Pakistan: Hospitals putting children at risk of HIV

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1:01Ghazal Abbasi:Save big money at Menards.

1:11These children are innocent. They are flowers. Why are they catching it? Adults should suffer from HIV, not children. I'm visiting a community in central Pakistan where something terrible is happening to the children I'm Ghazala Bassi and this is the documentary from the BBC World Service Over the past year, more than 300 children in the city of Thonsar have tested positive for HIV Parents like Yushad don't have HIV and can't understand how their children are getting infected I'm missing him. I don't understand what the reason is, how it transmits. One of my sons died. He had HIV. He is my other son.

2:07Ishaad's surviving son, Giza, is also HIV positive. For now, medication is keeping him alive. I don't know if it happened in the hospital. You only took them to Tonza, only to that hospital? Yes, yes, Tonza, Tonza. Tonza Hospital is a government hospital. During his treatment, he got so many injections. When we came back home, his condition got worse again. There were also so many staff there who said, these syringes are being reused. Irshad feels powerless to act on his suspicions about the hospital and the local government says there's no proof children are infected with HIV there. For BBC Eye and Assignment, we've gone undercover to investigate what's happened to Thansa's HIV children and who's to blame.

3:21With a severely underfunded and understaffed public health system, many Pakistanis attend private clinics like this one in the centre of Tonsa, run by Dr Gul Mohamed Gasrani. He's examining a young child with a cough and a fever. Back in 2024, Dr Gul began noticing something strange.

3:45The first child came around 31st October 2024. Then one came on 21st November 2024. Then I had five to six children in December. Sick children coming to his clinic kept testing positive for HIV. They came from communities tens of kilometres apart, and their parents seemed fine. So how had these children contracted the virus?

4:21One day a mother came to me and she told me that her daughter was injected with the same syringe as her cousin who had HIV. The same syringe was used on her, then it was used on her daughter. Then in front of her, it was used on 10 other children. She told me that this syringe was used at the government hospital, TESOL headquarters, THQ in Tonsa.

4:48Ghazal Abbasi:This is the picture we took in this shower kameez. He passed away on Friday.

5:01In 2024, eight-year-old Mohammed Amin was running a fever. His mother, Sugrabibi, took him to THQ Hospital for treatment, where he was given injections. but after being discharged, he got worse. My son started having pain. He developed a very high fever. I said, my son's condition is getting very bad. She returned to the hospital seeking help. They gave another injection. In the evening, we told them, please tell us some solution. The child is in a lot of pain. They said, there's nothing. He's fine. So Gris says despite what the doctors told her, it was clear to the family that her son was very seriously ill.

5:50Mohammed Amin used to sleep outside in rain and cold. He used to writhe, like when something is thrown into hot oil. They didn't listen to even one of us. When we insisted more, they used to say, take him out of the hospital. Eventually, Mohamed Amin was referred to a hospital in the neighbouring city of Multan where he was tested and diagnosed. They said in the report, your child has HIV, the disease has attacked. He began treatment, but it was too late. He suffered a major seizure at home and his terrified mother had no option but to rush him back to THQ hospital. After the seizure, his eyes also closed.

6:40His voice stopped. Before that, he'd been crying all night. Then, there at the hospital at five in the evening, he passed away. Sugra had already lost her husband two years before. Now, her only son was gone. But the family's trauma didn't end there.

7:06Shortly after Mohamed Amin's death, his older sister, Asma, developed flu symptoms.

7:15Ten years old. Ten-year-old Asma was also treated at THQ hospital. Two months later, Sugra says, her daughter fell seriously ill. At first it was just fever. Then when injections and drips were given to Asma, then severe body pain started. and high fever as well. I told the doctor that my amine had the same suffering as my daughter. I went and got tests done. The hospital staff in Tonsa said, your daughter has HIV.

7:53By early 2025, Dr Kasrani was becoming worried and began comparing the medical histories of the children who had tested positive at his clinic. I have reports of around 65 to 70 children who I've diagnosed.

8:12The TESL headquarters was the common factor. Almost all the children, 95 % of the children, had definitely visited there. He also heard the same story about reuse syringes and poor infection control from parent after parent. One young man, he has three children affected. He says, I tried to stop the nurses, saying, you're injecting the same syringe into others and then coming and injecting my child. So the nurse replied, this is our job, it's not your job. By early 2025, Dr. Kusrani and others had informed authorities that there was a major outbreak of HIV among children treated at THQ. and the parents of those children were demanding action.

9:05Arrest the criminals, they chant at a protest.

9:11For the past year at Dansa Hospital, HIV has been spreading among children in a bad way, this woman says. The hospital had become every parent's nightmare when, in March 2025, the government finally stepped in.

9:30As announced by the TV news on the instructions of Punjab's chief minister, a joint task force between UNICEF, the WHO and the Punjab Healthcare Department was set up to investigate what had gone wrong and why. At a press conference, the Health and Population Secretary, Nadia Saqib, said action would be taken against those responsible and she gave parents a warning. The use of syringes should be kept to a minimum. When your child falls ill, do not immediately go for injections. This is not safe. The government's report has still not been made public.

10:15During the last three months of 2025, we went undercover inside the Tehsil Headquarters Hospital, otherwise known as THQ. Dr Kasrani says most of the HIV-positive children he saw had been treated there. A staff member, convinced that children's lives were at risk, helped us to document serious wrongdoing. I felt that some concrete action should be taken. My duty is to save my people. We shouldn't play with our children's future. We're not identifying the staff member who used a hidden camera to film what was going on. He spoke to some of the nurses.

11:01Ghazal Abbasi:Have you got fever? You didn't get a fever injection prescribed from the doctor and paracetamol, but I will give them to you. It immediately becomes clear that the common method of treatment for any fever or ailment is via injection, mostly with liquid paracetamol. Our insider speaks to a nurse. We inject patients randomly with various injections for their peace of mind. And they're satisfied after getting the injections? Yes, so they leave me alone. The local government says infection prevention is routinely conducted at THQ. In our secret footage, we can see patients being injected through their clothing.

11:45The nurses are not wearing sterile gloves. No cotton swabs are used before or after the jabs. Patients walk around the ward with blood on their sleeves. One nurse appears to have some knowledge of the dangers of reusing syringes or medicine vials. We don't use this. It may have been used with children with HIV, so it's discarded. But there are frequent lapses in the safety protocols. Just off camera, we can hear a nurse being asked if there is a 10cc syringe Yes, she says, it's available but in used condition A syringe is placed on the countertop Liquid from the last patient is still visible inside it As her colleague picks it up

12:42A nurse rummages through the discarded needle box, an open cardboard box with no gloves on. We can even see a doctor injecting patients without sterile gloves. Used syringes and vials are frequently left alongside discarded needles on countertops that should be kept sterile. Cross-contamination seems almost inevitable. There's another issue too. No paracetamol vials today? No, we're out of them. I've asked for some, but it'll be difficult to get them. The local government says that THQ has no reported shortages of medicines, but we found patients being told to bring their own supplies. The pressure of constant shortages leads staff to take desperate measures.

13:36Ghazal Abbasi:We reduce the quantity of injection. If it's 40cc, we make it 20. If it's 30cc, we make it 15. We can't give a full dose if we don't have it. According to our source, nurses at THQ Hospital are routinely sharing vials of liquid medicine between children.

14:00We showed our undercover footage to a leading expert on infectious diseases. Dr Fatima Mir is Professor of Paediatric Medicine at Aga Khan University Hospital in Garaji.

14:13Ghazal Abbasi:The needles that have been used, some of the syringes are still seen lying on the table. Some are closed, some are open and they're still lying there as they were. So these are all items that will be reused. These are single-use items that are being used multiple times. It highlights that the infection control training of our healthcare providers is very poor. From dispensers to injectors to physicians. So now we must warn our injectors, you have become an active instrument for passing disease. We have to warn them that you have to move yourself to a safe practice.

14:54The constant use of injections rather than tablets isn't just a choice made by medical staff, says Dr. Fatima. It's something Pakistani families want and seek out when they visit doctors. Many believe that without injections, they're not getting proper treatment. You're listening to the documentary from the BBC World Service. Dream big and save big on your next backyard project at Menards. Whether you're shopping for edgers, pavers, or wall blocks, Menards has the largest in-stock selection of concrete landscape block ready to take home today. Build a beautiful border for your landscape with our Crescent Edgers on sale now through April 12th.

15:39Plus, check out our weekly flyer on Menards.com for all the great deals happening now. Save big money at Menards.

16:14Save big money at the Nards. I'm Ghazala Bassi and this is Assignment from Pakistan.

16:27The government did suspend the medical superintendent, Dayab Jandio, and two other senior managers. But our investigation can reveal that within three months of his suspension, Jandio was allowed to work with children again. We found he'd been reappointed as senior medical officer at a rural health centre on the outskirts of Tonsau. Chandio denies that the HIV outbreak is linked to THQ Hospital and the local government says no inquiry outcome has legally barred Dr Chandio from practice to date.

17:04A ban on volunteers working at THQ was introduced. The local government says the hospital administration enforces compliance of this ban. But as we found, six months on, unqualified volunteers were also back in business.

17:24Recorded secretly by our source, the hospital pharmacist has complained that volunteers steal her supplies and that widespread staff redundancies have left her defenceless.

17:43Today, 10-year-old Asma is with her uncle, visiting the grave of her little brother, Muhammad Amin, for whom diagnosis and life-saving medicine came too late.

17:56He's with God now, she says. He used to fight me, but he also loved me. I miss him a lot.

18:08Ghazal Abbasi:What can the poor do? What voice was I to raise? The child was gone. Asma is taking medicine from the government's doors. It's kept her from sharing her brother's fate. But her uncle, Garry Abid, fears it's not enough. Even now, this girl is becoming weaker. Day by day, she is becoming weaker. Our government does not even pick up those responsible. If the poor get into any trouble, they are detained immediately. But the ones responsible for doing this, nothing is said to them. In the months since it promised to deal with the outbreak, the local government claims to have conducted regular surprise inspections at THQ and that hospital workers who break the rules are subject to disciplinary and legal action.

19:02But it didn't take long for our hidden camera to capture proof children were still being put at grave risk.

19:13In the children's emergency ward, one of the volunteers is getting ready to give a series of paracetamol injections, which have been prescribed.

19:24He takes a new syringe and needle, pushes it into the top of a multi-use vial of paracetamol and fills. Subsequently, he injects his first patient through a cannula in the back of the baby's hand, but then he takes the same syringe and puts it back into the same medicine vial and refills the syringe. It's known as double dipping. There is no reason to believe he does, but if this child had HIV, the entire vial could now be contaminated. Then he uses the same vial to inject two more children through cannulas.

20:06We showed our footage to another expert, consultant microbiologist Altaf Ahmed. If the first child did have HIV or any blood-borne virus, what were the chances of passing that on? Very high chances, very high.

20:29Even if they've attached a new needle, the back part, which we call the syringe body, has the virus in it. So it'll transfer even with a new needle. Not only that, Dr. Ahmed says injecting these children via cannula increases the risk of infection further because contaminated medicine can enter the patient's veins directly, bypassing many of the body's natural defences. They increase a lot because they're directly injecting into the bloodstream so there are many chances of it spreading. Our hospital worker spent 32 hours filming undercover in the children's wards at THQ. He witnessed at least seven occasions when vials were double-dipped with reusable syringes and potentially contaminated.