ISLAMABAD As many as 130 children (aged under five years) died in November 2010 at the government hospitals in 76 districts across the country, a report said on Monday. However, mystery shrouds the cause behind the death of these children as the report, which is compiled by a non-governmental organisation ' Free & Fair Election Network did not reveal the cause of death of those children. It is pertinent to mention here that the report which the FFEN released on Monday is based on statistics collected by its observers from 76 districts across the country in the month of November last year. Besides, the report alleged that departments of the ministry of health had failed to eradicate polio from country despite many campaigns against this fatal disease for seventeen years. One confirmed polio case was reported in Pakistans largest metropolis, Karachi, in November 2010, indicating the persistence of the viral disease despite aggressive vaccination campaigns by the government since 1993 for its eradication, stated the report. According to data, five cases of probable poliomyelitis were documented in two districts - one in Kamber-Shahdadkot district of Sindh and four in Haripur district of Khyber Pakhtunkhwa (KP). Regardless of the criticism of this report, chairman of Bill & Melinda Gates Foundation has appreciated the role of National Programme Manager of Emergency Polio cell Dr Altaf Bosan and spoke highly of his efforts and commitment to eradicate polio from country. I appreciate your taking the time to meet with me to discuss Pakistans National Emergency Plan for Polio Eradication. I recognize your special role in following up with different provincial EPI project directors to implement the plan quickly and effectively, a letter (copy is available with TheNation) written by Bill gates and to National Program manager EPI cell Dr Altaf stated. It is pertinent to mention here that Pakistan remains one of the four countries including India, Afghanistan, and Nigeria, where polio is an endemic. The report quoting officials of the ministry stated that Pakistan was the only country where more polio cases were recorded in 2010, increasing from 89 recorded in 2009 to 144 in 2010. While many reasons may be cited behind persistence of polio in Pakistan, inadequate immunisation coverage remains the primary cause that may leave many children out of the vaccination loop. In addition to alarming number of maternal, infant and child mortality, a large number of respiratory tract infections (RTIs), gastro and skin infections were also reported during November, says FAFENs health scan report. When asked about the compilation of the, an official of FAFEN said that the FAFEN collected data about the reported cases of diseases from the government-run healthcare facilities during November 2010. 30 children died in Punjab, 20 in Sindh, 16 in KP, seven in Balochistan, two in FATA, and one in ICT. Besides polio, tuberculosis remained another disturbing disease with 28,128 confirmed and suspected cases being reported at government-run healthcare facilities in 76 districts across Pakistan only during November 2010. A majority of TB cases, 20,613, were recorded in Punjab, with the highest number of 5,918 reported in Rahimyar Khan district. It is important to note that according to the draft of the National Health Policy 2009, Pakistan is ranked sixth among the 22 high burden TB countries of the world. In November 2010, 53 per cent of all 1,767,722 reported cases of diseases documented at state-run healthcare facilities, as calculated in 76 districts countrywide, were due to respiratory tract infections (RTIs). Gastrointestinal infections constituted 20 per cent of the total cases of diseases in November. These were categorised into diarrhea and dysentery (taken together), and gastroenteritis. Skin diseases (Scabies) made 13 per cent of all reported cases of diseases in November. In this regard, Sindh was the most disease concentrated, with 115,599 cases observed out of a total 193,104 reported cases of scabies. Dengue was found to be rampant in Lahore district of Punjab, as 2,402 cases out of total 2,882 were reported. It is possible that the high number of cases is due to the turnover of patients from surrounding districts, as there is scarcity of specialised medical services in these areas. Overall, most cases of hepatitis, 2,664, were reported from Punjab. Sindh region was the most affected by malaria, as 113,381 cases out of a total 180,580 were reported in 20 districts monitored in Sindh. The high number of cases of malaria can be attributed in part to the unhygienic and unsanitary living conditions prevailing due to the recent floods. Interestingly, no cases of suspected HIV/AIDS were reported in any part of the country. It merits investigation as to whether this is due to under reporting, since according to the draft of the National Health Policy 2009, evidence indicates increasing prevalence of HIV among certain sections of society, like injecting drug users, making it a concentrated epidemic. The district of Rahimyar Khan (Punjab) followed by Gujranwala (Punjab), Kasur (Punjab), Khairpur (Sindh), and Lahore (Punjab) were observed to be the most disease concentrated in November, 2010. High numbers of infant, child and maternal mortality were reported in November 2010. In the 76 monitored districts, 145 mothers died due to pregnancy or delivery related complications. Alarming levels of infant mortality were also seen, as in one month alone, 1,138 infants died before the age of 12 months. A total of 130 children died before the age of five years in November in the government facilities in monitored districts. FAFEN accused officials of the executive district health offices of six districts including Mansehra (KP), Malakand (KP), Faisalabad (Punjab), Swabi (KP), Tank (KP) and Quetta (Balochistan) of withholding this information from FAFEN monitors.