KARACHI: The Sindh High Court on Thursday directed the provincial government to constitute a committee for an independent, impartial and comprehensive inquiry into the HIV outbreak among children at the Sindh Employees Social Security Institution-run Kulsum Bai Valika Hospital in the SITE area.
A two-member bench headed by Justice Adnanul Karim Memon and comprising Justice Muhammad Jaffer Raza announced its reserved judgement on a petition seeking an independent inquiry, registration of a case, lifelong medical treatment and appropriate compensation for the affected children.
The outbreak was first reported late last year. Screening by the Sindh government found at least 78 children infected with HIV at the hospital, while screening in the nearby area confirmed 120 additional cases. Advocate Tariq Mansoor, who filed the petition in May, claimed the total number of infected children was around 200.
The court observed that departmental proceedings and reports submitted so far had been insufficient to determine the number of affected persons, the source and circumstances of transmission, compliance with infection-control protocols and the Sindh Regulation and Control of Disposable Syringes Act, 2010, as well as the supervisory and individual responsibility of the officials concerned.
It directed that a committee headed by the Sindh chief secretary be formed. The chief secretary should co-opt two senior officers not below the rank of BS-20, preferably with no direct administrative involvement in the hospital or the proceedings under inquiry.
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The committee has been tasked with determining the actual number and particulars of children and other patients found HIV-positive who received treatment at the hospital; the source, circumstances and possible mode of transmission based on medical and scientific evidence; whether disposable syringes or other equipment were reused, improperly disposed of or inadequately sterilised in violation of law and protocols; the existence and implementation of infection-prevention measures; the procurement and use of auto-lock, auto-destruct or auto-break syringes; the role and responsibility of medical, nursing, technical, administrative and supervisory officials; whether any official failed to discharge statutory or supervisory duties; the status of departmental proceedings already initiated against 37 officials; any violations of the 2010 Act or other laws; and measures required to prevent recurrence.
The committee is to examine all relevant records, including medical and laboratory reports, screening data, procurement registers, duty rosters, infection-control reports, inquiry proceedings and CCTV footage where available, while affording a fair opportunity of hearing to any person against whom an adverse finding is proposed. It must submit its report to the competent authority and the high court within two months of its constitution, identifying the factual position and, where supported by evidence, fixing responsibility and recommending departmental, statutory or criminal action under Section 7 of the 2010 Act.
Pending the inquiry, the chief secretary is to ensure that all affected HIV-positive children and other identified patients receive comprehensive, uninterrupted medical treatment, including medicines, investigations, counselling and follow-up care, free of cost at institutions of higher standard as medically appropriate. Expenses are to be borne by the government or SESSI and the arrangement is to continue for as long as medically required.
Given the vulnerability of the affected children, the chief secretary is also to determine and process the entitlement of each affected child or family to compensation, financial assistance or other lawful relief in accordance with the applicable framework and policy, completing the process expeditiously and without unnecessary hardship. Authorities must ensure that no affected child or family is discriminated against, stigmatised or denied assistance on account of HIV status, and that identities and medical information are handled strictly in accordance with law and accepted standards of confidentiality.
The chief secretary and health secretary are to ensure immediate preventive and corrective measures at the hospital to eliminate further risk to patients and strict compliance with the 2010 Act, infection-prevention protocols and other health regulations, framing requisite rules where necessary.
The court noted that the matter concerned the protection of the rights to life, health, dignity and fair treatment under the Constitution and warranted an independent, transparent and evidence-based inquiry. It observed that the constitutional obligation to protect life under Article 9 extends to ensuring effective discharge of public-health and medical-safety responsibilities, particularly towards vulnerable patients, while adding that allegations or departmental proceedings cannot by themselves establish individual culpability, which must be determined on evidence and after due opportunity of hearing.
