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KARACHI: The Sindh High Court has directed the provincial government to establish an independent committee to conduct a comprehensive investigation into the reported spread of HIV among children treated at Karachi’s Kulsum Bai Valika Hospital. A two-member bench, headed by Justice Adnanul Karim Memon and comprising Justice Muhammad Jaffer Raza, issued the directions while announcing its reserved judgment on a petition seeking an impartial investigation, medical treatment and compensation for affected children. The court noted that the departmental inquiries and reports submitted so far were not sufficient to establish the actual number of affected patients, determine how the virus was transmitted or assess whether proper infection-control procedures were followed. According to figures presented by the Sindh government, 78 children were identified as HIV-positive at the hospital, while screening in the surrounding area detected another 120 cases. However, the petitioner claimed that the number of infected children could be around 200. The court ordered the Sindh chief secretary to head the inquiry committee and include two senior government officers of at least BS-20 rank. The officers should preferably have no direct administrative connection with the hospital or the investigations already conducted. The committee has been directed to establish the exact number and identities of HIV-positive children and other patients who were treated at the hospital during the relevant period. It will also investigate the possible source and method of HIV transmission on the basis of medical and scientific evidence. The committee will examine whether disposable syringes or other medical equipment were reused, improperly discarded or inadequately sterilised in violation of medical standards and applicable laws. It will also review the hospital’s infection-prevention arrangements, including the procurement, storage and use of auto-lock, auto-destruct and auto-break syringes. The roles of doctors, nurses, technical staff, administrative officials and supervisors will also come under scrutiny. The committee will determine whether any official failed to fulfil a legal, administrative or supervisory responsibility. The inquiry will further assess ongoing departmental proceedings against 37 officials and determine whether those proceedings adequately address individual responsibility. Officials will also examine whether the Sindh Regulation and Control of Disposable Syringes Act, 2010, or any other relevant law was violated and identify those responsible if evidence establishes wrongdoing. The committee has been authorised to examine medical and laboratory reports, screening records, procurement and stock registers, syringe records, duty rosters, infection-control reports, inspection documents, departmental inquiry material and relevant CCTV footage. The inquiry must provide an opportunity for a fair hearing to anyone against whom adverse findings are proposed. The committee has been directed to submit its report to the competent authority and the high court within two months of its formation. The court also directed the Sindh chief secretary to ensure that all affected HIV-positive children and other identified patients receive uninterrupted medical care while the inquiry continues. The treatment must include medicines, diagnostic tests, counselling and follow-up care and must be provided completely free of cost. The government and SESSI will bear all expenses, and no costs are to be recovered from affected children or their families. Treatment should continue for as long as medically necessary. Given the vulnerability of the children, the court also ordered authorities to determine whether affected families are entitled to compensation, financial assistance or other relief under the relevant laws and government policies. The court stressed that no affected child or family should face discrimination, stigma or denial of lawful assistance because of HIV status. It further ordered authorities to protect the privacy and confidentiality of the children’s identities and medical records. The Sindh chief secretary and health department secretary were directed to take immediate corrective and preventive measures at the hospital to prevent further avoidable risks to patients. Authorities were also ordered to ensure strict compliance with infection-control procedures and the law governing disposable syringes. The court said the case involved fundamental rights, including the rights to life, health, dignity and fair treatment. It observed that the matter could not be treated merely as an administrative issue because the state has a constitutional responsibility to protect life and ensure proper public health and medical safety. At the same time, the court cautioned that allegations or departmental proceedings alone cannot establish the guilt of individual officials. Responsibility must be determined through evidence and after providing the concerned persons an opportunity to defend themselves. The court also took notice of an incident involving the petitioner, Advocate Tariq Mansoor, during proceedings. According to the order, Mansoor allegedly raised his voice and encouraged people accompanying him, while some individuals reportedly recorded videos inside the courtroom. The court said the incident disrupted proceedings and affected the dignity and decorum of the courtroom. It also noted that the situation was serious enough for the bench to retire to chambers before completing the order. The court issued a show-cause notice to Mansoor, asking why contempt and criminal proceedings should not be initiated against him. Court security officials were also directed to explain an alleged security lapse that allowed a group of people to enter the courtroom and disrupt proceedings. The Sindh High Court Bar Association and Sindh Bar Council were asked to intervene and take appropriate measures regarding the alleged misconduct.