Mere tut-tut would not do: KARACHI FILE
By A. B. S. Jafri
ACCORDING to quarters that claim and are generally believed to be well- informed about the causes of cancer, the incidence of this deadly disease in Pakistan is in any number in the range of 100,000 to 200,000. Barely half of such threatened lives are saved. This is indeed horrifying, considering the pathetic inadequacy of facilities for treatment available in the country. Only these two points should make all of sit up.
Not the least disappointing is the remarkable imprecision about the statistics about the incidence of cancer. We are well into the 21st century, are we not? There is so much of talk about Information Technology and computerization. Guessing between 100,000 and its double seems to make this set of statistics betray an attitude to this danger to life that is casual, putting it mildly.
The first question that calls for an answer from some responsible quarter (if we really have any) in this context is why we know so little about so implacable a killer as cancer undeniably is? Groping between statistics so far apart only proclaims we are not serious about tackling such a terrible danger to life. Unless we settle down to think seriously, serious action would be unthinkable.
Though our knowledge about the causes of cancer is still not quite complete or comprehensive, it is more than sufficient to guide us in the field of prevention. Prevention, the wise have said, is infinitely better than cure - even when there is sure cure. But that is not the case with us in respect of cancer. Prevention becomes so much the more imperative.
Among the causes about which there is now almost no doubt, the highest risk is associated with use of tobacco - chewing as well as smoking. Medical opinion is particularly strong against tobacco smoking. There are, though, specialists who argue that chewing passes on the danger from tobacco straight to blood, while smoking danger would take a while longer to become lethal.
This debate between smoking and chewing tobacco is too academic and esoteric for the lay person. It should be sufficient for all concerned to heed the warning against the dangers in imbibing tobacco — whether chewing or smoking - to be persuaded to wean away from this habit, or addiction. Here is a vast deal more than enough for the wise people in our public health services to be doing more than playing with loosely compiled statistics.
This should remind us of the maxim that there are statistics, and statistics and lies. This may sound a touch harsh in the present reference to cancer. But there is no denying that even as lip service, dishing out imprecise statistics would fall awfully short of what needs to be done. It is also short of what we can do even within our admittedly meagre resources.
There is no quarrel with cancer specialists over their by now unshakable conviction that tobacco is a very big cause for cancer. Let it be conceded straightaway that there are more tobacco smokers in Karachi than anywhere in this country. This is not simply because there are more people here. It is because here we have a great deal more of tobacco smoking per thousand of people.
Now is about time people in Karachi gave more attention to tobacco chewing as also one of the major causes of cancer. If on an average we have more tobacco smokers in Karachi than elsewhere, the percentage of people addicted to tobacco chewing would be very much higher n this city. It is only casually that this point is mentioned. Then everybody forgets all about it.
Having identified and convicted tobacco as a killer beyond any defence or appeal, let us think of the danger in smoke emitted by machines burning hydrocarbon fuels - especially diesel and petrol. Karachi has more buses, taxies, trucks, tankers and rickshaws than anywhere in this country. It can be said that a very large number of these machines, notably automobiles, pump more exhaust than normally should because their engines are not tuned well enough.
Only once in a while one hears some somnolent NGO making a mention of the risk of cancer that resides in fuel exhaust with which the air in Karachi is by now just about saturated. It is agreed on all hands that the air we breathe in Karachi is the most polluted in Pakistan, despite the blessing of a constant sea breeze. Fuel exhaust is not the only pollutant but unquestionably the heaviest and most lethal to health.
Imagine the hypocrisy that surrounds all this talk about use of tobacco as laden with the deadly danger of causing cancer. No doubt the advertisements carry the government warning that smoking is 'injurious' to health. In the first place, it is not 'injurious,' it is proved to be deadly, lethal. Why this euphemism about some addiction that is now in epidemic dimensions?
The government is casual, be it federal, provincial or local. One should expect the local governing administrations to think of their responsibility in a matter that demands instant attention and sustained remedial action. Arguably, the worst culprit in this context is the television in Pakistan. There should be public outcry against tobacco advertisements on television screen that is now in the bedroom.
It is about time such hypocrisy about what is a proven risk to human life was abandoned - in the interest of human life. Advertising a killer drug with the fig-leaf of a mere warning is playing with life.

