Needles removed manually from syringes: What health commission found at Pakistan hospital at the centre of HIV outbreak

Concerns have emerged over healthcare standards in Pakistan after allegations of medical negligence and hazardous waste management practices surfaced at a state-run hospital in Sindh.

Dawn on Saturday (local time) reported that the Sindh Healthcare Commission found that needles were manually removed from syringes after use and were not placed in sharps bins at the facility. The incident was reported at Valika Hospital.

Here's what we know

After the lapses were reported, the healthcare commission, in a statement issued on Friday, said, "This raised serious concerns about the hospital’s medical waste management practices, as it was unclear where the removed needles had gone or how they had been disposed of."

According to the report, a team from the Sindh Healthcare Commission (SHCC) visited the hospital to assess compliance with its earlier recommendations. During the inspection, the technical staff was unable to explain how used needles were being disposed of or whether any alternative disposal method was in place.

The healthcare commission also noted that although the hospital management had previously established an Infection Prevention and Control (IPC) Committee, “many important issues were still found during the visit”.

Despite the IPC Committee being in place, the SHCC team found that the procurement of colour-coded bins and auto-disable syringes, along with most of the recommendations, had not been fully implemented.

Citing a statement from SHCC, Dawn reported, “The inspection team noted that no formal IPC training had been provided to the hospital staff. The hospital also failed to present any written IPC guidelines or policies to the SHCC team."

Further, it said that the commission was unable to verify the working condition of the autoclave during the visit. Additionally, the nursing and operation theatre (OT) staff were unavailable during duty hours, making it difficult for the inspection team to assess routine infection control at their duty stations.

It was also revealed that medical waste was not being segregated and disposed of in accordance with IPC guidelines, and the staff showed poor knowledge of safe medical waste handling. Additionally, the private contractor responsible for collecting and disposing of medical waste had not received proper training.

Valika Hospital under scanner after HIV outbreak

Valika Hospital, which is run by the Sindh Employees Social Security Institution (SESSI), has reportedly been in the news following an HIV outbreak, with roughly 78 children found to be infected with the virus. Separately, screening in the nearby area confirmed an additional 120 cases.

Sindh Chief Minister Syed Murad Ali Shah, earlier this week, was informed that several lapses had been reported at Valika Hospital, including non-adherence to infection-prevention protocols and the mishandling of single-use syringes, after two inquiries were conducted into the HIV outbreak.

Shah was informed that at least 37 officers and officials, including former and current administrators, doctors, nurses, laboratory personnel, and support staff, were suspended, and show-cause notices were issued to them on 3 July, asking them to submit their replies within 14 days.

HIV cases in Pakistan

The World Health Organization (WHO) and UNAIDS, last December, identified the HIV crisis in Islamabad as one of the fastest-growing epidemics in the WHO Eastern Mediterranean Region, consisting of 21 countries, with annual infections rising by 200 per cent over 15 years, from 16,000 in 2010 to 48,000 in 2024, Al Jazeera reported.

In a joint statement released on World AIDS Day on 1 December, the agencies estimated that around 350,000 people in Pakistan are living with HIV, with nearly four in five unaware of their infection.

The statement further said that the number of HIV infections among children aged up to 14 years rose from about 530 in 2010 to 1,800 in 2023.

It also highlighted major treatment gaps, noting that only 38 per cent of children living with HIV are receiving treatment, while just 14 per cent of pregnant women who need medication to prevent mother-to-child transmission have access to it.