Warning: This story contains details that readers may find disturbing
Mohammad Amin was eight years old when he died shortly after testing positive for HIV.
His fever was so bad that he insisted on sleeping in the rain, and he writhed in pain as if “he had been thrown into hot oil”, says his mother Sugra.
“He used to fight with me, but he also loved me,” said 10-year-old Asma, kneeling at her younger brother’s grave.
Shortly after her brother contracted the virus, Asma was also diagnosed with HIV. Their families believe both children contracted the infection from contaminated needles during routine treatment at a government hospital in Taunsa, Pakistan’s Punjab province.
They are two of 331 children identified by BBC Eye as having tested positive for HIV in the city between November 2024 and October 2025.
After a doctor from a private clinic linked the outbreak to a hospital called THQ Taunsa in late 2024, local authorities vowed a “major crackdown” and suspended the hospital’s medical superintendent in March 2025 – but a BBC Eye investigation can now reveal the dangerous injection practice continued months later.
During 32 hours of undercover filming at THQ Taunsa in late 2025, we saw syringes being reused in multi-dose vials of medication on 10 separate occasions, potentially contaminating the drugs inside.
In four of these cases we observed medication given to another child from the same vial. We do not know if any of the children were HIV-positive, but this practice creates a clear risk of viral transmission.
“Even if they attach a new needle, the back part, which we call the syringe body, has the virus in it, so this new needle can also transmit it,” said Dr Altaf Ahmed, a consultant microbiologist and one of Pakistan’s leading infectious disease experts, after watching our undercover footage.
We filmed staff, including doctors, injecting patients 66 times without sterile gloves, despite signs on hospital walls showing safe injection practice, and a different expert told us our footage highlighted widespread deficiencies in infection control training in Pakistan.
We also watched a nurse rummage through a medical waste disposal box without sterile gloves. “She is violating every principle of injecting drugs,” Ahmed said.
But when we showed our footage to the hospital’s new medical superintendent, Dr Kasim Buzdar, he refused to accept that it was real. He claimed that it could have been recorded before he took office or that “the footage could even be staged”, and insisted that his hospital was safe for children.
Dr. Gul Kaisrani, a local private doctor, raised this threat at the end of 2024 [BBC]
Gul Kaisrani, a doctor at a local private clinic, was the first to detect the outbreak in late 2024 after seeing an increase in the number of HIV-positive children in his clinic.
Almost all of the 65 to 70 children he found were treated with THQ doses, he says.
He recalls a mother telling him that her daughter was injected with the same syringe as her HIV-infected brother, and that the syringe was then used on several other children. Kaisrani says a father challenged him to reuse the syringe in THQ Tauntsa but was ignored by the nurses.
BBC Eye collected data from the Punjab Provincial AIDS Screening Programme, private clinics and data sets leaked by the police to identify 331 HIV-infected children in the town of Taunsa between November 2024 and October 2025.
Out of a sample of 97 HIV-infected children whose families were also tested, only four of their mothers tested positive. This suggests that very few of these cases are due to mother-to-child transmission. Mohammad Amin and Asma’s mother Sugra tested HIV negative – her husband died in a road accident two years ago.
Provincial AIDS screening program data lists “contaminated needles” as the mode of transmission in more than half of these 331 cases, including asthma—for the others, no mode is listed.
The Punjab government intervened in March 2025, when it said the number of cases was 106. Dr Taib Farooq Chandio, medical superintendent at THQ Taunsa Hospital, has been suspended, but BBC Eye can reveal he has been working with children as a senior medical officer at a rural health center on the outskirts of Taunsa within three months.
Chandio says that as soon as he came to know about the HIV-positive case, he took “necessary measures”. [BBC]
He told BBC i in an interview that THQ took “immediate” action after being notified of an HIV-positive case in Taunsa, but said the hospital was not the cause of the outbreak.
Chandio was replaced by Buzdar, who told the BBC that HIV was his “main focus” when he took over in March 2025 and that he had a “zero tolerance” policy for controlling unsafe infections.
“We conducted training programs for paramedics and staff nurses on how to prevent and defeat HIV. The most important part is our section on infection prevention and control. They are well trained on this,” he said.
But BBC Eye evidence shows that unsafe practices continue eight months later.
BBC footage shows discarded needles alongside syringes and open containers [BBC]
Our footage from November and December 2025, filmed over several weeks, captured syringes and vials frequently being left open on countertops along with discarded needles that should be kept sterile.
Most of the children we saw being treated at THQ Taunsa were injected through a cannula – a tube inserted into a vein – which increases the risk of further infection. By entering the bloodstream directly, contaminated drugs can bypass the body’s natural defenses.
We also videotaped a nurse pulling a used syringe from under the counter to administer fluids for the last patient. Instead of discarding it she hands it to her colleague, apparently ready to be reused on another child.
When we showed Buzdar our undercover footage, he insisted that it was filmed or staged before his tenure.
Asked what he would say to local parents after watching the footage, he said: “I can definitely tell them, with confidence, you should get your treatment at THQ Tounsa.”
In a statement, the local government said there was “no valid epidemiological evidence” “conclusively establishing THQ as the source”.
It added that a joint mission between children’s charity UNICEF, the World Health Organization and regional health services had highlighted the “role of unregulated private practices” and the “contribution of unscreened blood transfusions”.
But BBC Eye has leaked the joint mission’s April 2025 inspection report on the city’s disaster, which found many of the same issues as our investigation at THQ Taunsa.
“The conditions were particularly concerning in the pediatric emergency room,” says the report – one of the departments filmed by BBC Eye.
“Essential pediatric medications were missing, and unsafe injection practices were common. IV [intravenous] Fluids were being reused, cannulas were unlabeled, and used IV sets were hanging on stands. Hand hygiene was neglected – basins were blocked, and no sanitizers were available.”
Our undercover footage shows a nurse rummaging through a medical waste disposal box with her bare hands. [BBC]
Our footage highlights weaknesses in infection control training in Pakistan, says Dr Fatima Mir, a professor of pediatrics at the Aga Khan University Hospital in Karachi. “We must warn our injectors: ‘You will become an active vehicle for disease transmission.'”
Our research suggests that unsafe practices are driven in part by systemic pressures that include reliance on injections as a form of treatment and cultural preferences.
Pakistan has one of the highest rates of medical injections in the world, many of them medically unnecessary. Members of the general public ask for them, including their children, and doctors happily oblige, Meer says. “They should set the threshold for injecting practice very high. Only inject for life-threatening illnesses. For mild to moderate illnesses, use oral medication.”
Lack of drugs and supplies also promotes unsafe practices. The demand for injections can put a strain on resources, which are allocated to government hospitals through a quota system under the supervision of their superintendents. “They have a certain number of supplies and are told they should last the whole month,” says Mir. “Are they seeing that cutting corners is dangerous? And where should the money be spent?”
During our undercover filming we found supplies were often missing on the wards, and patients who could afford liquid paracetamol were told to bring their own. “They make us account for every little bit of medicine,” said one nurse.
We photographed staff who failed to wear gloves and staff who injected patients through clothing [BBC]
The practices documented at THQ Taunsa mirror those in previous outbreaks elsewhere in Pakistan.
In 2019, hundreds of children tested positive for HIV in the town of Ratodero in Sindh province, most of them with parents who tested negative. Local pediatrician Dr Imran Urbani told the BBC that he found repeated clinic visits and multiple injections in their medical history, “so it must have been transferred to one or the other of these medical settings”. By 2021 the number of HIV-positive local children had reached 1,500 – and new infections are still occurring.
When we were filming in Taunsa, several cases were reported in Karachi. In the Site Town area, children treated at the local government hospital, Kulsoom Bai Walika Hospital, later tested HIV positive.
Among them was two-year-old Mikasha.
Two-year-old Mikasha is a child from Karachi who has tested positive for HIV despite her parents’ tests being negative. [BBC]
A family member said hospital staff used the same syringe on several children: “They filled the same syringe and gave it to one child, then filled it again and gave it to another,” they told BBC i.
Dr Mumtaz Shaikh, the hospital’s medical superintendent, said in an interview that “skilled doctors” never reuse syringes, “so we have no idea that such incidents are happening in government hospitals”.
However, the federal health minister has publicly confirmed that 84 people have been infected due to the reuse of contaminated syringes in the hospital.
When we put the results of our investigation to the national government, a spokesperson said it had “acted promptly within its mandate to investigate the concerns. [and] Implement infection prevention and control measures”, with guidelines sent to health facilities in March 2025.
Back in Taunsa, Asma’s family says she is losing weight, and she is now facing lifelong treatment for a virus she was never exposed to.
Stigma can make life difficult for HIV-infected children like Asma [BBC]
The stigma associated with HIV meant neighbors often prevented their children from playing with her, leaving her isolated and sick, her family said. He asks his mother: “What happened to me?”
Standing at her brother’s grave, Asma says she misses him. “He is with God now.”
She works hard at school, according to the BBC.
“When I grow up,” she says, “I want to be a doctor.”
