A look into the sordid state of Health Care Delivery Systems in Pakistan; Deaths from the so-called “P.I.C Syndrome”; How it has shaken our trust in the pills we buy and the leaders we “TRY” !
On Dec 15, 2011, 56-year old Abdul Ghaffur (AG) reported to Mayo Hospital Lahore with bleeding from his nose. AG was a known patient of Diabetes and also Ischemic Heart Disease (IHD), a condition that leads to heart attack if not managed continually for life. Although he didn’t complain of fever or body aches, and the cold weather didn’t suggest Dengue Fever, yet his Dengue Serology was sent as the City had just three months back recovered from the worst Dengue Endemic. What the Mayo doctors didn’t know was that scores of patients with similar complaints were presenting at all other major tertiary care hospitals Jinnah, Allama Iqbal, Ganga Raam, and Lahore General Hospital. It was a trailer of what was to come in the running month, hordes of heart patients with bleeding from nose, in stools and in vomits, rashes, and various grades and types of skin darkening reported to the Emergency Rooms of the above facilities.
What set these patients from Dengue sufferers was the absence of fever and an abnormally cold spell that was unfavorable to any Aedes Aegypti larval growth. And what bound them was their P.I.C cards and the common illnesses for which they received free medicines from P.I.C. AG’s Dengue Test turned up negative and it took the most skilled Physicians at Mayo almost 19 days (4th Jan, 2012) to realize that AG’s bone marrow(BM) had shut down and he had a mysterious darkening if his face and limbs. By 11th Jan, 2012 a one-off inter-hospital coordination established that all 465 patients belonged to P.I.C. AG died on 15th Jan, 2012 despite the best available care. His White Blood Cells_ the cavalry of human body’s defence against any bug entering it had fallen too low after the BM stopped making them and his Diabetes had further weakened his ability to fight the massive infections that ultimately took his life.
By Jan 26th, 2012 seventy-nine of the ‘465’ patients died. By 2nd Feb, 2012, the count had soared to 130 odd. Almost all of the dead dying because their old age, weakened defences and a bone marrow that failed to regain its functions despite treatment, made fighting the subsequent infections impossible with antibiotics alone. Even today, despite the Royal Free Hospitals’ (Britian) suggested treatment (Leucovorin/Folinic Acid) few more lost their life…
So was the Anti-Malarial Drug, Pyrimethamine the real bugaboo behind this massacre? (as suggested by the Britians’ Medicine & Healthcare Regulatory Agency (MHRA) preliminary findings). Does it explain all the complaints these patients presented with at hospitals or is something else at play? How can our health care professionals miss the classic presentations of Pyrimethamine Toxicity if the patients only suffered its excessive dosing?