Courage to Differ

سرفروشی کی تمنا اب ہمارے دل میں ہے

2013-04-03T04:17:00.005-07:00

ہمیں آزادی نہیں چاہیے، ہمیں ایسی آزادی نہیں چاہیے جس میں انگریز حکمرانوں کی جگہ مقامی اشرافیہ لے
لیں۔ ہمیں ایسی آزادی نہیں چاہیے جس میں استحصال اور غلامی کا یہ ذلت آمیز نظام قائم رہے۔ ہم ایسی آزادی کے لیے جدوجہد کر رہے ہیں جو سارے نظام کو انقلابی تبدیلی کے ذریعے بدل کر رکھ دے‘۔
یہ زریں الفاظ مارچ 1940میں منعقد ہ مسلم لیگ کے سالانہ اجلاس کے کسی مقرر کے نہیں، نہ ہی ان الفاظ کو مارچ 2013 کے ’سونامے‘ میں شامل کسی راہنما نے ادا کیا۔ ان الفاظ کو ادا کرنے والا شخص، برصغیر کی آزادی میں نمایاں کردار ادا کرنے والا ایک سپاہی تھا، جس نے اپنے مقصد کی تکمیل کے لیے اپنی جان نچھاور کر دی۔ افسوس کی بات تو یہ ہے کہ جس وقت مینار پاکستان کے سائے تلے تبدیلی کے علم بردار فن تقریر کے جوہر دکھا رہے تھے، عین اسی وقت لاہور کے ایک دوسرے حصے میں چند افراد ’سرفروشی کی تمنا‘ رکھنے والوں کی یاد تازہ کر رہے تھے اور ان کو نہ صرف گالیوں سے نوازا گیا بلکہ ہاتھا پائی کی بھی بھرپور کوشش کی گئی۔

ہ طوفان بد تمیزی برپا کرنے والے، ’اسلامی تشخص‘ کے ان ٹھیکے داروں نے بینر اٹھا رکھے تھے جن میں سے ایک کے مطابق ’شادمان فوارہ چوک کو بھگت سنگھ کے نام سے منسوب کرنے کی جسارت پر ہم بھر پور احتجاج کرتے ہیں‘۔ جمہوریت کا تقاضا تو یہ ہے کہ پرامن احتجاج کی آزادی شہریوں کو حاصل ہے، لیکن مخالفین پر تشدد کی اجازت کوئی قانون نہیں دیتا۔ اسی روز اخبار میں خبر
چھپی کہ ’بھگت سنگھ کے چاہنے والے فوارہ چوک کا رخ نہ کریں، ہم کسی صورت بھگت سنگھ کو اہل اسلام اور اہل پاکستان کا ہیرو بننے کی اجازت نہیں دیں گے۔منجانب بھگت سنگھ نامنظور ایکشن کمیٹی‘

ان جاہلوں نے کبھی تاریخ کا سرسری سا مطالعہ بھی کیا ہوتا تو انہیں چند بنیادی حقائق کا اندازہ ہو جاتا۔پہلی عرض تو یہ کہ ہیرو بننے کے لیے کسی بھی انسان کو شادمان کی تاجر برادری کا سرٹیفیکٹ نہیں چاہیے بلکہ تاریخ خود اس چیز کا تعین کرتی ہے۔ دوسری بات یہ کہ بھگت سنگھ نے کبھی کسی مذہب کی حمایت کا دعوی نہیں کیا بلکہ وہ تو مذہب کی بنیاد پر تفریق کا سخت مخالف تھا۔

بھگت سنگھ نے برصغیر کی آزادی کے لیے جدوجہد کی، کسی مخصوص فرقے یا مذہب کی آزادی کے لیے نہیں۔ اگر بھگت سنگھ شادمان کے شاہینوں کی طرح تنگ نظر ہوتا تو کبھی ایک ہندو راہنما لالہ لاجپت رائے کے قتل کا انتقام نہ لیتا، نہ ہی گاندھی کی مخالفت کرتا۔ اور یاد رہے کہ یہ لالہ لاجپت رائے وہ صاحب ہیں جن کا ایک خط جناح صاحب نے 23مارچ1940کی اپنی تقریر میں پڑھا۔ اس خط میں لالہ جی نے لکھا تھا کہ میں مسلمانوں کی تاریخ اور فقہ پڑھ کر اس نتیجہ پر پہنچا ہوں کہ ہندو اور مسلمان اکٹھے نہیں رہ سکتے اور ہمیں اب کوئی راہ نجات نکالنی چاہیے۔

یہ ہمارا قومی المیہ ہے کہ ہماری نصابی کتابوں سے محض سطحی اختلافات کی بنا پر بر صغیر کی تاریخ کے اہم کرداروں جیسے بھگت سنگھ، لالہ لاجپت رائے اور سبھاش چندرا بوس کو حذف کیا گیا۔ ابن خلدون نے کہا تھا کہ تاریخ کا کوئی مذہب یا عقیدہ نہیں ہوا کرتا، لیکن اس بات کا خیال ہمارے اربا ب بست و کشاد کو کبھی نہیں آیا۔

تاریخ کا جنازہ صرف شادمان چوک تک ہی محدود نہیں رہا بلکہ مینار پاکستان کے سائے تلے بھی تاریخ کی آرتی جلائی گئی۔ کے کے عزیز صاحب نے اپنی کتاب میں لکھا کہ ہمیں قرارداد لاہور سے متعلق تاریخ غلط پڑھائی جاتی ہے کیونکہ آل انڈیا مسلم لیگ کا سالانہ اجلاس 24مارچ تک جاری رہا اور طریق یہ ہے کہ کوئی بھی قرارداد اجلاس کے آخری روز پیش کی جاتی ہے۔ 23مارچ1940 کو جناح صاحب نے تقریر تو ضرور کی لیکن قرارداد لاہور 24مارچ کو پیش کی گئی۔ سونامی پارٹی نے اپنے ’تاریخ ساز‘ جلسے کے میدان کو پانی پت سے تشبیح دی تھی۔ تاریخ کے طالب علم واقف ہیں کہ پانی پت کے میدان میں تین بڑی جنگیں لڑی گئیں۔ سب سے پہلے وسطی ایشیا سے تعلق رکھنے والے تیموری النسل بادشاہ بابر نے 1526میں ابراہیم لودھی سے جنگ کی۔ پانی پت کے مقام پر دوسری بڑی جنگ 1556میں بابر کے پوتے، شہنشاہ اکبر نے راجا ہیمو کے خلاف لڑی۔ اس مقام پر تیسری بڑی جنگ افغان بادشاہ احمد شاہ ابدالی نے مرہٹہ سرداروں کے خلاف لڑی۔

ہمیں کوشش کے باوجود اس دن کسی اخبار یا نشریاتی ادارے کی خبروں میں جلسے کے دوران کسی طرز کی لڑائی کا تذکرہ نہیں ملا۔ چند خواتین نے البتہ یہ شکایت ضرور کی کہ بارش کے باعث بھگدڑ مچنے کا چند من چلوں نے ناجائز فائدہ اٹھایا اور اس طرز کے ’معرکوں‘ کو پانی پت سے مشابہت دینا ناانصافی ہو گی۔ البتہ خان صاحب کو بابر سے ضرور تشبیح دی جا سکتی ہے کیونکہ بابر کا بہت مشہور قول ہے

’بابر بہ عیش کوش، عالم دوبار نیست‘ اور خان صاحب نے اپنی کافی ساری عمر اس قول کے عملی نمونے کے طور پر گزاری۔

اگر سونامی پارٹی والوں کی مراد پانی پت کی آخری جنگ تھی تو ان کو یہ بات باور کرانے کی ضرورت ہے کہ احمد شاہ ابدالی نے صرف مرہٹوں کو شکست نہیں دی تھی بلکہ دہلی کی بھی اینٹ سے اینٹ بجا دی تھی، یعنی وہاں بھی ایک طرح کا سونامی آ گیا تھا۔ اس سونامی کے نتیجے میں دہلی کا کیا حشر ہوا، اس کی تفصیلات پھر کبھی سہی۔ خان صاحب اور انکا ٹولہ کس کے ایما پر کس کی اینٹ سے اینٹ بجانا چاہتے ہیں، علما ء اس معاملے پر ابھی تک خاموش ہیں۔

ابھی یار لوگ جلسے کے حاضرین کی تعداد پر ہی بحث کر رہے تھے کہ خبر آئی کہ سونامی پارٹی نے جماعت اسلامی کے ساتھ انتخابی الحاق کا اعلان کیا ہے، گویا کہ پہنچی وہیں پہ خاک جہاں کا خمیر تھی۔ اس عمل سے صاف ظاہر ہو گیا کہ شادمان کے تاجروں اور سونامی کے دعوے داروں کی سوچ میں کوئی خاص فرق نہیں اور جیالے لاکھ نعرے لگا لیں، لیکن بھٹو مر چکا ہے اور مودودی ابھی تک زندہ ہے۔

Pakistan's Jewish Vote

2013-04-03T04:17:00.004-07:00

(Originally published in The News, on 3rd April, 2013)

Magain Shalome Synagogue - Karachi Pakistan

According to the Election Commission of Pakistan, there are around 800 Jewish voters registered in Pakistan out of which 427 are women and 382 men. This statistic seems odd because there are almost no Jewish people in the public sphere in Pakistan and they are not even considered as a minority group during policy discussions.

Historically, thousands of Jews were part of Karachi’s population at the time of Independence. Pakistan hasn’t treated its minorities well and Jewish people were not the only group to be neglected by the state.

Another factor that needs to be considered regarding not just the Jewish voters but our political and intellectual culture as a whole is the prevalent anti-Semitism (here it is strictly taken to mean anti-Jew) in the country.

Mehdi Hasan, a former editor of a British newspaper, recently wrote about the “banality of Muslim anti-Semitism”. He mentioned how Lord Nazir Ahmad blamed a traffic accident that he was involved in and his subsequent conviction on a Jewish conspiracy during an interview with an Urdu channel. For the political right, in Pakistani, blaming the ‘Jews’ is an established norm.

According to Bernard Lewis, the anti-Semitic ideas of the Christians first entered the Muslim world because of Islam’s conquest of Europe, which resulted in many Christians converting to Islam. Prejudices existed in the Islamic world, as did occasional hostility, but not what could be called anti-Semitism, for there was no attribution of cosmic evil to the Jews. Greek Orthodox Christians who found themselves living under Ottoman rule are said to have introduced the notion of the blood libel into the Middle East.

One of the most notorious books cited by people believing in the ‘Jewish’ conspiracy theories is the ‘Protocols of the Elders of Zion’. It is a collection of articles concocted in 1895 by the Russian Czar’s secret police in order to depict the growing strength of Marxists as a Jewish conspiracy.

It was first published in Russia in 1903, and claimed to expose a plan by the Jews to achieve global domination. It was published again after the 1905 Russian Revolution, when the ruling monarchy, stung by the mass uprising, blamed the Jews for instigating the workers’ strikes, peasant uprisings, and military mutinies.

The monarchy had also invoked The Protocols when it blamed the Jews for Russia’s defeat at the hands of Japan in 1904. When the czar was overthrown in the Bolshevik Revolution of 1917, anti-communist Russian exiles used The Protocols to blame Jews for that upheaval too. They depicted the Bolsheviks as overwhelmingly Jewish and executing the plan embodied in The Protocols.

In the 1920s, the London Times exposed The Protocols as a forgery. The newspaper revealed that much of the material had been plagiarised from earlier works of political satire having nothing to do with the Jews.

In 1951, Syed Qutb wrote an essay that clearly defined his view of the Jewish world. Titled “Our fight against the Jews”, the essay was later included in a collection published in Saudi Arabia in 1970. The Saudi booklet bore the same title as Qutb’s essay and was widely circulated in the Arab world, where it became a defining text. The 1970 Saudi version linked Qutb’s work with the discredited Protocols of the Elders of Zion.

Qutb’s essay is pock-marked with footnotes by the Saudi editor who used The Protocols to prove Qutb’s allegations against the Jews.

There are a lot of similarities between Muslims and Jews that are often overlooked due to prevalent anti-Semitism. Mustansar Hussain Tarar, the ace Urdu writer, once explained the similarities between Jews and Muslims in an article titled ‘The Jews and the Muslims (Dawn, February 26, 2006) as “Jews greet each other with ‘Sholom’ and we say ‘Salam’ when we meet. We consider the pig totaly haram and the Jews also refrain from eating it.

“We only eat zabiha meat and the Jews have their equivalent of kosher meat. Like us, they fast. Their skull cap is similar to our namazi topi, and their dress code is very strict. On the streets of New York you will come across neatly dressed Jews, men in black suits and woman in ankle-length skirts and they never wear jeans or revealing dresses.....They are very strict as far as personal hygiene is concerned. And they, like us, get circumcised.”

Despite whatever a certain political party wants us to believe, it’s already a New Pakistan in quite a few respects. We have transgenders, television hosts and film actors competing in the national elections. There is no Jewish person running for political office yet and 800 is not a sufficient number to ensure that in terms of community and identity politics. Moreover, there is no political party that has tried to woo the Jewish voters for the coming elections. Perhaps there will never be. No party has dared challenge the conspiracy theories either, perhaps that can happen in the new Pakistan in the process of being and becoming.

Till then we can only wait to see which way the ‘Jewish vote’ goes, if it goes anywhere.

یہ وہ سحر تو نہیں

2013-03-07T00:06:00.000-08:00

1947 کی بات ہے۔ پاکستان معرض وجود میں آ چکا تھا۔ فیض صاحب دہلی سے لاہور منتقل ہوئے تو نئے ملک کی حالت دیکھ کر دم بخود رہ گئے اور اپنے جذبات کو کچھ یوں بیان کیا:

یہ داغ داغ اجالا، یہ شب گزیدہ سحر
تھا انتظار جس کا، یہ وہ سحر تو نہیں

اجالا بیشک داغ داغ تھا لیکن تقسیم کے بعد شہر لاہور کی ادبی محفلوں کو چار چاند لگ گئے اور اس وقت جو ادب تخلیق کیا گیا، اس جیسا آج تک نہیں کیا جا سکا۔

وقت تبدیل ہوا۔ ابتدائی دنوں کا خمار ٹوٹا اور لاہور کی ادبی سرگرمیوں میں کمی آئی کیونکہ روزگار کے غم دلفریب ہونا شروع ہو گئے۔

وقت گزرتا گیا اور ادبی محفلیں کثیر تر ہوتی گئیں۔ طواف کو نکلے چاہنے والے، نظریں جھکا کر اور جسم و جاں بچا کے چلنے لگے۔ لبوں سے آزادی چھین لی گئی اور ’بول‘ کی صدا لگانے والے ملک بدر کر دیے گئے۔ پاک ٹی ہاؤس ٹائروں کی دکان میں تبدیل ہو گیا، کافی ہاؤس بند ہوتے گئے۔

اس جمود کے عالم میں لاہور ادبی میلے کا انعقاد ایک خوش آئند قدم تھا، اور امید ہے کہ اس طرز پر ہر برس کم از کم ایک تقریب ضرور منعقد کی جائے گی۔

تقریب کا آغاز معروف صحافی مظہر علی خان کے صاحب زادے طارق علی کی تقریر سے ہوا۔ موصوف نے دنیا بھر کے انقلابیوں کا ذکر کیا لیکن ادب سے متعلق کوئی بات کرنے سے گریز اختیار کیا۔

اسی دن کے ایک اور سیشن میں جناب نے سونامی پارٹی کی حمایت کا اعلان کیا جس پر وہاں کثیر تعداد میں موجود برگر بچوں نے خوشی کا اظہار کیا۔ ساری عمر بائیں بازو کی سیاست کا نعرہ بلند کرنے والوں کو سونامی پارٹی میں کیا خاص بات نظر آئی، علماء اس معاملے میں ابھی تک خاموش ہیں۔

ایک دانشور عزیزالحق صاحب نے ایسے لوگوں کے بارے میں کہا تھا کہ ’رہے ساری عمر یوپی کے نواب کے نواب اور سکھاتے رہے اہل پنجاب کو مزدور تحریک کے اسرار و رمو ز‘

تقریب میں ہمارا پسندیدہ سیشن پاکستانی فلموں کے بدلتے کردار سے متعلق تھا۔ ہم نے دیکھا کہ وقت ڈھلنے کے ساتھ کس طرح پاکستانی فلم سازوں، ہدایت کاروں اور لکھاریوں کی ترجیحات بدلتی رہیں، حتی کہ ایک وقت ایسا بھی آیا جب چنگیز خان کو مسلمان دکھایا گیا اور وہ ’اللہ کی رحمت کا سایہ‘ کہلایا۔

لاہور ادبی میلے سے ہمارا سب سے بڑا گلہ یہ رہا کہ تمام اہتمام ایک مخصوص طبقے کے لیے رہا، حتی کہ لاہور کے مہنگے ترین تعلیمی اداروں (جن میں سے ایک کا افتتاح برطانوی واسرائے نے کیا اور دوسرے کو برطانیہ کے گرامر سکولوں کی طرز پر قائم کیا گیا) کے طلباء پر ادبی میلے میں حاضری لازم قرار دی گئی۔

ان بچوں کی موجودگی کے باعث چند مضحکہ خیز واقعات بھی رونما ہوئے۔ ایک سیشن میں انتظار حسین صاحب نے جب دو چار منٹ اردو میں بات شروع کی تو ہال خالی ہونا شروع ہو گیا، اور یہ لازوال فقرہ سننے کو ملا :’چلو بھئی یہاں تو اب شعروشاعری شروع ہو گئی ہے‘۔ لاہور جیسے شہر میں اردو کا اس طرح جنازہ نکلتے، نہ پہلے دیکھا، نہ سنا۔

ایک موقع پر منٹو صاحب پر ہونے والے سیشن میں ان کی بھتیجی ڈاکٹر عائشہ جلال سے اصرار کیا گیا کہ گفتگو انگریزی میں کریں۔ مانا کہ بہت سے غیر ملکی مہمان بھی وہاں موجود تھے لیکن لاہور میں منعقد میلے میں منٹو پر بات اگر اردو میں نہ کی جا سکے تو یہ شرم کا مقام ہے۔

خورشید کمال عزیز صاحب، جو کے کے عزیز کے نام سے بھی جانے جاتے ہیں، اپنی کتاب ’تاریخ کا قتل‘ میں لکھ گئے کہ پنجاب کے لوگوں نے کبھی اپنی زبان کی قدر نہیں کی، پہلے اردو کی ترویج و ترقی کا بیڑہ اٹھایا تو کبھی انگریزی کی جانب راغب ہوئے، جبکہ حقیقت تو یہ ہے کہ نہ ہی اردو ہماری زبان ہے نہ ہی انگریزی۔ یہ دونوں زبانیں تو نوآبادیاتی زبانیں ہیں اور ہماری زبان تو دراصل پنجابی ہے۔

لاہور پنجاب کا دارلحکومت ہے اور یہاں منعقدہ ادبی میلے میں پنجابی پر کچھ نہ کچھ بات ضرور ہونی چاہیے تھی، لیکن جس طرز کا طبقہ بلایا گیا تھا ان کے ہاں پنجابی صرف انکے ڈرائیور حضرات ہی بولتے اور سمجھتے ہیں۔ وارث شاہ، بلھے شاہ، بابا فرید، منیر نیازی، استاد دامن اور امرتا پریتم کی ارواح کو اس طرح کی زیادتی پر بہت تکلیف پہنچی ہوگی۔

اردو پر دو عدد سیشن ہوئے جن میں سامعین تو ایک طرف، چند مقررین نے ہی تشریف لانا گوارا نہیں کیا۔ منٹو اور فیض کا تذکرہ تو بہت ہوا لیکن یار لوگ تو اب صاف کہتے ہیں کہ فیض اور منٹو ادب اور جدوجہد سے زیادہ فیشن کی علامات بن چکے ہیں، یا بنا دیے گئے ہیں۔

ہمیں انگریزی لکھنے والوں سے کوئی پرخاش نہیں مگر جس ملک میں ایک آبادی کی ایک بڑی تعداد آپ کی لکھائی نہ پڑھ سکے، وہاں آپ انگریز ی کی بجائے ولندیزی زبان بھی لکھ لیں تو کچھ مضائقہ نہیں۔ ہاں اگر آپ نے باہر کی دنیا کے لیے لکھنا ہے تو بصد شوق لکھیے، خیالات کسی ایک زبان کی میراث نہیں ہوتے۔

ادبی میلے کے خو ش آئند پہلووں میں بچوں اور نوجوان لکھاریوں کے لیے کیے گئے سیشن شامل تھے۔ اسی طرح ادب میں طوائف کے کردار پر ایک عمدہ سیشن ہوا۔ ادب اور خواتین پر بھی ایک سیشن رکھا گیا جس میں پاکستان میں سب سے زیادہ پڑھی جانے والی خواتین مثلاََ عمیرہ احمد کو مدعو ہی نہیں کیا گیا۔ میلے میں شریک ایک صاحب کے مطابق، جو ایک ہسپتال کی ڈسپنسری میں کام کرتے ہیں، میلے کا ماحول اور اس کے شرکا ء کسی دوسرے سیارے کے مکین لگ رہے تھے۔

کے کے عزیز نے پنجابیوں کی ایک اور صفت بھی بیان کی تھی، یعنی ’سارے جہاں کا درد ہمارے جگر میں ہے‘ لیکن اپنے علاقے اور اس کے لوگوں کی ہمیں کوئی خاص پرواہ نہیں۔

قابل عزت صحافی اور قلم کار محمد حنیف صاحب نے گم شدہ بلوچوں کا نوحہ پڑھا جو قابل داد ہے لیکن ان ہزاروں ’پنجابیوں‘ کا ذکر تک نہیں کیا جن کا واحد جرم صرف یہ تھا کہ وہ پنجابی ہونے کے باوجود بلوچستان میں رہائش پذیر تھے، ان ہزاروں معصوموں کا نوحہ کون لکھے گا؟

بہرحال حنیف صاحب نے کم از کم فوج کے پنجابی ہونے کی غلط فہمی اپنی آزاد نظم کے ذریعے ضرور دور کی اور کہا کہ ’نواب نو روز خان کو جس کتاب پر ہاتھ رکھ کر جھوٹا وعدہ کیا گیا، وہ کتاب پنجابی زبان میں نہیں تھی، اس کے بیٹوں کو جس پھانسی کی رسی سے لٹکایا گیا وہ رسی اچھرہ سے نہیں بھیجی گئی تھی، وہ راکٹ جو اکبر بگٹی کو لگا کوئی سیالکوٹ سے تیار ہو کر نہیں گیا تھا۔ فوج نہ سندھی ہے، نہ بلوچی، نہ پٹھان، نہ پنجابی، فوج تو بس فوج ہوتی ہے‘

ان تمام تلخ حقیقتوں کے باوجود ہم اپنی کشت ویراں سے ناامید نہیں اور توقع کرتے ہیں کہ آئندہ سالوں میں ادبی میلوں کے انعقاد میں بہتری دیکھنے کو ملے گی اور اجالا مزید داغ داغ نہیں رہے گا۔

ثنا خوان تقدیس مشرق کہاں ہیں؟

2013-03-01T07:44:00.002-08:00

چند روز قبل ایک سعودی باشندے فیہان الغامدی نے اپنی پانچ سالہ بیٹی کے ساتھ جو سلوک کیا، وہ نہ صرف ناقابلِ بیان بلکہ ناقابلِ فراموش بھی ہے۔ اسلام اور شریعت کے نام لیواؤں نے البتہ عدل کی مثال قائم کرنے کے بجائے بیٹیاں زمین میں گاڑنے والے معاشرے کی یاد تازہ کردی اور موصوف کو ایک کثیر سی قید اور چند سکے ادا کرنے کی سزا سنائی گئی۔ ابنِ تیمیہ کی تعلیمات پر قائم ریاست سے ہمیں یہی توقع تھی۔

اس واقع سے یہ بات تو واضح ہوگئی کہ سعودی عرب میں چوری کرنے پر تو آپ کے ہاتھ کاٹ دیے جائیں گے، نشہ آور چیزوں کی درآمد پر آپ کا سر قلم کیا جائے گا، لیکن اپنی بیٹی یا کسی سری لنکن آیا کو جان سے مار کر آپ سرخرو ہوسکتے ہیں۔
انسان چاند تک پہنچ گیا لیکن سعودی عرب میں آج تک عورتیں قانونی طور پر گاڑی نہیں چلا سکتیں، کیونکہ سعودی ابھی تک تیرھویں صدی میں رہ رہے ہیں۔

حال ہی میں سعودی حکومت نے حاتم طائی کی قبر پر لات مارتے ہوئے خواتین کو فارمیسی کی دکانوں پر کام کرنے کی اجازت دی ہے۔ یہ خبر پڑھنے کے بعد سے ہم حیرت میں مبتلا ہیں کہ آخر ابھی تک سعودیوں نے حاتم طائی کی قبر منہدم کیوں نہیں کی؟ ابنِ تیمیہ کی روح تڑپ رہی ہوگی۔

تمام عالم میں مسلم اُمّہ کے نام کی ڈگڈگی بجانے والے، اپنے ملک کی شہریت تک تو دینا گوارا نہیں کرتے بلکہ اُمّہ کے دیگر ٹھیکے داروں کے لیے ڈرون طیارے بھی ان کی سرزمین سے اُڑائے جاتے رہے ہیں۔ ایمان سے بتائیے، اگر یہ کھلا تضاد نہیں تو کیا ہے؟ خواتین کی ڈرائیونگ سے تو یقینا ایمان خطرے میں ہے لیکن شام، بحرین، یمن اور پاکستان میں دہشت گردی کی کھلم کھلا ترویج کس شرعی حکم کے مطابق ہے؟

ملک اسحاق اور حافظ سعید کو سالانہ بنیادوں پر ملنے والا ’چندہ‘ جن نیک کاموں میں استعمال ہو رہا ہے، اس کے متعلق سوال کیوں نہیں اُٹھایا جاتا؟ ہندوستان اور جنوب ایشائی ممالک سے جو لڑکیاں غیر قانونی طور پر سعودی عرب لائی جاتی ہیں، اُن کی عصمت اور غیرت کا خیال ثنا خوانِ تقدیسِ مشرق کو کیوں نہیں آتا؟
ہمارے معاشرے میں سعودی عرب کو کچھ زیادہ ہی عزت سے نوازا جاتا ہے۔ اس عزت افزائی کی ایک وجہ تو وہاں پر ہمارے مقدس مقامات کی موجودگی ہے، اس کی ایک وجہ ہمارے وہ عزیز اقربا بھی ہیں جو 80 کی دہائی سے وہاں دن رات کی محنت کے بعد ریال (اور چند کرم فرماؤں کے مطابق شدت پسندی کے جراثیم) اپنے گھر والوں کو ارسال کر رہے ہیں۔

اس عزت اور عقیدت کے مارے ہم عقل اور استدلال کا دامن ہاتھ سے چھوڑ دیتے ہیں۔ تاریخ کا مطالعہ کریں تو معلوم ہوتا ہے کہ موجودہ حکمران خاندان کی حکمرانی 1925 سے پہلے محض نجد کے علاقے تک محیط تھی اور پچھلے چودہ سو سال میں کبھی بھی انہوں نے مقامات مقدسہ پر راج نہیں کیا۔ خلافت عثمانیہ کی بندر بانٹ کے بعد انگریزوں کی حمایت اور امداد کے بل بوتے پر جزیرہ نما عرب پہ قبضہ کرنے والے آج خود کو ’خادمین حرمین شریفین‘ کہتے ہیں۔

بات چل ہی نکلی ہے تو لگے ہاتھوں اِبن تیمیہ صاحب کی کہانی بھی سُن لیجیے۔ تُرکی کے ایک گاؤں حران سے تعلق رکھنے والے تقی الدین ابن تیمیہ نے سلف یعنی ابتدائی دور کے مسلمانوں کے اعمال کو شریعت سمجھنے کے لیے ایک معیار قرار دیا۔

قادریہ سلسلے سے تعلق رکھنے والے ابن تیمیہ نہ صرف اہلِ تشیع کے سخت مخالف تھے بلکہ مزاروں کی زیارت کرنے کو بھی شرک سمجھتے تھے۔ انہوں نے پہلی دفعہ قانونی طور پر فوجی عدالتوں کو گواہی کے بغیر یک طرفہ طور پر سزا ئیں سنانے کا اختیار دیا۔

علاوہ ازیں، حالت جنگ میں دوسرے مسلمانوں کو قتل کرنے کی اجازت بھی جناب نے عطا کی (ان فتاویٰ کو موجودہ دور کے تکفیری آج تک استعمال کر رہے ہیں)۔ ابو غریب اور گوانتامو پر اعتراض کرنے والے نہیں جانتے کہ قید کے دوران تشدد کے حق میں قانونی توجیح تاریخ میں پہلی دفعہ ابن تیمیہ کے خاص شاگرد ابن قائم نے پیش کی۔ سن 1326 میں ابن تیمیہ کو مزار پرستی کے خلاف آواز بلند کرنے پر قید میں ڈال دیا گیا اور دو سال بعد قید کے دوران ہی انکا انتقال ہوا۔ وفات کے بعد دمشق میں واقع ان کے مزار پر کئی صدیوں تک زائرین کا تانتا بندھا رہا۔

ہماری سعودی عرب یا اس کے حکمرانوں سے کوئی ذاتی پرخاش نہیں، مجھ عاجز کی تو آپ سے محض یہ التجا ہے کہ براہ کرم اپنے گریبان پر نظر ڈالیں اور عقیدت کے بھنور سے باہر نکل کر حالات و واقعات پر نظر دوڑائیں۔

انصاف کا تقاضا یہ ہے کہ جس طرح عافیہ صدیقی کی سزا پر واویلا مچایا گیا ویسے ہی اس پانچ سالہ معصوم بچی پر کئے گئے ظلم کے خلاف آواز اٹھائی جائے۔

گورکھ دھندا

2013-03-01T07:41:00.000-08:00

ولی رضا نصر امریکہ میں ایران اور مشرقِ وسطی سے متعلق بین الاقوامی امور کے استاد ہیں۔ ان کی دو ہزار نو میں تحریر شدہ کتاب ’اسلامی سرمایہ داری کا عروج‘ میں ولی نصر صاحب کا موقف تھا کہ مسلمان ممالک میں کاروباری طبقے کے پاس پہلے کی نسبت زیادہ سیاسی طاقت موجود ہے اور اس طاقت کو استعمال کر کے انتہا پسندی کے عفریت کو شکست دی جا سکتی ہے۔

اس موقف کو واضح کرنے کے لیے انہوں نے دبئی، ملایشیا، ترکی، ایران اور ابوظہبی کی مثالیں پیش کی ہیں۔ ظاہراَ تو یہ بات معنی طلب لگتی ہے لیکن اس نظریے میں کئی سقم پائے جاتے ہیں۔ عموماَ کسی بھی ملک کا کاروباری طبقہ ملکی حالات میں امن اور تواتر چاہتا ہے کیونکہ امن کے بغیر تجارت ممکن نہیں ہوتی۔

پاکستان کے معاملے میں البتہ گنگا ذرا اُلٹی بہتی ہے، چنانچہ شدت پسندی اور انتہا پسندی کو فروغ دینے میں تاجر برادری کا بھرپور حصہ ہے۔ نوے کی دہائی میں کشمیر ی ’مجاہدین‘ کے لیے چندہ اکٹھا کرنا ہو یا ناموس رسالت کے نام پر ملک گیر ہڑتال کرنی ہو، پاکستان کی تاجر برادری ہمیشہ صفِ اوّل میں رہی ہے۔ یہاں اس امر کی وضاحت ضروری ہے کہ تاجر طبقے سے ہماری مراد درمیانی سطح کے کاروباری حضرات ہیں، بڑے بڑے کارخانوں کے مالکان اور کریانہ فروش نہیں.

ہمیں اپنی تاجر برادری کے کچھ بنیادی تضادات کو سمجھنے میں اکثر دشواری پیش آتی ہے۔ چور بازاری، ذخیرہ اندوزی اور ملاوٹ میں تو کوئی کسر نہیں چھوڑی جاتی لیکن نماز کا وقفہ بہرحال لازم ہے۔ اپنے ملازمین کی تنخواہ بڑھانے کے خیال سے ہی ہول اْٹھتا ہے لیکن مساجد کے لیے چندہ دینے میں کبھی بْخل سے کام نہیں لیا۔ حکومت کو ٹیکس دینا گناہِ کبیرہ سمجھا جاتا ہے مگر ’مجاہدین‘ کے لیے جان بھی حاضر ہے۔
کتاب ’پنجابی طالبان‘ کے لکھاری مجاہد حسین کے مطابق سن دو ہزار دو میں لشکرِ طیبہ کو روزانہ لگ بھگ دو کروڑ چندہ مل رہا تھا۔ یہ چندہ میرے اور آپ کی ریز گاری سے نہیں بلکہ تاجر برادری کی فضیلت سے اکٹھا ہو رہا تھا۔ یاد رہے کہ یہ وہی تاجر طبقہ ہے جس نے چند سال قبل ویلیو ایڈڈ ٹیکس VAT کے نفاذ کے خلاف کہرام برپا کردیا تھا۔ امریکی جھنڈوں کو ہفتہ وار آگ لگانے والے بیوپاری نیٹو کے ٹرکوں سے لُوٹا ہوا مال برسرِعام فروخت کرتے ہیں۔

چند احباب کے خیال میں پنجاب کے تاجر باقی صوبوں کے کاروباری حضرات سے زیادہ بنیاد پرست ہیں۔ پنجاب کا تاجر پنجابی شاؤنزم یعنی بالادستی کا علم بردار ضرور ہے مگر یہ تصور کرنا محض خام خیالی ہے کہ کراچی اور پشاور کے تاجر کوئی دودھ میں دھلے ہوئے ہیں، وہ بھی اِسی گھِن چکر کا حصہ ہیں۔

دلچسپ بات یہ ہے کہ پاکستان کا تاجر طبقہ انتہا پسندی کی پشت پناہی میں منفرد نہیں اور ایسی مثالیں ہمیں ہمسایہ ممالک میں بھی دیکھنے کو ملتی ہیں۔ ہندوستان میں ہندو مہا سبھائی تنظیموں کو ہمیشہ ’بازار‘ کی پشت پناہی حاصل رہی ہے۔ ایران میں انقلاب کے بعد مذہبی راہنماؤں کے عروج اور بائیں بازو کی جماعتوں کے زوال میں کاروباری طبقے کی مرضی شامل تھی۔

تاریخ دان جناب حسن جعفر زیدی کے مطابق انگریز کے دور میں وسطی اور بالائی پنجاب میں منڈیوں کے ارد گرد شہر بسائے گئے اور ان شہروں کے تاجر طبقے نے پاکستان بننے کے بعد کے بگاڑ میں نمایاں کردار ادا کیا۔ لاہور سے شائع ہونے والا ایک اخبار، جس نے نہ صرف پاکستان کو نظریاتی ریاست بنانے کا ٹھیکہ اٹھایا بلکہ غیر جمہوری اقدام کو پروان چڑھانے میں بھی مہارت حاصل کی، ہمیشہ سے کاروباری طبقے کے مفادات کا ترجمان اور محافظ رہا ہے۔

خدا لگتی تو یہ ہے کہ بنیاد پرستی پاکستان کے بالائی یا زیریں طبقے کا مسئلہ نہیں بلکہ ہمارے نو دولتی طبقے کا پھیلایا ہوا ناسُور ہے۔ اس مسئلے کو حل کرنے کے لیے ہمیں پہلے اس گورکھ دھندے کو سمجھنا ہو گا اور تب ہی ہم کسی قسم کے حل تک پہنچ سکتے ہیں۔

Aboard the First Metro

2013-02-19T23:26:00.001-08:00

(Published in The News on February 13th, 2013)

Public transport is an essential component of urban planning. All major cities in the world have some form of public transport system to facilitate the daily commute for their denizens. The various kinds of public transport systems include underground subway tracks, trams, designated buses and rapid transit networks.

Unfortunately in Pakistan, there is a serious lack of viable public transport in all major cities. Karachi, with a population of 20 million people, Lahore with almost half this population and other cities like Peshawar and Rawalpindi have no real (public) transport facilities for their residents.

A subway system for Lahore was planned by the previous provincial government but it had to be abandoned due to technical and political reasons. Our country does not have enough power sources to fuel a subway system efficiently. To counter the over-flooding of roads by vehicular traffic, political administrators across the country have used a similar but flawed agenda: build more roads.

In the last decade, Karachi saw its fair share of digging and paving of roads, resulting in a network of bridges, underpasses, overhead bridges and expressways. This planning was short-term and in a few more years, roads are going to be clogged again. Lahore has a different story to tell.

According to a survey conducted last year, only about eight percent of the population has access to a private automobile in Lahore. Nearly twenty percent of the city commutes by bus and 40 percent gets about on foot.

The report also highlights that collectively Lahoris take an estimated 9.8 million trips a day. For a city of nearly 10 million, this figure is less than half of other cities of comparable size. In addition nearly 65 percent of Lahore’s population lives in about 10 percent of its footprint (the areas north of GT Road and the railway station) and the remaining 35 percent of the population occupy the remaining 90 percent with a low-density sprawl.

Over the years, many attempts have been made to solve Lahore’s traffic problems. The widening of Jail Road and Ferozepur Road in the 1990s; the construction of underpasses and the widening of Canal Bank Road; and the construction of Ring Road.

All these efforts have resulted in temporary relief for a few years followed by a return of congested roads. Meanwhile, nothing has been done to improve the archaic public transport system or to make the city bicycle-friendly.

Against this backdrop, work on the bus rapid transport system on Ferozepur Road was initiated. After eight months of toil, we finally have a new transport route in the city. I attended the inauguration ceremony for the bus rapid transit (BRT) system in Lahore and got a chance to take a ride on one of the first metro buses.

During the inauguration ceremony, we were regaled with the usual technical details about the project, followed by a lengthy address by the deputy prime minister of Turkey.

It should be noted that the Turkish government helped the local government with the infrastructure for the project due to their expertise with similar projects in Istanbul. The ceremony itself was grand with more than 3000 participants, including politicians from different parties, civil society members, civil servants, vice chancellors, businessmen, members of the media and students. After the ceremony, a ride in the buses was arranged across the length of Ferozepur Road.

Despite my scepticism, I found the buses comfortable with a separate space for women and adequate standing and sitting space for male passengers.

Our buses were welcomed by cheers throughout the 27 kilometre long journey by not only the ‘PML-N faithful’ but also from people standing on rooftops and travelling in their own vehicles. I believe this is a step in the right direction and similar projects have to be started in other cities of Pakistan.

However, one of the biggest concerns with the project is the fact that people who already have vehicles will not prefer to travel on the BRT buses. There are no parking spaces near the stations and the number of people who will stop using their own cars to use this facility is negligible.

Thus, this system will cater to people who are already travelling via public transport. This hardly helps the situation since the idea should be to ensure a safe, cheap method of commute that all citizens can use.

And then there is the huge economic cost of the project. For a pilot project, the amount spent has been extravagant. Punjab’s overdraft limit has already been exceeded and after spending Rs6 billion on the sasti roti scheme and a 40 percent overdraft on the laptop scheme, this kind of spending is not advisable.

In conclusion? Whatever the merits of the BRT system, it is not economically feasible for the province. Now that work has been completed and the project has started, one can only wish it the best of luck and hope that it is successful.

Doctors on Strike

2013-02-19T23:17:00.001-08:00

(My first Article published in The News on 31st January, 2013)

A cat and mouse game is raging on between Young Doctors and Government of Punjab. There is a set pattern being followed by both sides, based on earlier skirmishes in the last two years. The primer is usually an untoward incident involving young doctors. As a consequence,there is outrage from young doctors while the government announces some form of committee to sort out the problem. Nothing discernible happens for next few weeks/months. Doctors come out on the streets and OPD(Out Patient Departments) are closed. A few individuals are dismissed from service by the Government and a few people are arrested. As a last resort, doctors announce withdrawal of emergency services, crippling the already overloaded public health system. Within a few days, some makeshift solution is cobbled up and things go back to normal. This routine is being followed for last 2 years and if things remain as they are, can be repeated this time as well.

Young Doctors have been branded assassins and mercenaries, devoid of all humanity, sacrificing all moral values to bargain for their demands. Hundreds of doctors have been terminated over the last two years, and dozens have been jailed. A vicious propaganda campaign was designed last year, costing the public exchequer more than 400 Million Rupees to malign doctors. There is little understanding of the issue plaguing doctors in this country and they are seen with derision and contempt because they have the temerity to demand their rights. The most prevalent misunderstanding about the doctors’ protests is the belief that they are demanding a pay raise. While this was true two years ago, the issue of pays was resolved. Let me clarify that it is not mentioned anywhere in the Hippocratic or any other medical oath that doctors ‘have’ to provide medical care regardless of the conditions. Regarding the morality of strikes, Awais Aftab, a fellow doctor, explained,

“A doctor enters into a contract with the society only by virtue of his contract with the Government, therefore, if the Government refuses to honor its obligation of providing adequate facilities and working conditions for the doctors, then the doctors’ obligation to work for the Government becomes questionable. This includes the issue of pay and service structure. If the amount of work and the circumstances in which they are expected to perform deviate significantly from the pay and facilities they are receiving, Government is violating its obligations. This can be augmented by a utilitarian justification. If the short-term harm brought about by the strike is balanced by a long-term benefit to the society in the form of an improvement in health-care, virtue of the fact that doctors can work more efficiently in better working conditions, then a strike is justified. But this utilitarian argument can only be an augmentation, not the crux, because we all know that human lives cannot be added and subtracted.”

The Prime demand of doctors is provision of a better service structure. The current structure is dependent totally on the whims of Baabus at Civil Secretariat who consider doctors as inferior and despicable species. There is no uniform system of promotion. I have documented cases of different doctors who graduated in the same year, from the same college, and having similar qualifications, where one of the two was promoted as a Professor and the other is still in grade 18. Hundreds of “relics of the past” are occupying positions in Major cities while young doctors are transferred to far flung areas. Professors of respective wards are kept busy in administrative affairs, affecting teaching schedules and regimes. Induction of doctors on Medical Officer posts is done via Federal Public Service Commission(FPSC). There were no inductions on regular seats for more than 15 years in the last two decades, contract employment was favored instead. Young Doctors in most major hospitals live in dilapidated hostels, single rooms shared by upto three people. More people do house jobs without any pay than those who get pay. These issue are important when you are doing more than 60 hours work per week without any reward.

In November 2012, an agreement was reached between Young Doctors and Government of Punjab that the new service structure would be implemented. Two months after that understanding there was no sign of implementation. The dispute over non-renewal of contracts and housing allowance was simmering in District Head Quarters(DHQ) Hosiptal Gujrawnala as a direct consequence of the non-implementation of doctors’ demands. A team of interlocutors from Lahore was there on 2^nd January 2013 when the whole scene got ugly, resulting in physical violence by doctors and by hospital administration. It was broadcast on live television across the nation with some spiced up subtitles. As a result, more than a dozen doctors were arrested and are still in Jail. OPDs(Out Patient Departments) are closed throughout the province in protest and a major ‘Dharna’ has been planned for 7^th February 2013.

Personally, I do not endorse the physical violence unleashed by young doctors in Gujranwala and want an impartial inquiry into the matter. Apart from that, I stand by the doctors’ community in the struggle for the proposed(and agreed-upon) service structure. Government of Punjab has tried all sorts of delaying tactics including court delays, invitation to 200 Army doctors, induction of substandard doctors during the strikes and police torture. As a doctor and as a human being, I hope the issue is resolved completely this time, or both sides are going to lose.

Public Health Care in Pakistan: A basket case

2013-02-19T23:10:00.000-08:00

(Originally Published in two parts in The News as "Our Sickly Health Care" on February 7 and February 8 2013)

"The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being" according to the constitution of World Health Organization.
The constitution of Pakistan guarantees basic rights and liberties to all citizens of the state. These rights derive from fundamental principles of justice in accordance with which the State of Pakistan assumes the sole monopoly of power over its citizens. To provide health facilities to the citizenzs, there is a Universal Health Care system in Pakistan. This means that any citizen of Pakistan can get treatment at public sector health care facilities in the country. Pakistan has a wide network of healthcare infrastructure, including 919 hospitals, 5334 Basic Health Units (BHUs) and Sub-Health Centres, 560 Rural Health Centres (RHCs), 4712 Dispensaries, 905 Maternal and Child Health (MCH) Centres and 288 Tuberculosis Centres. This system is supposed to cater to a population of around 190 million people.

Thus, one doctor at a public hospital is supposed to cater to about 1724 people, while 1504 people have to vie for a single bed at a public hospital. In a physician per 1000 people statistic, Pakistan ranks 120^th among 200 countries, with only India, Iran and Egypt among developing nations below us.

Pakistan is among the only three countries left in the world with Polio Virus infection, the other two being Afghanistan and Nigeria. Recent reports indicate that Karachi, Peshawar and Hyderabad,Lahore and Rawalpindi have turned ‘polio-endemic’ due to continuous detection of the wild poliovirus virus type-1 in the sewage samples collected from there. There are more than a million people in Pakistan have Chronic Liver Disease while 10% of the population has had exposure to Hepatitis B and C viruses. As many as 1.2 million people die of waterborne diseases in Pakistan every year, of them 250,000 are children under the age of five years. In a recent meeting organized by a public health research and consultancy firm, 54% of the most serious crises and shocks Pakistan has suffered in the last three years have been health-related as compared to only 3% that have been law and order related.

We have had brushes with Widespread Dengue Virus Infection, the PIC(Punjab Institute of Cardiology)-Syndrome outbreak, Naegleria Infection in Karachi and the very recent Cough Syrup-controversy. To quote a report by Pakistan Institute of Development Economics,
“Pakistan’s health care system is inadequate, inefficient, and expensive; and comprises an under-funded and inefficient public sector along with a mixed, expensive and unregulated private sector. These poor conditions in the health sector may be attributed to a number of factors like poverty, malnutrition, unequal access to health facilities, inadequate allocation for health, and high population growth and infant mortality.”

There is acute shortage of data for health indicators in Pakistan. Health, is not a priroity of either the Government, or the people, until an emergency strikes. Every new government has brought in new health policies but implementation of these policies has not been undertaken over time. Take the case of Punjab. It is the most populated province of Punjab. There has been no Health Minister for the last 5 years and the Chief Minister has kept the portfolio with himself. The current government has opened medical colleges in almost all major cities of Punjab over the last 4 years. The lack of planning is apparent in this case as no new teaching hospital has been established and retaliatory shelving of plans by the previous government has affected the system. Without proper teaching hospitals, medical students graduating from newer colleges will have to move to other cities for getting better exposure to clinical training. The last teaching hospital established in Punjab was Jinnah Hospital, in Lahore, in the mid-90s. Regarding retaliatory politics, the half-complete building of Wazirabad Institute of Cardiology is a living testament.

Started on the orders of the previous Chief Minister, this project aimed at catering to cardiac patients between Lahore and Rawalpindi and adjoining areas. At present, if a person needs cardiac care in Gujranwala/Gujrat/Jhelum area, he/she needs to visit either Lahore or Rawalpidni due to lack of any facilities nearby. Time, though is a crucial matters in cases of Heart disease and an early detection can significantly improve chances of Improvement. Patients are brought from all over northern part of Punjab to Lahore because of Lahore-centric health spending. There are 17 medical colleges in Lahore, compared to 17 in the rest of the province. For about 600 burn patients annually, there are a grand total of THREE specialized burn centers in Punjab. Similarly, only 155 mechanical ventilators are available in Lahore’s public hospitals for a patient load of more than 5 hundred thousand patients every month.

Tubeculosis, Hepatitis, Cholera, Malnutrition,Polio and recently, Measles, are some of the major problems being faced by the Public health providers. With the advent of Breaking News culture, any issue deemed imprtant by the media becomes important, public health almost never makes the cut, unless there is significant panic, as in cases of Dengue, PIC-syndrome and Cough Syrup-controversy. High mortality rates don’t bring high ratings, thus no need to focus on the isssue, let the children die. Newborns only matter when bitten by mice etc, that sells. The dismal condition of public health infrastructure has given rise to a popular phenomenon in Pakistan; People taking up things in their own hands. We required a public ambulance service, Cue Edhi and Cheepa. We needed good schools and Universities; Enter Private Schools and Universities. Similarly, to fill the huge void of public health, private entities and charity based organization stepped in. Currently, almost 80% of health sector in Pakistan is based in Private sector.

For a self-respecting middle class Pakistani, visiting a public sector hospital is nothing less than a nightmare. Due to over-burden of patient load, resources dry up fast. Data collected by the author for one particular ward at a teaching hospital in Lahore revealed that in a duration of 24 hours, around 700 patients visited the medical emergency of the hospital. There were only 45 beds available in that particular ward. At the end of 24 hours, 60 patients had been admitted, resulting in patients having to share beds in majority of cases. There is acute shortage of beds in teaching hospitals and there are no plans on the horizon till now that anything is going to be done in this regard. According to figures from last budget, Punjab Government has allocated a spending of Rs 120 for every citizen of Punjab. That is not sufficient even if you want 2 surgical sutures.!!

There is an overall sense of pessimism in the Public Hospitals, which ultimately leads to the exodus of doctors to greener pastures. This is just the tip of the iceburg. All doctors are not god-fearing, messianic figures either. A lot of senior doctors practice twice a day; spending morning in government hospitals and evenings at private clinics. Then there is the issue of equipments and their effective running. Two months ago, the X-ray machine at the largest hospital of the Province was out of order, and remained like that for at least two weeks. No heads rolled. No reporting in the media. Situation is even worse in other provinces. There are hardly any specialized centers in Balochistan or even Khyber Pakhtunkhwa(excluding Peshawar) or Gilgit Baltistan.

It is the first law of Health Economics that
“ Increased Spending on health leads to increase in per capita GDP”. Currently less than 2% budget is allocated for Health Sector and even with this pittance, the behemoth of public health care system is functioning admist crises. The first and foremost solution to the numerous problems is presence of political will to spend more money on healthcare. Until that will is mustered, there is scant chance of improvement in the system.

Furthermore, there are significant Problems concerning public health both at the policy and implementation level, especially after the devolution of Health Ministry to Provinces. Spending has to be increased, population explosion has to be halted, Long term policies have to adopted to increase the outreach of public sector healthcare, private sector needs to be regulated, more Teaching hospitals and specialized centres need to be established in areas like FATA, Balochistan, Southern Punjab and Gilgit Baltistan.Our State has failed in providing the citizens good health care and it is affecting the whole economy. Media and civil society have an increased role to play in this regard, because of negligent behaviour of the state. One of the tenets of the doctors’ movement has been increased spending on public hospitals and decrease in VIP protocol patients. Very recently, category for “poor” patients was shelved by the administration at Punjab Institute of Cardiology and no one has taken any notice of that.

It should not be forgotten that a state that absolves itself of its responsibilities, is paving way for its own downfall. Spending public money on flyovers, foreign visits and security guards is not going to solve the problems of health and education in this country.

Of Protocols and Parchi System

2013-01-04T02:31:00.000-08:00

Published on 04 January, 2012 in The Friday Times

"Kindly admit our patient, Doctor Sahab. We have talked to the Medical Superintendant and your Head of Department. They have sent us here."

I was sitting in the ward, making discharge slips for patients when someone got my attention by uttering these words. I checked the papers and found that the man was right. He had been sent to our hospital by a top office-bearer of the ruling political party in the province. I was reluctant to oblige such commands as I don't personally think political workers are any more deserving of a doctor's attention than the downtrodden people who fill government hospitals. By sheer luck, there was no vacant bed available in the ward. I explained the situation politely to the man and the hospital employee sent by the "Protocol Office" (designated to oblige influential people, their relatives and lackeys). They tried to reason with me by pointing out that the M.S. had talked to our professor twice and he had written on a slip that these people should be accommodated. I asked my immediate superior about this, and he was also of the view that we have no spare beds and can't accommodate someone just because they have better connections. He talked to my interlocutor himself and in the end the party left without the bed. This was one of those rare times when we resisted the protocol patients, as we have come to call them. Most of the time, however, anyone designated as a protocol case gets preference over ordinary patients.
At the public hospital where I work, there are special VIP and VVIP wards specified for senior bureaucrats, political figures, judges and their families. In spite of that, countless patients are referred by political figures to the hospital with small slips on their letter pads. This is true for almost every public hospital in Pakistan. As we are based in Lahore, we get most of our "slips" from party affiliates or government officials employed by the ruling party of Punjab. In other provinces, only the names change and the "slip system" remains the same. Underlying this whole culture is the belief that unless you are influential enough, you won't get good treatment from public service providers, be they doctors or engineers or policemen. This understanding breeds a more-than-bearable nepotism for any society.

The worst abusers of public service systems are public servants themselves. Senior bureaucrats consider government property as their personal fiefdom. To ensure that every whim of the politicians and bureaucrats is fulfilled, most appointments on the post of Medical Superintendents are politically motivated. Subservience and acquiescence are the requisite qualities desired by the higher-ups for the highest posts in public hospital administration.

Doctors themselves are no less culpable. It is usually said that doctors make the worse patients. I would like to add to this axiom that they not only are the worst patients, they usually are the worst attendants as well. I distinctly remember one time when a classmate of mine at medical school brought her grandmother over to our ward for admission. We provided her with the best care that we could. After two days, she passed away. Since then my classmate has not talked to me, as if it was my fault. She herself is a doctor.

I have worked in the Intensive Care Unit (ICU) and a lot of times we've had undeserving patients brought in by other doctors. The ICU is supposed to be for patients whose lives can be saved by intensive care and who are on the brink of death. This is true unless you happen to know a doctor; then rules and regulations can be thrown out of the window. The tragedy of public hospitals in Pakistan is that unless you know someone working there, you are not awarded any extra care. As a doctor, I always try to provide equal care to my patients, irrespective of their status. I am not alone in behaving like this. We feel ashamed when resources are diverted for the sake of "sifarshis". We are sick of tending to the favored ones. We believe that our healthcare system is already neglected and needs no further roadblocks than the ones it already confronts. My request and plea to the people at the top: kindly stop pulling your rank to make us care for your cronies. Thank You.

We Survived Sandy

2012-11-11T13:30:00.000-08:00

(A little background on this piece. I am visiting the United States these days as a fellow of "Emerging Youth Leaders of Pakistan" program, initiated by the Atlantic Council, funded by the Carnegie Corporation of New York. This post is a recollection of memories gained in New York, our first destination.)

Times Square

Ad for Newsies

Maine Monument, Central Park

Library of Columbia University

SANDY

Seinfeld Restaurant

Cathedral of St John

NY Skyline from Rockefeller Center

View of NY from Empire state building

We Survived Sandy

“Do you Speak Arabic?” and “Are you wearing a [suicide] vest?” were two of the questions I was asked when I told people that I was from Pakistan. It is usually said that you take some part of your country with you wherever you go and the first thing you do in another country is to confront their stereotype about you. Being in New York, that too during one of the worst storms in the history of the city, was a great experience to have. The first thing I noticed as soon as we reached JFK Airport was the large number of visitors, mostly from Eastern Europe, who were waiting to go through Immigration. I have heard nasty/creepy stories about Immigration at U.S airports but what I got was quite non-descript. No cavity search, no long interrogations, no suspicious looks or change in attitude. It was a bit disconcerting as well to know that they didn’t deem me important/suspicious enough to at least do a full body scan.!!

As soon as we slipped out of the airport, we faced a gush of strong chilly wind which accompanied us throughout our visit. We reached our hotel after forty minutes of travelling(or sleeping, in my case) and were welcomed there by Mr. Shuja Nawaz and Huma from the Atlantic Council. After depositing our luggage in our respective rooms, we got a chance to wander out in the streets of New York. During that detour, I discovered that Cart food is considered good in New York, which is totally contrary to what we(or at least my family and medical fraternity in general) think about cart food in Pakistan. We got Shawarmas from “The Halal Guys” and later had a walk up the avenue to visit Times Square.

After our first visit of Times Square, we got addicted to it and we visited Times Square at least once daily. We got pictured on the camera feed present there, ventured up the red steps, got loads of pictures and what not.

In the preceding days, we were largely confined to our hotel due to the “Franken-Storm” named Sandy. We had two intellectually engaging sessions with Mr. Shuja Nawaz and I got to meet Prof Manan Ahmad at Columbia University. It was during the meeting with Mr. Manan that I realized where I was sitting at that time. It was the “Seinfeld” restaurant, the exterior of which was showed in almost every episode of my favorite television comedy show. It did not have the same interior design but it was nonetheless a great feeling for a die-hard Seinfeld fan to be at that particular Diner. We also got to visit Columbia University and had lunch at a nearby Japanese Restaurant. I still don’t remember what I ate that day(I was clueless while eating as well).

During the visit to Columbia, we went to witness Cathedral of St. John the divine, which is the 4^th largest Christian church in the world and probably one of the biggest Gothic churches in the world. It had an exquisite exterior and I don’t think I have ever seen a building that grand and beautiful in my entire life. We encounter a shady(albeit Silver-Tongued) character there who, apart from detailing the history of the church and its reconstruction, also pestered us with Conspiracy theories and how different “signs” had already appeared on the walls of the church forecasting the future.

Being in New York City during Sandy was both a nightmare and an opportunity to witness emergency management in a “developed” country by ourselves. Early Warnings were issued and the local government responded to the storm as well as they could. A lot of difficulties had to be faced, including power shutdowns and absence of the Subway system, which practically paralyzed the city. Many of our plans had to be shelved because of these problems but we still managed to walk around the city, as much as we could. It was a unique opportunity for us to have a firsthand experience of how a “Developed Country” responds to national emergencies and disasters. We have seen what happened in our own country in the wake of Earthquake in 2005 and Floods in 2010 and 2011. Due to effective management and early warnings, the impact of the storm was reduced and less than a hundred people lost their lives due to the storm, which does not reflect accurately the gravity of the situation.

While we were busy confronting our own stereotypes, we also discovered how wrong so many people have been about New Yorkers. It is usually said that New Yorkers are arrogant, detached and apathetic. I confess that one week is too soon to reach any conclusion but at least for this much duration, we(or at least I) found New Yorkers to be none of the above. I had previously thought that taking so many pictures and getting people to take pictures of us or with them would be at least a bit annoying for most people, but No sir, it was not the case. We got pictures with Cops in Times Square at 11 p.m., with paramedics on Broadway at 5 in the morning and asked a florist at 6 a.m. to take a picture of our group. None of those people even displayed a smirk. A taxi driver once refused to charge some of the fellows because he was a Pakistani while a Rickshaw driver gave us good enough discount on the ride. My beard was also supposed to be a problem for me but it never was, not at the immigration, not in the city, not in any of the offices that we went.

It is also frequently said by travelers that a city can only be truly explored if you walk through it. I have done this experiment previously and have fallen in love with parts of Lahore because of this exercise. In New York, all we did was walking. We were fortunate that our hotel was located near so many memorable places and we got the chance to explore a lot just by walking. On a personal note, I am not a big fan of pets but the amount of cute dogs I saw on the streets of Manhattan reduced some of the strong feelings I had about this issue. Initially there was some problem with food, as after breakfast we had so many options but their “Halal-ness” was not verified so we were reluctant to experiment. I am already a vegetarian so it was not a big gastronomic shock for me but for some of our fellows, it was a very difficult time. I had Japanese food for the first time which I liked, not so much the American staple diets.

United States is supposed to be the Land of Free so the first thing that I did upon reaching my hotel was to use YouTube, which has been blocked in Pakistan for the last few weeks.
My mind couldn't stop comparisons when I saw different things in the streets of New York. Cart Food, which is shunned by most well-off Pakistanis, is considered good enough in New York. Tap Water can be used for drinking purposes, without a second thought about any water-associated illness. Thank Yous and Sorrys are much more common. No one gives you a second look, whatever your skin color or dress might be. People get out of the way if you want to get pictures of a particular place. Zebra crossings actually work and vehicles would stop for pedestrians even if the pedestrians are violating the rules. No one cuts through the line, how long that might be. No whistling in theaters. People generally follow time for meetings and excuse politely as soon as the time finishes. These few little actions may not be thought of much by people in the U.S because they have grown accustomed to them but for folks from the "developing world" (thats a misnomer), they are fascinating.

We visited a grassroots organization working for development of under-privileged South Asian children, named SAYA (South Asia Youth Action). It was heartening to witness active community participation in helping the community itself. We also visited an office of the United Nations Organization (UNO), where we met the Chief Knowledge management office of the UN. Later that day, we visited the Rockefeller Centre and Grand Central Station, both of which are among favorite tourist destinations.

One fine morning, we decided to visit Downtown area and ended up in Greenwich Village. To our utter amazement, there was no electricity in the area, reminding us of Pakistan. We even saw a utility store which was being run under the light of a solitary candle. Most of the shops were closed and streets were generally deserted. We saw a statue of Mr. Gandhi in the Greenwich area. It was followed by a spur of the moment decision to visit the Empire State Building which was nearby. I and another fellow were among the first batch of visitors to the Empire State building that day (tours start from 8 a.m. onwards). It was an out of the world experience to be standing on top of Empire State and finding the city of New York under our feet. It was really cold up there as well but the joy and excitement were overwhelming. It was a proper “Empire State of Mind”.

We visited the offices of New York Times, one of the most widely read newspapers in the world, on 2^nd November, 2012. For an aspiring journalist such as myself, it was akin to visiting Heaven. The one thing that caught my eye apart from the exquisite interior design was the amount of books present on each of the staff's workstation. Despite being a bookworm myself (6 half/quarter-read books lying on my own side table), I was amazed. I don't know many journalists or press people in Pakistan who read such a huge amount of books (a few of them do, but they are exceptions not the rule). Douglas Schorzman, Foreign News Editor of NYT talked to us about various issues regarding NY Times. He was joined for sometime by Susan Chira, assistant managing editor for news of The New York Times. Mr. Douglas was eloquent in answering queries of inquisitive youth leaders from Pakistan and provided detailed answers. He also took us on a short tour of the News Offices. We were able to appreciate the “Open Culture” at New York Times which represents transparency on part of the Newspaper.

To conclude our visit of New York, we got a chance to watch a Broadway Show. Two groups were formed, one of which opted for watching “The Lion King” while the other, including myself, opted for watching “Newsies”. It was one of the most exhilarating experiences of my life. No wonder the play won the prestigious Tony Award for best play. Performance of the actors was so good that one of my companions wondered if it were a 3D movie? I have seen and acted in semi-professional theater in Pakistan and have watched some good theater performances but Broadway was a different galaxy altogether. It was surreal, magical, and inexplicable, beyond the reach of words. It was the perfect ending to our Topsy-turvy tour of New York, a cherry on the top.

Brain Drain(Part 2)

2012-10-11T19:22:00.000-07:00

(Published in The Friday Times on 12th October, 2012)

Dr. Adnan was the best graduate of his MBBS session three years ago. He had achieved the highest marks in almost all the annual exams during his five years of medical school. He completed his house job of one year and spent almost 6 months in preparing for the entrance exam to a Residency program in the United States (the USMLE or United States Medical Licensing Exam). He cleared the first two stages (it's a three-stage exam) with ease and applied for a visa, so that he could visit the United States and take the third and final exam of USMLE. But he was denied a visa for the United States. He has spent almost 300,000 rupees in fees for the tests, and it has taken him a year for him to reach this stage. But his efforts have been in vain.

126,931. That is the number of Registered Medical Practitioners (people who have obtained MBBS degrees and have completed a house job of one year) in Pakistan, according to the Pakistan Medical and Dental Council. Every year, some 8,000 fresh medical graduates join this list. A vast majority of Pakistan's medical graduates want to move to either the United States, the United Kingdom, Australia, the Middle East or other green pastures in the world beyond Pakistan. According to a report aired on Geo News on 8th August 2012, Pakistan has become the largest exporter of young doctors to Britain's state-funded National Health Service (NHS). The number of Pakistanis registered on the GMC (General Medical Council) data stood at 8,552 on 7th of August, 2012. Similarly, according to a research paper titled 'Pakistani Physicians and the Repatriation Equation', published in the New England Journal of Medicine, Pakistan has contributed approximately 10,000 international medical graduates (IMGs) to the United States. In a research conducted in 2007 titled 'Reasons for migration among medical students from Karachi', it was revealed that Over 95% of Aga Khan University (AKU) and over 65% of Baqai University (BU) final-year medical students intend to go abroad for their postgraduate training.

And all this while Pakistan is facing an acute shortage of trained doctors, according to reports by the World Health Organization (WHO).Pakistan cannot meet its needs for healthcare, given the current levels of production and dependency on physicians in the organization of the system. Although out-migration contributes to the problem, it is the growing demand for healthcare from increases in population and adverse conditions that generates ill-health. The most important question to ask about this mass migration is: Why are all these people leaving their country?

The answer is manifold and, speaking as a health professional myself, painful to state.

The survey done on medical students of Karachi's elite Aga Khan University and Baqai Medical University revealed that the two most important factors behind this intent as pointed out by the students are poor salary structure and poor quality of training in Pakistan. I can vouch from my personal experience that as soon as a medical student enters the medical school, the next big question regarding his/her life is the "plan" or path he/she intends to take after graduation. Even during the one-year training of the house job - something I am currently pursuing - the queries about the "future" are among the most frequently asked questions by one's seniors and family members.

It is an absolute travesty that in Pakistan the practice of "Career Counseling" for medical professionals is practically nonexistent. Most middle-class parents only have three or four career options for their kids: Doctor, Engineer, Banker/Accountant and if all else fails, Army. In a similar fashion, when a medical student enters medical school, it is from his/her seniors that guidance about any future plans is acquired. Traditionally, there are four ways to pursue post-graduation for Pakistani students. The first one is the FCPS (Fellow of College of Physicians and Surgeons, Pakistan) route, which involves four years of clinical training at a tertiary care hospital in Pakistan. After completing four years of training and passing the FCPS exams, you are considered a specialist in whichever field you chose to pursue. The second and most attractive option is that of obtaining a residency in the United States, where the training standards are the highest in the world. For that route, a candidate has to go through the three stages of the USMLE exam (the examination fee for each step is more than 1.5 lakh rupees), the third of which can only be done in the United States.

After the residency and an exam, the candidate becomes "Diplomat American Board" for the chosen specialty. It should be noted that the ratio of people who get their desired residency after passing the exams is around 50-60%, which means that despite getting excellent marks, you are not guaranteed to get your favored specialty (for example Anesthesia or Neurosurgery) in 50 to 60% cases. The time required to complete this whole process ranges between 3 to 5 years.

The third option is that of pursuing post-graduation in the UK. To follow that route, one first has to pass the PLAB (Professional and Linguistic Assessments Board) exam, which is a two-stage test. The examination fee for each stage is also more than one lakh rupees. After completion of PLAB, post-graduation courses are taken, based on available spots in the preferred specialty. The whole process of completing this route takes around 5-7 years. An alternate route to acquiring British certification is the MRCP/MRCS (Member of Royal College of Medicine/Surgery) route, which is a two-stage route, but the training can be obtained in Pakistan while exams have to be taken in the UK.

The fourth and latest addition to the options is that of post-graduation in Australia. For that, a candidate has to pass the entrance exam of the AMC (Australian Medical Council), which also has two separate tests. The examination fee for each step is in the range of the fee for USMLE. There is no guarantee of getting a post-graduate education in Australia even after getting excellent marks in the first entrance exam.

Most medical students in Pakistan don't know which path they will take, even whether they will be able to work in their desired field or if they will get a job where the salary is adequate after about ten years of medical training. And this, I am sorry to say, is the primary dilemma of the medical community, the so-called "cream" of the Pakistani nation.

Doctors Strike: The Aftermath

2012-09-15T07:15:00.001-07:00

Doctors’ Strike: The Aftermath

It has been two months since one of the largest strike by doctors shook the province of Punjab. It all started with the closure of Outdoor Patient Departments (OPDs) in all major hospitals across the province as a gesture to protest against the attitude of the Government of Punjab in provision of a better service structure for Doctors. It was a move designed to be of minimal impact because only ‘stable’ patients visit OPDs and there was no threat to patients’ lives. Last year similar protests by doctors led to a commitment by the Chief Minister to provide a new service structure and committees were formed to pave the way for formulating an acceptable formula. The closure of OPDs happened after one year of useless meetings with the representatives of Punjab government.

Last year, government was unable to control doctors and the chaos led to loss of many precious lives and ended with a truce. This time around, Khwaja Salman Rafiq (brother of Saad Rafiq and Special Assistant to Chief Minister on matters of Health) was designated the responsibility to ‘deal’ with the situation. Punjab Government started giving half-page advertisements in all major newspapers stating it had already done too much for the doctors and that doctors were essentially getting too big for their own boots. An estimated Rs. 1.6 million per day was given to newspapers and Rs. 450 million of public money was spent on advertising by ‘Khadim e Aala’s government. In addition, Essential Services Act was enforced by the govt, making it mandatory for doctors to do their OPD duties or else receive legal proceedings.

On 1^st July, 2012(after 21 days of OPD closure), a police raid was conducted at Doctors’ Hostel, Services hospital Lahore, resulting in arrest of numerous doctors. The same night, hundreds of other doctors were arrested from their homes. There was another raid at Doctors’ Hostel, King Edward Medical College on the night of 2^nd July. A total of 360 doctors were kept in Jails including Kot Lakhpat, Attock and Mianwali for four days. As a result of all this, emergency services were withdrawn from all major hospitals and any negotiations were made subject to release of all the doctors.

I want to recount some of the ‘stunts’ pulled out by the government during all this, apart from ‘Advertisement’ money from the public exchequer.

1. ‘Medical Martial Law’:

As a ‘contingency’ plan during the closure of OPDs, Punjab government requested help of Army Medical Corps (AMC) to decrease patient overload. This was an unprecedented act of desperateness and expediency shown by the big-wigs of Punjab Government. This ‘experiment’ did not work out though. It failed miserably. Senior Doctors said it on record that the Army doctors were not trained to deal with such situations. Additionally, those doctors were paid Rs 2000 per hour of duty and special police contingents were employed outside hospitals where the Army doctors worked. For comparison, government of Punjab was paying Rs 800 per day to junior doctors and Rs 1400 per day to seniors whose places the Army doctors took for few days.
There were reports of those Army doctors misbehaving with the senior doctors and the ‘flexible’ duty hours practiced by our 'Jarri Jawans'. At the start of the Strike, Zaid Hamid's Baloongra's alleged that YDA punjab is actually “NGO funded Young Animal Association” and they work for money, not for saving lives. The 'Brave' Army Doctors that came 'to the rescue' didn't work for free though. This is the characteristic selective Amnesia practiced by Qibla Zaid Hamid and his followers. For the Record, only 200 Army Doctors were deployed.!!!

2. The PCO Doctors

During the strike by Junior Doctors, Government hired around 500 new doctors (in place of around 5000 doctors) on ad-hoc basis. Those individuals are known these days as ‘PCO doctors’. They mostly include foreign graduates (who can’t normally get jobs at Government Hospitals as per orders of Chief Minister) and people who could not get job in ordinary circumstances. Some people, who had not practiced medicine for more than 10 years, joined the service just to get a paid Job. Chief Minister Punjab is fond of parroting the mantra of ‘Merit’ but these blatantly out-of-merit inductions did not gain his attention. All these people were hired against the rules and on ‘paid seats’ while more than 50% doctors work in government sector without getting any pay.

3. The legal Front

Apart from hundreds of doctors arrested without any justification, four doctors from Mayo Hospital were charged with Murder of a child that died in the Pediatrics Ward on the night of 1^st July, 2012. The Strike was also challenged in court and it resulted in involvement of Lahore High Court in the matter. The court ordered to release all doctors who were arrested without any legal reason and granted bail to the four doctors alleged to be involved in the Murder. It was further ordered that matters pertaining to Service Structure should be solved amicably by the Punjab Government.

4. Lies and Damn Lies
Throughout the strikes, there was a continuous propaganda mongering done against the ‘Cream of Nation’. Government Officials lied on Television programs and press-conferences about doctors being greedy, selfish, hooligans etc. The entire Advertisements campaign consisted of Jacked up figures that were used to fool people.

The Aftermath

On 2^nd August, one month after the strike, a follow-up meeting was called up by Young Doctors Association in Services Hospital Lahore. Dr. Amir Bandesha, member of the committee delibrating the future service structure, explained at length about the proposed changes to the existing structure and the points on which a consensus had been reached between Punjab Govt and YDAP. ‘PCO Doctors’ are still working in the hospitals despite resumption of services by young doctors and it is the demand of YDAP to transfer them to DHQs and RHCs. After the meeting of general council of Young Doctors Association on 29^th August, 2012, province-wide protests were held on 5^th of September to exert further pressure on the Govt to solve our problems. Committees have failed to provide us any relief and even the Lahore High Court has been unable to enforce the writ of law. Another Protest/Dharna is planned for 19^th September and a March to the CM Punjab House after that. Is another showdown between doctors and State on the way?

Brain Drain-1

2012-09-14T02:16:00.000-07:00

(Published in The Friday Times on 14-09-2012)

33,703 candidates appeared in the entry test for medical colleges in Punjab last year, competing for 5,271 seats in 40 public and private medical and dental colleges. Nearly 3,500 seats are available in 15 medical and 3 dental colleges in the public sector, while 1,850 seats are available in private medical and dental colleges. This suggests that the top 3,000 candidates would be able to secure admission in the public sector and around 2,000 more will get admission in Private Medical Institutes.

These figures raise the question: What about the rest of the 28,000 students who passed FSc (Pre-Medical) with more than 60% marks but were deemed not good enough to get admission into a medical college, either due to merit or financial issues, as Private Medical Colleges charge almost half a million rupees every year only in tuition fee?

As the saying goes: where there is a will, there is a way. And that's another way of saying that students who want to become doctors should make use of opportunities to study medicine abroad.

Medical education in developed countries such as USA,UK, Australia and Canada is much more expensive than in Pakistan, so the options for most Pakistani students are either China or the ex-Soviet states such as Kazakhstan or Kyrgyzstan. Medical Education in these countries is imparted in English, so there's no worry about language barriers. Browse through any English or Urdu daily in Pakistan and you'll see advertisements for institutes in these countries.

This trend of going abroad to get a degree in medicine started in the 1990s when Central Asian colleges became a destination for students who lacked good marks. It should be pointed out that the minimum eligibility criteria for the Medical Colleges Admission Test (MCAT) is 60% marks in FSc. Initially, students with marks as low as 35-40% were able to secure admissions in Central Asian colleges. It was a dream come true, a shortcut bypassing the system in Pakistan. Chinese medical institutes offering medical courses in English started in the last decade.

At present, around 2,000 Pakistanis are studying medicine in
various medical schools across Kyrgyzstan. According to the
United Nations, a July 2006 survey of medical students at nine
institutions in Kyrgyzstan rated their level of knowledge
between 2 and 2.6 on a five-point scale. In China, there are 6
medical colleges and 1 dental college recognized by the
Pakistan Medical and Dental Council (PMDC). Each of these
medical schools has around 150-200 Pakistani students per
session. Nine hundred Pakistani medical students are presently
studying medicine in Cuba on scholarships awarded by the
Cuban government after the 2005 earthquake. But PMDC does
not recognize Cuba's medical colleges and the living conditions
of our students there are pathetic. Around 100 Pakistani
students are studying medicine in Bangladesh.

Vulnerable students are duped into some of these places with
fancy titles like 'WHO Recognized Medical Institute'. The fact
remains that WHO (World Health Organization) "has no
authority to grant any form of recognition or accreditation to
schools of medicine or other training institutions. Such a
procedure remains the exclusive prerogative of the national
government concerned." (This is WHO's own clarification.)

The Pakistani state has done little to stall this "business".
Pakistan's embassies in the respective countries do not own
the students if they face any difficulties regarding the whole
process. In Cuba, students live 15 Kilometres away from the
city in which their college is located. In China, many
universities which are not officially recognized enroll students
using paid agents in Pakistan. Every admission gets the agent a
fixed amount of money and the unsuspecting student can't get
out of this maze easily.

The big problem facing Pakistan's health system is the influx
of these Foreign Educated Doctors and their integration into
the system. These medical graduates are not at par with their
counterparts from Pakistan-based institutes and that creates a
chasm in their ability levels. In almost all the foreign
universities, clinical training, the backbone of undergraduate
programs, is seriously lacking because of obvious language
constraints. You can teach students in English but you can't
teach them all the required nuances of the local language in
such a short period of time. Without the necessary knowledge
of the local language, how can anyone get a good medical
history from a patient? (Around 70% of clinical diagnoses are
based on a patient's medical history.)

PMDC has made it compulsory for all international medical
graduates to pass a specially designed test to practice medicine
in Pakistan. This is the only intervention done on a
governmental level for these doctors. A lot of those who can't
pass the test end up working for private hospitals, as they
can't get jobs in the public sector. This alternate pathway for
medical education is going to flood Pakistan with a lot of
substandard doctors very soon.

Diary of a young doctor(part 6)

2012-08-16T23:58:00.004-07:00

(Published in The Friday Times on 17th August, 2012)

Medical Science, like other disciplines of science, is a constantly evolving subject. New discoveries are being made, new ways to treat and look at diseases are being researched and newer drugs are being introduced on a daily basis. But the medical profession in Pakistan is lagging far behind the rest of the word in innovation and research. Very little, if any, research is being done by public sector hospitals and medical colleges. Apart from the Aga Khan University and Shaukat Khanam Hospital, there are no recognizable research centers in the country. Due to this issue, most of the books we consult during MBBS are written by Western or Indian authors.
It may come as a surprise to the reader that doctors in Pakistan are required to do research as part of their curriculum, both at the undergraduate and post-graduate levels. The ground realities, though, are very different. Very few of the "researches" done by Pakistani authors are published in international publications. On the undergraduate level, the research is mostly very basic and does not require much critical thinking, nor is it up to an international standard. The Community Medicine departments (responsible for overseeing research) ask students to choose from a particular list of topics on which research can be done. No funding is provided for the purposes of research. Students usually take shortcuts just to fulfill the academic requirement, and the matter is over after the final exams.
On the post-graduate level, where research is an important tool in the rest of the world, Pakistani doctors do not spend enough time on research topics. Most of the topics are re-hashed versions of the same old 'traditional' things. A grand sum of Rs 2,200 can get you a good synopsis on your chosen topic. Plagiarism is not thoroughly checked, so liberties can be taken in that regard. I questioned some of the senior doctors about this trend and they pointed out a few factors responsible for this problem.

The foremost issue is financial. Most post-graduates do not have job security and often have to work at multiple hospitals. In addition, they do not get any kind of funding for the sake of research. In such conditions, all they do is look for shortcuts to fulfill the academic requirement. In Shaukat Khanam Hospital, doctors are paid handsome salaries and have job security, resulting in some serious research work being done there. The proposed Service Structure that was the demand of doctors during their recent strikes is a much-needed step as it would at least provide job security, if not lavish pays.

The second most important reason for lack of research is the absence of critical thinking from our curricula. Research is borne out of questions about persisting problems and requires finding solutions to problems. We, on the other hand, learn and see throughout our academic life that 'he/she who crams the most, achieves the maximum marks'. From nursery school all the way to the final year of MBBS, we learn how to rote-learn particular texts and then regurgitate them in our exams. Questions are discouraged at almost every level and many teachers think it a disgrace if they do not know the answer to a student's question. In addition, there are almost no research societies working in medical colleges. The only one that I encountered was a small society working out of Punjab Medical College, Faisalabad.

The third factor in this regard is the lack of teachers and instructors who can guide students about research. This problem is present both in medical schools and in the College of Physicians and Surgeons, the premier body that awards specialization degrees in Pakistan. In many cases, the supervisors for research are not well-versed in the art of evaluating a research paper as it is very different from an examination paper.

Despite all these problems and glitches, there are still some success stories. Pakistani doctors, particularly surgeons, have developed many indigenous solutions to the problems they have faced over the years. The need of the hour is to promote critical thinking and research among the medical community so that Pakistani doctors can compete on an even keel with their international colleagues.

Diary of a Young Doctor(part 5)

2012-07-27T01:50:00.001-07:00

(published in The Friday Times on 27th July, 2012)

"I am really thankful to you doctor sahiba, you saved my daughters' life today," said the mother of a young woman to one of my female colleagues.

The very next day, another attendant had this to say,

"You doctors are murderers. You don't know how it feels when your loved ones die. You have killed our young brother. We will never forgive you."
Both of the above-mentioned statements reflect a common misconception in our society, that doctors are supposed to be messiahs who save lives. I may have to face the wrath of some of my fellow professionals for saying it out loud, but this can't be farther from the truth. During the five years of medical school, followed by countless years of medical training, all we learn are a set number of protocols to follow. There is no subject or even a chapter dedicated in any of our books on 'How to Save a Life' (excuse me for the reference to a song with the same name by the band The Fray). The main problem with this assumption is the immense responsibility it places on the shoulders of the attending physician/surgeon. Doctors, in general, safeguard the best interests of their patients but having the mantle of 'saviour' placed on their shoulders is more than a little unfair.
As a result of the 'messiah' label, doctors become the automatic fall guys when a tragedy occurs. Doctors are obliged to do their best, regardless of the expected results, and when their efforts fail, the first impulse of the attendants is to blame the doctor for the demise of their loved one. I am not saying that medical science is guesswork; but why is the medical profession considered a "calling from God"? It is high time we learned to differentiate between a profession and a calling from God. Doctors are "working" in hospitals. They aren't on a divine mission to save everyone who comes their way. They provide a service and in return expect to get paid for it. (And we know how that's gone done in our country.)
When doctors announced a strike to demand for a better service structure, the widespread reaction was that doctors should be philanthropists who put others before themselves and don't ask for a compensation package in return for the time they have invested.
To quote the columnist Ayaz Amir: "The young doctors' strike was not about doctors versus ailing and suffering humanity. In the Islamic Republic suffering humanity is a handy cliche, readily invoked to score a political point and as readily consigned to the upper layers of forgotten memory when the need passes. If anything, this strike was doctors versus a hidebound bureaucracy, one of the most ossified bureaucracies in the lands which can claim descent from the British Raj."

During the strike by doctors, one of the major objections was that doctors were supposed to provide health services in any condition, as they have taken an oath to do so. Let me make it absolutely clear that in the original Hippocratic Oath that was formulated around the year 425 BC, there is no provision that makes it mandatory for a doctor to provide health services to anyone who wants them. In the revised Hippocratic Oath, constituted by the British Medical Association, one of the points declares: "I will do my best to help anyone in medical need, in emergencies. I will make every effort to ensure the rights of all patients are respected."
Similarly, according to PM&DC (Pakistan Medical and Dental Council) Ordinance of 16th July 2011, Section 9, Sub-Section 2 (a) : "A medical or dental practitioner shall be free to choose whom to serve, with whom to associate and lay the timings and place of professional services to be provided."

While Sub Section 2(b) reads: "A medical or dental practitioner shall not be bound to treat each and every person asking his/her services."
In my opinion, one of the underlying causes of outrage against doctors during the strikes was the "messiah" proposition. How can someone who is supposed to "save lives" go on strike? As a nation, we are prone to miracles and magical rescues; we are always hoping for some messiah to come and save us from the "mess" we are in. This messiah complex has in the past led to acquiescence to dictators and demagogues. We, as a nation, need to mature and start believing in processes and institutions, not saviours. Bottom Line: Doctors are not messiahs; they are ordinary professionals doing the best that they can.

Reflections from Pakistan India Social Media Mela 2012

2012-07-16T07:13:00.001-07:00

(an abridged version published by Express Tribune Blogs on 16th July, 2012)

Question: What is the one common thing between a writer from Mumbai, a Journalist from Delhi, a famous film maker from India and a Junior doctor from Lahore?

Answer: The fact that all of them loved hearing Iqbal Bano(it was actually Meesha Shafi, as pointed out later by Jugal Mody) sing 'Dasht e Tanhai main' on the radio, at wee hours in the morning while waiting to get CNG at a gas station in Karachi.

For me, that one moment captured the spirit of Pakistan India Social Media Mela 2012. No wonder the slogan of the event said, “Faasla Na Rakhen, Pyar ho Jaanay Dain’(Translation: Overcome distances, Let love happen)

Organized in Karachi by PeaceNiche, in collaboration with the United States Consulates in Lahore, Islamabad and Karachi, it was supposed to be a gathering of social media enthusiasts from India and Pakistan. This being Pakistan, the criticism leveled at the event started much before the event itself. It was an invite-only affair and most people who were invited were recommended by other people. Participants from Lahore and Islamabad were sponsored by U.S Consulates in Lahore, Islamabad and Karachi for their travel and accommodation.

It was my first visit to Karachi and I was really excited by this opportunity. I boarded the plane from Lahore airport on the evening of 12th July, along with the rest of participants from Lahore. The visit was not only an opportunity to interact with new people but also to get a respite from the hectic schedule at the hospital. During the flight, I had a good, long chat with my seat mate whom I discovered to be a fellow participant. I got some flak after the plane landed, from assorted uncles who were unfortunate enough to have gotten seats around us. The first thing that I noticed after landing in Karachi was the wind. We were transported to Avari hotel and allotted rooms. When I reached my designated room, I had to pinch myself to judge if I was not dreaming. The rooms were spacious, comfortable and had attached baths separated by glass walls.

We were offered BBQ dinner at the top floor of the hotel. That was where we first met fellow participants from India including Onir, Karuna John, Jugal Mody, Venket Ananth, Sabbah Haji, Annie Zaidi, Raheel Khurshid and Sanjay Rajoura. I immediately struck cordial notes with one of them because of me being a vegetarian. Later, I took part in an interesting discussion about Marxism, Class Struggle and Pakistan Movement taking place at an adjacent table.

The next two days were one of the best that I've had. Despite being an adopted Lahori, I didn't miss Lahore for a moment. I wouldn't have met many of favorite people at one place if I had not come to the mela, including Nadeem F Paracha (one of my mentors), Ali Chishti, Marvi Sirmed, Beena Sarwar, Mohsin Sayeed, Muhammed Hanif, Faiza S Khan, Musharraf Ali Farooqi, Declan Walsh, Amir Mughal, Murtaza Solangi, Hassaan Belal a.k.a mighty, Sana Saleem, Ali Arqam, Zebunnisa Burki and the wonderful people from across the border. At the start of first day's session (around 9 a.m. which was an inconvenience for many people) Senator Rehman Malik, usually at the receiving end of mockery by social media people, was generously praised for urgent attention to the visa problems faced by guests from India.

The sessions were mostly insightful and informative but I personally enjoyed the off-session activities where I got the chance to interact with some amazing people.

Some of the memorable sessions dealt with online activism, role of social media in education sector, use of non-profit for non-profit organizations, online activism, Pakistan-India relations, ‘Slactivism’, impact of party politics on Social Media, Internet Censorship, Cyber-Bullying and Twitter as the new Newsroom.
I was a panelist at the session 'Fight Club:Rise of the Troll' alongside Bina Shah, who had come fully prepared with research, Mohsin Sayeed, star of our show and a delightful presence throughout the mela, Raza Rumi and Rab Nawaz, editor of the magazine Laaltain and member of Khudi Pakistan. Some sessions were, indeed, boring but that is how things work usually. Due to my involvment in the recent doctors' strikes, I had plenty of questions to answer. I was branded 'the revolutionary doctor' by Sher Ali, an Express Tribune reporter and 'Hartaali doctor' was my nick name. After the first day, the event was declared open to everybody because of the quips about elitism and exclusion.

There was a Qawalli session after first days’ proceedings and it featured Fareed Ayaz and Abu Muhammad, the best Qawwals in Asia. They enthralled the crowd with their renditions from Sufi poetry.
There was a standup comedy act on the second day by Sanjay Rajoura and he left the audience rolling on the ground with his observational comedy about Facebook albums, Indian Cricket and some social peculiarities. He received a standing ovation at the end.

Contrary to popular expectations, the event did NOT offer a solution to the Kashmir Problem, brought an end to killing of Shias and Hazaras in Pakistan, decreased the level of radicalism in Pakistan or ended the hostility between Pakistan and India. Kashmir was mentioned, but only as a barter for Coke Studio by Sanjay in his stand up act. The issue of persecution of minorities was discussed in detail and panelists included members from Ahmedi, Hazara and Christian communities. It was a social media event, not a Track 2 diplomat meeting. There were many Hazara participants there as well, which was encouraging. It was not a kitty party and for the record, only two women were actually wearing Sari(Even if they were, Whats wrong with that?), so over-generalizations have to be avoided.

It was a unique coming together of people who know each other mostly by twitter names and such events should take place at least once a year. It was a tremendous effort by Sabeen Mahmood and her team at PeaceNiche, and I would like to thank and congratulate the team at PeaceNiche and the U.S Consulate staff for their co-operation and hospitality. I would also thank my new friends from Karachi and India, for their love and company. I left the event with a heavy heart, new friends and acquaintances and countless good memories.

A big shout out to my new friends
Faizan Lakhani, FurSid, Aroosa Shaukat, Sheru, Tuba, Shiraz Hassan, Osama, Faheem(@smokenfog), Yasser Latif Hamdani, Shahab(@UncleFu), Rab Nawaz, Sara Muzzammil, Awais Aftab, Bilal Tanweer, Salman Lateef and Zeeshan Haider.

Diary of a young doctor (Part 4)

2012-07-15T06:45:00.004-07:00

(published in The Friday Times on 13th July, 2012)

Pay Up
"Please give me some money, I'm hungry and don't have any money to buy food," said the beggar.

"I wish I could, my friend, but I earn less than you do," was my reply. And I was not bluffing.

There is a simple basic rule that governs almost all professions in the world: you work and that earns you money. There are strings attached to this simple fact according to diferent fields but the basic notion remains the same. Soldiers claim to fight for the country, police officers risk their lives for maintaing law and order, public servants work (or at least they are supposed to work) to provide services to their countrymen. At the end of the day, however, they all get paid for it. From the highest offices of the country to the lowest, from generals to chowkidars, from CEOs to clerks, the maidservants that work in houses, sewage workers, technicians, sales boys, they all get paid for doing their job. But in present-day Pakistan we are making one big exception to this rule: doctors.

I have chronicled the lives of young doctors and have described the trials and tribulations associated with their job. It is hard to believe that despite all this hard work, most doctors working in public sector hospitals are not paid. Imagine a person with 17 years of education, working 28 days a month, doing 30 hr/48 hr duties, and earning a grand total of zero rupees per month.

Imagine a life with no pay, no job security and no health insurance (given that we deal routinely with HIV positive and Hepatitis C infected patients). All that keeps us going are the 'thank yous' of patients and a hope that someday, things will be better.

After the doctors' protests last year, pays were increased. This does not mean that everyone is getting that pay. In the department where I work, there are 28 people working as House Officers and around 30 as Medical Officers/Post Graduate Trainees (PGRs). Out of 28 House Officers, only 8 are on the paid seats while the remaining 20 are working on 'honorary' basis (there is not much honor involved; it is a euphemism). Similarly, out of 30 Medical Officers, only 15 are getting paid. The situation is similar or worse in other departments and hospitals across Punjab. People working on honorary seats perform equal duties, do everything as others do, the only difference is that they are not paid for doing that work. This is a unique and frankly disgusting way of treating a professional, and there is no precedent for it anywhere in the world. Apart from interns at offices, everyone gets paid for their jobs. At times, even the Senior Registrars, after 10 years of medical training, have to work on honorary basis.

There is an inside story to this practice. Theoratically, the seats in wards of teaching hospitals are preferably given to the graduates of the institute that the hospital is attached to. This results in unequality at times because graduates of other institutes opt for institutes in bigger cities. In the case of Punjab, graduates from all over the province prefer to do their clinical training in either Lahore, Multan or Rawalpindi. There is also the issue of non-residents. If a resident of Lahore got admission in Rawalpindi Medical College or Nishtar Medical College, he/she would prefer to complete his/her post-graduate training in the native town. Due to this shuffling, there are more candidates for less seats and departments employ different people on honorary basis. The merit list for giving a job for post graduate training starts from graduates of the same institute. Second on the list are graduates of other government institutes and lastly, the graduates of private medical colleges, including the ones in China and Russia.

There are ways that people bypass the merit system, because in Pakistan there is a single key for every lock: Sifarish. If you have the requisite Sifarish, you can bypass the merit and get a paid seat in your desired department.

To cope with the economic pressure due to lack of any pay, doctors from public hospitals look for jobs in the private sector which forms 80% of our health sector. As a result, most of the unpaid (and in some cases, even the paid ones) do jobs at private hospitals in the evenings and in public hospitals in the morning. After living for more than 25 years on the largesse of your parents, if you still do not earn anything on your own, it reflects poorly on you. Also, during post-graduation, a lot of doctors are tied in the knot of marriage and it is difficult to ask your parents for sustenance of another person while you earn nothing. I personally know some people who delayed their marriages because they did not have the means to support a new member of the family. In some other cases, the young doctors were the only source of income for their families and had to wait till completion of their post graduation to marry.

This system of 'honorary' jobs should end as it is nothing but a kind of slavery.

Diary of a Young Doctor(part 3)

2012-06-29T00:55:00.002-07:00

(published in The Friday Times on 29th June, 2012)

Diary of a Young Doctor III

"Please guide us, doctor. We have come back because the local dispenser [quack] refused to administer the injection you wrote for our son, saying it is too 'heavy'."

I was busy making the 'discharge form' of a patient when that couple came towards me and said those lines. Their teenage son had been discharged yesterday upon their request, and I had prescribed an injection that he needed every day for the next week. The couple said they would get their son the shot through a dispenser in their locality. And they were back the very next day.
A doctor can, just by clicking on the computer screen, get free medicines for needy patients

This is not a unique situation. Apart from managing patients feigning abdominal pain in the emergency ward and waking up during the "on call" nights after every hour to change a transfusion bag, this is what young doctors do in "routine". A routine day comprises duty of about 6 hours, from 8 in the morning to 2 in the afternoon. We start the day by checking patients on the beds allotted to us and by writing down the DPNs (Daytime Patient Notes). This is followed by a survey of our work and additional examination by our immediate seniors, the Medical Officers. After that, there is the ward round by any one of the designated consultants/specialists. During the round, the consultants listen to the medical history of patients from house officers or medical officers and look through the investigations carried out previously. Then, according to the situation of the patient, investigations or different drugs are advised which are added later to the charts by House Officers.

If the patient is newly admitted and can't buy medications on their own, there are two ways of getting them free medicine. There is a list of medications that are provided to our wards every day by the hospital. They include most of the commonly required drugs, and a doctor can, just by clicking on the computer screen, get free medicines for needy patients. Another way is through the Medical Superintendent (MS) of the hospital. For that, the patients' file has to be signed by the MS himself, which is not a hard thing to do. Then there is the problem of urgent investigations. For that, house officers have to counsel the attendants and sometimes have to get involved themselves to get those tasks done through the emergency department. At times, the bureaucracy of it all can get in the way and frustrate patients.
I have seen patients who think they are not being treated fairly threaten the doctors by mentioning political figures or members of the bureaucracy

As in the rest of Pakistan, a patient is likely to get sufficient attention (which mostly means more than normal) if they know someone in the hospital hierarchy. This doesn't mean that doctors don't care for their patients; it's just that we find it difficult to divert our energies where they are not required.

This 'protocol' business can turn ugly. Many a times I have seen patients who think they are not being treated fairly threaten the doctors by mentioning political figures or members of the bureaucracy. It happens particularly frequently in the hospital where I work because we have to deal with all kinds of government employees and their kith and kin. According to one of my seniors, even if the gardener of CM house brings a patient to the hospital, he expects to get 'protocol' equal to that of the CM himself.

Hospitals are great places, not only for learning medicine but also for learning about the different shades of life. I would like to mention some of the most interesting cases I have seen in my brief clinical career.

The fiancee with the headache before her FA exams brought to the emergency by her very concerned fiance, the CA student who had not eaten anything for a month due to some kind of love affair; the 65 year-old woman patient who insisted on smoking despite the disease in her lungs; the helpless relatives of a 70 year-old woman who had to get dialysis but couldn't find the hospital where it was urgently available; the 50 year-old woman with tuberculosis of the meninges (brain coverings) and an untiringly colorful vocabulary; the madrasa student who sat for his Dars e Nizami exam while he was admitted in the hospital; the women loudly reciting Quranic verses around a very sick patient and freaking out the doctors; a 15 year-old boy spending most of his time around his ailing mother in the ward and running around taking her samples for laboratories; the young patients (mostly girls) with acid/bleach intake for suicide purposes and the attitude of their families towards them; and all those patients who are never satisfied when they are prescribed pills and demand injections and drip infusions just to feel medical; and all the drug mules who are accompanied by police or custom officials and deny any wrongdoing until the last minute.

There are also issues among various departments in the hospital that cause unnecessary delays in diagnosis and treatment of patients. The Radiology and Pathology departments provide services to all the rest of the Hospital, and are indispensable in the management of patients. If the same tests are to be done from private labs, the cost is not affordable for most of our patients, who belong to the lowest strata of the society economically.

I would also like to mention that there are almost no holidays for young doctors during their house jobs. In the department where I work, we only get 2 holidays in a month, both Sundays. Apart from that, we only get one emergency leave per month.

Diary of a young doctor (part 2)

2012-06-15T01:49:00.000-07:00

(published in The Friday Times, on 15th June, 2012)

There was a frantic knock on the door of the doctors' room. A half-asleep lady came in abruptly. It was 2 o'clock in the morning and there was absolute silence in the rest of the ward. The lady gasped and said, "Dr Sahib, the condition of my patient is serious, can you please come and check her?" I had no option but to get up from the couch I was lying on, get my stethoscope and accompany her to the bed of that patient. As it turned out, the lady was a patient of liver failure and was having pain in the abdomen. After a brief checkup, I wrote down a simple ant-acid and asked the patient to take some water. Problem Solved. Sleep be damned.

The above-mentioned scenario is one of the many that we have to endure during our 28-30 hour long ward duties, also known as "long calls". After a regular day at work, the whole ward becomes the responsibility of 4-5 doctors who are said to be "on call" while the rest of the doctors go home. This duty has to be done once a week and at a weekend once a month. The regular tasks that we are required to perform during our calls include noting down blood sugar levels of diabetic patients, monitoring blood pressures of any serious patients, doing a routine checkup of patients in the ward, dealing with occasional complaints (like the one mentioned above) and lastly, to oversee casualties that occur on our watch. We are required to be present in the ward at all times during duty hours, and it basically means little rest and little to no sleep. After every 5-10 minutes, there are knocks on the doctors' room and one attendant after another barges in to get the required "attention" for their patients. In many cases, the condition of the patient is "irretrievable" and it is difficult for both the doctor and the attendant to see the patient suffer. Most of the patients admitted in medicine wards are suffering from either chronic liver disease (due to very high prevalence of hepatitis in our population), tuberculosis in its various forms, stroke (known as 'brain hemorrhage' in popular culture), kidney failure, meningitis (infection of the coverings of brain), chronic pulmonary disease (due to long-term smoking) and fever due to infections. Patients are checked twice daily, once in the morning and once in the evening.In a country with so many health-related issues, negligible amounts of money are being spent on patient care in public hospitals. A lot of patients can be saved by provision of simple ventilators but the number of ventilators across hospitals in Lahore is no more than 100-150! Similarly, dialysis units and liver transplant facilities, which are considered routine in developed countries, are not easily available in most tertiary care hospitals in our country. The human aspect of being a doctor can be seen during ward duties, as doctors give their best efforts and energies to save the patient without having any relation with the patient. In many cases, young doctors work out of their comfort zones to treat the patient as well as is humanly possible.
Young doctors are the wheels upon which the health care system is working
The culture of attendants in our country is not only cumbersome but also problematic at times. Due to socio-cultural beliefs, more people are willing to stay with the patient than is necessary. The problem arises when doctors are inconvenienced by attendants craving attention, leading to neglect of other patients. Even when forced to leave the ward during rounds, the attendants are back as soon as the restriction is over. Last year, a team of doctors were visiting from the United Kingdom for a project and they were surprised to see so many attendants in our wards. They recounted that in the UK, attendants are allowed to visit the patients only during scheduled hours and even at those times, so many attendants were not allowed to visit the ward, ultimately avoiding the mess that we have to face. At this juncture, I would also like to point out that the running of emergencies and the wards is primarily done by the young doctors and they are the wheels upon which the healthcare system is working, despite all glitches. It is an unfortunate reality that most doctors working in public sector hospitals are not even paid for their jobs, making their work more worthwhile than it already is. As I wrote earlier, there is acute shortage of bed space in public sector hospitals. Last year, during the dengue outbreak, when the Chief Minister visited many hospitals including the one I work at, he was appalled to note that two and in certain cases three patients were present on one bed. Based on his instructions, patients were adjusted but it was a short-term measure and the situation remains the same. I personally have had to discharge patients at times because of acute shortage of space. I felt extremely bad doing that but the patients themselves wanted to go home and be comfortable. The toughest aspect of ward duty I found was the time of casualties. The usual scenario goes like this. Doctors are mostly aware of the patients who are having a really bad time and they try to counsel the relatives beforehand. When a distraught attendant comes running in, calling for attention, the concerned doctor rushes to assess the patient. When the patient is critical, the doctor calls his batch mates for help and combined efforts are done to resuscitate the patient. If the patient can't be revived, the protocols are followed and the attendants are informed about their patient's demise. The response of the attendants to the news depends on various factors including the age of the patient, disease of the patient and the quality of counseling done previously. In case of young patients, the reaction of the relatives is quite severe and I have seen my colleague's collars ripped off by an angry relative. Due to their inability to cope with grief, many attendants blame the doctors for the casualty of their patient, without acknowledging the work done by the same doctors when that patient was alive.
At the end of the day, it is not a fair world and a doctor can do only as much.

Goodbye,Dr House

2012-06-06T16:51:00.001-07:00

(published by Express Tribune Blogs on 6th June, 2012)

As the saying “all good things come to an end” goes, “House M.D.”, the brilliantly written show, ended last week. There have been numerous television dramas over the years based on doctors and hospitals including “General Hospital” from the 60s to “Scrubs” and “Grey’s Anatomy” during the 2000s. “House M.D.” embarked on a journey to create its own presence and niche when it first aired in 2004.

It is based on an ingenious but misanthropic doctor who is willing to cross all boundaries to solve a case. His actions are seen to be driven by his passion for medical puzzles and mysteries, instead of a general feeling of care and well-being for his patients.

The character is loosely based on Sherlock Holmes, the fictional character created by a Scottish physician and writer, Sir Arthur Conan Doyle. Dr House is a graduate of Johns Hopkins school of medicine and has served fellowships in nephrology and infectious diseases. In the series, Gregory House heads the Diagnostics Department at Princeton Plainsboro Hospital (PPTH), in New Jersey. The department takes only one patient at a time with barely any criteria for selection. Usually patients with atypical symptoms are dealt by the Diagnostic Department. Both the department and the hospital are, however, fictional.

In the first three seasons, his team includes Eric Foreman, a neurologist, Dr Chase, a cardiologist (later head of surgery and then the department of diagnostics) and Dr Allison Cameron, an immunologist. Other important characters include Dr Lisa Cuddy, the administrator of PPTH and Dr James Wilson, an oncologist and the only friend of Dr House. House abides by one golden rule about patients and life in general – “everybody lies”. That is the reason he seldom talks to his patients or even believes in what they tell his team about their medical history.

Hugh Laurie, a British actor, plays the character of Gregory House and his acting attracted nothing but praises from the general viewers and critics. Despite his British accent, he effortlessly adopted the American accent throughout the show.The show was popular not only amongst people with medical backgrounds but also for aficianados of acting and drama. The character House is famous for his witticisms and there is a whole website dedicated to “House-isms”. I would like to mention some of the quotes here for all of us to enjoy and reminisce the intelligent humour we all will miss the most.

House: “Me and humanity, we got together too young.”

Patient: “How do doctors get this idea that you are better than everyone else?”

House: “Probably because of all that ‘pulling people back from the brink of death’, but its just a guess.”

House: “Treating for wrong diagnoses can result in side effects, like death.”

Chase: “The dream doesn’t mean anything. Can we start acting like it doesn’t mean anything?”

House: “Sure. We can also act like walls don’t mean anything. But then we’d hurt our noses.”

House: “Evolution does not work that way. You can’t talk legs onto a fish. If we’re going to go extinct, we’re going to do it drinking Scotch and driving muscle cars.”

House M.D. means more to me than a simple drama for the purpose of entertainment, which it definitely provided its viewers with. I started watching it when I was in medical school and even now, when I am undergoing my clinical training, I still watch it. It evokes so many memories that I feel difficult to let it go, like many of its fans.

House M.D. will live on, even after it goes off air. It will and may have already inspired countless people towards the medical profession. It showcased the much-neglected human side of doctors emphasising on their human errors. With teary eyes, I bid farewell to one of my favourite television shows, House M.D.

My Tuesdays will be emptier without another episode of the show and if I ever develop any atypical disease, I would want someone like House M.D. to treat me. He may dismantle my hopes for living but at least he would not let me die due to a lack of effort.

Diary of a young doctor(part 1)

2012-06-01T06:53:00.006-07:00

(published in The Friday Times on 1st June, 2012)
I felt as if I could not move my legs. It was as if my body was disobeying my mind.It was 4:45 a.m. and my alarm bell was piercing my eardrum. I did the only thing I could do at that time: I pushed the snooze button. I knew I had to get up in a few minutes and by then my legs probably would have enough energy to crawl out of bed and move. It was a Saturday morning and I had to be in the 'Accidents and Emergency Department' for my 12-hour duty from 6 a.m. to 6 p.m. I had returned the previous day after doing a 28-hour ward duty which included very little sleep and quite a bit of leg work. The reason my body was temporarily refusing to obey my mind was my tiredness and lack of energy. In the end, I made it to the emergency department and performed my duties as a House Physician for 12 hours straight. This is how the life of a young doctor unravels.
A lot of patients visit the emergency ward because they want "urgent" treatment of things that can be easily dealt with on a regular scheduleI am a medical graduate undergoing my first year of medical training known commonly as House Job. Being on the junior-most rung in the ladder of the public health care system, we are the first point of contact for the people coming to public-sector hospitals. We have to perform emergency duty once a week and twice every other week. In the emergency department, we treat the patients who require urgent consultation with a physician. The patients come in, we examine the patient and write medications for them accordingly, their attendants get the free medications from the medical store located inside the department and those drugs are then administered to the patients by the nursing staff. This chain is the usual protocol followed in most public sector hospitals. In some cases, some drugs are not available in the medical store inside the department so the attendants are asked to get them from any nearby store.In the hospital where I work, we have the Hospital Management Information System through which we enter medications for patients using laptops and they can get their medication from the medical store without any hassle. On a regular basis, we treat patients suffering from gastroenteritis (caused mostly by unhygienic food and water consumption), fever and body pain, and patients who are already on medication for chronic conditions like diabetes, kidney failure, liver disease or heart disease. Patients are charged only for the minimal admission fee; laboratory tests and radiological investigations, including X-rays, ultrasound and CT-scans, are done without any charges.
I return home with an aching back, an empty stomach and pain in the balls of my feetEmergency Duty is mostly spent by us while moving from bed to bed and not being able to sit for more than five minutes. There are very few seats available in the emergency department and most of the work is done without much respite. During the duty hours, more time is spent by us counseling the patients and their attendants than actually treating people. Everyone wants to get our attention first and it can become hectic very fast, with beds filling up to twice their capacity and still more patients streaming in. Things can get heated as well and incidents of fights between the doctors and patients have been noticed in the last few years. There are no security guards in the emergency rooms, leaving the duty of self-defense to the doctors themselves.Incidents of bullying by attendants led to the formation of the Young Doctors Association 5 years ago.The facilities that I have described above are at par with almost any private hospital in the city. But the only people who tend to visit public sector hospitals are of the lower-middle class or the lower classes. One reason for this is that there is a shortage of both space and personnel in public sector hospitals. We cannot refuse treatment to any patient and this puts a strain on our already scarce resources. A lot of patients visit the emergency ward because they want "urgent" treatment of things that can be easily dealt with on a regular schedule. I have personally seen patients of sinusitis, occasional headaches, acid peptic disease and increased blood pressure in the emergency ward while all of them are theoretically out-door department cases.In the emergency room, a house officer examines patients, takes blood samples, passes nasogastric tubes or folley's catheters, checks blood sugar levels and blood pressure and has to write prescriptions on discharge of the patients. These few tasks are repeated from the start of the duty till the duty finishes after 12 hours. There are times when the inflow of patients is very high and it becomes extremely difficult to shuttle between patients based on the severity of their symptoms; and there are times when most patients are stable and the doctor can catch his or her breath for a while.Apart from fulfilling our duty, we also receive many prayers and good wishes from patients who are successfully managed. The road is not full of roses, though, and patients complain if the treatment is not working. The toughest aspect of the job is to face the incidents of mortality in the emergency. In most of the cases I have seen, attendants raise a hue and cry at the death of their loved one, and that frightens the rest of the patients. In those moments of grief, all the doctor can do is to inform the attendants and get signatures from them on the death certificate.As for me: at the end of the 12-hour duty, I return home with an aching back, an empty stomach and pain in the balls of my feet. I try not to walk much after I reach home and after a few hours of rest and some dinner, go to sleep, ready for another day at work.

2012-05-29T09:40:00.000-07:00

Debunking more conspiracy theorists.

I used to believe that Zaid Hamid and his boys were at the pinnacle of conspiracy mongering. It was until I saw Terminal X, a website dedicated to similar conspiracy mongering and I did some background check on one of their stories, named,
“Report: Israel's Al Qaeda exposes itself by "confirming" CIA's hoax at Abbottabad” by Zaki Khalid. The report itself can be seen at their page, I have simple provided the biographies of their “reliable sources”. These idiots want to “disprove” stuff by using data that is absurd and its validity is suspicious, they clutch at straws to somehow justify their own agendas.
I have always emphasized that while conspiracy theories abound on the Internet, a half-decent effort to find a different narrative on the Internet than the one being peddled, can give you a much better picture regarding the event.

1. They start by quoting Steve Pieczenik who, surprise surprise, is a critically acclaimed author of psycho-political thrillers.

2. A mention of “United Jerusalem Foundation” has also been made in the post. The name says it all. Dubious.
http://www.unitedjerusalem.org/index2.asp?id=170047&Date=10/27/2002

3. The post also mentions Pierre-Henri Bunel who is a former French artillery and intelligence officer, later working in construction and as a writer on radical Islam and the Serbian War.

At the end of 1998, when a member of the French delegation to NATO's military committee at the headquarters in Brussels, he was accused of treason between July and October 1998 for passing documents to Serbian colonel Jovan Milanovic. These documents indicated the future strikes in Serbia during the Kosovo Conflict. While newspapers alleged a traditional pro-Serb bias in the French military, he claimed to be acting under orders of French intelligence services with the object of convincing the skeptical Serb government that the NATO threat of bombing was real. On 15 December 2001 he was condemned by a military tribunal, demoted in rank and sentenced to five years in prison. Three years were suspended, he was freed from La Santé Prison in the Spring of 2002.

4. The assertion that Tim osman=OBL is totally false, see how
(http://www.911myths.com/html/tim_osman_was_bin_ladin_.html)

Lets talk about Ted Gunderson and Michael Riconosciuto, the two US representatives who were apparently at this meeting.

(Spoiler Alert: One of them is mentally sick while the other is a drug addict.!!!!)

Gunderson at first appears a good witness, being a former “Senior Special Agent-in-Charge” in Los Angeles up to his retirement in 1979. However, all is not necessarily as it seems. Check out his web site, (www.tedgunderson.com) , and you’ll find articles on satanism, “sexual child abuse - elite involvement”, “plans for civilian internment”, and more. We’ve no problem with anyone expressing their views, but Gunderson wants to cash in, too: the most interesting claims here (“TERRORISTS' ACTIVITIES: ADVANCED KNOWLEDGE FURNISHED TO THE FBI 6 MONTHS PRIOR TO 9-11!”) are only available to those willing to pay out $10 to $25 for his reports (http://www.tedgunderson.com/Products-Reports.htm).

Further, Gunderson appears to have an uncertain reputation, even amongst the conspiracy community.

Was Gunderson was one of the top FBI COINTELPRO supervisors during the wipe out so-called dissidents in the 60's and 70's? From Gunderson's position in New Haven, Philadelphia and Los Angeles, he had means, motive and opportunity to participate in COINTELPRO. Mr. Gunderson, what were you doing for J. Edgar Hoover in the 60's and 70's?

See (www.stewwebb.com/Ted%20Gunderson.html) for more.

What you will discover at the site is Gunderson’s own account of the meeting (much more at the link):

Subsequently, Gunderson arranged a meeting in the spring of 1986 at the Hilton Hotel on Ventura Boulevard in Sherman Oaks, Calif., between himself, Riconosciuto, Ralph Olberg, who covertly represented the State Department at the meeting and served on its Middle East desk, and a man identified as “Tim Osman.”

As Gunderson would discover only last year, “Osman” was bin Laden, dressed in ordinary casual Western attire and traveling on a Turkish passport.

Gunderson has also since found that there is a real Osman, who is a Turkish official.

(http://www.tedgunderson.com/Articles/US%20Armed%20and%20Promoted%20Terrorist.htm)

Even if there was a meeting, then, how can we be sure this Osman was bin Ladin?

Perhaps we can learn more from the other participant in the meeting, Michael Riconosciuto. Or perhaps not... The primary article from his point of view appears to be “When Osama Bin Laden was Tim Osman”, and it contains no more hard evidence than you’ll find anywhere else (but don’t take our word for that -- follow the link and find out for yourself).

Riconosciuto’s credibility isn’t enhanced by the fact that he’s been locked up in prison since 1991, after being found guilty of drug offences (charges the above article says were “trumped up”, without offering any support for that), but that’s not our only problem with him. Here’s a timeline detailing some of the claims surrounding Riconosciuto that have been made over the years.

1960's: Peripheral contact with JFK assassination suspects

At the age of 12, a young science genius named Michael Riconosciuto was building listening devices for the detective agency of Guy Banister in New Orleans. As a teenager, he had his own laboratory, and was doing cancer research, as Judyth Baker was also doing at the time in Florida. David Ferrie later mentioned to her that they had been expecting a young cancer researcher on the scene in May 1963, and assumed Judyth Baker was the person they were expecting. It may have been Michael Riconosciuto instead, and Judyth may have fallen into the situation by chance, showing up in New Orleans two weeks before Michael did.

(http://groups.google.co.uk/group/alt.conspiracy.jfk/browse_thread/thread/1151609bc6be315b/ee8030d3292386da?lnk=st&q=%22Michael+Riconosciuto%22&rnum=1&hl=en#ee8030d3292386da)

That group of people can be traced directly back to the JFK assassination through Garrison's primary grand jury witness, Fred Lee Crisman (AKA Jon Gold). Look for Gold's book [out of print and hard to find] "Murder of a City - Tacoma" where he discusses being called to Garrison's grand jury. Gold also speaks of the genius of Michael Riconosciuto, then a 13 year old electronic wiz, busy tapping the phones of the police and sheriffs' departments because law enforcement was interrupting his father, Marshall's drug business.

1973: Accused of links to assassination of Chilean leader Salvador Allende

Michael has often described himself to me as a "chicken" to the CIA's perverted "chicken hawks". As a VERY young man he accompanied "Dr." John Philip Nichols to Chile to assist in the assassination of Allende.

1980: Involved with delaying the release of the US hostages in Iran:

On May 18, 1990, Riconosciuto had called the Hamiltons and informed them that the Inslaw case was connected to the October Surprise affair. Riconosciuto claimed that he and Earl Brian had traveled to Iran in 1980 and paid $40 million to Iranian officials to persuade them NOT to release the hostages before the presidential election in which Reagan became president of the United States.

(http://www.lycaeum.org/books/books/last_circle/5.htm)

Early 1980's: "In the early 1980s Michael also served as the Director of Research for a joint venture between the Wackenhut Corporation of Coral Gables, Florida, and the Cabazon Band of Indians in Indio, California"

(http://www.orlingrabbe.com/binladin_timosman.htm)

1980's: has knowledge of bio-warfare research

According to Riconosciuto, the Pentagon's Defense Advanced Research Projects Agency (DARPA) was in charge of the classified contracts for biological warfare research.

http://www.orlingrabbe.com/binladin_timosman.htm

1980's: Invents the a-neutronic bomb

Riconosciuto's talents were much in demand. He had created the a-neutronic bomb (or "Electro-Hydrodynamic Gaseous Fuel Device"), which sank the ground level of the Nevada test site by 30 feet when a prototype was tested. Samuel Cohen, the inventor of the neutron bomb, said of Riconosciuto: "I've spoken to Michael Riconosciuto (the inventor of the a-neutronic bomb) and he's an extraordinarily bright guy. I also have a hunch, which I can't prove, that they both (Riconosciuto and Lavos, his partner) indirectly work for the CIA."

(http://www.orlingrabbe.com/binladin_timosman.htm)

Another possible weapon candidate soon surfaced: the "A-Neutronic" bomb. In this scenario, a mad criminal scientist (the infamous Michael Riconosciuto, currently serving time in a US prison), developed for the US Government a new super-weapon that involved blowing a cloud of chemicals into the air, charging the cloud with a large excess of electro static energy by means of a small rocket-carried "wire", and then detonating the resultant "fuel-air" mix to create a small nuclear-type explosion.

(http://groups.google.co.uk/group/alt.satanism/browse_thread/thread/e63b5771fa3a9265/d08ef92951b35ba1?lnk=st&q=%22Michael+Riconosciuto%22&rnum=131&hl=en#d08ef92951b35ba1)

1980's: has "connections with the Chinese industrial and military group Norinco"

http://www.orlingrabbe.com/binladin_timosman.htm

1983-84: Modifies PROMIS software for the Department of Justice to install a "back door"

http://www.lycaeum.org/books/books/last_circle/5.htm

Spring 1986: meets bin Ladin as a "representative of the mujahadeen, the Afghan fighters resisting the Soviet invasion of Afghanistan"

http://www.orlingrabbe.com/binladin_timosman.htm

March 1991: knowledge of CIA funds and financial scandals

[Riconosciuto] said he was also responsible for the manner in which caused the interdiction of funds from the sale of Red Chinese gold and the manner in which large sums of CIA funds were secreted and knowledge of where those funds are located.

"The information available on my computer equipment would also tend to prove and show that the above described treasonous deals are related to the ongoing international scandals involving the Bank of Credit and Commerce International and the Banca Nazionale del Lavoro and that crucial features of said deals are centered in Chicago and involve the courts and prosecutors in Chicago," he stated.

http://www.federalobserver.com/archive.php?aid=1366

1991: forces a "professional hit man" to confess to his crimes:

Nichols and Riconosciuto had forced Marowitz to confess to his crime by hanging him upside down in front of the airplane propellar.

"Riconosciuto recalled, " ... So he [Marowitz] starts talking ... and Bob goes out of the room like this: `Oh my God, I don't want to hear anymore,' covering his ears. This Marowitz starts confessing to every hit he's ever done, including the Dorfman killings in Chicago. ... I mean, all hell breaks loose. All of a sudden Ted has found the torpedo in the Dorfman killings ..." After the "hanging" incident, Marowitz fled to Israel."

"The transcript was taken from Riconosciuto's first (taperecorded) meeting with Alan Boyak on May 5, 1991 at the attorney visiting room of the Tacoma, Washington house of incarceration....."

1991: Jailed

One week after giving an affidavit to Inslaw regarding the PROMIS software in 1991, Riconosciuto was arrested on trumped-up drug charges.

http://www.orlingrabbe.com/binladin_timosman.htm

August 11 1991

Believes ""AIDS" was created in the U.S. bio-warfare labs"

(http://www.newsmakingnews.com/vmessaymr3,17,00.htm)

July 1998: Knows of embassy bombings in advance, despite being locked up in jail

Thirty-four days before the East African embassy bombings of August 7, 1998, Riconosciuto notified the FBI in Miami that the bombings were going to take place.

(http://www.orlingrabbe.com/binladin_timosman.htm)

2001: Has developed technology to remove oil dependency

Some powerful people may have good reason to want to keep Michael where he is.

Michael has developed technology which will revolutionize energy and make current polluting oil dependency obsolete. This technology will survive, no matter what happens to Michael, but it is a horror to think that this man is being repaid for his brilliance and patriotism by a 30 year jail sentence.

http://groups.google.co.uk/group/alt.chaos/browse_thread/thread/38917fc3d26608e1/d90c2c5a7642f10c?lnk=st&rnum=10&hl=en#d90c2c5a7642f10c

2001: Maintains Mujahadeen contacts:

"In the 1980s Michael Riconosciuto was involved in negotiations with the Mujahadeen on behalf of the US government. The negotiations were for arms and $600+ million per year in aid to assist in the war against the Soviets. Michael was encouraged to make his own contacts within the Mujahadeen network. After all these years, he still maintains his contacts"

(http://web.archive.org/web/20011224074730/http://www.mindgallery.com/hiddenroom/wizard/)

Most of these reports are second-hand, so we can’t be sure that Riconosciuto was behind every claim here. However, if only half of these stories originated with him then it would be enough to make us sceptical of what he’s saying, not least because the Osman story didn’t materialise until after September 11. Why not? bin Ladin had been in the press for years, so why not mention it earlier? Are we supposed to believe that he knew of the 1998 Embassy attacks, but then forgot to mention the US connection to bin Ladin, the supposed culprit? And if Riconosciuto didn’t know Osman was bin Ladin at the time, then how can we be sure he was now?

We’re not the only people who are sceptical of Riconosciuto. Here’s what Chip Berlet wrote back in the 1990’s:

Another oft-cited source in the October Surprise story was Michael Riconosciuto, who provided many tantalizing leads to investigative reporter Danny Casolaro before the free-lancer's death, which was ruled a suicide (see "The Octopus File," CJR, November/December 1991). Riconosciuto claimed to have specialized knowledge in computer science and software design, the kind of knowledge that, he said, made him useful to intelligence operatives. Casolaro was looking into the alleged theft by the Justice department of a privately owned software program called Promis. Riconosciuto offered an explanation: he told Casolaro that someone in the Justice department had given the software to American intelligence operatives for resale to intelligence agencies in Canada and abroad. One form of payment, he told the journalist, was the orchestration of the release of the American hostages being held in Iran.

Riconosciuto went on to weave a tale involving the Cabazon Indian reservation in southern California, purportedly the site of a supersecret research and testing base for weapons of interest to intelligence operatives. Casolaro began to see the reservation as part of a globe-spanning entity of untold power, which he called The Octopus.

Jerry Uhrhammer of the Tacoma, Washington, "Morning News Tribune" was the only reporter to cover Riconosciuto's three-week-long drug trial, held in Tacoma in April 1991. In the July/August 1992 "IRE Journal", Uhrhammer wrote:

"Any reporter who checked the court file prior to Riconosciuto's trial could have found documents that offered a psychiatric explanation for [his] conspiracy tales. Psychiatrists who examined him in 1972, prior to his first drug conviction, portrayed him as a mentally unstable person who had trouble discerning between fact and fiction."

Uhrhammer added:

"I have been dismayed and appalled by some articles in which Riconosciuto is quoted as a primary source, if not sole source, in support of some conspiracy theory, but without any warning to the reader that his credibility is suspect or nonexistent."

We’re uncertain about the witnesses to this meeting, then. The only document purporting to show that “Tim Osman” was bin Ladin is unsourced, as far as we can see (email if you know exactly where it came from). And even if we take the story as literally true, it doesn’t offer strong support for the common “bin Ladin was trained by/ funded by the CIA”. claims. In fact Gunderson’s account has him picked to meet Osman exactly because he didn’t work for a Government agency any more, therefore this story could be used to show there weren’t strong links between bin Ladin and the CIA at this time.

Given these issues, it’s hard to see how the Osman story can tell us very much on its own. More evidence is essential before we can begin to form a reliable picture about what, if anything, this means.

On Prophecies and their veracity

2012-05-26T03:16:00.000-07:00

(an abridged version was published in Pakistan Today on 23rd May,2012)

Prophecies and their veracity

A lecture titled “A Longer view on dreams and prophecy” was organized by Lahore University of Management Sciences at the start of April, 2012. In that lecture, Professor of South Asian History, Manan Ahmed spoke at length about various aspects of prophecies.

Professor Manan explained the significance and methodology of prophecies. Prophecy is always in the past, but it is applied in the present. Another aspect of prophecies is that they appear at times of crisis, to 'rationalize' those crises and to point towards a better future.

Professor Manan gave example of Qudratullah Shahab's book 'Shahab Nama', the last 2 chapters of which, contained prophecies. Similar rhetoric was used by Shahab's contemporaries, Wasif Ali Wasif,Ashfaq Ahmad and Bano Qudsia.

Prophecies of Shah Naimatullah Wali, which have been used by Zaid Hamid recently, were published first after 1857(end of Mughal Empire),then 1948(Serious problems faced by the new nation), then 1974,1975((Loss of East Pakistan), 1988 and then 2008.

Interestingly, such prophecies are not only propagated by Zaid hamid but also spread via columnists such as Javed Chohdary, Haroon Rasheed and Amir Hashim khakwani.

Other examples of famous prophecies at the times of crisis include the time when Tatars invaded the Muslim territories. The “sages” of those time started saying that the Tatars were actually “Yajooj Majooj” and that the day of judgment was approaching soon.

The prophecy I want to discuss in this post is the one allegedly made by Molana Abul Kalam Azad, the famous Congress Leader and Ideologue. That prophecy was recently highlighted in the show Khabar Naak and in Kamran Khan show.

The long prophecy is based on an alleged interview of Abul Kalam Azad when he visited Lahore in March 1946, conducted by Shorash Kashmiri. In that interview, Abul Kalam Azad said,

“I feel that right from its inception, Pakistan will face some very serious problems:

1. The incompetent political leadership will pave the way for military dictatorship as it has happened in many Muslim countries.

2. The heavy burden of foreign debt.

3. Absence of friendly relationship with neighbors and the possibility of armed conflict.

4. Internal unrest and regional conflicts.

5. The loot of national wealth by the neo-rich and industrialists of Pakistan.

6. The dissatisfaction and alienation of the youth from religion and the collapse of the theory of Pakistan.” (The complete interview can be read here).

Previously, this interview was published in an Indian magazine named “Covert” with the headline, “Maulana Abul Kalam Azad: The Man Who Knew The Future Of Pakistan Before Its Creation” catapulting Mr. Azad’s status from a senior politician to that of a modern day Nostradamus. Based on some analytical evidence, I shall try to prove that the interview never actually happened and the whole “prophecy” is a work of fiction created by Mr. Shorish himself.

1. The interview is supposed to have taken place in March 1946 when Abul Kalam Azad was visiting Lahore for negotiations about a possible Congress-Unionist Party coalition which ultimately led to All India Muslim League being left out of power despite being the majority party.

2. Shorash Kashmiri was a committed member of Majlis e Ahrar, founded by Ataullah Shah Bokhari, a firebrand speaker and religious scholar. Majlis e Ahrar was famously against the formation of Pakistan. It should be kept in mind that Shorash was a famous for his oratory skills and as a political worker, not as a serious journalist. This interview was not published by Shorash Kashmiri until 1969, when he joined Awami League, which was at that time quite anti-Pakistan in its outlook.

3. On the topic of Pakistan and creation of Pakistan/division of India, Abul Kalam Azad wrote a whole book, titled “India wins Freedom” which was published in 1958 while Azad was alive. This particular “prophecy” is not mentioned or even hinted about in the book devoted to this topic. Some people assume that the re-print of the book which occurred in 1989 and included additional pages, contain anything related to this, which is completely wrong.

4. The publication of this interview in the Indian magazine “Covert” was a blatant attempt at glorification of Azad and historical revisionism. The aim was to degrade Mr. Jinnah by painting him as short-sighted while simultaneously increasing the stature of Abdul Kalam Azad at his expense.

( Please Note that this post is about the prophecy of Azad that I have mentioned above and not his views about partition of India and formation of Pakistan.)

Hello, its Goebbels Speaking

2012-05-21T01:55:00.000-07:00

Hello, Its Goebbels

(Joseph Goebbles was a German politician and Reich Minister of Propaganda in Nazi Germany from 1933 to 1945. As one of Adolf Hitler's closest associates and most devout followers, he was known for his zealous oratory and anti-Semitism.

Goebbels earned a Ph.D. from Heidelberg University in 1921, writing his doctoral thesis on 19th century romantic drama)

Hello,

Its me, Dr. Goebbels, writing from my grave, where I am turning with agony upon getting the news of a flowery diatribe launched by a pen-warrior, a key-board jihadi, with penchant for the word “paladin”. See, this is what happens when instead of making them learn by experience, you force your children to cram the SAT word lists, the whole “Word Smart” books and their likes. Just like a rotten apple causing explosive diarrhea, that cramming can lead to an emotional outburst from the yet-green mind of the average Pakistani Child. My advisors told me that exactly Nine hundred and Eleven SAT words were used in the beautiful blog written by the author. I, for one would have jumped upon the bandwagon to find the “hidden meaning” of the number 911 but since my untimely death, that mantle has been handed over to Zion Hamid and Shahid Masood. The writer has shown extremely good skills of copy/pasting from a thesaurus and he should be hired in the first instance by an Urdu newspaper as soon as he turns 18. It is easy to ride on the high horse, on the pulpit, if you allow me to delve into similar verbosity shown by the amiable writer, and pass silly judgements on people without coming up with any facts or agreeable data. This trend is not new and will never cease to exist. In our time, with the mighty Nazi Party at the helm, we cut out all voices of dissent and under the guidance of the supreme leader--a hero of war--reached the technological and sociological heights that were unparalleled by comparison in that era. We were self-sufficient, hard working, hated our neighbours with a passion, believed that we are the best nation in the world and sent the dissenters to camps where we used their labour for the greater good. Sounds familiar? Oh, I digress.

Despite my poor English language skills and scant interest in the happening of far off countries like Pakistan, I still keep tabs on major players in the news arena. Express Tribune as a Pakistani newspaper is one of the few that I am interested in. It is not exactly “Der Angriff” in terms of propaganda-spewing but it certainly has an agenda: An agenda to cater to the English-reading population of Pakistan and to project a progressive image of the country. While my opinion on this matter does not mean much to you dear reader, I have one simple Question, Who doesn’t have an agenda? Name one newspaper in the world without an “agenda”. The rhetoric against Express Tribune is a spin-off of the video created by the modern day crusaders at Pakistan Cyber Force(How I wish we had developed Internet in our time.!!!).

While the whole blog peiece was a piece of art and I would highly recommend the Lahore Museum to store its manuscript,
the most enlightening parts were

“Today Imran Khan is like a classic hero who has emerged as a paladin of nationalism, baptised in the waters of public opinion, made great and filled with courage”

and

“He who is conscientious enough to prefer steep heights of truthfulness, selflessness, patriotic spiritedness over the primrose path of least resistance, of timid appeasement, of petty self seeking, always gets pilloried by the forces of status quo and inertia, so goes another law of history. Imran Khan has committed no crime, violated no law, breached no trust, betrayed no cause, wrecked no chariot-merely that he was guilty of sticking to his guns and having the courage of his convictions, courageous and cognizant enough to chart a different course, sing a different tune, and write a different script” and

“Granted that these writers always ran low on writer’s ink and that logic and profundity were never their forte, but have they become so sterile, jaded and pathetically predictable as to be unable to write a single article without hurling mud at a celebrated national hero? History is replete with examples of once high and mighty writers, eventually running out of ideas and becoming clichéd and banal towards the fag end of their careers, but what to talk about the desultory and vapid ways of these writers who seems to have met their waterloo even before a Toulon?”

I am tempted to ask the amicable writer (Did you notice how I changed the words, while saying the exact same thing ?) about his knowledge about the Great Khan beyond watching Television Anchors swooning over the “change” initially(and later eating a humble pie) and posts on his party’s official Facebook page but I won’t. It would be cruel of me to remind the young gun of all the “turn-coats” becoming the faces for the “Change” promised by the 59(or is it 60?) year old leader of the youth. I will not invite inevitable curses and trolling by the party faithful by suggesting a change in temperament with regards to the party and its “supreme leader”. I would also not waste your and my time advising the previously apolitical youth to read “actual books” or to attend “actual protests” if they want a political education. Why should they come out of their schools, colleges, coffee houses and air-conditioned cars(Glass Houses?) to find nothing but dismay? This would all be in vain. Nobody changes parties or opinions after debating their merits and de-merits. Proponents of such deluded mind-set should look at how democrats/Republicans in the United States and Conservatives/Labor Supporters in the United Kingdom always vote for their respective parties. As the last man standing for the once-great Nazi party, I see potential in the uprising of the youth of Pakistan.

May the Shadow of Fuhrer remain upon us forever,

Yours Faithfully,

Jospeh Goebbels

Magdeburg Cemetry

Its not the Corruption, stupid

2012-05-20T08:43:00.005-07:00

(an abridged version was published in Pakistan Today on 18th May, 2012)

It’s not the corruption, stupid

The mantra of corruption and eliminating corruption has gained increasing popularity after the historic Lahore “Jalsa” by Pakistan Tehreek e Insaf. The politicians of that party and the supporters have raised hue and cry over the issue of corruption by the politicians and bureaucrats. This, interestingly, is not a new phenomenon. There has been an undercurrent in the socio-political discourse about this issue and for the last 30 years, corruption is hailed as the root cause of most of our problems. Their solution to this problem seems to be a “technocratic” government, a model which has been tried at least twice in this country and failed to change anything. I beg to differ with this point of view and I want to explain why do I think that? (Spoiler Alert: I am not on the payroll of any party).

To start with, I would like to quote some facts and figures.
According to Pakistan Public Opinion survey 2009, 45% people said that the single most important issue facing Pakistan was Inflation, 26% said it was Unemployment, 17% said it was Terrorism, 15% said it was Electricity and water, 10% said it was poverty and only 8% said it was Corruption.

This does not mean corruption does not exist on a large scale in our country. Unfortunately, the only corruption being highlighted is the one done by the elected representatives of the people while the other institutions keep on looting this country without a second thought. As Mohammad Haneef once wrote, “Pakistan's army is as corrupt as the politicians from whom it wants to save the country. It's just better at paperwork.” Corruption is deep-rooted in our society and eliminating it would require more than sloganeering or a single regime change.

Columnist Umair Javed, explained how Corruption is now an intrinsic part of our society and why the current discourse against corruption is based on forgetting a few basic tenets,

“Whilst I generally agree to the harmful effects of corruption in so far as it induces low levels of efficiency, wastage of scarce resources and promotion of incompetence in merit-based situations, I am more concerned with this fetish of treating corruption as an alien disease. If the premise of their solutions relies on the extraneous nature of the problem itself, then the situation can be made a lot more interesting and complex if the primary assumption is discarded and a new one is set in place, i.e. corruption is not alien to the system, it is an inherent code of practice that has evolved over time in certain parts of the world, primarily from the experience of the public realm undergoing certain forms of social organization and re-organization such as colonialism, kinship associational modes and a cultural continuity of sorts that has synthesized these varying social experiences.”

We need to understand the dynamics behind corrupt practices and how ordinary people are equally responsible for a corrupt society than a politician or a bureaucrat. Bringing an end to corruption will take at least a generation which would be brought up on the agenda of honesty and belief in hard work rather than nepotism and paying your way out of trouble.

We may love to hate them but we should learn some lessons in this regard from our neighbors, India. Last year Anna Hazare in created a stir in the Indian society and media by launching a crusade against “the corrupt practices” of politicians. It was idealistic, utopian and ultimately failed to reap any rewards.
Pankaj Mishra, wrote the following about that movement in the NewYork Times,
“Led by Anna Hazare, the movement was presented by sections of the media as a long overdue political awakening of the middle class, even as India’s second freedom struggle.
With a mostly urban constituency in mind, Hazare’s vision was narrowly focused on the alleged misdeeds of elected officials—above all those in the ruling National Congress Party, which has traditionally sought votes from the Indian poor—and bureaucrats. Among other things, he called for the establishment of an unelected anticorruption agency, which, lavishly budgeted, would have extraordinarily wide powers of surveillance, policing, and prosecution—and, by implication, make the state more efficient and technocratic and less encumbered by the
unruly and lengthy processes of parliamentary democracy.”

After all the above mentioned points, I should also mention what in my humble opinion is the biggest problem facing Pakistan. It’s the population explosion and the aspect that makes it more alarming is that it is not considered among the top Five or Ten challenges facing Pakistan. None of the major political parties in Pakistan has focused its policies or plans on how to control the population problem
With more than 180 million people, Pakistan has nearly six times the population of Afghanistan (or Iraq), twice the population of Iran, and almost two-thirds the population of the entire Arab world put together. Rapid increase in population has led to decrease in the efficiency of the infrastructure that was established for lesser number of people. It has also led to a gross income disparity, decrease in natural resources, youth bulge and unemployment on massive scales.
To some extent, hypocrisy is also one of our biggest problems and it has been given no attention as well. A 59 year old leader of the youth, flying to a city on a private jet to lead a rally demanding a change in status quo, how much more cliched can it get.