date of delivery so that they may vaccinate the child within 24 hours of birth to prevent the transmission of virus.
Another important area of consideration comprises 4.4 million unvaccinated orphans living in various orphanages. The said NGO is coordinating with leading orphan houses in Karachi and drawing up a programme to carry out vaccination of these orphaned children, beginning with Karachi and then moving on to other cities.
The situation will change only if the government spends more money on health, and through preventive measures, like immunisation, which can eradicate hepatitis, polio, measles, tuberculosis and many other illnesses.
A solid commitment on the part of the government and agencies towards primary prevention and healthcare is badly needed, and sincere efforts have to be made to improve the quality of life and decrease morbidity and mortality.
DR ASGHAR NAQVI
KARACHI
