SCOTT DETROW, HOST:
In Pakistan's port city of Karachi, at least 140 children have recently tested positive for HIV. The cases aren't linked to high-risk adult behavior but to everyday medical care. This is not the first time Pakistan has seen a surge of HIV infections among kids. And as Betsy Joles reports, it again points to shortcomings in hospital safety.
(CROSSTALK)
BETSY JOLES, BYLINE: Ayesha Aftab took two of her children to Kulsoom Bai Valika Hospital for what she suspected were symptoms of typhoid or malaria. She brought along her youngest, Muhammad Rehan. He was soon flushed with fever too. The doctor on duty suggested an antibiotic injection to knock out Rehan's symptoms faster than a pill or syrup.
AYESHA AFTAB: (Non-English language spoken).
JOLES: "I thought, OK, the doctor knows better," Aftab says. It was then she noticed that injections were being given to child after child.
AFTAB: (Non-English language spoken).
JOLES: "For God's sake, you're giving injections to three or four patients from different families," Aftab recalls saying. "Why are you using injections in this way?" Her children later tested positive for HIV. Dozens of other parents who brought their children to Valika Hospital say their kids now have HIV too. At least six of them have died. Parents accuse hospital staff of spreading the virus by reusing syringes and needles for injections and IV drips.
One father, Syed Mehtab Shah, says he watched a nurse retrieve a syringe from inside a trash can.
SYED MEHTAB SHAH: (Non-English language spoken).
JOLES: "This happened in front of our eyes," he says. Multiple government-ordered inquiries since last November have found safety issues at Valika Hospital, including improper handling of syringes. The department that manages the hospital suspended some staff, and the provincial government promised families financial compensation. But parents say more action is needed. They brought their kids to Valika Hospital in the first place because they could get free care there through a Social Security program that generally serves low-income workers.
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED PROTESTER: (Chanting in non-English language).
UNIDENTIFIED PROTESTERS: (Chanting in non-English language).
JOLES: So on a weekday this summer, families gathered to demand accountability from hospital administration and the government.
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED PROTESTER: (Chanting in non-English language).
UNIDENTIFIED PROTESTERS: (Chanting in non-English language).
AYESHA KAMRAN: (Non-English language spoken).
JOLES: "They're still sleeping," 24-year-old Ayesha Kamran says of those in charge. "They're not waking up because these are the children of laborers. Whether they live or die, it makes no difference to them." Another mother places a hand on Ayesha's shoulder to calm her down.
(SOUNDBITE OF BABY CRYING)
UNIDENTIFIED PERSON #1: (Non-English language spoken).
JOLES: "Enough," she tells her. "Be quiet." Two significant pediatric HIV outbreaks were flagged in Pakistan in 2019 and 2024. They saw many of the same problems now being alleged at Valika Hospital.
FATIMA MIR: There's so many chinks in the armor and so many things in healthcare practice which are suboptimal, they have to be, you know, dealt with in an organized way.
JOLES: Fatima Mir is a pediatric infectious disease specialist at the Aga Khan University Hospital in Karachi. She says without major reforms, more hospitals in the country risk spreading HIV.
MIR: Infection prevention and control is actually the emergency right now.
JOLES: The stakes are high, says prominent activist Zulfikar Ali Bhutto Jr., because in addition to lifelong symptoms, children with HIV face the stigma that can come with a positive diagnosis. He's pushing for education about even the basics, like how HIV can't be spread through touching or sharing food. In many people's minds, HIV and AIDs relate to sex, which can carry shame in Pakistan.
ZULFIKAR ALI BHUTTO JR: Maybe there'll be a cure for HIV soon, but at the same time, most likely these children will have to live with this disease for the rest of their life, as far as we know. So they need to live in a world that is kind to them.
JOLES: For now, discrimination is prevalent. On the way to an interview, NPR received this WhatsApp voice note from the father of two HIV-positive children.
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED PERSON #2: (Non-English language spoken).
JOLES: "How many people are coming with you for the visit?" he asks. "No one in our area knows that our children have HIV." He worried that if too big a group arrived at his house, people might start asking questions. His daughter, Manahil, was already refused admission to school because of her diagnosis. Three of his other daughters were denied admission by association.
UNIDENTIFIED CHILD: One, two, three.
UMAIMA ANSARI: (Non-English language spoken).
JOLES: Another parent, Umaima Ansari, says her 3-year-old son, Hussain, has also been turned away from medical care.
ANSARI: Two.
UNIDENTIFIED CHILD: (Non-English language spoken).
JOLES: Hussain tested positive for HIV following a potential lifesaving operation soon after birth. His family suspects the surgery or a later blood transfusion gave him the virus. Ansari recalls the advice she received after her son was diagnosed.
ANSARI: (Non-English language spoken).
JOLES: "Don't tell anyone he has HIV. People will stop meeting you. People will stop coming over to your house," she says. At home, Hussain receives the opposite kind of attention, says his oldest sister, Rahimeen.
RAHIMEEN: Without him, we are nothing 'cause the love we gave him. He is a star of our house.
JOLES: She looks over at her brother's small body lying on the bed under a whirring fan.
RAHIMEEN: We just love Hussain - don't want him to suffer that much.
JOLES: Hussain's family says they're prepared to fight the judgment he faces outside these walls. They just never imagined his life would be forever altered by medical care meant to keep him healthy.
For NPR News, I'm Betsy Joles in Karachi, Pakistan. Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.