Panic after 900 children are positive for HIV

RATODERO, PAKISTAN >> Nearly 900 children in the small Pakistani city of Ratodero were bedridden early this year with raging fevers that resisted treatment. Parents were frantic.

In April, the disease was pinned down and the diagnosis was devastating: The city was the epicenter of an HIV outbreak that overwhelmingly affected children. Health officials initially blamed the outbreak on a single pediatrician, saying he was reusing syringes.

Since then, about 1,100 citizens have tested positive for the virus, or one in every 200 residents. Almost 900 are younger than 12. Health officials believe the real numbers are probably much higher, as only a fraction of the population has been tested so far.

Gulbahar Shaikh, the local journalist who broke the news of the epidemic to residents of his city and the nation in April, watched as his neighbors and relatives rushed to clinics to line up and test for the virus.

When officials descended on Ratodero to investigate, they discovered that many of the infected children had gone to the same pediatrician, Muzaffar Ghanghro, who served the city’s poorest families and appeared to be at the center of the outbreak.

Ghanghro was arrested and charged by the police with negligence, manslaughter and causing unintentional harm. But he has not yet been convicted, and in an interview with The New York Times, he insisted he is innocent and has never reused syringes.

Health officials now say that Ghanghro is unlikely to be the sole cause of the outbreak. Visiting health workers saw many cases of doctors reusing syringes and IV needles. Barbers take the same razor to the faces of multiple customers, they said, and roadside dentists crack away at patients’ teeth on sidewalks with unsterilized tools.

To counter the outbreak, Pakistani authorities in May began shutting down the clinics of unqualified doctors and illegal blood banks — many of which were found to be reusing syringes. Months later, however, some of those clinics had since reopened, locals say.

At least 35 children have died in the area since April 25, according to Dr. Imran Akbar Arbani, who had tipped off Shaikh about the outbreak as he also alerted government authorities.