KARACHI: 11 hepatitis centres to start work this month: Rs2.58bn programme
By Mukhtar Alam
KARACHI, July 18: As many as 11 designated centres, including one at Karachi, will start giving treatment during this month to hepatitis patients in Sindh under the Prime Minister’s Programme for Prevention and Control of Hepatitis, according to health officials.
The programme, launched in August last year, has an estimated cost of Rs2.58 billion to be spent over a period of five years. Sindh has been promised treatment resources, including Interferon injection, for 1,740 Hepatitis-C patients in the first phase of the programme which is supposed to continue up to June 2006.
The programme also envisages measures for safe blood transfusion, use of sterilised medical equipment at government and private hospitals and prohibition of the reuse of syringes.
The quarters concerned, mainly the patients already registered by the federal health ministry for treatment, have eagerly been waiting for the centres going operational. “We apprehend that the traditional lethargy of the bureaucracy, lack of capacity at the selected centres and poor publicity of the facility are the factors which can jeopardise the targets set by the planner,” said a keen observer, suggesting that efficient monitoring and evaluation of the centres’ working is a must.
Though there is no sound scientific study about the number of hepatitis patients in the country, it is established that Sindh has the highest rate of unsafe injection, which also contribute, among others, to the rise in Hepatitis-C cases.
According to Sindh health officials, an estimate evolved by the ministry of health suggests that about 3.6 per cent of the population in Sindh is affected with Hepatitis B virus, while 5.4 per cent of the population suffers Hepatitis C. As far as Hepatitis A (a self-limiting disease) is concerned, nearly 97 per cent population has at least one episode before the age of 15.
Holding the PM’s initiatives in a high steam, a health care facilitator noted that the programme needed to be publicised further so that a big majority of the affected people which could not afford proper treatment, could approach the government organisations and centres for a timely relief.
It is learnt that a majority of the centres being established in Sindh lacks basic facilities, proper accommodation and medicine storage facilities. A number of centres are yet to set up the committee with the task of verifying and recommending patients deserving free medicine.
When contacted by Dawn for details of the PM’s programme for Prevention and Control of Hepatitis, Deputy Programme Manager Dr Rana Mohammad Safdar from Islamabad said that the programme was now out of the initial days’ organisational hang-ups.
Against our initial target of 50 centres to be set up in the first year of the programme (2005-2006), we have established 60 centres at different teaching hospitals and district headquarter hospitals throughout the country, which would be made functional in a week or so. He said that every centre would comprise pathological laboratory, diagnostic facilities, physicians and vaccines for scanning and confirmation of hepatitis cases, and delivery of the required medical treatment.
“At the headquarters, Islamabad, we have received about 300 letters from Hepatitis-C patients, including about 100 from Sindh, seeking treatment,” Dr Safdar stated, adding that approval letters had also been sent to selected patients who would now contact their designated cure centre and would be able get medicines free of cost.
He said that there was a commitment to provide treatment to 14,000 Hepatitis-C patients in the first phase in the country, while Sindh would be provided with medicines meant for 1,740 patients. “We are also working for providing treatment for another 500 hepatitis patients in Sindh,” he added.
In reply to a question, he said that in Karachi another hepatitis centre would be established at the Civil Hospital Karachi during 2006-07.
The hospitals where such centres have been established for extension of PM’s programme in Sindh are: Jinnah Postgraduate Medical Centre, Karachi; Civil Hospital Badin; Civil Hospital Sukkur; Civil Hospital Mithi (Tharparkar); Civil Hospital Mirpurkhas; Civil Hospital Dadu; Civil Hospital Jacobabad; Civil Hospital Khairpur; People’s Medical College Hospital, Nawabshah; Chandka Medical College, Larkana; and District Headquarter Hospital, Jamshoro (taluka headquarter Kotri).
The provincial coordinator for PM’s programme, Dr Zulfikar Ali Gorar told Dawn that these hospitals were required to form a committee for provision of drugs. A person from OPD will report to the physician who will refer the case for laboratory tests after the confirmation of lab tests; physician will take the case to a designated committee and get the concurrence.
If the committee agrees, the case will be sent to the provincial coordinator for arrangements of Interferon and Ribavirin through the DG Health Services, Sindh. Mr Gorar further stated that the committees were being formed at different centres. He said that Sindh had already received about 33 per cent of the total requirement of medicines for 1,740 patients from Islamabad.
He said that about 97 cases had been referred to Sindh by the federal unit of the programme and the same would now be considered and examined. Replying to a question, he said that there was some problem regarding scientific storage of the costly medicines, but within 10 days or so, all centres would start handling such patients.
According to experts, Hepatitis-C is a liver disease. The infection spreads when blood or bodily fluids from an infected person enters the body of an unaffected person.
Because symptoms like tiredness, loss of appetite, stomach pain, nausea and vomiting, develop slowly most people with chronic HCV infection do not know they are infected and can unknowingly transmit the virus to others.
The HCV is not spread by casual contact such as hugging, kissing, sneezing, coughing, eating/drinking and using an infected person’s utensils, but it may be transmitted if needles, syringes or other utensils of drug use are shared with an infected patient. Hepatitis may take two to three decades for serious liver damage to occur, experts say, stressing that early detection of HCV is very important as treatment at the early stage proves effective.
