The Punjab Directorate of Health Services (DHS) seems indifferent to the plight of hepatitis patients despite knowing the fact that the chronic disease has been declared “most prevalent” in Pakistan.
A senior official has pointed out many flaws that are affecting the drive to curtail the chronic viral hepatitis in the largest province of the country.
He told Dawn that the DHS’ Hepatitis Control Programme was practically dysfunctional due to the negligence of the authorities concerned. The number of patients with all types of hepatitis virus was increasing manifold and this upward trend was going unchecked in Punjab, he said.
He cited some reports on the prevalence of this chronic disease that depict an alarming situation in Pakistan in general and Punjab in particular.
According to a recent World Health Organization report, he said, the world had been divided into three zones -- high hepatitis prevalent, intermediate, and low prevalent zones -- and “Pakistan stands in the intermediate zone.”
And it is feared that Pakistan is heading towards the first zone since the government is introducing flawed programme to fight this menace.
Similarly, the report said, all five hepatitis viruses were prevalent in Pakistan.
It said hepatitis A and E infections were endemic due to poor water and sewage systems. “Although the two viral infections occur in their sporadic form, mini-epidemics of hepatitis E occur regularly during monsoon rains and floods due to major contamination of drinking water with sewage.”
The WHO report further said it’s estimated that nearly four million people in the country had been exposed to hepatitis B virus and about eight million to hepatitis C virus. “Hepatitis D virus is prevalent in certain districts of Punjab, Balochistan and Sindh due to the existing hepatitis B cases and low coverage of hepatitis B vaccine in this high-risk population.”
On the other hand, the official said, the gravity of the situation could be judged from the fact that the Directorate Health Services of the largest province (Punjab) was managing hepatitis control programme on the basis of six-year old statistics. “Normally, fresh statistics are believed to be pivotal in devising effective strategies and policies for the success of a programme,” he said.
Gathered by the Pakistan Medical Research Council in a survey carried out in 2007-8, these figures were being communicated by the DHS in the official meetings, ceremonies and seminars as reference, he said. He said the Hepatitis Control Programme was also making strategies and planning on the basis of these ‘outdated’ statistics.
The official said the Punjab government had recently observed a week to create awareness about prevention and cure of hepatitis. The director general health shared statistics of the PMRC 2007-8 survey about the burden of the hepatitis disease in Punjab which shocked the medical and public health experts. The experts were expecting that the department would come up with fresh statistics about the disease’s burden.
Moreover, the official said, the Hepatitis Control Programme, launched in 2006, was being run on the basis of a PC-I despite being an “endemic issue”. The official said instead of making the programme a permanent feature of the health system, the PC-I was being revised every year. The PC-I took at least two to four months for approval every year and during this period the programme remained dysfunctional.
After devolution of the health chapter to the provinces, the federal government had time and again asked the provinces to look after the subject at their level. However, the Directorate made no effort to compile its own data to know the scale or ratio of the patients affected by the virus. “The Directorate has failed to establish authority or body at the provincial level to conduct fresh survey to update it about the actual burden of the diseases including hepatitis,” the official said.
The Directorate has been running the programme without its head for the last few months. Currently, the Punjab DG health is holding the portfolio of its director.
The official said the situation was also disturbing on curative side. “The Polymerase Chain Reaction (PCR) is a relatively simple and inexpensive tool for diagnosing diseases. It is the only reliable method of diagnosing hepatitis C but unfortunately it is available in one teaching hospital – Jinnah Hospital – in Lahore catering a population of more than 10 million people,” he said.
An employee of the Jinnah Hospital told Dawn that the lab was collecting blood samples of only 50 patients daily for diagnosing hepatitis C. He said more than 150 patients visited the lab for this test but the institute’s management had fixed a quota of 50 due to limited budget and manpower.
“We receive blood samples from 8pm to 11am daily,” he said, adding that a PCR test for hepatitis C cost between Rs5,000 and 12,000 in the private sector. He said the hospital lab issued reports against each sample a month after receiving the blood sample due to rush of patients.
Health Secretary Jawad Rafique Malik said the department had various proposals to revamp the directorate. He said after devolution of the health sector to provinces, the Punjab health department had started registration of 100,000 more hepatitis patients from the level of the teaching institutes to the THQ hospitals. Earlier, only 50,000 patients were registered under the Hepatitis Control Programme.
He expressed his annoyance over the presentation of six-year old statistics by the health director general saying the programme management should consolidate data afresh.
Wednesday, November 12, 2014
Pakistan - Lahore : Hepatitis – official machinery counts on ‘outdated’ figures
The Punjab Directorate of Health Services (DHS) seems indifferent to the plight of hepatitis patients despite knowing the fact that the chronic disease has been declared “most prevalent” in Pakistan.
A senior official has pointed out many flaws that are affecting the drive to curtail the chronic viral hepatitis in the largest province of the country.
He told Dawn that the DHS’ Hepatitis Control Programme was practically dysfunctional due to the negligence of the authorities concerned. The number of patients with all types of hepatitis virus was increasing manifold and this upward trend was going unchecked in Punjab, he said.
He cited some reports on the prevalence of this chronic disease that depict an alarming situation in Pakistan in general and Punjab in particular.
According to a recent World Health Organization report, he said, the world had been divided into three zones -- high hepatitis prevalent, intermediate, and low prevalent zones -- and “Pakistan stands in the intermediate zone.”
And it is feared that Pakistan is heading towards the first zone since the government is introducing flawed programme to fight this menace.
Similarly, the report said, all five hepatitis viruses were prevalent in Pakistan.
It said hepatitis A and E infections were endemic due to poor water and sewage systems. “Although the two viral infections occur in their sporadic form, mini-epidemics of hepatitis E occur regularly during monsoon rains and floods due to major contamination of drinking water with sewage.”
The WHO report further said it’s estimated that nearly four million people in the country had been exposed to hepatitis B virus and about eight million to hepatitis C virus. “Hepatitis D virus is prevalent in certain districts of Punjab, Balochistan and Sindh due to the existing hepatitis B cases and low coverage of hepatitis B vaccine in this high-risk population.”
On the other hand, the official said, the gravity of the situation could be judged from the fact that the Directorate Health Services of the largest province (Punjab) was managing hepatitis control programme on the basis of six-year old statistics. “Normally, fresh statistics are believed to be pivotal in devising effective strategies and policies for the success of a programme,” he said.
Gathered by the Pakistan Medical Research Council in a survey carried out in 2007-8, these figures were being communicated by the DHS in the official meetings, ceremonies and seminars as reference, he said. He said the Hepatitis Control Programme was also making strategies and planning on the basis of these ‘outdated’ statistics.
The official said the Punjab government had recently observed a week to create awareness about prevention and cure of hepatitis. The director general health shared statistics of the PMRC 2007-8 survey about the burden of the hepatitis disease in Punjab which shocked the medical and public health experts. The experts were expecting that the department would come up with fresh statistics about the disease’s burden.
Moreover, the official said, the Hepatitis Control Programme, launched in 2006, was being run on the basis of a PC-I despite being an “endemic issue”. The official said instead of making the programme a permanent feature of the health system, the PC-I was being revised every year. The PC-I took at least two to four months for approval every year and during this period the programme remained dysfunctional.
After devolution of the health chapter to the provinces, the federal government had time and again asked the provinces to look after the subject at their level. However, the Directorate made no effort to compile its own data to know the scale or ratio of the patients affected by the virus. “The Directorate has failed to establish authority or body at the provincial level to conduct fresh survey to update it about the actual burden of the diseases including hepatitis,” the official said.
The Directorate has been running the programme without its head for the last few months. Currently, the Punjab DG health is holding the portfolio of its director.
The official said the situation was also disturbing on curative side. “The Polymerase Chain Reaction (PCR) is a relatively simple and inexpensive tool for diagnosing diseases. It is the only reliable method of diagnosing hepatitis C but unfortunately it is available in one teaching hospital – Jinnah Hospital – in Lahore catering a population of more than 10 million people,” he said.
An employee of the Jinnah Hospital told Dawn that the lab was collecting blood samples of only 50 patients daily for diagnosing hepatitis C. He said more than 150 patients visited the lab for this test but the institute’s management had fixed a quota of 50 due to limited budget and manpower.
“We receive blood samples from 8pm to 11am daily,” he said, adding that a PCR test for hepatitis C cost between Rs5,000 and 12,000 in the private sector. He said the hospital lab issued reports against each sample a month after receiving the blood sample due to rush of patients.
Health Secretary Jawad Rafique Malik said the department had various proposals to revamp the directorate. He said after devolution of the health sector to provinces, the Punjab health department had started registration of 100,000 more hepatitis patients from the level of the teaching institutes to the THQ hospitals. Earlier, only 50,000 patients were registered under the Hepatitis Control Programme.
He expressed his annoyance over the presentation of six-year old statistics by the health director general saying the programme management should consolidate data afresh.
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