Not a single tap providing safe drinking water in Sindh: experts

Experts at a seminar on Monday blamed the sewage-mixed water being supplied in Sindh, including Karachi as the biggest cause of the spread of Extensively Drug Resistant (XDR) Typhoid and many other waterborne diseases, calling upon the authorities to ensure the provision of safe drinking water to the people.

They urged the common people to adopt precautionary measures, including use of boiled water for drinking, avoid eating and drinking juices outside and wash their hands with soap regularly.

They said that in addition to contaminated water, food and juices sold on the streets and roads were emerging as the second major cause of typhoid among children as mostly boys till 15 years of age were testing positive for the XDR typhoid. They urged the people to visit qualified doctors in case of a persistent fever, stomach upset, vomiting and diarrhea, instead of going for self-medication.

The seminar on “XDR Typhoid – Updates and Management” had been organised by the Pakistan Medical Association (PMA) and it was addressed by infectious diseases experts from Aga Khan University, Shaheeh Mohtarma Benazir Bhutto Trauma Centre Karachi and Indus Hospital. Government officials, including Sindh Secretary Health Saeed Awan, Chairman Sindh Health Care Commission (SHCC) Prof Dr Tipu Sultan, and CEO SHCC Dr Mihaj Qidwai, also spoke.

Secretary General PMA Dr Qaiser Sajjad and Dr Qazi Wasiq moderated the seminar. Dr Sajjad said that this activity was part of the PMA’s public service activities to create awareness and help people take care of their health on advice from experts from the relevant fields.

Speaking as the chief guest at the seminar, Sindh Secretary Health Saeed Awan said unsafe drinking water was a chronic issue in the province and needed to be resolved to prevent diseases, including typhoid. He suggested that the Karachi Metropolitan Corporation (KMC) and Karachi Water and Sewerage Board (KWSB) authorities should be invited to such seminars to answer issues related to the provision of safe drinking water to the people.

He noted that the Sindh government was going to acquire the best available vaccine, i.e. Typhoid Conjugate Vaccine (TCV), through Gavi and earlier they had committed to providing this vaccine by October this year, but on the insistence from the Sindh government, half of the doses of the TCV would be delivered to the provincial government by the end of the next month or the start of May this year.

“In the meanwhile, we are in constant touch with Unicef, WHO and AKU to contain this epidemic, but we don’t want to scare people,” he said and urged the Pakistan Medical Association (PMA) and the media to create awareness among the masses about preventive measures against XDR typhoid and other waterborne diseases.

Saeed Awan maintained that in order to provide better health facilities, the provincial government was spending Rs115 billion annually on health, while it had also activated the Sindh Health Care Commission to ensure that the people got quality health facilities.

One of the experts, Prof Dr Farah Naz Qamar from the AKU, said XDR cases were first reported from Hyderabad in 2016 where contaminated water emerged as the major source of its outbreak. She called for the provision of safe drinking water, creating awareness among the people about the importance of safe drinking water, washing hands and maintaining hygiene and vaccination as measures for prevention.

She further stated that the AKU had carried out a vaccination drive in the Hyderabad following its outbreak, and soon they would be going to vaccinate thousands of children in the Lyari Town of Karachi as they had acquired 70,000 doses of Typhoid Conjugate Vaccine from its only manufacturer.

To a query, she said Pakistani health authorities should talk to major companies of the world which had the capability to produce conjugate vaccine while efforts should also be made for the technology transfer so that Pakistan could produce this much needed vaccine locally.

Another AKU expert, Dr Seema Irfan, observed that around 20 per cent of the population of Pakistan didn’t have the toilet facility while a large number of people did not have access to clean drinking water.

Dr Shehla Baqi from the SMMBB Trauma Center Karachi said blood culture was the golden standard to diagnose the XDR typhoid and urged the authorities to ban Typhidot and other tests, including Widal, as these tests often misled physicians.

Chairman Sindh Health Care Commission Prof Tipu Sultan deplored that not a single tap in Karachi was providing safe drinking water, which was available to citizens some 30-40 years back. He added that the PMA, the KMC and the health department must join hands to start preventive measures so that people could remain safe as there was a lack of resources to treat such a large population.

The head of the diagnostic lab at the Civil Hospital Karachi, Dr Ghulam Fatima, deplored that not a single public lab in the interior of Sindh was performing blood culture to diagnose XDR typhoid and offered her department’s services to train pathologists and microbiologists in blood culture and other diagnostic techniques.