A road map to what & where?

EARLY in May, while Colin Powell was on his visit to Israel and the occupied territories, he met Mahmoud Abbas, the new Palestinian prime minister, and separately with a small group of civil society activists, including Hanan Ashrawi and Mostapha Barghuti. According to Barghuti, Powell expressed surprise and mild consternation at the computerized maps of the settlements, the eight-meter-high fence, and the dozens of Israeli army checkpoints that have made life so difficult and the future so bleak for Palestinians.

Powell’s view of Palestinian reality is, to say the least, defective, despite his august position, but he did ask for materials to take away with him and, more important, he reassured the Palestinians that the same effort put in by Bush on Iraq was now going into implementing the road map. Much the same point was made in the last days of May by Bush himself in the course of interviews he gave to the Arab media, although as usual, he stressed generalities rather than anything specific. He met the Palestinian and Israeli leaders in Jordan and, earlier, with the major Arab rulers, excluding Syria’s Bashar al-Asaad. All this is part of what now looks like a major American push forward. That Ariel Sharon has accepted the road map (with enough reservations to undercut his acceptance) seems to augur well for a viable Palestinian state.

Bush’s vision (the word strikes a weird dreamy note in what is meant to be a hard-headed, definitive and three-phased peace plan) is supposed to be achieved by a restructured Palestinian Authority, the elimination of all violence and incitement against Israelis, and the installation of a government that meets the requirements of Israel and the so-called Quartet (the US, UN, EU and Russia) that authored the plan. Israel for its part undertakes to improve the humanitarian situation, easing restrictions and lifting curfews, though where and when are not specified.

By June 2003, Phase One is also supposed to see the dismantling of the last 60 hilltop settlements (so-called “illegal outpost settlements established since March 2001) though nothing is said about removing the others, which account for the 200,000 settlers on the West Bank and Gaza, to say nothing of the 200,000 more in annexed East Jerusalem. Phase Two, described as a transition to run from June to December 2003, is to be focused, rather oddly, on the “option of creating an independent Palestinian state with provisional borders and attributes of sovereignty” — none are specified — culminating in an international conference to approve and then “create” a Palestinian state, once again with “provisional borders.”

Phase Three is to end the conflict completely, also by way of an international conference whose job it will be to settle the thorniest issues of all: refugees, settlements, Jerusalem, borders. Israel’s role in all this is to cooperate; the real onus is placed on the Palestinians, who must keep coming up with the goods in rapid succession, while the military occupation remains more or less in place, though eased in the main areas invaded during the spring of 2002.

No monitoring element is envisioned, and the misleading symmetry of the plan’s structure leaves Israel very much in charge of what — if anything — will happen next. As for Palestinian human rights, at present not so much ignored as suppressed, no specific rectification is written into the plan: apparently it is up to Israel whether to continue as before or not.

For once, say all the usual commentators, Bush is offering real hope for a Middle East settlement. Calculated leaks from the White House have suggested a list of possible sanctions against Israel if Sharon gets too intransigent, but this was quickly denied and then disappeared. An emerging media consensus presents the document’s contents — many of them from earlier peace plans — as the result of Bush’s new-found confidence after his triumph in Iraq. Sceptics and critics are brushed aside as anti-American, while a sizable portion of the organized Jewish leadership has denounced the road map as requiring far too many Israeli concessions.

But, the establishment press keeps reminding us that Sharon has spoken of an “occupation,” which he never conceded until now, and has actually announced his intention to end Israeli rule over 3.5 million Palestinians. But is he even aware of what he proposes to end? The Ha’aretz commentator Gideon Levy wrote on June 1 that, like most Israelis, Sharon knows nothing “about life under curfew in communities that have been under siege for years. What does he know about the humiliation of checkpoints, or about people being forced to travel on gravel and mud roads, at risk to their lives, in order to get a woman in labour to a hospital?”

Another chilling omission from the road map is the gigantic “separation wall” now being built in the West Bank by Israel: 347 kilometers of concrete running north to south, of which 120 have already been erected. It is twenty-five feet high and ten feet thick; its cost is put at 1.6 million dollars per kilometer. The wall doesn’t simply divide Israel from a putative Palestinian state on the basis of the 1967 lines borders: it actually takes in new tracks of Palestinian land, sometimes five or six kilometers at a stretch.

It is surrounded by trenches, electric wire, and moats; there are watchtowers at regular intervals. Almost a decade after the end of South African apartheid, this ghastly racist wall is going up with scarcely a peep from the majority of Israelis or their American allies who, whether they like it or not, are going to pay most of its cost.

The 40,000 Palestinian inhabitants of the town of Qalqilya in their homes are on one side of the wall, the land they farm and actually live off of is on the other. It is estimated that when the wall is finished — presumably as the US, Israel and the Palestinians argue about procedure for months on end — almost 300,000 Palestinians will be separated from their land. The road map is silent about all this, as it is about Sharon’s recent approval of a wall on the eastern side of the West Bank, which will, if built, reduce the amount of Palestinian territory available for Bush’s dream state to roughly 40 per cent of the area. This is what Sharon has had in mind all along.

An unstated premise underlies Israel’s heavily modified acceptance of the plan and the US’s evident commitment to it: the relative success of Palestinian resistance. This is true whether or not one deplores some of its methods, its exorbitant cost, and the heavy toll it has taken on yet another generation of Palestinians who have not wholly given up in the face of the overwhelming superiority of Israeli-US power. All sorts of reasons have been given for the emergence of the road map: that 56 per cent Israelis back it, that Sharon has finally bowed to international reality, that Bush needs an Arab-Israeli cover for his military adventures elsewhere, that the Palestinians have finally come to their senses and brought forth Abu Mazen (Abbas’s much more familiar nom de guerre, as it were), and so on.

Some of this is true, but I still contend that were it not for the fact of the Palestinian stubborn refusal to accept that they are “a defeated people,” as the Israeli Chief of Staff recently described them, there would be no peace plan. Yet, anyone who believes that the road map actually offers anything resembling a settlement or that it tackles the basic issues is wrong. Like so much of the prevailing peace discourse, it places the need for restraint and renunciation and sacrifice squarely on Palestinian shoulders, thus denying the density and sheer gravity of Palestinian history. To read through the road map is to confront an unsituated document, oblivious of its time and place.

The road map, in other words, is not about a plan for peace so much as a plan for pacification: it is about putting an end to Palestine as a problem. Hence the repetition of the term “performance” in the document’s wooden prose — in other words, how the Palestinians are expected to behave, almost in the social sense of the word. No violence, no protest, more democracy, better leaders and institutions, all based on the notion that the underlying problem has been the ferocity of Palestinian resistance rather than the occupation that has given rise to it.

Nothing comparable is expected of Israel except that the small settlements known as “ illegal outposts” (an entirely new classification which suggests that some Israeli implantations on Palestinian land are legal) must be given up and, yes, the major settlements “frozen” but certainly not removed or dismantled. Not a word is said about what since 1948, and then again since 1967, Palestinians have endured at the hands of Israel and the US.

Nothing about the de-development of the Palestinian economy as described by the American researcher Sara Roy in a forthcoming book. House demolitions, the uprooting of trees, the 5,000 prisoners or more, the policy of targeted assassinations, the closures since 1993, the wholesale ruin of the infrastructure, the incredible number of deaths and maimings — all that and more, passes without a word.

The truculent aggression and stiff-necked unilateralism of the American and Israeli teams are already well-known. The Palestinian team inspires scarcely any confidence, made up as it is of recycled and aging Arafat cohorts. Indeed, the road map seems to have given Yasser Arafat another lease on life, for all the studied efforts by Powell and his assistants to avoid visiting him.

Despite the stupid Israeli policy of trying to humble him by shutting him up in a badly bombed compound, he is still in control of things. He remains Palestine’s elected president, he has the Palestinian purse strings in his hands (the purse is far from bulging), and as for his status, none of the present “reform” team (who with two or three significant new additions are re-shuffled members of the old team) can match the old man for charisma and power.

It may seem quixotic for me to say, even if the immediate prospects are grim from a Palestinian perspective, they are not all dark. I return to the stubbornness I mentioned above, and the fact that Palestinian society — devastated, nearly ruined, desolate in so many ways - is, like Hardy’s thrush in its blast-beruffled plume, still capable of flinging its soul upon the growing gloom. No other Arab society is as rambunctious and healthily unruly, and none is fuller of civic and social initiatives and functioning institutions (including a miraculously vital musical conservatory).

Even though they are mostly unorganized and in some cases lead miserable lives in exile and statelessness, diaspora Palestinians are still energetically engaged by the problems of their collective destiny, and everyone that I know is always trying somehow to advance the cause. Only a minuscule fraction of this energy has ever found its way into the Palestinian Authority, which except for the highly ambivalent figure of Arafat, has remained strangely marginal to the common fate. According to recent polls, Fateh and Hamas between them have the support of roughly 45 per cent of the Palestinian electorate, with the remaining 55 per cent evolving quite different, much more hopeful-looking political formations. — Copyright 2003, Edward W. Said

The men who cried wolf

SHOCK, horror! It turns out that the unelected leader of the free world and the more obsequious of his minions lied to their people and to the rest of the world. Saddam Hussein, they insisted, would love nothing better than to lob missiles loaded with chemical or biological compounds at London or Washington.

And rest assured, they said, that he possesses these weapons of mass destruction. We have, they said, incontrovertible intelligence (a claim that sounds particularly preposterous whenever it is made by George W. Bush) that the evil Iraqi dictator has been manufacturing and concealing WMDs.

The world could still be saved, they suggested. That would involve death and destruction, but was there any choice? Could the world simply sit and watch while Iraq pressed ahead with its nuclear programme? Never mind that Saddam didn’t have the delivery systems necessary for posing a threat even to Israel, let alone to other western nations. After all, he could easily share his WMDs with Al Qaeda, couldn’t he? Never mind that Osama bin Laden viewed the Ba’athists as infidels.

So, nothing short of an invasion would do, really. Allowing Saddam to continue to pose a threat to all that the West holds dear simply wasn’t an option. Nor was it viable to permit Hans Blix and his team to continue with their inspections. Why, they could be at it for years. The hundreds of thousands of American troops deployed in the Gulf couldn’t conceivably be made to wait indefinitely. They were hungry for revenge.

Revenge? Whatever for? What had Saddam ever done to their homeland? Well, there was September 11. A substantial proportion of American soldiers appear to believe that Saddam was personally responsible for the toppling of the Twin Towers in New York. There are no prizes for guessing where they got that notion from.

If there’s anything surprising about the parliamentary inquiry in London and somewhat less vociferous questions being raised in Washington and Canberra about the case for war made by the British, US and Australian governments, it’s the fact that anyone should be surprised by the failure of the occupation forces in Iraq to discover any traces of chemical or biological weapons, let alone a nuclear programme.

Donald Rumsfeld, who has lately transferred his attention from Iraq to Iran, now says that Saddam’s WMDs may never be found. After all, their relevance as an excuse for invasion is now academic. Rumsfeld lost little time in retracting his confession, offering the absurd analogy that just because Saddam hadn’t been found, nobody was assuming that he had never existed. And apologists for the Bush administration continue to

propound the theory that if no WMDs are found, it can only mean that Saddam and

his scientists were able to destroy them on the eve of the invasion.

They are undeterred by the obvious lack of logic in that presumption. If Saddam had any secret weapons, why wouldn’t he use them when threatened with elimination? And anyone who knows anything about chemical or biological armouries is aware that no one can get rid of them without leaving tell-tale traces.

The next line of argument is: to hell with the weapons, isn’t it enough that Saddam’s regime has come to an end?

Well, it’s hard to be sure that the more than 5,000 civilians and tens of thousands of Iraqi soldiers killed in the conflict would agree with that assessment about their “liberation”. Their relatives, too, are unlikely to be thrilled.

What about the remaining Iraqis? Are they delighted by what has been ordained for them, not so much by fate as by the cowboy in the White House? The evidence suggests otherwise. Lawlessness of unprecedented proportions. An infrastructure destroyed twice over that no one is in a hurry to repair. Basic scarcities that no one is in a rush to remedy. Medical facilities reduced to a fraction of their pre-war efficacy — which already left a lot to be desired, thanks to more than a decade of misdirected sanctions.

And before any kind of Iraqi administration is installed in Baghdad (there’s no road map or timetable involved), US proconsul Paul Bremer is making sure that as many state-owned corporations as possible are privatized. After all, he represents an administration uncommonly attached, even by American standards, to multinational corporations. And what good is a war if it doesn’t yield profits? And what are the odds that Iraq’s oil industry will be privatized before the occupation forces yield authority to a puppet administration?

Speaking of which, the aftermath of the invasion of Afghanistan offers a useful example of what can be expected in Iraq and elsewhere. Hamid Karzai and the 5,000-strong multinational peacekeeping force hold sway in Kabul, but the rest of the country is back under the control of warlords, just as it was before the Taliban took over. Some of them formally owe allegiance to Karzai, but refuse to pass on to Kabul any of the revenues they collect. All of them individually command forces substantially larger that the incipient national army. Several provinces are effectively Taliban territory, according to western reports.

Some 18 months after the capture of Kabul, about 11,000 US soldiers are still engaged in combating what are described as Al Qaeda and Taliban forces. Meanwhile, the cultivation of opium has risen 18-fold since the fall of the Taliban and continues to grow, with Afghanistan once more designated as the source of 75 per cent of the world’s heroin.

As for reconstruction, the international pledge of five billion dollars is, even by the World Bank’s frugal estimate, no more than half of what Afghanistan needs for a kick-start. The American share in the largesse is only $300 million. In its most recent budget, the White House tellingly neglected to mention Afghanistan at all, and congressional intervention was required to pencil in a token commitment.

If the seeds of democracy and self-sufficiency ever sprout in Iraq or Afghanistan, it is extremely unlikely that posterity will apportion any of the credit to the US. This is not in any way to suggest that either Saddam’s grotesque regime or that of the Taliban was in any way worthy of preservation, regardless of what they offered obedient citizens in terms of security or welfare. The point is that their removal would have made far greater sense had it been accomplished by indigenous opposition forces. And that would have been a far likelier scenario had the West been less vehement in its support of Saddam and of fundamentalist forces in Afghanistan during the 1980s.

And the fate of Afghanistan and Iraq renders all the more ominous the rhetoric that has lately been directed against Iran. there can be little question that Tehran boasts a regime that is unpalatable in the extreme to large numbers of Iranians, as well as to most other level-headed people. At the same time, the clerical hierarchy’s nuclear ambitions have never been much of a secret.

Yet a paean from Bush must seem like a kiss of death to liberal forces in Iran. There is little doubt that mullahcracy has been disastrous for Iran, but there is no importable remedy. If the ayatollahs are to be superseded, the impetus must come from within Iran. There has lately been plenty of evidence of it among the young, but Bush has done them no favours by voicing his support.

In a prescient article written well before the military assault against Iraq, Eric Margolis pointed out: “Iraq is not the main objective for the small but powerful coterie of Pentagon hardliners driving the Bush administration’s national security policy. Nor is it for their intellectual and emotional mentors in Israel’s right-wing Likud Party. The real target of the coming war is Iran, which Israel views as its principal and most dangerous enemy. Iraq merely serves as a pretext to whip Americans into a war frenzy and to justify insertion of large numbers of US troops into Mesopotamia....

“Prime Minister Ariel Sharon called for an invasion of Iran ‘the day after’ Iraq is crushed. In the US, Pentagon hardliners are drawing up plans to invade Iran once Iraq and its oil are ‘liberated’. They hope civil war will erupt in Iran, which is riven by bitterly hostile factions, after which a pro-US regime will take power. If this does not occur, then Iraq-based US forces will be ideally positioned to attack Iran.”

The hypocrisy of the hullabaloo over Iran’s nuclear potential ought to be viewed in the light not only of Israel’s barely secret nuclear armoury or the nuclear capabilities of India and Pakistan (which, as American allies, get little flak), but of the unimaginably vast US stockpiles and Washington’s intention of violating all existing arms-control treaties to develop strategic nukes that can be used in a war theatre.

Bald-faced lies are a relatively inconsequential part of the western arsenal compared to the warheads. Bush isn’t by any means the first US president to dissemble, and he won’t be the last. The problem is that the coterie surrounding him has set its sights on global domination. Its goal must be thwarted, and it would help, for starters, if the governments in London and Canberra stopped treating the received wisdom from Washington as the gospel truth.

E-mail: mahirali@journalist.com

Let us wash our brains

EVER since the iron curtain was pulled down, and citizens of the former Soviet Union were allowed to go out and see the world for themselves, there has been a sea change in the type of news emanating from that vast disintegrated empire. As if to prove that they are as human as the rest of us, the corny and the bizarre now make as much news from those lands as from other parts of the world.

I like two items in particular that I read in a London daily some time ago, both pertaining to the use of brains. Actually there have been countless news reports ever since restrictions were lifted from what sort of information about “the perfect nation with perfect leaders and perfect citizens” should be allowed to go out, but they are not all about brains and their uses. These two somehow appealed to me for reasons with which I shall conclude this piece.

The first story said that the brains of Lenin, Stalin and other prominent Soviet leaders, including Nobel Prize winner Andrei Sakharov, had been preserved for study in a Moscow science institute.

The second informed the world that the brains which formerly designed deadly long-range missiles in a Ukraine factory were now engaged in Russia in producing things like meat grinders. While the purpose of both was the same — to make mincemeat — the list of new articles being manufactured by those scientists and engineers ranged form tractors to children’s toys.

And what a decline for the KGB, once the most feared and hated spy agency in the world! For the leaders’ brains are said to have been placed in its custody, and are being kept in locked premises that no one can enter. Apparently the KGB now deals with dead brains only, but is as secretive about them as it once used to be about the whereabouts of live human beings who didn’t see eye to eye with the government’s political and national views.

On the other hand, the human brains engaged in the former Ukraine missile factory have been set free and are now busy in flights of fancy on how best to utilise their talent to provide happiness to the present users of the factory’s products. I may add that all these reports, and my caustic comments on them will now have to be seen in another light after President Vladimir Putin’s ambitious plans to make the Russian empire a force to be reckoned with — by the United States.

A Russian journalist, Artyom Borovik by name, who was responsible for the scoop on the brains of Lenin and Stalin, had revealed that it was the latter who had initially ordered the study to prove that the father of communism in the Soviet Union and other top leaders were part of a kind of “master race.” So Hitler was not the only one to claim that he belonged to a race of superior Aryans and was, therefore, justified in eliminating lower race human like Jews and Anglo-Saxons.

Brorovik also disclosed that the study of Lenin’s brain had been stopped more than 40 years ago — somewhere in the fifties. Maybe Stalin had come to believe by then that there was no point in further research to prove that Lenin was God. The very fact that he couldn’t stop himself from dying must have convinced his successor of the great leader’s mortal existence. Even so it took Stalin some thirty years to be fully converted to this way of thinking, which only proves that he was not much of a brain himself. Rather a slow thinker, I must say.

Since the study of Lenin’s brain was declared top secret and filed away in some dark recess of the Kremlin, we have no means of knowing what it had actually revealed. Unfortunately also, nothing is known about the quality of Stalin’s own brain. It must have been galling for the man not to have bits of it tested in his lifetime.

Maybe some of the over ten million Soviet citizens eliminated by him were scientists punished for not being able to do that, i.e. dissecting the brain of a living man to prove how good and indispensable it was for the country’s progress and glory and how superior it was to the brain of the United States’ President.

Attempts to prove that one race is physically and intellectually better than another were not confined to the old USSR and to Nazi Germany. In our own country the process is going on all the time. If we can’t somehow establish that the community or the province we belong to is more cerebral than the others, we work the other way round and try to show that the rest are simply morons and less gifted than we are.

How can we get an equivalent of the missile factory to divert our brain power, based on our martial personality, from its destructive potential to such beautiful activity as making children’s toys? Sadly, even the thought of our children’s future doesn’t deflect us from thoughts of self-aggrandisement and our murderous ways. We are all guided missiles programmed to destroy and annihilate, and we are not bothered that, like killer missiles, we too are destined to be destroyed in the bargain.

Before the Partition, we Muslims of India suffered from the complex that we are less clever and intelligent than the Hindus. But we managed to get Pakistan despite their supposedly higher brain power. After independence, we Pakistanis of the western wing began to harbour inflated notions of our superiority over the Bengalis, but it is they who got the better of us. They are one nation while we are still debating how to become one. Had we been considerate and sympathetic, Bangladesh would not have been created. If the Hindus in united India had been more realistic and accommodating, there would have been no need for Pakistan. It is up to us to ponder if these complexes and obsessions about superiority and inferiority are leading us anywhere, and whether it is not better to make humility, love and tolerance our basic creed. That might be the only way to salvation.

Health sector in the doldrums

THE health sector in Pakistan is in a state of crisis. Yet the policy makers appear to be unconcerned about the sufferings of the people. The pity is that the induction of the so-called democratic government has not made the slightest difference to the quality of life of the common citizen.

Matters of more immediate concern to the common man than the constitutional and political conundrum have gone by default. Issues of governance and policymaking have been pushed into the background. How many politicians have cared to look into the implications of various policies which have been formulated by government functionaries without any parliamentary debate? How many have bothered to analyze the federal and provincial budgets, which have been presented recently, in a meaningful fashion? Have any of them attempted to monitor the implementation of various policies announced with such fanfare?

On the contrary, the energies and attention of the politicians and the media have been focused on the political tussle which has gripped the country since October.

All this suits the interests of the powers that be. Many of them are foreign donors who are acting in collusion with their local agents. It keeps public attention diverted from the basic issues which are understandably the real concern of the man in the street. One of these is the health care provided to the people and the health policy which provides the parameters for the health delivery system. .

In the last decade or two, the Pakistan government has been gradually disengaging itself from the social sectors under the directives of the World Bank/IMF combine. It has encouraged the private entrepreneurs to fill the vacuum thus created and has devised the concept of the public/private partnership in an attempt to make this shift in emphasis palatable.

One would not dispute the imperative of involving the private sector and the NGOs in the health delivery system of the country, given the financial constraints that exist. But the key factor in this arrangement is the role assigned to each of them. If the private sector assumes a preponderant role, it is inevitable that the cost of health care will rise and become increasingly inaccessible to the indigent, whose number has been escalating.

Some might argue that in absolute terms the government’s health budget has constantly been on the rise and it is unfair to accuse it of shirking its responsibility of providing basic medicare to the people. In the five-year period of 1995-2000, the government’s health budget went up from Rs 16.3 billion to Rs 24.2 billion — an increase of nearly 50 per cent.

But what needs to be assessed is whether this increase in the health budget has benefited the people in the same proportion. WHO’s World Health Report 2002 paints a depressing picture. According to this document, the health-adjusted life expectancy at birth in Pakistan is 50.9 years when our government places life expectancy at 63 years. In other words, if you adjust the years lost in illness, the healthy life span of an average Pakistani is considerably reduced.

This finding is further reinforced by the high incidence of disease in the country. This is not a very pleasing situation for people to find themselves in. While in comparative terms they may be living longer than their ancestors did, the state of their health is definitely more dismal than ever before. Even to sustain their unhealthy lives, people have to spend more and more out of their own incomes to obtain some relief from their suffering.

According to the WHO report, the private sector accounted for 75.2 per cent of the total amount spent in the health sector in the country in 1995. This share went up to 77.2 per cent in 2000. In other words, the private sector — this mainly means out of pocket expenses for most people — is spending nearly thrice the amount the government allocates to the health sector. This does seem to be quite a lopsided partnership.

And how does the government spend the money it earmarks annually for the health budget? A look at the budget documents presented by the federal and provincial governments last week shows that the bulk of the government’s health funds goes into the salaries of the staff.

In fact, this head also absorbs most of the increases whereas the spending on items such as medicines, X-rays, utilities (gas, electricity and water) has either remained pegged at the same level or has even been lowered. Hence the people have had to pay for this shortfall.

One could have accepted this imbalance with equanimity if the government’s public health policy had been directed towards creating a healthy and risk-free environment for the people. That would have resulted in a lower prevalence of illnesses and ensured a better health environment for the people. But this has not been done and one may well ask who should be bearing the cost of medical treatment of a person who suffers from infections caused by impure water, mosquito bites, insanitation and polluted air? If the government is failing in its duty to provide the people basic necessities such as potable water and ensure efficient disposal of sewage and garbage, it has no right to burden the people with the heavy cost of medical treatment of the diseases which are a result of these lapses.

Even in the field of preventive medicine, the failure is too palpable to be ignored. Recently a leading paediatrician pointed out that the immunization coverage in the country for the six preventable childhood diseases has declined.

According to him, it has fallen from 80-90 per cent in the eighties to 50-60 per cent today. With this poor performance, can we ever hope to eradicate diseases such as polio and tuberculosis which call for a concerted immunization drive?

From what the functionaries in the relevant departments have to say, it is plainly a shortage of funds and manpower that has hit the Expanded Programme for Immunization over the years. This is a pity because the EPI had got off to such a promising start two decades ago.

The shortage of funds is not the only problem affecting the public sector health institutions. A substantial amount of the money provided for health care is siphoned off by the corrupt among the staff. Sizable in number, that section freely indulges in corrupt practices. Pilferage by them from hospital pharmacies facilitates a regular flow of drugs into the open market.

In the absence of strict monitoring and the failure to enforce discipline, absenteeism is also on the rise — said to be as much as 30 per cent in some public hospitals and other health-care centres. The irony is that the private sector is relatively free from corruption and other irregular practices such as absenteeism, negligence, ineptitude and so forth.

But it is not inherently suited to undertake the responsibility of providing services at a low cost to the public. Moreover, it has never been known to enter the field of preventive medicine. where there is little scope for profit.

The only solution is for the government to enhance its own role and spending in this field. It is strange that in the Third World countries, where poverty is rampant and the people need greater state support, the governments are spending less and less on health care, thereby raising the financial burden of

individuals and families who have to pay considerably more in seeking the services of

private doctors, clinics and hospitals.

As against this in the industrialized states where the people are generally much better off, the governments provide greater social security and bear a substantial share of the burden of health- care spending. In Sweden, for instance, the government contributes nearly 75 per cent of the country’s health spending.

Even in the US, the bastion of capitalism and market economy, the government’s share in the health expenditure is nearly 50 per cent.

There is need to redefine the nature and scope of the public-private partnership in health and education in Pakistan. Given the poverty of the people and the virtual de-emphasis on public health and preventive medicine, it is the height of injustice to make people foot inflated medical bills presented by the private sector because they have nowhere else to go.