Christian sewage worker dies after doctors on Ramadan fast refuse to touch him

A Pakistani Christian sewage cleaner has died after three doctors refused to treat him for fear that he would invalidate their Ramadan fast.

Irfan Masih died on 1 June, in Umar Kot, Sindh, some 185 miles from Karachi. He was one of three Christian sewage workers who had fallen unconscious, overcome by poisonous fumes as they attempted to unblock a sewer. But when the three men were brought into the Civil Hospital, a succession of doctors refused to treat them until they were washed. They claimed that their Ramadan fast would be invalid because of the filth covering his body.

The delay led to Irfan's death.

Horrible, dangerous work

This is a story which shines a light on the shocking, institutionalised discrimination faced by many Pakistani Christians and other minorities.

In Pakistan, many Christians are forced to do the kind of menial jobs formerly deemed ritually or literally unclean by people from a 'higher caste'. One of the worst of these is cleaning the sewers, which often means that a cleaner has to hold his breath and dive into the filthy blackwater sewage to open the blockage. This is a job that Muslims refuse to do. Indeed, the word for low caste - chuhra - is a derogatory term reserved for sanitary workers and often used in Pakistan synonymously for 'Christian'. In Umar Kot - Irfan Masih's home - almost all of the 75 Christian families work as sanitary workers. It is horrible, dangerous work: a report by Minority Rights Commission published in 2012 said that at least 70 Christians have died since 1988 while cleaning sewerage pipelines.

No protection, no treatment

Irfan and two other Christian workers - Shaukat Masih and Yaqoob Masih - were ordered to go and unblock a sewer. The sewer in question had already claimed the lives of two sanitary workers in September 2012, so naturally the three men were concerned for their safety.

"They objected that the lines, clogged for a long time, would be filled with poisonous gases," said Irfan's brother, Parvaiz. "But the inspectors told them that they either open the clogged lines or quit their jobs." According to Parvaiz, they were not provided with any protective equipment or clothing.

Yaqoob Masih went down first to unblock the pipe, but was overcome by poisonous gas.

"My brother Irfan then went down to tie a rope to Yaqoob to bring him up," explained Parvaiz. "When Yaqoob was being pulled up, the knot came loose: Yaqoob fell on Irfan, who also fainted. Lastly Shaukat went down to bring them both up but he also fainted."

The men were eventually hauled out by relatives and taken to hospital. But the first doctor to attend them - Muhammad Yousuf - refused to examine them until they were washed.

"He told a ward assistant to get the bodies of the three washed and then he would examine them, as he was fasting, and any physical contact with them would mean Allah would disapprove of his fast," claims Parvaiz. "This same attitude was adopted by two doctors, Allah Daad and Jaam Kambar, who did not provide any medical treatment."

Finally a fourth doctor came - Hanif Arisar - who immediately recognised the severity of the situation and tried to resuscitate Irfan. He ordered for oxygen to be administered, but when the oxygen arrived, the cylinder appeared to be empty. Shaukat and Yaqoob were taken to Hyderabad in a critical condition.

Irfan, sadly, was dead.

Christian protest

Following Irfan's death a number of Christians from Umar Kot gathered to protest, and demanded that a criminal case be registered against three doctors. The Police eventually registered a case of murder by negligence against six people, including the three doctors.

The accused doctors have denied the accusation and claimed that Irfan Mash 'was already dead when they brought him in'. However, a local journalist, Nahid Hussain Khatak, who reached the hospital about 10 minutes after Irfan Masih, corroborates much of the account from Parvaiz. And when BBC reporters asked to see the entry register - which lists each patient brought in to the emergency room and their medical condition - Dr Kumbhar claim they couldn't find it because it had been removed by local Christians.

Meanwhile, the incident has been widely reported on TV and in the newspapers. Worldwide media, including the BBC, have also taken up the story.

"The politicians came here because the case was highlighted in the media," said Irfan's father, Nazeer. "Otherwise, no-one bothers."