March 24, 2003	Monday	Muharram 20, 1424

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ISLAMABAD, March 23: A glaring fact, which has yet to enter the official vocabulary and is absent even in the Poverty Reduction Strategy Paper (PRSP), is the role of high prevalence of disease coupled with poor quality of health care system in the rapid rise in poverty.

Yet, according to a recent survey of the UNDP, it was found that on an average 65 per cent of the extremely poor are ill. They have suffered from illness on an average of 95 days.

In the rural areas, the morbidity among women above 25 years is as high as 75 per cent, while among men of the same age group, the situation is far from satisfactory. Forty-five per cent of them suffer from poor health.

Those who are slightly above poverty line are pushed into poverty due to the high prevalence of disease among them, while those who are already poor get pushed into deeper poverty as a result of loss of income and high medical costs resulting from illness, Dr Akmal Husain, an eminent researcher on social and economic issues, remarked in a paper presented at a recent seminar in Islamabad.

When this issue was raised at a meeting on child welfare, a health ministry official asserted among other remarks that health care had been provided at the people’s doorstep, but that it was under-utilized. This is because these facilities are without any medicine and first-aid material.

Even those with poor resources, therefore, go to private unqualified allopathic practitioners rather than to basic health units or government hospitals. As a result, when the poor fall ill they suffer for a protracted period and get locked into the vicious circle where indebtedness and deeper poverty becomes their fate.

Thus, there is the paradox that the population per doctor has fallen from 2,082 in 1990 to 1,529 in 2000, but the access to health care and cure has receded continuously — a tribute to inadequate coverage and poor quality.

Commercialism propelled by the ethos promoted by the World Bank has meant that only those can obtain proper treatment and benefit from the advances in medicine who can pay for it. Here is the laissez faire in its full ugly cry!

A social scientist observed that one of the reasons why this problem had remained neglected was the fact that bureaucracy as well as politicians at the helm of affairs in policy-making and policy-implementation already enjoyed optimal health care at the taxpayer’s expense.

Those in the high echelons of power are at liberty even to obtain expensive treatment in foreign hospitals out of the government funds. Hence the conspiracy of silence in the corridors of planning!

In his speech at a poverty seminar recently, the deputy chairman of Planning Commission indicated that while formulating the PRSP, its authors laboured under the delusion that provision of preventive medicine was enough to combat widespread morbidity in the populace, both rural and urban.

It was pointed out to him that diseases such as cancer, hepatitis, hypertension, heart ailment, diabetes, asthma etc. were on the increase among people who had survived communicable diseases.

At present, only people in government service and in employment of multinational companies have access to free medicine and health care.

“Is it not the government’s responsibility to ensure that the people, having survived cholera, diarrhoea etc., are able to enjoy a life of reasonable comfort,” an old man who lost his business while fighting illness said.

It is strange indeed that those who live on taxes have all the facilities in the world while those who pay taxes are left to fend for themselves.

But that, it seems, is the measure of success of the kind of world visualized by the World Bank and IMF — a vision hugged by our policymakers in their enthusiasm to prove themselves good boys.