COMBATING HEPATITIS AND HIV IN SABZI MANDI ISLAMABAD
Al‐Mustafa Development Network |
DEFINITION Hepatitis is the malfunction of liver caused by one of four viruses called A, E, B and C. A and E are the most common forms and usually found common with all human but B and C are the most dangerous and alarming forms of this virus that can cause permanent disability and even death. FORMS OF HEPATITIS Hepatitis A: The malfunction of liver caused by the viral infection of Hepatitis A is found normally in children and young adults. The virus is transferred to human body by the infected, blood, water and food. The human body in feces excretes this virus. Therefore lack of proper drainage of waste water is one of the most prominent reasons of its epidemical spread. Boiling and filtering of drinking water may prevent human from this infection. The defense mechanism of the body implicitly detects and overpowers the virus in two to six weeks. That’s why the death rate of infected patient is very low for Hepatitis A. Hepatitis E: The epidemiological spread and preventive measures of this virus are the same as those for hepatitis A. However, this viral infection is particularly dangerous for pregnant women. Therefore thirty percent of such patients die while others do recover in two to six weeks without any medication. Hepatitis B: HBV is transmitted to a human body through blood or body fluids of an infected person in the same way as Human Immunodeficiency Virus (HIV). The mode of transmission of HBV is vertical (means from mother to newborn baby), blood transfusion, unsafe injection, and unsafe sexual contact with an infected person. Hepatitis C: HCV is transmitted primarily through direct contact to human blood through unscreened infected blood transfusion, reuse of needles, syringes and other medical or shaving equipment, syringe sharing of drug addicts. Its severe form is cirrhosis of liver, chronic hepatitis and liver cancer. HIGH RISK AREAS As indicated a person may get infection of Hepatitis from the following sources; 1. 2. 3. 4.
Unclean drinking water Unhygienic conditions Intravenous drug usage Reuse of shaving blade
5. Unsafe sex If we look around there are many areas where sources of Hepatitis are prevalent like congested areas of markets, bus stations, slums and larger migrant settlements. Poor public health facilities and congestion contributes to the vulnerability of people living at such places to the infection of Heaptitis. SABZI MANDI ISLAMABAD Sabzi Mandi situated at a corner of Federal Capital Islamabad appears to have high rate of Hepatitis. Mandi’s apparent picture clearly speaks about the prevalence of Hepatitis. Sabzi Mandi is a hub for the vegetable and fruit trade from all over Pakistan. All areas of Azad Jammu & Kashmir and some portions of NWFP and Punjab use this market directly or indirectly. Fruits and vegetables from across Pakistan is transported here in bulk and then transported to other areas making this Mandi the largest in upper Punjab region. However, Sabzi Mandi has very poor conditions of water supply, sewerage and waste management. People working in Sabzi Mandi belong to different areas of Pakistan and AJ&K. We can distribute people in Mandi as follows; 1. 2. 3. 4. 5.
Aarhti (person who buy directly from growers) Shopkeepers (person who buys from Aarhti and sell to outdoor/indoor sellers) Transporters (person who transport the goods from and to Mandi) Laborers (person who serve for loading and unloading of goods) General customers
An approximate number of people directly associated with Mandi are 20000. However there are some 10000 people who are living inside or near Mandi belong to NWFP, Punjab and AJ&K. Major proportion of these people are laborers who live jointly in single rooms and homes so as to save some money. Majority among this group is illiterate and fall in risk group that can easily contract Hepatitis and even HIV. CURRENT ACTIVITY Keeping in view the outlook and apparent picture of Sabzi Mandi, ADN decided to conduct a baseline study to guess about the major causes of the prevalence of Hepatitis and HIV; and the level of understanding among people about this disease. Banners and placards were displayed with messages related to Hepatitis and HIV.
It is carefully estimated that 40% of Mandi workers are suffering from some kind of Hepatitis and maximum number of labor class use self medication to cure minor illnesses. These estimated findings are based on the informal discussions, questionnaire findings and interactive community dialogues. In the presence of such a alarming situation, ADN decided to launch an awareness campaign in the Mandi to raise awareness level among people about Hepatitis and HIV. ADN’s awareness campaign helped increase general awareness level about understanding Hepatitis and HIV. It also sparked a response among minor ill individuals to get their blood tested for any sign of deadly diseases. To further sensitize ADN has conducted 15 awareness sessions with participation of shopkeepers and laborers. More than 500 persons have participated in these sessions where they were told about the causes and consequences of Hepatitis and HIV. They were told how to avoid such diseases and what precautions they must adopt. After these sessions a training workshop with participation from representative union of Sabzi Mandi and shopkeepers was held where they were mobilized to spread the information among other workers, staff and family members. FUTURE PLANS As plan of its project ADN has decided to arrange a blood testing camp in the premises of Mandi for the blood screening of 100 persons. This would be done in two steps; 1. 500 persons would be screened for Hepatitis on general device method 2. Found positive on device method, 100 persons would be selected for advanced Elisa method for blood testing to verify results of screening. These 100 people would be given this opportunity on the basis of their economic vulnerability. IMPORTANT POINTS 1. Mandi is a place where people from many areas of Pakistan and AJ&K interact. Any person infected at this place may carry this infection back to his home, town and area. 2. This is the first campaign in the Sabzi Mandi Islamabad on this topic. 3. Results from Mandi can predict prevalence in other such Markets and congested locations of the country.
4. Mandi is a place where people fall in income range of Rs.100,000/‐ per day to Rs.200/‐ per day, therefore increased awareness level can help mobilize the resources to bear blood testing and disease controlling costs within Mandi itself. 5. Mandi is one of places where maximum number of illiterate persons are engaged and single awareness campaign can increase understanding of such diseases not only to maximum persons but to maximum areas.