Pakistan-Mysterious disease strikes children

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Re: Pakistan-Mysterious disease strikes children

And the story is not over yet. The parents refuse to take the WHO's report, and this article now comes out in the Daily Times. I thought this thread was dead. I'm not sure what happens next, but I'll continue to follow it.

Apparently the WHO report blamed this on many factors, including mostly genetic disease, plus malnutrition and vitamin deficiencies. I believe, based on previous articles in this thread, that the severe fever mentioned in this article is likely typhoid (although could be other infections of the nervous system such as JE or meningitis). Either way, the cases paralyzed by fever do not appear to be recent.

Certainly, many genetic diseases do not manifest themselves until children grow up, and the consistency of the symptoms seems to indicate that perhaps the same genes are widespread in this population, so perhaps many of these children have the same genetic disease.

At least there is no mention of "new" cases, and the description of fever followed by certain paralysis in a week is gone.

The biological contamination in the water is likely E. coli or something of that nature, that might cause some fever, but is unrelated to the paralysis. My reading of the fluoride contamination in Achhro Thar presents a much different picture than this "outbreak", with symptoms like fluorosis on the teeth and things of that nature that are markedly absent here.

Despite this report, I tend to trust the WHO over the parents of these children, but I do admit that the previous article was a bit condescending. At least the Daily Times has stopped yelling "mystery disease".

http://www.dailytimes.com.pk/default.asp?page=2009%5C12%5C19%5Cstory_19-12-2009_pg12_11

Paralysed children of Rehri Goth: ‘Controversial’ WHO report irks parents of victims

By Amar Guriro

KARACHI: The controversial report issued by the World Health Organisation (WHO) about the mysterious disease that caused paralysis of lower limbs in more than 200 children in Rehri Goth, irked the parents of the children and they decided to protest against it.

Around 200 children of different age groups living in Rehri Goth along the coastal belt of the city were reported to be affected with a mysterious disease causing lower limb paralysis.

After media reports of these affected children, a three-member team of the WHO, headed by Dr Soomar Khoso, visited the area and held meetings with 17 afflicted children.

Talking to this scribe one official of WHO Sindh on condition of anonymity, as officials are strictly bound not to talk to media persons on-record, confirmed the news that WHO has issued the said report.

Disclosing details of the report, he said that multiple reasons have been cited as the cause of the disease.

“Some of the children are afflicted with genetic disorders, others have Vitamin D shortage and a few were affected with severe fever causing lower limb paralysis,” he said.

On a question he confirmed that no blood samples were taken to diagnose the actual cause of the disease. “The report was issued on the basis of physical appearance and medical history,” he said, adding that only three samples of tap-water in the area were sent to the WHO laboratory in Islamabad that rejected the presence of fluoride, arsenic and other chemical contamination, however, biological contamination was detected in the water samples. The report also states that close-kin marriages could also be one reason behind the disease.

However, as per local residents, the majority of the population is consuming underground water, and according to the water-quality experts’ fluoride and arsenic contamination in aquifers could be a reason for the diseases, but WHO has not taken the samples of the underground water.

Similarly, Vitamin D deficiency among fisher folk is also debatable because medical experts say they not only have high fish intake, but also spend long hours under the sun, both known sources for Vitamin D.

The parents of the children reacted severely over the report, “We reject genetic disorder to be the reason as most of the children got this disease at the age of 16 and we suppose that the report was issued only to get rid of the patients. Therefore, we are thinking we will protest against WHO at Karachi Press Club,” said Hussain, a fisherman and father of four affected children. Talking about the close-kin marriages, he rejected saying it is not an isolated practice pertinent only to this colony but happens throughout Sindh and other parts of Pakistan. “We demand the government of Pakistan and WHO to go through the detailed medical examination of these children and then start treating them,” he concluded.

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This is a different source, and a strange article. While poverty may be the root cause, it is not an etiology. The last line of this article, combined with blaming poverty suggests that these disabilities may still be being used to draw attention to the background health situation.

http://www.thenews.com.pk/updates.asp?id=94245

Strange disease plagues Karachi locality of fishermen
Updated at: 1025 PST, Wednesday, December 23, 2009
KARACHI: A mysterious disease has come to haunt the fishermen locality Rehri Goth situated in Karachi causing mental and physical handicap to dozens of residents, Geo News reported Wednesday.

Karachi’s backward area of Ibrahim Hyderi and adjoining impoverished Rehri Goth are awash with the spectacles of helplessness and vulnerability at every step.

The 16-year son of Jam Panhon, a resident of the indigent locality Ibrahim Hyderi, his brother and two sisters have turned physically and mentally retarded, shoving also Jam at the threshold of the handicap.

Stricken by surprise and curiosity, when Geo News team arrived in the adjoining Rehri Goth, they were received by the fact that the inexplicable disorder is the plight story of none less than 200 children and adults.

According to social workers, the strange illness has taken in its fold not only children but also the adults.

Geo News team took along Health Consultant Dr Humaira Javed to the impecunious locality. The team found four disabled children lying down in a row on floor in the house of Muhammed Hussain resident of Rehri Goth. The basis of all reasons told by the consultant stipulate the poverty as the root cause of this unexplained disease.

If only the breaths can be termed as life, then these children can be believed to be alive; however, in an era of government by people who raise the slogan of the people’s government, the very thought of nation having future sans healthcare and hygiene sends chills down the spine.

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And an article suggesting the possiblity that this is several diseases.

Also of note is that this source is taking credit for getting the children treatment.

http://www.dailytimes.com.pk/default.asp?page=2009%5C12%5C24%5Cstory_24-12-2009_pg12_4

Efforts to help children of Rehri Goth pay off

KARACHI: Repeated efforts of Daily Times to highlight the woes of around 200 children in Rehri Goth that are suffering from a mysterious paralysing disease and the government’s apathy over the issue, the hard work finally paid off with Sindh Health Minister Dr Sagheer Ahmed visiting the area and assuring the victims’ parents that they would be provided free of cost treatment.

Ahmed later told Daily Times that he met 12 children affected with the disease. He said the children are not suffering from a single disease, but different illnesses. “Some of them are suffering from a genetically inherited disease, while others are afflcited with thalassaemia, rickets and diabetes. We are setting up two camps to ascertain the number of patients and the diseases they are afflcited with,” he said.

It is pertinent to mention that Daily Times was the first one to take the initiative of bringing this issue to public knowledge and subsequently published follow-up stories over how the health authorities were being negligent in dealing with the problem.

Earlier, the Infection Control Society (ICS) arranged a medical camp in Rehri Goth in Bin Qasim Town to ascertain reasons behind the mysterious disease. Medical experts of ICS, including Dr Azra, Dr Saeed Abassi and Dr Khurshad Hashmi, took blood samples of the affected children and physically examined them. The Pakistan Fisherfolk Forum, in collaboration with a medical team of ICS, organised the medical camp in the area, where child specialists examined the children and distributed medicines. A team of the Sindh government and the World Health Organisation (WHO) had also visited the area, but nothing was done for the affected children. amar guriro

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Certainly looking like several factors, if not several illnesses.

http://www.thenews.com.pk/print1.asp?id=214993

Cause of Rehri Goth child paralysis remains contentious



Thursday, December 24, 2009
By By Jan Khaskheli

Karachi

Contrary to the recent findings of an international health organisation, a team of doctors from the Infection Control Society (ICS) has concluded that contaminated water cannot be ruled out as a causative factor for the rampant child paralysis in Rehri Goth.

This revelation from the ICS, which is a non-governmental organisation working on health issues, comes in the wake of recent reports from an international health organisation, which had concluded that contaminated water could not have caused paralysis among children in Rehri Goth. While conceding that the water in the area was contaminated, the organisation had categorically cited Vitamin-D deficiency and genetic factors as the essential culprits.

Dr Azra, who was part of the five-member ICS team, told The News that according to her team?s findings, there are multiple reasons for the disease found in children in the coastal locality. She said that they had initially thought that these cases of paralysis were related to polio, but they were wrong.

Dr Azra linked poverty and lack of health facilities with the problem, and said that the team believed that due to lack of awareness, people did not take their children to hospitals once the symptoms of the disease appeared. As a result, the problems multiplied, leading to paralysis. She added that the ICS team has taken blood samples and conducted other tests for further analysis in order to suggest proper treatment.

Doctors in the ICS team detected a host of causes for the disease among children, and said that they could not overlook the negative impacts of lack of sanitation, contaminated water and deadly chemicals flowing into the nearby sea.

Meanwhile, a Pakistan Fisherfolk Forum (PFF) spokesperson told The News that they have approached the ICS team to set up emergency centres for the rehabilitation of the victims, especially those who the team thinks need immediate treatment. He said that the ICS team agreed to the PFF?s proposal and such centres will be established soon.

The PFF has also received information from the Illyas Jat locality in the same neighbourhood, where at least 15 children are said to be suffering from similar symptoms. The fisherfolk forum has formed a team which will visit all neighbouring coastal localities to ascertain the prevalence of the disease.

The PFF spokesman said that they have already highlighted the issue of increasing marine pollution, but the ?ignorant authorities? are not taking this seriously.

Meanwhile, residents of the area have appealed to the provincial government to look into the matter sympathetically and diagnose the real causes of the disease which has caused immense panic in the entire coastal zone of Karachi.

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Re: Pakistan-Mysterious disease strikes children

Pollution and poor hygiene is also being blamed for an outbreak of skin diseases in the coastal areas of Karachi
Source: http://www.dailytimes.com.pk/default...2-2009_pg12_14


Thursday, December 24, 2009

Skin diseases hit coastal areas of city

Text and photos by Amar Guriro

KARACHI: A large number of people living in the coastal areas of the city, majority of them children and women, are suffering from various skin diseases such as scabies, ectoparasite skin infection and eczema due to polluted water and lack of hygiene.

The residents of these areas are mostly poor fishermen, and according to a local non-governmental organisation, Kalachi Social Viable Association (KSVA), the skin diseases have spread on a vast scale in coastal areas such as Rehri Goth, Ibrahim Hyderi and other areas of Bin Qasim Town.

The organisation has estimated that 1,218 children of 720 families in Ibrahim Hyderi alone have been inflicted with skin diseases. Their initial findings reveal that water pollution and lack of hygiene could possibly be the cause behind the outbreak of the diseases, while a lack of proper state-run healthcare facilities in these areas has worsened the situation.

?Every third adult and second child in Ibrahim Hyderi is suffering from a skin disease and it seems that outbreak is spreading rapidly,? said Dr Taju Nisa Farooquie alias Farah, a doctor at a medical centre run by KSVA.

?Most of the skin disease patients are poor and cannot afford proper treatment, thus their family members also become affected,? said Farah, who attends around 100 patients daily, majority of them suffering from skin diseases.

This scribe visited several affected families and observed that the diseases have reaced epidemic levels in some areas.

A teenager fisherman Imran Dhorai, resident of Kariyani Paro of Ibrahim Hyderi, was born with rashes on his skin.

The rashes became so severe that as he grew up, almost all of his body became covered with strange patches.

The disease rendered him unable to continue his profession as a fisherman and he had started working as a mechanic in an auto garage. The disease also destroyed his social life as he feels strange while mingling with his peers and also feels that he would never get married. ?Sometimes, I can?t even sleep...during summers I feel as if my body is on fire and in winters, scaly pieces of skin shed from my body that feels unbearable,? he told this scribe with teary eyes.

He consulted several doctors and also visited hakeems. He even went to take a bath in natural hot water fountain in Manghopir that is believed to heal skin diseases, but all went in vain.

The disappointed fisherman even resorted to consulting faith healers, but even that did not work.

Another fisherman blamed the increasing sea pollution for the situation and said the pouring of untreated highly toxic effluent directly into the sea has created the problem.

He backed his claim by saying that hundreds of industrial units in the Korangi Industrial Area release effluent directly into Arabian Sea through the Korangi Nullah.

Dr Ashok Kumar, who also works at the KSVA medical centre, said there is a lack of proper hygiene in these areas, and this could be one of the reasons behind fungus infections.

?Most of the residents in these coastal areas are fishermen and therefore lack of hygiene and polluted water could be the reason behind the skin diseases.?

Bin Qasim Town Town Nazim Jan-e-Alam Jamot said there are several families afflicted with skin diseases in his town. ?There are state-run hospitals in these areas, but they lack medicines and proper funding,? he said.

?We are arranging a medical camp in Ibrahim Hyderi for immediate relief of patients,? said Kiran Jamot, a KSVA office-bearer.

Sindh Health Minister Dr Sagheer Ahmed said his department has arranged two camps in Ibrahim Hyderi for the patients.

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I trust this article more than any of the previous ones. This seems like a pretty accurate evaluation of what is going on there. I might put a " - genetic disorders and malnutrition" onto the end of the thread title.

http://www.dawn.com/wps/wcm/connect/dawn-content-library/dawn/the-newspaper/local/16-rehri-children-suffering-from-genetic-disorder-429-hs-03

KARACHI: The Sindh health minister with a team of senior paediatricians paid a visit to a poverty-ridden locality of the metropolis, Rehri Goth, on Wednesday to get first-hand knowledge about the reports that children of the area had become victim of some mysterious ailment.

As a result of the visit, four children of Rehri Goth, aged between four and 10 years, were rushed to the Civil Hospital Karachi, where doctors would evaluate them clinically for treatment.

The head of the paediatric ward-II in the CHK, Prof Iqbal Memon, told Dawn that one of the children was admitted to the intensive-care unit while others were admitted for evaluation and treatment for severe weaknesses, including nutritional weaknesses, anaemia and slow growth.

There had been reports about Rehri Goth, a neglected population of about 30,000 people in Ibrahim Hyderi, that it was haunted by some mysterious diseases.

Health Minister Dr Sagheer Ahmed and his team of doctors visited the locality to know whether it was an outbreak of some disease or something else that made the area children sick.

The minister and his team met and interviewed several persons, who had gathered along with their sick children at a house in Khalifa Para, Rerhi Goth.

Later, he told newsmen that there was nothing mysterious behind the children’s ailment.

He said the children were the victim of genetic disorder, rickets, muscular dystrophy, thalassaemia and other diseases due to ignorance of their parents and the overall environmental and unhygienic conditions.

He said he had interviewed parents and saw the children along with a team of senior doctors, who were of the view that the disorders could have been averted provided the families had the opportunities for any improved education, health and financial resources.

‘However, it is never too late and the government will help these families of fishermen,’ he added.

The health minister said that a camp would be set up again at Rehri Goth on Thursday to ascertain the exact number of children affected by genetic disorders or inherited diseases.

Some independent social and health workers told Dawn that though the disease problems in children existed for last many years, it could be highlighted only in recent months.

‘We need free ambulance service and free physiotherapy for our affected children,’ said some parents. ‘The government should ensure the establishment of fully-fledged health-care centres with doctors and equipped with machines and medicines in our vicinity and other coastal areas as well,’ they added.

Health Secretary Syed Hashim Raza Zaidi, Dr Iqbal Memon, Dr Zulfiqar Bhutta, Dr Abdul Majid, Dr A. D. Sajnani, Dr Saeed Qureshi, Prof Juned Ashraf accompanied the health minister.

The medical superintendent of the CHK, Dr Qureshi, said that a team of doctors had already visited the area and asked the NGOs working in the area to ask the families concerned to bring their children to the CHK for clinical investigations, but no positive development could be noticed.

Dr Iqbal Memon said the affected children were suffering from mental retardation, nutritional weakness, muscular dystrophy, vitamin D resisting rickets, genetic brain dystrophy and infections. ‘I am afraid that a couple of children also suffer from bone dysphasia,’ he said.

Dr Bhutta of the Aga Khan University said that such diseases were also common in other villages, which were facing pathetic health and education infrastructure, across the province and the country. This could be attributed largely to inter-family marriages and there is a need to educate parents on the subject, he added.

Meanwhile, the health minister said in a press release that the treatment and physiotherapy would be provided to all the sick children of Rehri Goth

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http://www.thenews.com.pk/daily_detail.asp?id=215199

Rehri Goth child paralysis



Camp established to assess, treat disease

Friday, December 25, 2009
By our correspondent

Karachi

After a wave of mysterious disorders affecting the children of Rehri Goth, Sindh Health Minister Dr Sagheer Ahmed has ordered the establishment of a camp in the area to assess and treat the ailing children.

A team of doctors from the Civil Hospital Karachi visited Ibrahim Hyderi and met the children of Jam Punnoh to evaluate their condition.

Reports regarding a mysterious disease plaguing the residents of Rehri Goth, had been circulating in the media with no particular cause coming forth. Dr Ahmed visited the area with a team of doctors on Wednesday to find out the real cause of the disease. After interviewing several people in the area the minister later told media persons that the ailment is not mysterious. Rather it is a ?genetic disorder? including other diseases like, thalassemia and muscular dystrophy. Dr Ahmed said that the disease is a result of unhygienic conditions in the area and ignorance of the parents.

The team of doctors, who were present with the minister, was of the view that due to lack of financial resources, education and health facilities the disease had spread so much in the area but said that it?s still not too late as the government will help the families of those infected.

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There is other text in this article, but it deals with H1N1 in Karachi, which is irrelevant to this thread.

http://www.nation.com.pk/pakistan-news-newspaper-daily-english-online/Regional/Karachi/25-Dec-2009/Walk-for-swine-flu-awareness

Medical camp at Rehri Goth
On the directives of Sindh Minister for Health, Dr. Sagheer Ahmed, a medical camp has been established in Rehri Goth to assess and treat the ailing children of the area.
An announcement here on Thursday said that a team of doctors from Civil Hospital Karachi visited Ibrahim Hyderi area and met the children of Jam Punnoh to examine their condition.
Meanwhile, three children of a resident, Hussain have been shifted to Civil Hospital Karachi where they are being treated at the Paediatrics Ward.
It was pointed out that the Provincial Health Minister Dr. Sagheer Ahmed had visited Rehri Goth and Ibrahim Hyderi on Wednesday and ordered for shifting of children of Hussain to Civil Hospital Karachi and evaluation of children of another resident Essa to the Aga Khan Hospital.

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http://www.thenews.com.pk/daily_detail.asp?id=215534

214 patients examined at Rehri Goth

Karachi

As many as 214 patients were examined by the doctors at the medical camps set up at Rehri Goth and Ibrahim Hyderi areas. In an official statement issued on Saturday, it was said that the medical camps were set up on the directives of Sindh Health Minister, Dr Sagheer Ahmed. In all, 77 children were examined by the doctors during the past two days at the medical camp set up at Rehri Goth while 132 youngsters were examined at the camp at Ibrahim Hyderi. Meanwhile, six camps have been established outside the Sindh government hospitals to foster awareness about swine flu. The camps are located outside the Civil Hospital Karachi, Skin Hospital Saddar, Sindh Government Hospital Korangi, Sindh Government Hospital Saudabad, Sindh Government Hospital Liaquatabad and Sindh Government Qatar Hospital Orangi Town.

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Wow. After going silent for a week, the source that started this thread spits out this. Certainly could be arsenic poisoning, but almost every other source had blamed this on genetic defects. Obviously, I can't fully trust this source.

http://www.dailytimes.com.pk/default.asp?page=2010%5C01%5C01%5Cstory_1-1-2010_pg12_10

Health sector largely ignored

KARACHI: The reputation of provincial health department officials was exposed during 2009 that saw several disease outbreaks in the city. The state-run hospitals remained out of medicines during the year and the health department completely failed to manage the situation and provide relief. From the beginning of the year drinking water contamination, acute water shortage remained at the top of the list of water related issues. Arsenic contamination in underground water caused around 200 persons, mostly children, to suffer from lower limb paralysis in Rehri Goth and Ibrahim Hyderi in the coastal belt of the city. Additionally outbreaks of diarrhoea were also reported in the biggest slum area of Karachi. Furthermore, the city has been in a grip of fear from Dengue Haemorrhagic Fever (DHF) and Swine Flu, as the both outbreaks remained in the headlines throughout the year. amar guriro

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And ironically, the other main source in the area also published a year-end review, in which they blame this on malnutrition and genetic disease.

I only posted the appropriate part of this article - much of the rest of this article deals with political issues.

http://www.thenews.com.pk/print1.asp?id=216039

The news that the mystery of the illness that had crippled at least 200 children in the fishing villages of Rehri Goth, on the outskirts of Karachi, has been 'solved' has been presented by the Sindh government as 'good news'. But is this really the case?

Experts say malnutrition, genetic disease and lack of awareness had contributed to the distorted bones and abnormal growths afflicting the children. They say in other villages, many more such children can be found. The images of the children laid out on reed mats is evidence of the extent of the neglect of people and the inability of the state to bring about any improvement in their lives over six decades after the country was created.

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http://www.thenews.com.pk/daily_detail.asp?id=216403

12 more months of broken promises



Saturday, January 02, 2010
By Jan Khaskheli

Karachi

The residents of Karachi?s 129-km coastline begin another year with the same lingering problems of water shortage, inadequate sanitation, and the lack of health and education facilities. The year that ended on Thursday brought nothing substantial for the dwellers of city?s suburban areas except announcements, diseases, increasing pollution and broken promises.

The performance of the health department left much to be desired throughout the year and the indifferent attitude of officials meant that the coastal communities were left at the mercy of all sorts of health problems ? most troublingly manifested in Rehri Goth where 200 children suffered from a crippling disease/disorder that the health officials were clueless about.

Nazim Union Council Gabopat, Keamari Town, Mubarak Sanghu, told The News that a compiled report of the past eight years shows that successive governments had done nothing in terms of development of basic health centers (BHC) and schools ? qualitatively and quantitatively.

Most of the BHCs and schools in the area are not functional. There are four dispensaries meant for the residents of Lal Bakhr, Hussaini Goth, Mubarak Village and Deh Allah Bano and all of them have been closed for years. Though the Mubarak Village dispensary was established about 12 years ago, the provincial health department is yet to appoint a doctor there. This means that in cases of emergency, the residents of these areas have to take patients to hospitals in the Mauripur area, some 30 kilometres away.

In many of these areas, people also revealed that, because healthcare facilities are located far away from the villages, a considerable number of expecting mothers die before reaching hospitals. There is a dire lack of genuine initiatives in these areas. For example, in the case of the Rehri Goth disease/disorder, teams of different government and non-government health practitioners, including one led by the provincial health minister, visited the locality, got blood samples and conducted necessary tests. Yet nothing was done to fight and eliminate the problem.

The area activists told The News that, on the directives of the minister, four affected children of one family were admitted in Civil Hospital Karachi, but the children?s parents had to bear the cost of medicines, which created deep disappointment in the community. While Sanghu did give some credit to Pakistan People?s Party MNA Qadir Patel for launching an electricity project for 35 coastal villages near Hawks Bay, he said that there has been no follow up and the KESC is yet to start the project despite the fact that the entire payment has been made in this regard.

Similarly, he said, a Rs20-million sanitation project for Benazir Quarters in the same neighbourhood has been under process for a long time now, which has raised questions regarding the commitment of the government.

Meanwhile the activists of, Bhit Island and Mubarak Village in Keamari town complained to The News that though legislators and ministers had paid several visits to these localities and made many promises, nothing materialized on the ground.

In this regard, Gadap Town Municipal Officer Gul Hassan Kalmati said that there had been no initiatives regarding water supply, sanitation, road construction and rehabilitation of rural health centers (RHCs) from the provincial or city governments in the town limits during the year 2009. The TMO added that the City District Government Karachi completed two 50-bed hospital projects, one each for Gadap and Memon Goth in 2009, but neither is functional yet.

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The rest of this article is not suitable for FT.

http://www.thenews.com.pk/print1.asp?id=218026

PFF women?s wing leader, Tahira Ali, said that women in the coastal areas do not have access to potable water, and most of their time is wasted by fetching water for domestic needs. In this situation, neither can they keep their homes clean nor can they educate their children, she said.

Ali also linked the mysterious diseases in Rehri Mayan to poverty and restlessness of the mothers, who usually wander in filthy streets and go door to door in search of potable water.

Ruqqaya Usman, a woman from the community, said that the women are the real custodians of some 1,260 small and big lakes and the 350-km-long coastal area of Sindh.