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FEATURE |
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| PAKISTAN: Focus on Blood Banks
and HIV/AIDS |
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An Intravenous drug user taking drugs on the
streets of Karachi |
Karachi: Jamal Khan is so desperate to fund
his drug habit that he sells his blood and begs in the
streets of Pakistan’s southern port city of Karachi.
"I can’t work, I can’t steal. What else
can I do to buy heroin?" the 35-year-old asked IRIN,
who routinely sells a bottle of blood to one of numerous
blood banks in the North Nazimabad neighbourhood of Karachi
whenever he can - sometimes as often as three times a
month.
His AB negative blood group has a market value of between
US $7 to $10. His wife and two children left him soon
after he stopped working as a taxi driver. "I tried
my best to get rid of this addiction, but nobody helped,"
he said. Although he tested positive for hepatitis many
years ago, he continues to sell blood unabated.
There are thousands like Khan, who sell their blood
as a last resort in order to eat and fund their drug
habit in this South Asian nation. The problem is that
inadequate screening of such blood means that whatever
diseases the substance users may carry - including HIV/AIDS
and hepatitis - are being passed on to the general population.
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| "Some blood banks purchase blood from whomever
goes to them without any proper screening," Saleem Azam,
the president of the Pakistan Society - an NGO working with
intravenous drug users and people living with HIV/AIDS - told
IRIN from Karachi. |
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| The doctor noted there were around 100 blood
banks in the city, but only 20 percent of them did the necessary
screening, thereby becoming channels for the transmission of
diseases. In fact, a large proportion of professional blood
donors like Khan have never been tested for HIV/AIDS. |
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| Azam believed there were half a million untested
people nationwide currently selling bloods. "Intravenous
drug users pose the highest threat of transmitting HIV/AIDS
through blood transfusions," he said. |
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| It is estimated that between 70,000 and 80,000
of Pakistan’s population of 140 million is HIV positive.
Official figures are much lower. Towards the end of last year,
1,942 cases of HIV and 231 of AIDS cases were reported to the
National Aids Control Programme. While heterosexual transmission
accounts for at least 40 percent of reported cases, exposure
to contaminated blood or blood products accounts for about 19
percent. |
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| According to a World Bank report, about 40 percent
of the annual 1.5 million blood transfusions in Pakistan are
not screened for HIV. Whereas screening in the public sector
has made progress, private blood banks lag far behind, with
little enforcement of screening regulations. |
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| In 1998, the AIDS Surveillance Centre in Karachi
conducted a study of professional blood donors and found that
one in five were infected with hepatitis C, one in 10 with hepatitis
B, and one percent with HIV. |
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| Birjees Mazhar Qazi, the national coordinator
for blood transfusions at the National Institute of Health in
the capital, Islamabad, told IRIN that, country-wide, there
were some 170 blood banks in the public sector and 450 in the
private sector. "These facilities are generally unsatisfactory,
with extremes ranging from poor, fragmented services to state-of-the-art
facilities meeting international standards," he said. |
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| Qazi added that in the government-run blood banks,
the situation was much better. It is estimated that more than
90 percent of blood bags in the public sector are screened for
HIV and hepatitis B and C. |
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| "The government is taking the issue very
seriously and has introduced new legislation through the Safe
Blood Transfusion Ordinance last year," he said, adding
that this had initiated the establishment of federal and provincial
blood transfusion authorities, which will ensure that there
are organised, safe, blood transfusion services all over the
country, with an increase in public awareness. |
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| And while the situation is particularly worrying
in rural areas, some feel that there are even gaps in the capital.
"There are insufficient equipment and testing facilities,
and only a few institutions provide adequate safety measures,"
Aftab Alam, a lawyer with the NGO Consumer Rights Commission
of Pakistan (CRCP), told IRIN. |
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| But despite critics saying new legislation on
its own would have little impact, according to Abid Atiq, the
national programme adviser for UNAIDS in Pakistan, the government
was doing its best to improve the situation. "They have
introduced a law for blood transfusion services. Hopefully things
will improve further," he told IRIN in Islamabad. |
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| A visit to the state-run Pakistan Institute of
Medical Sciences (PIMS) Hospital in Islamabad verifies such
claims. About 900 blood donations take place at the hospital
every month. According to Nasrullah Khan, who is in charge of
the blood bank at PIMS, every bag is screened for HIV and hepatitis
B and C |
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| Just back from a ministerial HIV/AIDS conference
in Nepal, where the spread of HIV through blood banks was highlighted,
Pakistan's health minister told IRIN that untested blood was
being eradicated from the system. |
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| "All hospitals by law cannot use the blood
without the tests being carried out," Muhammad Nasir Khan
explained, adding that all blood would be monitored closely
by the health ministry. "We are also encouraging people
to use blood transfusions from relatives," he added. |
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| This feature is sourced with permission
from IRIN, a UN humanitarian information unit, but may not necessarily
reflect the views of the United Nations or its agencies. If
you re-print, copy, archive or re-post this feature, please
retain the credit and disclaimer. Quotations or extracts should
include attribution to the original sources. The copyright is
with UN Office for the Coordination of Humanitarian Affairs. |
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| IRIN (Integrated Regional Information
Networks) is part of the UN Office for the Coordination of Humanitarian
Affairs (OCHA). Born out of the 1994 crisis in the Great Lakes
region of central Africa, IRIN pioneered the use of e-mail and
web technology to deliver and receive information to and from
some of the most remote and underdeveloped places in Africa.
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