Interior Sindh: A Death Zone for Kidneys

Interior Sindh: A Death Zone for Kidneys

There is perhaps no other part of the country more down-trodden than interior Sindh. Poverty, lack of infrastructure, unemployment, feudalism, and political corruption has left interior Sindh and its populace completely helpless. 

To make matters worse, the lack of educational infrastructure and government oversight has made it almost impossible for the denizens of the land to leave for better pastures. Instead, the good things in life are reserved for those that already have too much. Interior Sindh is also one of the parts of the country where feudalism and the immense problems that brings exist in its primordial form to this day. The political class is the land-owners who are also the business-class. 

They live like nobility and none of their children deign to live in the land their ancestors used to own. And so, they have no reason to fix it. Their sick are treated abroad, their young are educated abroad, and abroad is where they go for their vacations and where they invest their wealth. One of the myriad of problems that the denizens of the land face are the immense infrastructural issues that lead to other issues in the area. For example, one of the biggest problems in interior Sindh is the provision of potable water. Although most Pakistani cities, even the ones like Islamabad and Karachi face water problems, there is no place where the problem is more acute than Interior Sindh. There is a lack of infrastructure for the provision of safe drinking water, that and the other underlying problems around this one have caused interior Sindh in general, and Sukkur in particular to become one of the worst places for kidneys in Pakistan. 

This is in direct contrast to ancient times when Sindh was taken care of and it served as a center for both trade and education, becoming a fountainhead of cultural wealth during those times. For both the populace of Sindh and that of larger Pakistan, this is a matter of great shame and steps need to be taken to rectify the situation. If we cannot restore Sindh to its stature of old, let us instead ensure that the children of Sindh do not develop kidney stones before reaching puberty. 

Statistics

Pakistan comes in at 19 when it comes to mortality resulting from kidney related issues. Close to four percent of the total deaths in the country are caused due to kidney disease. 

There is a major rise in the incidence of chronic kidney disease (CKD) all over the world. It was ranked 27^th in the list of causes of total number of worldwide deaths in 1990, but rose to 18^th in 2010. It is unique among other chronic ailments, due to its perplexing epidemiology. CKD significantly reduces the lifespan of a person by increasing the risk of cardiovascular mortality and its progression to end-stage renal disease (ESRD). In a comprehensive review and meta-analysis, the world-wide prevalence of CKD was found to be 23.4% in Stage 1–5 and 10.6% in Stage 3–5

It is an extremely heterogeneous disease when it comes to severity and prevalence across the globe. There is such a confluence of factors ranging from cultural habits, water provision infrastructure, and available healthcare and awareness that leads to kidney diseases becoming chronic that the variance in severity and occurrence across the globe makes sense. 

However, coming to Interior Sindh in general and Sukkur in particular, the situation is much worse than it is being reported. 

Anecdotally, if you ask anyone from Sukkur or with relatives from Sukkur if there has been a death in their family related to Kidney disease, there is a high chance you would get an affirmative answer. The unfortunate fact on top of all of this is that there is a large proportion of people suffering from these diseases in Interior Sindh that are children. There has to be something wrong going on that people are developing and dying from kidney disease at such a young age. Recently, I was told by a police inspector stationed in Karachi that his nephew had just passed suddenly due to renal failure. Apparently, it was not a surprise. Despite being a non-smoker and not suffering from diabetes or other health issues he passed suddenly when his kidneys shut down in the night. 

The Sindh Institute of Urology and Transplantation (SIUT) head Dr. Adbul Hasan Rizvi has warned that Sukkur, the third largest town of the province, has become a ‘red zone’ with regard to prevalence of kidney stone disease among children. He said that 90 per cent of the patients visiting the SIUT were patients of kidney disease.

Underlying Causes

Though the rate of kidney diseases is on the rise across the world. When it comes to South Asia, there is a generally higher rate than the rest of the world. One of the reasons for this is that South Asia is also a hot-bed for heart issues and diabetes mellitus caused partly by the modern diet and partly by how colonialism affected our genes more than a century ago. In any case, these are not the only reasons why the mortality rate is so high in rural Sindh and even Sindh’s third largest city-Sukkur. 

Unfortunately, one of the biggest reasons for the high rate of mortality caused by Kidney Disease in Sukkur and interior Sindh is the lack of safe drinking water available to the populace. Sukkur’s water supply and water table are both unsafe for consumption due to contamination and has been demonstrably shown to be unsafe multiple times in the past. Even so, the nobility of course has high level filters or drink from mineral water supplied to their mansions when they are even in Pakistan to begin with, so it is not a problem that effects them. 

In Conclusion

There are two things that need to be done in order to reduce the amount of people suffering from Kidney disease in Sindh. One is raising awareness and provision of safe drinking water to prevent future illnesses from developing due to consumption of contaminated water. Second is the provision of more healthcare services like availability of clinics for checkups and dialysis machines to keep up with the demand that has unfortunately shot up in the last few decades.