Tetanus claiming lives daily

Ghani Muhammad, 34, is concerned his son, Faraaz, may not survive the injuries he suffered when their house caved in during the quake on 8 October. Faraaz, 6, did not suffer serious injuries. Ghani, and other villagers in their home area close to the town of Battagram, pulled him out from under the debris within 45 minutes. The only injuries inflicted were multiple abrasions on his face and head -and a deep gash running from his knee to his ankle. Doctors at a field hospital stitched the wound five days ago. Faraaz has also been given oral antibiotic tablets. But, Ghani says: "They asked me to pray that he does not get tetanus. I am really terrified, because each day we hear of people who were not all that badly hurt dying from it, as no preventive injections are available here." Indeed, as the Federal Relief Commissioner Major-General Farooq has already acknowledged, there is a critical shortage of the vaccine across the country, and that 100,000 were "required immediately." Pakistan's stockpile of some 4,000 injections ran out many days ago, and doctors across the affected area say the results of this shortage could be disastrous. More vaccines, from Egypt and India have been brought in, but supply is still not sufficient to meet the existing demand. "Tetanus has claimed at least three lives in this Battagram area during the past week. The problem is that people are coming in with infected wounds that have not been treated or even cleaned out with soap and plain water. They could survive the injuries themselves, even now, but the tetanus infection is putting dozens of lives at risk," said Dr Hammad, 24, working at the Battagram field hospital. Dr Hammad, whose previous experience had been in the western city of Lahore, has rarely seen a case of tetanus before. "It is terrible; really painful – and it is so frustrating because just one shot could prevent it," he explained. The government of Pakistan has officially confirmed five deaths due to tetanus. However, doctors on the ground, both in Pakistan-administered Kashmir and in quake-hit northern parts of North West Frontier Province (NWFP), are convinced the toll is much higher. "Our friends in Bagh, told us they have seen two deaths in two days. The same kinds of reports are coming in from everywhere here, I believe the toll must be over a dozen, or perhaps much more," said Dr Saadia Aziz, a medical student who has been working for over a week in various parts of Mansehra district. The fact that even 14 days after the quake, people in the many remote mountain areas have still not received medical aid, is of course contributing immensely to the crisis. "This delay in medical attention is leading to a really grim situation. Even minor injuries are turning septic and claiming lives," Isabelle Simpson, of Medicins Sans Frontieres (MSF) said. MSF teams have also reported tetanus in Pakistan-administered Kashmir, and called for urgent attention to the issue. Meanwhile, at Battagram, new patients are brought in daily from the scattered villages of the area. In some cases, relatives who walked for days to get them to a hospital have carried them down. Those coming in report that many others left behind are also badly injured, their condition worsening by the day. "I know all about tetanus. My brother had to have a shot when his hand was cut at a building site where he worked. But now, hundreds of injured people are still without any treatment, let alone a tetanus shot," said Afzal Khan, who had helped carry in an injured villager from his home over 30 kilometres away, in the mountains of Allai. The fact that most people in the area have never been immunised against tetanus, also, according to doctors, makes them particularly vulnerable to infection. Whereas tetanus is on the list of vaccinations all children are supposed to receive, the programme is not always effectively implemented, especially in more far-flung areas. As such, it is feared the deaths caused by tetanus will continue to rise by the day. If stocks of vaccine are not swiftly distributed to the dozens of field hospitals now set up in affected, and all at risk immunised, the disease will kill many more – and add to the death toll in a disaster that international relief agencies now believe is amongst the worst ever in the world.