KARACHI: The Sindh High Court (SHC) directed the provincial government on Thursday to constitute a committee for an “independent, impartial and comprehensive” inquiry into the HIV outbreak among children at Karachi’s Kulsum Bai Valika Hospital. A two-member SHC bench, headed by Justice Adnanul Karim Memon and comprising Justice Muhammad Jaffer Raza, issued the directive as it announced its reserved judgement on a plea seeking an independent inquiry, registration of a case and lifelong medical treatment as well as appropriate compensation for the affected children. The outbreak was initially reported late last year, following which the Sindh government carried out screening at the Sindh Employees Social Security Institution-run hospital located in Karachi’s SITE area. According to data shared by the Sindh government, at least 78 children have been found infected with HIV at the hospital while a screening in the nearby area also confirmed 120 additional cases. But Advocate Tariq Mansoor, the lawyer who moved the SHC on the matter, claims in his petition filed in May that the total number of infected children is around 200. The court observed in its order on the plea that the 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”. Keeping this in view, the court deemed it necessary “in the interest of justice, transparency and public confidence that an independent fact-finding mechanism be constituted by the competent authority, without expressing any final opinion regarding the guilt or innocence of any individual”. It directed that a committee, headed by the Sindh chief secretary, be constituted. The chief secretary should co-opt two senior officers not below the rank of BS-20 and “preferably having no direct administrative involvement in the affairs of the hospital or the proceedings under inquiry” to join the committee, the court order stated. The court directed that the committee should determine: The actual number and particulars of children and other patients who were found HIV-positive and who received treatment at the hospital during the relevant period The source, circumstances and possible mode of transmission of HIV infection, based on available medical and scientific evidence Whether any disposable syringe or other medical equipment was reused, improperly disposed of, inadequately sterilised or otherwise used in violation of the applicable law, rules, protocols or standard medical practice The existence and implementation of infection-prevention and control protocols at the hospital The procurement, supply, storage, distribution and use of auto-lock, auto-destruct or auto-break syringes and the relevant record The role and responsibility of medical, nursing, technical, administrative and supervisory officials concerned Whether any officer or official, by act or omission, failed to discharge a statutory, administrative or supervisory duty The status and legality of the departmental proceedings already initiated against the 37 officials and whether such proceedings adequately address the actual responsibility of the persons concerned Whether any provision of the Sindh Regulation and Control of Disposable Syringes Act, 2010, or any other applicable law has been violated and, if so, the persons prima facie responsible The measures required for preventing recurrence of any such incident in the future The court order further stated that the committee should be empowered to examine all relevant records, including medical and laboratory reports, screening data, procurement and stock registers, syringe records, duty rosters, infection-control and inspection reports, inquiry proceedings, CCTV footage where such incidents occurred in Sindh and other material necessary for an “objective determination, while affording a fair opportunity of hearing to any person against whom an adverse finding is proposed”. The committee should submit its comprehensive report to the competent authority, as well as the SHC, within two months of its constitution, the order read. It elaborated that the report should identify “the factual position and, where supported by evidence, fixing responsibility and recommending appropriate departmental, statutory or criminal action pursuant to Section 7 of the Sindh Regulation and Control of Disposable Syringes Act, 2010”. Pending the inquiry, the Sindh chief secretary should ensure through the relevant departments and SESSI that all affected HIV-positive children and other identified patients receive “comprehensive, uninterrupted and appropriate medical treatment”, including medicines, investigations, counselling and follow-up care, entirely free of cost, at any institution of higher standard as medically appropriate, the court ruled. “All such expenses shall be borne by the government/ SESSI and shall not be recovered from the affected patients or their families, and the arrangement shall continue for as long as medically required,” the court directed. More to follow