{"id":5940,"date":"2025-03-06T08:00:00","date_gmt":"2025-03-05T22:30:00","guid":{"rendered":"https:\/\/hepatitissa.asn.au\/communitynews\/?p=5940"},"modified":"2025-04-04T09:16:22","modified_gmt":"2025-04-03T23:46:22","slug":"turning-the-tide-of-hepatitis-c-treatment-in-machar-colony","status":"publish","type":"post","link":"https:\/\/hepatitissa.asn.au\/communitynews\/2025\/03\/turning-the-tide-of-hepatitis-c-treatment-in-machar-colony\/","title":{"rendered":"Turning the Tide of Hepatitis C Treatment in Machar Colony"},"content":{"rendered":"\n

In southern\u00a0Pakistan<\/a>\u2019s Sindh province, on the edge of Karachi\u2019s bustling fish harbour, sits Machar Colony. It is an informal settlement where life is harsh, often unkind, and plagued by overcrowding, poor sanitation, and limited access to basic services. The community\u2019s struggles with health and well-being have long been exacerbated by these conditions, leaving residents vulnerable to a range of medical issues.\u00a0<\/p>\n\n\n\n

M\u00e9decins Sans Fronti\u00e8res (MSF) had been providing essential healthcare services in Machar Colony since 2012, offering emergency services, maternal health, and general health consultations. However, as the years progressed, MSF\u2019s team noticed troubling patterns at our health clinic.  <\/p>\n\n\n\n

\u201cMany residents started coming in with symptoms such as body aches, fatigue, decreased appetite, fever, or sometimes infection signs that hinted at a serious health issue,\u201d says Dr Khawar Aslam, the project\u2019s medical lead, who has been working with the team since 2014.<\/p>\n\n\n\n

\u201cAs we investigated further, we found that a significant number of these cases were related to\u00a0hepatitis C<\/a>, a viral infection that affects the liver and can lead to severe health complications.\u201d\u00a0<\/p>\n\n\n\n

\u201cNotably, during that time, Pakistan had the second-highest hepatitis C disease burden globally, and had already initiated its national hepatitis control programme in 2005,\u201d says Dr Aslam. <\/p>\n\n\n\n

\"\"\n\t\t\t\n\t\t\t\t\n\t\t\t<\/svg>\n\t\t<\/button>
A skilled lab technician carefully fills a blood sample from a Hepatitis C patient, setting up a cartage for accurate testing with the innovative GeneXpert\u00ae (Cepheid) platform at the MSF Hepatitis C clinic in Machar Colony, Karachi, Pakistan, on Wednesday, April 24, 2024.\n\nPhotographer: Asim Hafeez For MSF<\/figcaption><\/figure>\n\n\n\n

Hepatitis C transmission in Pakistan is largely driven by inadequate sterilization of medical equipment and the improper reuse of needles and syringes. Contaminated blood transfusions also pose a significant risk. Common practices like barbering, tattooing, and piercing are contributing to the spread of the virus, as equipment is often not properly sterilized. In addition to these factors, the growing issue of intravenous drug use is also fuelling the transmission of hepatitis C in Pakistan.  <\/p>\n\n\n\n

According to the World Health Organization (WHO), as of April 2024, Pakistan has the highest number of viral hepatitis C infections in the world, with around 8.8 million cases. The country accounts for 44 per cent of all new hepatitis C infections attributed to unsafe medical injections. People are usually screened for hepatitis C only when they start showing signs of liver disease, which is often too late. If left untreated for too long, hepatitis C can progress to severe liver disease and even liver cancer. <\/p>\n\n\n\n

\n

Many people in Machar Colony were unaware that they were infected, because the virus can remain dormant for years without showing symptoms<\/q>.<\/p>Dr Aslam<\/cite><\/blockquote><\/figure>\n<\/blockquote>\n\n\n\n

\u201cEven those who recognised their condition, either elsewhere or at our clinic, often faced obstacles to treatment, including high costs and the challenge of travelling to distant hospitals.\u201d <\/p>\n\n\n\n

\u201cResidents have limited income sources, primarily relying on fishing, daily wage work, or small-scale businesses, which barely cover their daily needs,\u201d Dr Aslam continues.<\/p>\n\n\n\n

\u201cAdditionally, upon referrals to other hospitals, identity cards were required for hepatitis C care; however, most of the community in Machar Colony was undocumented, so they were refused treatment.\u201d<\/p>\n\n\n\n

Recognising the urgent need for action, in 2015 MSF started a comprehensive programme to provide free testing and treatment directly to residents. The hepatitis C services were integrated into the existing healthcare facility, allowing our teams to reach people who would otherwise remain unaware of their condition. In 2018, we closed our basic healthcare services and shifted our focus solely to the treatment of hepatitis C patients. <\/p>\n\n\n\n

\"\"\n\t\t\t\n\t\t\t\t\n\t\t\t<\/svg>\n\t\t<\/button>
During a mobile clinic in Machar Colony, Karachi, MSF nurse Aman Ullah explains more about the symptoms of hepatitis C, how it affects people, and what measures can be taken to prevent it, Pakistan, November 2023. (Photographer: Gul Nayab for MSF)<\/figcaption><\/figure>\n\n\n\n

\u201cMy wife was diagnosed with hepatitis C about a year ago and received successful treatment at the MSF clinic in Machar Colony,\u201d says Javeed Ali, one of the programme\u2019s patients.<\/p>\n\n\n\n

\u201cWhen I subsequently developed symptoms such as leg and back pain, as well as weakness, I sought medical attention and was referred to the MSF clinic.\u201d <\/p>\n\n\n\n

\u201cInspired by my wife\u2019s positive experience, I underwent testing and was diagnosed with hepatitis C,\u201d says Ali. \u201cI then completed a three-month treatment course, and fortunately, my follow-up test results were negative. My wife and I are both now in good health.\u201d <\/p>\n\n\n\n

To effectively address the crisis, MSF implemented a proactive strategy focused on community engagement. In a basic healthcare setup, free-of-charge hepatitis C services including screening, diagnosis, treatment, health education, and patient support were provided under one roof.  <\/p>\n\n\n\n

Between 2022 and 2024, MSF teams conducted widespread testing, going door-to-door and using mobile vans to offer in-home testing for residents aged 12 and older. This approach, called \u2018bending the curve\u2019, ensured that no one was overlooked and that those who tested positive were quickly referred for treatment, helping to bend the curve of hepatitis C prevalence in the community. <\/p>\n\n\n\n

\u201cBy offering free services in one location, we made it easier for people to access care,\u201d says Dr Aslam. <\/p>\n\n\n\n

\n

Our goal was to reduce infections and stop the disease from spreading. We\u2019ve reached nearly 100 per cent of the community, spreading awareness and facilitating immediate treatment for those in need.<\/q><\/p>Dr Aslam<\/cite><\/blockquote><\/figure>\n<\/blockquote>\n\n\n\n

MSF also collaborated with the Ministry of Health to bring hepatitis C care closer to the community. In August 2022, we established a treatment facility at the Baldia town rural health centre, in Kemari district, Karachi. In this initiative, patients referred from Baldia hospitals\u2019 outpatient departments, and those identified by community health workers, were screened for hepatitis C. The community health workers were trained to educate the community about hepatitis C risk factors and prevention.  <\/p>\n\n\n\n

Patients diagnosed with chronic hepatitis C received treatment for 12 or 24 weeks, depending on the severity of their liver disease. Additionally, all patients were offered hepatitis B vaccination to prevent future infections. This centre, handed over to the Ministry of Health in August 2023, serves as a crucial hub for hepatitis C treatment in the region. It is equipped with modern diagnostic tools and is now recognised as a key site for hepatitis care in Sindh province. <\/p>\n\n\n\n

\"\"\n\t\t\t\n\t\t\t\t\n\t\t\t<\/svg>\n\t\t<\/button>
MSF team members embark on a mission to find and support Hepatitis C patients, scouring the streets during an outreach activity in a neighborhood of Machar Colony, Karachi, Pakistan, on Wednesday, April 24, 2024. \n\nPhotographer: Asim Hafeez For MSF<\/figcaption><\/figure>\n\n\n\n

In addition to reducing hepatitis C, MSF also played a vital role in Machar Colony during the COVID-19 pandemic. We supported vaccination efforts in Machar Colony and surrounding areas, ensuring residents received vital information about COVID-19 symptoms, prevention, and vaccination. MSF teams also distributed reusable masks and soap to help the community stay safe during the pandemic.<\/p>\n\n\n\n

As our hepatitis C programme concludes, the results are clear: thousands of lives have been transformed, and the rate of new infections has significantly declined. While hepatitis C remains a challenge in Machar Colony, the alarming spread has been curtailed, thanks to widespread awareness and early detection. <\/p>\n\n\n\n

MSF has achieved the target of mobilising nearly 100 per cent of the community for hepatitis C awareness, and screening more than 72 per cent of residents.  Between 2015 and 2024, MSF screened over 129,922 individuals in our clinic and in the community, undertook 64,984 consultations for hepatitis C at the MSF clinic, performed 25,553 diagnostic polymerase chain reaction (PCR) tests, and provided treatment to over 9,398 patients. Among them, 6,909 completed their treatment. Of the remaining people, 2,061 were lost to follow-up without completing treatment, 176 with completed treatment were lost to follow-up, 14 people died during this period, while for the remaining 50 people, either treatment was not completed or follow-up stopped. Of the 6,909 completed treatments, 6,755 were cured of hepatitis C, which is 93.3 per cent, while the remaining 459 failed treatment. The success of MSF\u2019s treatment initiatives will serve as a model for similar programmes in other underserved communities across Pakistan. 

M\u00e9decins Sans Fronti\u00e8res (MSF) first began working in Pakistan in 1986 and currently provides a range of health services across all four provinces of the country, including maternal and child healthcare, primary healthcare, treatment for cutaneous leishmaniasis (CL), drug-resistant tuberculosis (DR-TB), and ongoing emergency responses. <\/p>\n\n\n\n

Reprinted <\/a>with permission from M\u00e9decins Sans Fronti\u00e8res.<\/em><\/strong><\/p>\n\n\n\n

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