<i>Tragedy saw rise of an unsung hero</i>

Bangladesh is full of unsung heroes -- but few remain as unrecognised as Dhaka Shishu Hospital's kidney specialist, Prof Mohammed Hanif. No doubt, in his daily practice as a doctor he saved the lives of many patients, but it was in fact his role as a whistle-blower exposing the dangerous practices within the country's pharmaceutical sector that saved more lives, and particularly deserves the country's praise.
His exceptional work however remains largely unacknowledged and -- sadly -- he continues to be resented by those within the health and pharmaceutical establishment who care little about safe drugs but a lot about making money.
Dr Hanif first came to experience the tragedy of hundreds of children dying from kidney failures in 1982, when he started his career as a resident doctor in PG Hospital in Dhaka. Every day, patients were being admitted with both kidney failures and fever, and despite being treated with dialysis, were still dying.
"I remember, so many children were dying! It was clear that we simply could not do anything to help the children recover. At the end of my shifts, the nurses would tell me again and again that I should just write death certificates for the children, as it was clear that during the night some of them would die. There was nothing we could do."
He was at PG Hospital for four years, and in 1986 moved to Shishu Hospital. "The same thing was happening there. I went away to Australia for further studies for a year, and when I came back in 1988, not much had changed, children were still dying from renal failures completely inexplicably," he said.
He recalled being contacted by Bangabhaban Hospital. "They said the children of staff working at the prime minister's and president's houses, were suffering from renal problems and then dying. I think almost twenty children had died. We checked the water and did other tests at the president's house to see what could be the problem. But we could find nothing that explained what was happening to the children."
Shishu Hospital set up a committee with Prof Hanif as the chair. "Two things happened around 1990 that made us realise that it was something to do with the paracetamol the children were taking. We realised about then that we had children coming to the hospital in need of minor operations like circumcisions, who had no renal problems of any kind. They would have the operation, and then a few days later they would start having renal failures. For those children, it was clearly something inside the hospital was causing the renal failures."
Prof Hanif read a Newsweek article that talked about adulteration of paracetamol in Nigeria.
He was now absolutely convinced that it must be adulterated paracetamol that was causing the deaths. Now the struggle was to convince the government authorities to do something.
"We sent a sample of Adflame's Flammodol to the government drug laboratory asking for it to be tested for diethylene glycol. I never heard back from them. Then we asked the Directorate of Drug Administration itself to take a sample and send it to the drug laboratory. I never heard back from them either. We sent a sample to Japan but we could not read the results. We sent a sample to Fisons but they said their tests could not find any diethylene glycol, but I was convinced that could not be right," remembered Dr Hanif.
"Then I thought we had to find a totally independent and high quality laboratory to do the tests -- and so sent a sample to a person I knew who worked in Massachusetts. He found a government laboratory willing to do the analysis. The test proved positive for diethylene glycol."
Prof Hanif wanted to go public, but others were asking him to wait and make sure that the results were conclusive. "There came a time when I could not wait any longer. Myself and my colleagues had just completed a study that showed that most of the unexplained child deaths could be explained by their taking of paracetamol. So I booked a room and invited all the press and explained the results of the study, and that Adflame's Flammodol had tested positive for diethylene glycol."
It was only when it had been made public that the government started to act, banning the use of all paracetamol syrups, undertaking its own tests, and when the results proved positive, prosecuting those people in four companies alleged to be responsible.
Rather than lauding him as a saviour of children, sections of the media, egged on by a part of the pharmaceutical sector, however started to attack Prof Hanif. "It was alleged that I was trying to destroy the reputation of the Bangladesh pharmaceutical sector. When I went to meetings in the health ministry, I was treated really badly. In meetings I was even threatened," he recalled.
17 years on -- with no justice for the thousands of families whose children were killed in the 1980's and early 90's -- Prof Hanif was again the person who blew the whistle on Rid Pharma this year, for selling adulterated paracetamol causing deaths of at least 28 children.
Sitting in his small office, Prof Hanif hopes that there will never be a third time, but questions the capacity or the willingness of the government to take steps to regulate the import of toxic diethylene glycol, and to properly regulate the pharmaceutical sector.
"The Directorate of Drug Administration is just so corrupt and inefficient," he remarked as he said goodbye and walked off to his next round through wards.