Corroding lives

Even hours before the incident, Zahid’s (name changed) thoughts had been centered on the routine, mundane issues of his life. He had only stepped out of his house when something was spattered on the left side of his face, and the next thing he knew he was writhing around on the ground, screaming in agony and excruciating pain.

Now he is in a hospital, awaiting several surgeries, trying to come to terms with the fact that he too was yet another victim of a horrendous acid attack. His facial features have been changed drastically from one side.

There is a lot of work to be done through plastic surgery; his lower lip has melted, his nose has been reduced to only nostrils, and his eye on the affected side is red and watery, left without much sight. He cannot close that eye while sleeping and even his ear lobe has melted.

When he had touched his face at the time of the attack the skin of his hands too was affected, shriveling up in blotchy patches. Rendered almost faceless, the man does not know what to do.

“I never knew how much someone’s life could flip over in a matter of seconds,” he lisps as it is difficult for him to talk. “It was an assault, I know. This acid was not an accident it was directly flung onto me from the side. Even so, I have no idea who could do such a thing; I have no enmity with anyone.”

While he knows it was deliberate, he is still unsure that it was meant for him. It might be an accident, he says; he could have been mistaken for someone else.

ON THE RISE: In the last couple of years, about 1,100 reported cases of acid have come to the forefront, while many others go unreported. The instances of acid throwing have become so much of a trend in the country that the radius of reasons have extended to lengths never thought of before. Revenge, family feuds, honour issues, enmity over property or business, are some of them. But much more common is something as trivial as spontaneous anger. The victims are mostly women, but even men like Zahid have been attacked, proving no one is really safe.

The main reason lies in the unlimited supply and unchecked sale of acid. There is no monitoring and no checking. There are no licenses and absolutely no track or trail of those involved in buying or selling the dangerous liquid.

Prof Dr Farid Ahmed Khan, head of Plastic Surgery at the Mayo Hospital burns ward, where Zahid is admitted, says during 2011 about 237 acid attack cases have come in. Most of these are homicidal in nature, he says, where eight out 10 victims are women. The rest are divided into two other categories: suicidal and accidental, where accidental incidences are relatively higher.

A victim usually lands up in hospital, first thing after an attack, so doctors see them in the worst possible condition. Dr Fareed says cases are sometimes terrible and require about 10 different surgeries only in order to get the person back in proper shape. The cosmetic part does not even count at this stage.

“Availability of acid should definitely be restricted,” he says. “We see all kinds of burn cases here and we know how bad an acid burn can be. To think that people actually throw acid on some one knowingly is a horrible thought. In any case the acid should be at least labeled properly in correct bottles with the level of concentration written on it.”

He recounts an instance where a man burnt himself while performing ablution, because someone had left a water container with acid in it. He says many times acid is kept in mineral water bottles, easily accessible by anyone, even children.

“We receive one acid victim every two days,” he says. “It shows a despicable and growing trend.”

While Dr Fareed counts male chauvinism, spontaneous retaliation and a low conviction rate among the primary reasons of acid cases on the rise, criminologist Dr Khaleel Ahmed says that along with these, the one major reason of women being victims of acid attacks is that they are objectified. “When a person is treated like an object, there are ownership issues, and when that feeling arises, there is a thought pattern which goes along the trail of ‘if I can’t get her then no one else should either.’ This kind of mentality leads to a desire for disfigurement.”

In fact, he says, now male victims are on the rise too.

“Though the reasons for acid throwing are sociological in nature, the cause of the rising cases is also related to a very physical problem: that of easy access to acid,” he says. “Acid attacks are a mindset which must be changed through education. But there is another side; blocking the sale of acid to any ordinary person.”

Dr Khaleel says the Acid Prevention law passed recently in the National Assembly was a seriously needed legislation, but it took too long to bring it about. “In any case, implementation is what is needed more than laws themselves. We do not have any legislative framework that decides that acid should not be sold to every third person on the street. We have no idea who bought acid and why. Almost anyone can sell acid, without needing a license for this. This is a society full of contradictions; we will push for sleeping pills not to be sold over the counter, but when acid, which is deadlier, is being sold over the counter, everyone remains silent.”

Lawyer Javed Iqbal Raja is of the view that the curbs on acid sale will not make a difference. Instead, acid cases should be taken as terrorist acts which will ensure an immediate convictions rate rather than letting the case hang for so long. “Knives and guns are sold too, it just depends on how you use them.”

But Dr Khaleel disagrees.

“The weapon (acid) has already dissolved,” he says. “With knives and guns, the weapon can still be recovered as forensic evidence. Even if it is absent from location, we can mark it as that and try to find it and recover it. But how can acid be recovered? And because it cannot be, it becomes all the more difficult to trace the person who did it. There are no fingerprints, no other DNA sample we can look for.”

He suggests that there should be acid sale licenses with strict criteria.

“Everyone should not easily be given a license. There should be a background check, and that person’s details should be with the related department. A buyer should declare where he is from, why he needs the acid and provide his personal details and CNIC copy to the seller. And if it is a factory that needs acid on regular basis, they should do it through the same person each time.”

Aurat Foundation’s Punjab regional director Mumtaz Mughal says most of the women victims of such attacks come from middle and lower class backgrounds.

“It (acid sale) should fall under excise department which controls chemicals, but does not have acid on their list,” she says.

“The whole problem is that acid legally does not fall under poisonous or dangerous chemicals. Once it is taken as that, there would be less legal issues to face in these cases. We are pressuring excise department into taking this chemical under its protection.”

Meanwhile, Dr Khaleel concurs that conviction rates could rise and victims be given justice if acid attacks were regarded as terrorist acts. “Under the definition of terrorism, this is an act which is carried out by person/s to intimidate a segment of society in order to get their interest safeguarded. A crime against a hapless person is a crime against the state, and this is technically a terrorist activity.”

— PUBLISHED APR 28, 2012 01:07AM

How to save a life

Humongous orange cranes rambled across the hills of debris. Surrounding the site were open-mouthed men and women gazing at the work being done. They were all residents of the neighbourhood, some of them waiting for their own relatives to be brought back from their dusty graves.

It had been four days since the massive explosion at a vet pharmaceutical factory, Orient Labs, but even then people were are buried underneath. The four-storey building collapsed as a gas cylinder suddenly exploded, last week. One of the injured workers, who was hospitalised after rescued from under the rocks and boulders, said that the owner of the factory had told them to leave the gas running after work, so that the cylinders could fill up during the weekend. However, before the gas could be turned off, the cylinder reached full capacity and exploded from the second floor.

All at once, confusion spread through the neighbourhood, when sleeping residents were shaken up to a bomb-blast-like sound and rushed outside palpitating with fear. All emergency services were alerted and rescue work was underway. Victims, who were slowly being brought out, were shifted to the Jinnah Hospital Lahore. Town Municipal trucks arrived to carry the loads of debris from the site. Police cordoned off the site (although in futility) and the morning sun slowly rose to see unprecedented chaos in the area.

Through the confusion, rescue workers arrived promptly and handled the situation expertly.

Workers of several welfare organisations and even political parties were present at the situation, but Rescue 1122’s prompt and anchored response was irreplaceable.

The Urban Search Rescue Emergency Service’s department of Dirt Rescue (DR team) was on the spot from the first morning and continued working through the week, camping on-site.

Some workers were replaced by shifts, but initially, many had not returned home for more than three days. Farooq Ahmed, who is the media officer of the Rescue 1122 Emergency Service, was one of those. Sporting a rescue helmet, thick leather gloves, and his neon-orange uniform jacket, Farooq had been on site since day one of the incident, but still his energy levels were high. Obviously, he said, the scene requires high energy levels. He cannot just dose off ‘at work’.

Training versus ‘presence’

There is a lot more than high energy levels that keep the rescue workers going. First off, they are the only trained workers available for accidents, whether natural or artificial. As Farooq pointed out, they have been trained to be different from other emergency services.

“Training and presence are two different issues,” he said, squinting in the strong sun light. “We are not only on site we also have basic knowledge in coping with the situation.” For instance, many of the victims trapped underground many have incurred serious injuries. Many have already come out with broken bones, and to transfer them to ambulances, rescue workers must have first-aid knowledge of how to free them, lift them, and then carry them to the vehicle. A lay person would lift them without any care and the patient could not only displace a bone, he or she could easily also rupture nerve.”

At the site, the crane lifts some dirt and revolves around to release it in the truck, as if a colossal hand is opening up its fist. Rescue workers have spent entire nights digging for and dragging the area with special equipment in order to clear trapped people as a first priority. They are using cutters, hydraulic cutters, and AK-12s, which have the ability to cut through concrete and steel.

“It doesn’t do a lot of cutting,” said Farooq. “But it does cut out a substantial amount of concrete and is usually used for us to get through.” He clarifies that much of the media have reported that they have been digging through his hands but this was not true. His hands are gloved, not open, and in any case, digging with hands is not right.

One of the men waiting for his relatives couldn’t stand to see much more. He said he has been visiting the site off and on for two days, waiting for his missing relative to come forward, but the rescue workers had been delaying the process. He shouted and yelled, “Can’t you speed up the whole process? I have my niece in there!” A huge throng of people gathered around him, hungry for any kind of ‘gossip’. Muhammad Rafiq, who is the in charge for New Town Society, comprising about 212 houses, stepped forward and tried to silence the man, but it soon turned into a loud verbal argument. Even Farooq was captured into the controversy, but he refused to answer trivialities and in an artful movement, they bring a truck right behind the mob, and tell them to move. The sheer size of a huge vehicle in such a narrow lane immediately disperses the mob, and Farooq manages a triumphant smile. “See the speed with which they stopped this argument? Rescue workers have been trained to handle situations like these too,” he grins. “We know there will be people like him who are stressed and worried and are prone to create noise. We don’t take him personally.”

‘Godsend’

“These workers are a godsend,” said Amanat, one of the residents. He was staying at fringe but helping tired workers by sending tea, biscuits and water in their one tent camp which had been propped up in an empty plot. “We have been watching them work, and it is amazing how someone can do this in such a way. This work is very difficult and it requires a lot of skill and know-how. The best part is they are so decent and polite to the people while working.”

Rafique, the society in-charge, also agreed.

“If it wasn’t for the rescue workers and the way they brought out severely injured people, I think that more people would have died than now. These workers have genuinely rescued and saved victims’ lives,” he said. “Speeding up wont help, it will only cause greater issues.”

Indeed speeding up would only cause the people to be subject to rough movements. Farooq said, if they dig any deeper all at once, the ground could vibrate causing bigger portions of debris to fall on the trapped victims, while scooping up more earth than is appropriate at one time might just, very crudely put, ‘slice a person in half’.

Meanwhile Dr Rizwan Ahmed, who was sitting inside the camping tent spoke about the background of the organisation. His own motivation came from staying in Italy and doing social work there.

“I saw how the Italians worked for their people, and I was very inspired by their rescue teams,” said the veteran doctor, who is also Emergency Officer Operations. “Rescue may have been launched about four years ago, but it has been thought of 15 years ago by those involved in it.”

He described the importance of training which even ambulance drivers receive, something not given priority to in Pakistan. “In our organisation, everyone from the top man to a sweeper is trained. This is without exaggeration.”

Handling victims and experiences

“Handling the victim as a first responder is always most important,” said Dr Rizwan. “We get patients with spinal injuries, to those who are simply shaken because of a traumatic experience. We have to take care of them. But it is not easy.”

Though Dr Rizwan has been a doctor for a long time now, he said that he himself has been shaken by many experiences.

“This building collapse was something which has not really surprised us, because we have been to worse sites. But my worst experience has been on bomb blast sites.”

While on-site difficulties with the building collapse involve collection of mobs which have to be dispersed as they interfere with the work done, the issue is nothing when compared to a bomb-attack site.

“If I speak honestly, I have felt repulsed, afraid, and extremely depressed after seeing victims of bomb blast,” he disclosed. “This may be a terrible accident, but it is still just that: an accident. Man made disasters are so heart rending…when I think that someone actually wanted to kill innocent people like this, it’s terrible to know.”

He talked about the blast at Manawan Academy and Data Darbar.

“I saw this man whose skin, and flesh had all been ripped off by the bomb blast and I could see his teeth. In that state, he was losing his heart beat. I tried my best to revive him, and talk to him, telling him that he was looking good, and motivating him…but it was just so difficult to tell him all that when inside I was feeling terrible about it myself.”

Often people also take advantage of the situation, especially when monetary compensation has to be given. Those with missing family members literally bring along pieces of bones of flesh and ask for money saying those belonged to their family members.

“I was at Data Darbar, and we had to go inside, to pick up roasted, black bodies of victims, slipping over blood on the floors, and we have to remain in our right state of minds at the same time. It is not easy. I did my medical degree 11 years ago, and have come across a lot of cases but the sights at bomb blasts are horrific.”

Including women on the field

Rescue workers are not just limited to men. While men are needed and even preferred for more of the physical labour, in large cases where the work force is little (in the building collapse about 200 workers are on site), women are also included.

In the most recent batch, about 40 young women graduated from the Rescue Academy. Currently, about 67 have been deployed all over Punjab. Four of the women, who had just finished their shift, sat demurely behind the tent and had their tea. They were tired but happy because they had done a day’s work and they like doing what they do.

“I have a daughter and my husband also works here,” said Rizwana smiling cheerfully. “Even other girls who work here are supported by their families to do this kind of job.”

“We have always been passionate about social work,” said Zobia. “And now we have found the right place and the right method of doing it. And we receive intensive training. We are taught climbing, swimming, running, and other activities that are needed for these times. And we are taught in the same class along with boys, so there is no discrimination.”

Even then women usually stay back at the stations to do desk work because of the social taboos that they face in society. For instance, if there is a mob burning tires and people are injured, the presence of women is note likely to make a difference to the rioting public.

However, when need be, and the problem is large and unmanageable, they are called on operation. First aid, medical response, disaster management and most of all psychological counselling are what the female staff of the Rescue team do best. These are general tactics. Other women specialize too, such as in swimming. Zobia is one of these.

“Occasionally, in water disasters, we have to swim in to fish out bodies.”

Their counselling, too, is not restricted to female victims.

“We first introduce ourselves to the victim and tell them why we are there,” said Mariam.

“Then we try to make them talk so they can stray their mind from the disaster. It is important to make them talk so they are not traumatised later. We want people to look at our uniforms and feel safe and secure.”

— PUBLISHED FEB 16, 2012 04:58PM

 

‘Closed rooms will always suffocate me’

LAHORE: Muhammad Anees sits upright on the hospital bed which is stained with the grime from his body. Some of his blood, seeping out from his wounds has also left dark reddish brown spots on the sheet.

His face is markedly swollen, one of his eyes puffed up to the point of a darkly comic sight, surrounding skin tinged with bluish purple bruises.

He has been in hospital since Monday, the day Orient Laboratories, at Multan Road, was reportedly blasted off by a gas cylinder, resulting in at least 21 deaths, and many others feared buried beneath mounds of debris.

Anees recounts his awful experience. He was trapped under a table, which in turn was heaving under the weight of the debris.

A pile of bricks was resting on top of his head which he had eventually gotten rid off, by wriggling out from under them. He could only move his legs, and by ‘paddling’ them up and down, he managed to save some other boys who were trapped in the same room as him.

“Our employer used to tell us to leave the gas on after we left work each Saturday,” said Anees, his lips dry and chapped with dehydration. “He said the gas could be turned off on Monday and over the weekend the cylinder would be filled in.”

But on Monday the cylinder exploded.

The four-storey illegal building, collapsed as a result and the amount of debris of the structure is still piled high even four days after the incident.

Rescue 1122 workers managed to save about 15 to 16 people by Wednesday morning, including a man who had been trapped underneath for 47 hours (and later died), and a 60-year-old woman who came out miraculously almost uninjured, but 21 others died instantly in all probability.

Another patient, Imran, says he could never forget the horrifying experience that he had on Monday. “It was so suffocating; I could not breathe because of the dust and debris I was locked under. I don’t think I can ever forget this. Closed rooms will always suffocate me.”

For Anees, a matter of instant pride was the fact that he had saved his best friend. “As I was wriggling my legs, I let loose my friend Shehryar. I let loose others also in the same way. But I’m lying here feeling good just to know that I saved my best friend.”

As a gesture of gratitude, Shehryar who was not admitted came all the way to meet Anees in hospital.

But, according to some estimates, about eight more people were still buried beneath the debris. Two orange cranes roam around the area like monsters, dragging the soil in order to get rid of the debris, then eventually dig deeper so others can be rescued.

Two women workers are also helping the rescuers by telling them where to dig. They are from the packaging department of the factory and know where most people would be trapped.

Shazia points to the place where, she thinks, some people she knows are trapped.

“I know many people who are still missing,” she says. “One of them was our manager, a complete tyrant who used to take all our hard earned money. She must have learnt her lesson now.”

She says none of them have slept since four days.

“How can we when all our colleagues are stuck in that awful grave? And especially after seeing the dead bodies of our friends being brought out …I remember this boy who we used to call ‘Hero’…he’s gone now,” she says, a tinge of sadness flickers across her face.

Despite the level of death and destruction, not many authorities or political leaders have shown up. Despite the site of collapse falling under a PML-N constituency, Chief Minister Shahbaz Sharif could not visit the site till Wednesday evening.

“It is expected that chief minister will just distribute cash among the bereaved families to stem the situation,” says Ajmal who has lost his sister-in-law in the collapse. “But who can equate the death of our families with money?”

 

— PUBLISHED FEB 10, 2012 06:16AM

Indian fishermen embrace freedom

A row of dead eyes meet the crowd’s stare. They are awed by the reception at the Wagah Border, where they will leave from to go back to their home in India. But while activists stand happily holding rose garlands for them, nothing is mirrored in the expression of these fishermen.

The last time Pakistan freed the Indian prisoners from their jails – mostly in Sindh – was back in November 2008. Now, two years afterwards, some others are being freed, but only as a bait to allow the Indian government to free some Pakistani prisoners too.

If any one is affected by the foreign relations, it is the fisher folk, the poorest people in both India and Pakistan. Often when catching fish at night in open seas, they mistakenly cross over to the other country’s borders. At times it has been a storm that has blown them over. Some die, the others are arrested.

“About 120 known Pakistani prisoners are languishing in the jails of India,” says Lal Khan, a peace activist, who has also written a book pondering over whether the Indo-Pak partition can ever be undone. “Out of these the sentence of 80 is over, the rest are under-trial prisoners.”

In the jails of Sindh, a total of 582 fishermen mainly from Gujrat have been caught and jailed. Iqbal Haider, a renowned human rights activist, says that out of these 456 have completed their sentence, and 128 are under trial, but the fate of 14 others is ‘confusing’. “Out of the ones who have completed their sentence, 100 are being freed today.”

On a harrowing trip, in an ordinary 62-seater public bus, from Karachi, the freed fishermen arrived at the Wagah Border where they had to go through documentation and Customs before they left for the other side. But it is sure that they will never want to turn back. Photographs on their documents from before being jailed show a much more animated face. Though they were crushed under poverty, they were at home and could sail the seas whenever they wanted. Now they say that their boats have been confiscated by the Pakistani authorities and they are going back to nothing.

“I used to earn Rs100 a day,” says Bhupat. “I had left behind a mother and my wife and children. I have no idea how they have been making ends meet. And I have no idea what I will do.”

The only fraction of emotion is shown at this point, when Ashok, who stands behind him in line, interrupts and says, his voice trembling: “What can we do besides fishing? This is all that we have done our lives, it the only business in our villages!”

But the rest of the prisoners, it seems, have taken a solemn oath amongst themselves in revealing anything more.

“Yes we have been treated well by the jail authorities,” say about 10 of the fishermen who were interviewed by Dawn, but it is patently obvious that their eyes betray the opposite. One of them musters the courage to say that during his three years in jail, life was more tolerable in the last two years. But he refuses to say anything more.

Thirty-year-old Dheeru when asked if he had anything to say to the states of India or Pakistan, turned his head away in disgust. Turning back, the dead stare stung as he replied: “It is because of them that our three years have been spoilt, our families have lived in hell, and we have lost our only way of earning income. I would never say anything to these people.”

But Ganda, a younger man in his twenties represents a more optimistic thought pattern, perhaps.

“I request the states of both countries to let go of all the fishermen they have arrested over the years. We are brothers, and we are poor people, and have nothing to do with any hostility in the relations of India and Pakistan. Please! Leave us alone!”

— PUBLISHED SEP 01, 2010 12:00AM

Footprints: Where the Law Fails

As Basra Bibi sits in the courtyard of the Edhi Home, tears constantly well up and her eyes are red and swollen — but she is quiet. Pain is evident in her face as she watches her five-year-old son play with a twig.

“The thing that hurt me most is that it was my parents who kicked me out of their house first, and beat me up, even in the police station,” she tells me.

Read More

Bad medicine

“My father died last week, and now my mother has been hospitalised with the same problem. I swear to God, if something happens to her, I will burn this hospital down,” says Yasmin, as her eyes well up with angry tears. She is among the hundreds of people whose family members have been affected by the contaminated drugs doing the rounds at Lahore’s hospitals.

The news of these mysterious deaths has been doing the rounds since early January, and the current death toll (at the time of reporting) stands at 75, with over 200 patients (from all over Punjab) admitted in Lahore’s Mayo, Jinnah, Services, General and Ganga Ram hospitals. Medicines issued by the Pakistan Institute of Cardiology (PIC) remain the common link among these patients.

While it remains to be proved, common consensus is that the December 2011 batch of the medicine was the main cause of these mysterious deaths. It is feared that of the 46,000 patients to have been issued the medicine (from the latest batch), a large number could have fallen sick and died at home, with the number of hospital cases also feared to rise.

The Services Hospital has, in fact, seen an increase in the number of bereaved relatives, who have been filing in papers for their deceased family members. Coming to terms with the tragedy at hand, carrying certificates of death, they stand around confused and muddled. No one, they say, comes to their help.

Puzzling symptoms “My father was admitted on January 1, after he started throwing up blood,” says Saquib. When his father was admitted, Saquib believes there must have been at least 50 other patients with the same symptoms at the Services Hospital.

“My mother began bleeding from the nose and mouth,” adds Shazia.

“Her face was dark like coal, she couldn’t eat or drink anything, she kept complaining of a dry throat, and her mouth smelled like a decaying corpse…as if something inside her was dying.”

Shazia is back at Services Hospital now, seeking a death certificate for her mother. The registration of her mother’s death may also allow her to receive the compensation money announced by Chief Minister Shahbaz Sharif. The hospitals, however, seem to be avoiding registering any more deaths over the next few days, especially those caused by this mysterious illness. Officials at the hospital, she alleges, are misleading her.

Several grieving relatives have not received death certificates, while others complain that their loved ones were forcibly discharged while they were still seriously ill.

“My father was very sick and weak, with blood in his urine and a constant nose-bleed,” says a young man, requesting anonymity. “But they administered a drip which stopped the vomiting for some time and told us to go home and carry on with the medication. No one bothered to check what was actually wrong. Some days later, my father died.”

Nothing, really, was meant to be wrong with medicines being used by the heart patients since they had been using the same pills for, in some cases, decades. Nothing had happened then, and they fail to understand what is happening now.

Saquib’s father had been admitted by early January, with the symptoms. By mid-January, the death toll had climbed up to 27. Only after January 20, 2012, did the constant media coverage wake up a slumbering Punjab Government and bring it on the forefront, unprepared. At first, tests conducted at a government-run lab showed no irregularities in medicines. However, with increased media coverage, a further test proved the presence of a toxic chemical.

Fatal formula According to sources, a blood-thinning drug called ‘clopidogrell’ was initially believed to be the cause of the mysterious illness. However, reports showed that four to five of the affected patients were not using this drug. Later, it was strongly suspected that “cardiovastan” (brand name, drug formula: Simvastatin), which is a cholesterol-lowering drug was the reason.

The drug, which was being distributed to the patients, is being locally manufactured by Mega Pharmaceuticals.

Drugs, sources say, are tendered by private companies but only after being tested by labs for pre-qualification and are then re-tested before they are paid for – a procedure followed by the manufacturing company.

“Usually drugs are only assembled in Pakistan, with the raw materials being imported from abroad,” says the source. “The raw material used for this batch was perhaps not imported and was instead produced locally, making it sub-standard. Or, the arsenic used in the paint on top of the pill was in excess and resulted in poisoning. We are not sure what the cause is.”

Catching the culprits Among the owners of the factory, who have been sent arrest warrants, one name that is repeatedly emerging is that of a PML-N parliamentarian, who is allegedly the ‘real’ owner of Mega Pharmaceuticals, while the ‘paper-owner’ is someone else, who is also involved in the chemicals business. While the matter remains puzzling, if the allegations are proven to be true, it may turn out to be a case of the Punjab Government trying to cover up the involvement of their MNA. In a more serious development, it has been discovered that another medicine, manufactured by the same pharmaceutical company, is being sold in the same packaging by the name of Megasar (formula: Losartan potassium, with international name Cozaar), which is prescribed for hypertension.

Packaging two drugs in a similar manner is dangerous and misleading, according Dr Asma Zaman Faruqi, one of the United Kingdom’s (UK) top consultant pathologists.

“The two drugs are not similar in their actions and should not be packaged identically,” she says. “Both simvastatin and cozaar have been associated with haematological disorders, one of which isthrombocytopaenia – a condition in which the platelet-count falls, leading to bleeding disorders. It is a rare complication in both the drugs. It also needs to be investigated whether the patients involved were taking any other medicine or substance, which could have interacted with their medication.”

“The patients,” Dr Faruqi says, “could have been taking blood-thinners such as aspirin” and recommends a close study of the outbreak.

Mysterious moves Earlier this week, the Medical Superintendent (MS) at Services Hospital, Dr Rehana Malik was stressing out in her office. Stealing a few minutes away from the pressures of the work outside, Dr Malik was in her office faxing figures to the health secretary of the Punjab Government and arranging for more beds and blankets for the medical wards, where the PIC patients were admitted.

However, in a swift and sudden action, Dr Malik was removed during the night shift by the chief minister, without announcing any replacement.

PML-N spokesperson Khwaja Salman Rafique, who arrived at Services Hospital on Wednesday morning, told reporters that the CM removed Dr Malik since he was not satisfied with the regulation of the wards and believed there monitoring was not up to the mark. Without any further explanation, the MS was nowhere to be found, even by aggrieved relatives, who wanted to carry out the paperwork.

Samples of the medicine, Salman said, had been sent abroad for testing, under the directives of the CM, who had taken ‘serious notice of the situation.’

A police FIR was lodged at the Shadman Police Station under Section-321, and the FIA have already caught four manufacturers, who are currently on remand.

“We must also note that more than 100 people have left and have recovered,” Salman insisted.

Meanwhile, another order issued by the chief minister – to serve the patients free of cost – has gone unnoticed by officials.

“I have to run around to get this injection for a bone-marrow,” says Waheed, whose wife is ill. “It costs about 60 rupees, but with the way things have gone, these people should not charge us with even a paisa.”

His wife has suffered from severe bruises on her skin, and her platelet level is below normal. Many other patients complain of chest pain and lack of oxygen.

Blame game The President of Pakistan Medical Association Punjab Dr Ashraf Nizami, has condemned the CM for his carefree attitude towards health-related issues in the province.

“He (Shabaz Sharif) holds a portfolio of Health Minister, when there should be a separate ministry for this purpose,” says Dr Nizami. “He has failed to make any improvements in the health standards in his province. In fact, this is the second epidemic outbreak during his tenure, where people are dying in dozens,” he adds, referring to the dengue outbreak from last year.

The enquiry committee set up by the CM is headed by Dr Javed Akram, who also owns a pharmaceutical company, called Don Valley Pharmaceutical. “It is technically owned by his wife, but how can we exclude him from the issue?” questions another doctor at PMA.

The 48-member committee’s other members include PIC Chief Executive Professor Muhammad Azhar, Services Institute of Medical Sciences (SIMS) Principal Professor Faisal Masood, Professor Irshad Hussain, Professor Farzana Chaudhry, Professor Bashir Ahmad, Professor Farkhanda Kokab, Additional Secretary Health (Technical) and Dr Muhammad Anwar Janjua.

The hospitals are making attempts to retrieve the contaminated drugs, but some patients or mourning relatives are not complying.

“This is proof that we have in our hand,” says Waheed, pointing to the medicine. “We are going to keep it.”

PPP MNA Uzma Bukhari has vowed to keep the issue active and predominant during national assembly sessions. “We want an unbiased inquiry,” she says.

“It is disgusting the way the CM simply puts price tags on lives by compensating them with money. The man holding both portfolios should at least face the assembly and be held accountable for this crime. He never bothered to attend assembly sessions during the dengue epidemic, and he is still acting as if nothing has happened. The figures are simply alarming,” she adds.

Meanwhile, at the hospitals, patients and their relatives are left in the lurch – not knowing whether to remain hopeful of seeing their loved ones recover from the mysterious, or, to expect the worst.

                                              – PUBLISHED JAN 27, 2012 07:56AM