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AIDS: the biggest threat to humanity today.

No one knows the story of Muhammad Raffiqu - a policeman, who has died in the prime of his life when he was only 29. He was the resident of Karachi Company Islamabad and was allegedly a homosexual. No one knows who were the people with whom he had sexual relations. When he was admitted to the polyclinic he was initially diagnosed as a diarrhoea patient. But later when he threw light on his case history the officials of National AIDS Prevention and Control Programme visited him in the hospital. He also apprised them of the details but nothing has so far been done to trace out the where abouts of those who were the major cause of his death. This particular case is enough to show how serious are we in tackling the most fatal disease.

The sources in the National AIDS Programme (NAP) said that in the previous budget an amount of only rupees eight lacs and ten thousand was allocated to the NAP. "Everyone expects more and more from us but with so meagre resources we can only provide technical assistance to the provincial governments other organisations and our own centres all over the country", they said. A NAP official says there is hell of a difference between the reported HIV + /AIDS patients and the estimated number. Almost 40 diagnosed patients have so far died of AIDS infection all over Pakistan.

There are 30 surveillance centres in the country which conduct surveys to know the trends of different sections of the population and the trends of high risk groups. "These reports greatly help us in making future strategies but we cannot only rely on these numbers," he said. The sources said to introduce this programme in the whole country almost 300 million rupees are required. For the year 1993-94, 20 million rupees have been fixed but there is a strong apprehension that even this amount might be decreased in the future. The NAP officials said Moeen Qureshi's government had helped us a lot by providing media facilities. "Before September 1993 the word AIDS was totally prohibited on the electronic media. The only purpose of our media campaign is to create awareness among people about this disease. Later we will also be seeking help from artists to convey the message in a different way", the sources said.

They said the television charges one lac 20 thousand rupees for one minute and in the Prime Time we present this message thrice. They also demanded that television people should not deal with them on commercial basis. The Muslim also contacted the PTV officials on this issue. They said during the Prime Time they telecast three times the advertisement on AIDS on 30 per cent discount. PTV official said "this is a very sensitive issue so we will have to handle it with utmost care and responsibility". This is a community problem. Every person and all concerned public and private organisations must contribute in the awareness campaign. In our society or anywhere else in the world these are always two methods which work. One is to terrify people and the other is to educate them and the process of education should not be prolonged. And if we want to educate people (to provide information through education is a very slow process) then this horror will change into an epidemic. We should not wait for an outer force to help us. We must start an awareness campaign immediately because the increasing number is an alarming and threatening sign for the whole society.

The Ministry of Health has issued a statement in which it says "The situation can even worsen with an overall lack of knowledge about aids in our country. There are many factors which are the main cause of increasing the number of HIV positive/ AIDS patients. These include intravenous drug-use, professional blood donors, misled sexual behaviours and the regular deportation of HIV plus Pakistanis from the Gulf back to Pakistan." The Ministry of Health has taken the first bold and timely step against the deadly virus. They addressed this sensitive issue with a well-thought out "plan of action" in the shape of an AIDS Awareness Media Campaign but "We can't do this while remaining in the limited area and with a strict use of explicit definition the methods of infection".

A doctor of Rawalpindi General Hospital says we should tell people about the cause and ways of prevention and first of all we must define what is AIDS?

AIDS is an abbreviation of Acquire Immune Deficiency Syndrome. If anybody acquires this virus then the immunity of the person is destroyed slowly. The body doesn't resist against any disease as this virus attacks on the white blood corpuscles.

Doctors say everyone should come forward to defeat this deadly disease because individual efforts will not be able to stop this horror. In Pakistan the level on which efforts are being made to deal with this menace is far lower than it should be. in Thailand an NGO person through his efforts has succeeded in establishing a section in the Prime Minister's Secretariat. This issue must be on the top priorities of the government and they should involve the whole nation to encounter this challenge.

An official of the National AIDS Prevention and Control Programme says "here people and governments are afraid of Mullah. We can't offend Mullah because of his social influence on the majority of population". The NAP officials say we can't conduct surveys in red light areas and for this purpose we have to involve non-governmental organisations (NGOs). They helped us in conducting Sero Positive surveys in the high risk groups such as, prostitutes, STDs (Sexually Transmitted Diseases), drug users, trans-sexuals unisex), prisoners, TB patients and truck drivers. The modes of transmission of this fatal infection are: hetrosexual (70.9 per cent), blood transfusion (11.6 per cent), unspecified (8.1 per cent), bisexual (4.7 percent), homosexual (2.3 per cent), drug abuse, injections (1.2 per cent), drug mother to child transfusion (1.2 per cent). The breakdown of the cases by sex shows that 89.5 per cent male get infection while 10.5 per cent female get AIDS infection.

A doctor of Pakistan Institute of Medical Sciences (PIMS) says no rule has been enforced here for the safer blood transfusion. Mostly in blood banks, blood is not screened for other preventable diseases such as hepatitis which is as dangerous as AIDS, the doctor points out. The NAP official informs that 1.5 million units of blood is transfused annually in Pakistan but this is not screened for HIV. Most of the blood available in the market with an AIDS free certificate has actually not been checked or screened" the doctor mentions. These private and public blood banks should ensure through their screening facilities that the available blood is free of HIV, the doctor says. The second alarming mode of the transmission of HIV is blood transfusion. Almost 70 per cent of blood donors are addicts and to fulfil their addiction they can do anything. They are involved in sexual activities for this purpose. Homos or bisexuals use them. So sexual behavior and blood transfusion are interlinked with each other. There must be strong check on blood banks and some kind of legislation should be done to restrict it.

Another doctor of RGH says here in Pakistan to inject heroin and other pharmaceutical drugs in body or in intravenous is not common but slowly this trend will shoot up. Scientific sources say the spread of AIDS points out that by year 2000, the number of AIDS cases is likely to reach 40 million in the world, of which 30 million will be among adults and the rest among children. The same sources say that if the spread of AIDS continues unchecked, with no effective and accessible cure becoming available to those infected, the number is likely to reach uncontrollable proportions. The present situation is not far from what is being apprehendedf or future. The World Health Organisation (WHO) believes that between 300,000 and 500,000 people will suffer symptoms of AIDS every year and almost 1,000 and 1,400 cases a day. The only way to combat the disease is through prevention, slaving off the evil before it strikes and keeping away from the sources of danger.

In order to fight this deadly disease, NAP invited religious leaders to involve them in this awareness campaign. During the seminar they concluded "sale of liquor should be banned altogether because it is the basic cause of all the evils. Ban on prostitution should be strictly enforced, co-education be strictly discouraged and Bazar-e-Husan banned. Other things such as video cassettes and films which introduce obscenity should also be banned immigdiately". Scientist at the University of Bergen have conducted tests which reveal that the natural dye found in plants such as blueberries (bilberries) can prevent the HIV virus from multiplying. Professor Dag E Helland says his team of scientists has discovered unique compounds which could have an immense potential within AIDS research. Chemical tests have shown that the natural dye in blueberries has no toxic effects on the bodys' healthy cells from multiplying.

"This means that with the help of these substances we can develop a medicine against AIDS which has no harmful side-effects", says Helland. He is not surprised that the key to the mystery of HIV might finally come from fruits and berries, as there are countless resources in nature which can be used in a medicinal context.

In December 1993 the Gulf states deported 240 HIV positive and three AIDS patients and in this way within a year number of cases has doubled. The experts say in order to change people's attitudes related to the AIDS patients, direct, clear and precise information on a mass level should be given.
Sero Survey Report
from October 15 to December 10, 1993
High Risk Screened No. of HA/
Groups HIV+VE 1000
Prostitutes 594 8 13.5
STDs 961 12 12.5
Drug Users 659 02 3.0
Trans-sexuals 61 01 16.4
Prisoners 300 04 13.4
TB Patients 600 -- --
Truck Drivers 300 03 10.0
TOTAL: 3475 30 8.6

Some Facts About Hepatitis

Hepatitis which is caused by viruses, and therefore called viral hepatitis (there are many other causes of hepatitis) is of five different types, with different modes of transmission and severity of effects. The ones of major interest these days are Hepatitis A and Hepatitis B, the other less frequent ones being C,D and E. Hepatitis A is the more common type and is usually spread through eating/ drinking infected food or water ie. through Ingestion. Avoidance is based on good personal hygiene, clean cooking and eating practices, and proper supply of potable water and an effective sewage disposal system. There is no vaccine available for preventing this illness.

Hepatitis B is the one causing recent public health concern and is spread through Inoculation (direct introduction into tissue) of infected body fluids blood, sexual secretions, other body secretions) from an individual carrying these viruses. ft is not spread by ingestion (eating/drinking) or inhalation (through breathing). Vaccination available is specifically recommended for:

* People requiring repeated blood transfusions

* Patients on renal dialysis (artificial Kidney) machines

* Sexual partners of Hepatitis B carriers (hetro and homo)

* Children born to Hepatitis B carrier mothers

* Medical staff, - doctors, nurses, laboratory workers

* Illicit drug users (using syringes and needles).

* Young individuals having multiple sexual partners

Transmission is also possible through infected surgical equipment, multiple use syringes, common use shaving razors, ear/nose piercing etc. In case of doubt regarding the need for vaccination, consult your doctor, as all medical decisions need specific evaluation. A blood test (HBs Ag and anti HBs) is required before vaccination, as approximately 10-15 percent of people may not benefit from receiving these injections. Those who are vaccinated must remember that they are not protected against all other types of hepatitis, but only Hepatitis B.
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Author:Aslam, Nabeela
Publication:Economic Review
Date:Sep 1, 1994
Previous Article:Health facilities in Pakistan.
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