Hospitals not ready for bio-terror attacks

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writes Naufil Hasan

An anthrax scare caused Advocate General Sindh, Raja Qureshi, to lodge a First Information Report (FIR) against a US national, Abdul Qayyum, for sending him an envelope containing the deadly strain, though tests conducted on the envelope at Aga Khan Hospital later proved negative.
According to details, Mr Qureshi’s office received an envelope from a certain Mr Qayyum which was suspected of containing anthrax powder. Some of his staff said they felt ill after opening the envelope. Tests run on the envelope as well as the personnel suspected of having been exposed to anthrax, however, proved negative.

The two arrested “suspects” in the case, who belong to a non-governmental organisation from where the letter is said to have originated, have been cleared by the investigating agencies and let off, though not before they acquired international notoriety for being possible perpetrators of the crime. Now the Civil Lines police have registered a case against “unknown perpetrators”.
“We could not determine anything from the men questioned by us. We are convinced that they do not have any link with the envelope containing anthrax,” DIG Karachi Tariq Jamil told TFT. But the DIG said investigations were underway to determine the real perpetrators of the crime. “This is not a closed case,” he said.

Sources in the Federal Investigation Agency (FIA) say the federal government has set up five anthrax alarm teams to cover the four provincial capitals as well as the city of Rawalpindi. “The teams have been set up under instructions from the Ministry of Interior and are tasked with investigating any anthrax-related cases in the five cities,” an FIA source told TFT.

In Karachi, Director, FIA, Babar Khattak has constituted a 3-member committee to respond to any anthrax alert. The team is supposed to investigate such cases, collect data and file a complete record for further investigations. The provincial health department has been directed to provide laboratory and medical assistance to the team. The team would also take up the anthrax case relating to the newspaper group Jang.

  The postal service has, meanwhile, taken its own precautions. A resident of Karachi’s Gulberg area received a call from a post office a few days back. The caller asked him if he wanted to receive an envelope posted from Europe and whether he wanted to open it himself or allow the postal staff to do it for him. TFT asked the Postmaster General, Sindh, Qamar Afzaal Jamil, if these were standard instructions. “No, we cannot do this for every envelope we receive. It is simply impossible. But we have taken measures to at least do it for parcels and envelopes coming in from Europe or the USA,” he said, adding: “We do not have the resources or manpower to check every envelope and we get over 200,000 of them every day.”

Mr Jamil also told TFT his department had taken the basic precautions to avoid exposure of its staff to any hazardous chemical or biological materials. “We have provided special gloves and clothes to our staff, particularly to those who work in the International Mail and Forest Post Sections located at I.I. Chundrigar Road and Shahrah-i-Faisal,” he said.

The staff have also been told to inform the concerned authorities “if you do find any such envelope”. “We have asked all major hospitals to report every such case to us immediately after they receive any information involving exposure to anthrax,” Khalid Latif Chaudhry, provincial health secretary told TFT, adding: “We have requested the federal government to provide us latest equipment, technology and expertise to cope with anthrax-related incidents.” Secretary Chaudhry fears there could be more anthrax-related cases in the near future.

However, TFT investigations show none of the government hospitals is equipped to respond competently to incidents of bio-terrorism. Even the Aga Khan Hospital, perhaps the best private hospital in the city, has limited technology and expertise to detect and cure such patients.
“Our hospitals do not have the technology or the resources to cope with such cases. The entire South Asia lacks the facilities to handle such situations,” Dr Shershah Syed, Secretary General, Pakistan Medical Association, told TFT. “We may not be able to give a proper response to a bio-terrorist attack.”

Dr Tipu Sultan, president of the Karachi chapter of Pakistan Medical Association says anthrax is a disease of the animals caused by Bacillus Anthracis. In their natural state, anthrax spores are found in the soil throughout Asia and Africa. In the US anthrax spores are common in the rural soils of Texas, Oklahoma and the Mississippi Valley. “Only the germinating form of bacillus anthracis is fatal; it has not yet been established whether it can proliferate significantly outside the animal body.”

Dr Sultan thinks we do not need to worry much about any large-scale anthrax attack. “There is no lab in the developing world that can grow a large number of anthrax spores, purify them and then combine them with a fine powdery substance. This is an anti-human weapon created by the West. If it comes here, it has to be mailed from Europe or the USA,” he said.

Sources in the Sindh secretariat told TFT the provincial authorities have issued a circular to all departments asking them to establish separate mail-sorting departments and to provide special gloves and clothes to the staff deputed there.
“We have requested Islamabad to bring in foreign experts who can train some of our staff on how deal with such silent terrorists,” a senior official of the provincial government said.

A disaster action plan was discussed between PMA and officials of the Federal Ministry of Health in Islamabad on November 9. The meeting discussed the various steps that need to be taken to institute a proper response mechanism. “We hope to put things in place in a month,” a PMA office-bearer told TFT.
The private courier companies have also devised mechanisms at their offices to respond to any such contingency.