HYDERABAD, Pakistan: Looking visibly dejected, Salman Ghaznavi is busy performing religious rituals for his teenage daughter, Maimona, who tragically passed away a fortnight ago.
He has just disembarked from a rickshaw to offload a small cauldron of cooked rice to serve to the guests who came to his house for his late daughter’s second-week fateha, collective prayers.
Employed in the travel agency sector, middle-aged Ghaznavi could not conceal the depth of his grief over losing the eldest of his children.
“We were unable to do anything. Maimona was diagnosed with dengue virus infection. I got her medical test done and as she ran a high fever, I took her to the government-run Bhitai Hospital in Latifabad [Hyderabad],” he recalls, his voice laden with sorrow and grief that cut to the bone.
At Bhitai Hospital, he was advised to take her to Liaquat University Hospital (LUH), a tertiary-care hospital affiliated with Liaquat University of Medical and Health Sciences (LUMHS).
“No ambulance was available at the hospital and I had to take her to the hospital in a rickshaw in the second week of October, where she was pronounced dead,” he recounts, his grief leaving him shattered.
Maimona is among approximately 43 dengue victims, both elderly and young, according to heirs’ claims and hospital records. Hyderabad Deputy Commissioner Zainul Abideen Memon confirms 13 deaths in Liaquat University Hospital (LUH).
These also included three patients from districts other than Hyderabad as of November 3. However, many deaths slipped through the cracks of official records, as was the case in private health facilities or home deaths.
We were unable to do anything. Maimona was diagnosed with dengue virus infection. I got her medical test done and as she ran a high fever, I took her to the government-run Bhitai Hospital in Latifabad [Hyderabad].” – Salman Ghaznavi, grieving father
Another 14-year-old girl, Haniya Rizvi, the daughter of a police constable from the same neighbourhood, died on November 2 due to dengue, according to her family.
Negligence allegations surface
While Ghaznavi perhaps accepted the grim reality, Amir Zardari, a practicing lawyer from Hyderabad, refused to take it lying down. He decided to fight, much to the chagrin of LUMHS consultants and LUH doctors, who also resorted to protests.
Amir Zardari’s son, Hasnain Zardari, in his early twenties, succumbed to dengue in LUH’s Intensive Care Unit on October 22.
While Hasnain was admitted, Amir had filed a criminal miscellaneous application before the sessions court, alleging negligence in his son’s treatment. Despite his efforts, Hasnain could not survive.
Following Amir’s complaint, the police station concerned registered a case under murder charges against several LUH doctors, including Medical Superintendent (MS) Dr Ali Akbar Dahri and LUMHS consultant Prof Dr Iqbal Shah, sparking a firestorm of protests and an Outpatient Department (OPD) boycott by doctors and paramedics.
They argued that the murder section should not have been applied to senior medical professionals. Subsequently, a three-member inquiry committee, headed by the Director General of Health Services of Sindh, was formed on October 28 to review Amir Zardari’s complaint.
Cases go uncounted
Protests by doctors and paramedics continued into early November, even as the dengue outbreak spread like wildfire. Meanwhile, the Sindh government’s health department, regrettably, appeared to remain in a state of denial, turning a blind eye and underreporting both patient numbers and deaths, as official figures suggested.
If this influx continues, we’ll have to vacate additional wards to accommodate dengue patients.” – Dr Ali Akbar Dahri, MS Liaquat University Hospital.
On October 26, the health department disclosed that 1,083 confirmed dengue cases were reported across Sindh, with just 439 case by October 25.
Sindh Health Minister Dr Azra Fazl Pechuhu pointed out in the health department’s report that it was because the health department maintains a record of all patients admitted to government hospitals or treated in OPDs, excluding cases tested in private facilities.
The Diagnostic and Research Laboratory (DRL) of LUMHS has extensive outreach across Sindh through its branches and sample collection points.
During the COVID-19 pandemic (2020-2021), DRL handled one of the largest volumes of tests in the province. Surprisingly, the Sindh Health Department does not incorporate DRL data in provincial or Hyderabad records.
DRL’s figures show that 7,793 tests were conducted between September 11 to 22, of which 3,296 cases were tested positive for dengue across 58 provincial branches.
Likewise, during the first fortnight of October, 17,364 tests were conducted, yielding 7,679 positives. In Hyderabad alone, 2,579 positive cases were recorded in September and 2,065 in October.
By contrast, the data compiled by Hyderabad’s District Health Officer (DHO) reported only 394 cases between Oct 1 to 14 and ‘zero’ deaths between October 1 and November 2, totalling 2,306 cases.
“The 394 cases are from six government and eight private hospitals, all connected via our office link,” says DHO Dr Pir Ghulam Hussain. When asked if DRL data is excluded, he clarifies, “DRL doesn’t fall under our administrative domain.” He, however, wrote to the Deputy Director General Vector Borne Diseases (VBD) to obtain DRL data.
After collecting selective data, the Health Department reported on Oct 30 a sudden spike in the past 24 hours (October 29-30), showing 1,558 new cases — a grim reminder that the outbreak is far from under control.
Beds overflow corridors
Dengue cases typically emerge between September and November due to weather conditions for the vector. However, this year, the virus proved particularly deadly, leaving thousands battling high-grade fevers and claiming a significant number of lives.
Preventive strategies were lacking. Early intervention could have curtailed outbreaks in May–June.” – Dr Sughand Memon, Assistant Professor at LUMHS
The Liaquat University Hospital serves Hyderabad and the broader lower Sindh region. Despite its status, it remained under-resourced, able to accommodate around 35 confirmed dengue patients in the medical ward, with beds spilling into corridors.
LUH Medical Superintendent Dr Ali Akbar Dahri realised the rising patient load. “If this influx continues, we’ll have to vacate additional wards to accommodate dengue patients,” he tells WE News English.
Apart from the resource constraints, another hurdle at the dengue peak was the availability of test kits. “Kits are unavailable in several district hospitals, and officials awaited supplies,” says a divisional civil administration official, wishing not to be named.
Procurement delays due to litigation further hampered timely distribution of kits, according to Ibrahim Memon, Additional Secretary Procurement Monitoring & Inspection Cell of Sindh Health Department.
Preventive gaps
Dr Sughand Memon, an assistant professor of infectious diseases at the LUMHS, has treated numerous dengue patients in various health facilities. She warns that stagnant water post-monsoon serves as a fertile breeding ground for Aedes mosquitoes.
“Preventive strategies were lacking. Early intervention could have curtailed outbreaks in May–June,” she says.
Dengue transmission remained uncontrolled, with deaths often linked to dengue shock syndrome, a danger easily avoidable with early diagnosis and proper hydration.
Symptoms include persistent vomiting, severe abdominal pain, restlessness, sudden drowsiness, bleeding, low blood pressure, and cold, clammy skin, typically after the fever subsides. Secondary bacterial infections may further increase mortality.
Dengue outbreaks have intensified since the 1990s, with Lahore witnessing 21,000 confirmed cases and over 60 deaths in 2017. According to the NIH March advisory, 100–400 million people worldwide are affected annually, predominantly in urban and semi-urban areas.
In Pakistan, confirmed cases rose from 21,016 in 2023 to 28,427 in 2024, mostly post-monsoon. Dengue is endemic in over 100 countries, with multiple serotypes circulating in Pakistan.
Surges occur when temperatures hover between 26–29°C for 3–5 weeks and humidity remains at 60 per cent — conditions that allow the virus to spread like a wildfire.
