Outbreak of deadly form of malaria worries medical association

A spate of recent deaths caused by malaria in a rural district of the southern province of Sindh has alarmed the country's medical association which fears a shortage of doctors and indifferent monitoring could lead to further problems, according to a health official. "Reports are coming in from Thar and Shikarpur that [the incidence of] falciparum malaria [a deadly variety of the illness that can cause immediate fatalities] is very high and 17 people have already died in recent months, according to provincial government figures, in Mirpurkhas district," Dr Shershah Syed, the head of the Pakistan Medical Association (PMA), told IRIN from the southern port city of Karachi, the Sindhi capital. But the outbreak was confined mostly to rural Sindh and the neighbouring south-western province of Baluchistan, Syed added. "Punjab and the North-West Frontier Province (NWFP) are not as badly affected," he explained. In some areas of Sindh, the ratio of the occurrence of falciparum malaria was 85 percent while the aim of any anti-malaria programme was to keep the ratio below 10 to 13 percent, Syed maintained. "Falciparum is a big problem. It causes death," he stressed. Karachi, Pakistan's biggest city and coastal metropolis, had not been as badly affected as the rural areas, Syed said. "Karachi hasn't been as badly affected because there are more doctors available in the private sector and patients are able to visit a doctor immediately. Or, perhaps, two or three days later - even that isn't a problem," he said. But the situation in Sindh had worsened, Syed said, because of key government appointments - such as the Executive District Officer (EDO) Health - being delayed and because of the absence of any follow-up to chemists' reports on key issues such as the malaria outbreak. "At the moment, the Sindh health department is in total disarray: there is no EDO Health; no one has been appointed. No one is monitoring the chemists' reports," he fumed. Malaria is estimated to cause at least 50,000 deaths in Pakistan each year. But Sindh is considered even more prone to the disease - along with other illnesses - following huge, rain-fuelled floods that ravaged the southern province during the monsoons last year, causing hundreds of deaths and leaving tens of thousands homeless. A leading Karachi physician told IRIN in August that he feared malaria could become endemic over the next few months because of deep, stagnant flood-water in rural Sindh helping to breed large numbers of mosquitoes.