| 12 February 2005 | Saturday | 02 Muharram 1426 |
Which democracy will suit us?
KESC privatization
Abuse of public funds
Rape victims' identity
Perks for parliamentarians
Is Bush sold on democracy?
Shoaib's departure
Written exams for classes I-III
Expo 2005
Commentary
Girls not women
Shifting of US consulate
Ban on dance and music
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In response to the points raised by Dr Zafar Abbas (Jan 31) and Mr Zafar Omer (Feb 10) on the subject of "health for all", I have a few observations: Many private and public medical colleges have sprung up over the past few years.
A large number of students come together from various backgrounds. Medical students who originally belong to rural areas generally prefer to stay back in urban areas such as Karachi, Lahore and Hyderabad after the completion of their studies.
They tend not to go back to their own communities to deliver medical services, which are so often crucial for the well-being of their areas. While working in rural areas, doctors are not completely independent in their clinical practice and are often obliged to follow the unofficial "laws" of the local sardars, nawabs and waderas.
They may not be allowed to follow standard procedures during their practice such as maintaining patient confidentiality or providing counselling on family planning. They may be fearful for their own personal safety in the event of producing a medical report which could implicate a local influential person in a court of law.
Incidents such as the one in Sui, where a lady doctor was allegedly raped by officials who were responsible for the protection of the local community itself, keep younger doctors, especially those who belong to urban areas, to stay away from the remote stations. This creates a gap in healthcare for the local population, increasing the mortality rate and deepening an already existing healthcare crisis.
With over 70 per cent of the country's budget being spent on defence and repaying debts, and a fraction of the remaining spent on education and health, it would be extremely difficult to implement a system where a "consultant" or "specialist" could be trained to cater for the healthcare needs of 1,000 patients.
Even within developed countries like the UK, there is a single general practitioner (family practitioner) available for about 1,800 to 2,000 patients. This doctor is not a specialist but trained as a generalist, dealing with patients from all age groups coming with a wide variety of clinical and psychiatric complaints.
Only in certain cases is a patient referred to a hospital-based "speciality consultant". Over 75 per cent of the cases are treated by the GP within the community. The entire National Health Service is funded through taxation.
Within Pakistan, state-funded healthcare is not widely available in the rural areas and even within urban areas; only the poorest of the poor go to government dispensaries and hospitals.
Above all, there is no accountability in the event of clinical misjudgements leading to deterioration of a patient's conditions or even resulting in his death. Bearing in mind the above, I have a few recommendations to make:
a. Independent bodies are required to maintain clinical standards whilst implementing a nationwide healthcare programme. The PMDC alone would not be sufficient to monitor the activities of healthcare professionals.
Such bodies should be given full autonomy to take preventive and disciplinary action to protect patients regardless of their healthcare provider, be it private or public.
b. Doctors originally belonging to the rural areas should take the initiative and take up posts within their communities, paving the way for others to follow.
Government should ensure that doctors working in the rural areas are adequately protected not only from rogue elements but also from the influence of local civil servants, the clergy and landlords.
c. Instead of focusing attention on training hospital-based "specialists" such as surgeons, gynaecologists and paediatricians, the government should implement a strategy to train generalists; Family doctors who could provide basic healthcare to the communities and only refer patients to specialists when felt necessary.
d. Faculties for family medicine should be set up within each university providing medical education. The College of Physicians and Surgeons Pakistan and nursing colleges should take up this matter seriously, and fellowships awarded within the discipline of family medicine.
Already the CPSP's fellowship programmes are rated as at the same level as Britain's MRCP. Teams comprising doctors, nurses and health visitors should be trained to ensure that primary care is delivered to communities.
DR SHAAZ MAHBOOB
London, UK
Which democracy will suit us?
Several correspondents have expressed their opinion/suggestions in response to Mr Shabbir's Abbas Harianawala's letter "Democracy: is there an alternative?" (Feb 7).
Mr Vittal P. Pyati (Feb 10) rightly says: "India with more schisms than Pakistan in respect of language, religion, caste, etc., has a thriving democracy. So can Pakistan if only the military is confined to the barracks and politicians are less corrupt."
Politicians' corruption and ineptitude are the major roadblocks to democracy in Pakistan and the root cause of military interventions. Is there a way to create better politicians or upgrade the political skills of the existing politicians so that they can operate more efficiently in a democratic set-up?
Should we develop a code of ethics for politicians and ask them to abide by it? Should our legal system develop a new chapter on the rules of politics in democracy, and create a court of politics to try cases of political crimes committed so often by our politicians?
Can we promote a school of politics where all politicians, young and old alike, are trained and qualified in the art of politics in democracy? The school could also be responsible for disciplining or disqualifying politicians who operate beyond the rules of fair politics.
HUMAYUN ZAFAR
Toronto, Canada
(II)
This has reference to Mr Solangi's suggestion (Feb 10) that Pakistan should adopt a confederation model of democracy. It's about time we too had a 'Subcontinent Union'.
If the Europeans can unite in European Union after killing millions of their folks in the two world wars, there is no reason why we cannot have a similar (even better) union where we can benefit from trade, culture, defence and each other's scientific know-how. The union could become one big trading bloc with nuclear capabilities.
SYED MUNIM
Lahore Cantt
KESC privatization
This refers to the report on the KESC's privatization (Dawn, Feb 10). With due respect to our senators, I disagree with their demand for reversal of the sale of the KESC. The workers have strong objection to its privatization.
Why? It is because they have their own private fiefdoms in the organization to the detriment of the people of Karachi who have suffered enough at the hands of the KESC.
As far as workers' retrenchment is concerned, they should rest assured that only those people will be retrenched who do not add value to the organization. Would the senators like to pay people, in their own personal industrial concerns, who do not do any work? Have the senators studied the following:
- How much money has to be injected into the KESC every year?
- Why is the level of service of the KESC third rate to say the least?
- Why do the poor people of Karachi have to pay for burnt electrical appliances due to the faulty supply of the KESC?
- Why do commercial consumers have to pay about Rs9.50 per kw hr?
A leader is one who leads or guides. Our senators should be showing the way to their workers and not be led by them.
MIAN SHAUKAT HUSSAIN
Karachi
Abuse of public funds
This refers to the news report "3 PMs spent Rs43m on Umra, Senate told" (Feb 10.) Things must be going really well in Pakistan. The report says the Senate was told that former prime ministers Zafarullah Khan Jamali and Chaudhry Shujaat and the incumbent prime minister, Shaukat Aziz, spent Rs16.7, 15.23 and 11.12 million, respectively, on their entourages during Umra in 2004! And what's more, the taxpayers paid for all this. Certainly, this must be a sign of great prosperity.
Is not their record of corruption and mismanagement the main reason President Musharraf cites for preventing Benazir Bhutto and Nawaz Sharif from returning to Pakistan? But under his own watch, men ushered into supreme office, themselves millionaires, ruthlessly abuse public funds to perform personal religious rites.
Should not these three be made to publicly reimburse in full the amount they have taken from the national exchequer?
MUBASHIR KHAN
Indianapolis, IN., USA
Rape victims' identity
Mr Omar Mirza's letter (Feb 10) proposes banning the revelation of rape victim names as, he says, is the case in the United States. First, the US rape shield laws generally govern the admissibility of evidence and testimony of an alleged victim's sexual history during trial, based on the theory that evidence of past behaviour is irrelevant to the current case.
They do not address revealing the identity of victims. The mass media according to legal experts are free to print those names. The US constitution guarantees the mass media that right. Newspapers and TV stations in America choose not to exercise their right in order to protect the victim's privacy.
Second, unlike in Pakistan, US rape victims are not designated "kari". Hence, rape victims in America are in no danger. In Pakistan, the revelation of a rape victim's identity in certain cases where they might be killed by their community actually safeguards the victim.
PROFESSOR ARUN KHANNA
Indianapolis, IN., USA
Perks for parliamentarians
I was shocked to learn about the increase in the perks and privileges of our parliamentarians and ministers. These are the people who cry hoarse about their concern for the poor but feel no qualms in asking for more. Enabling them to maintain a certain standard of living is cited as the reason.
This is indeed understandable considering their life-style. The least these 'servants of the people' deserve are cars worth billions. How else will lowly Pakistanis learn to fear them? But why could we not get just two instead of 72 of these cars (for the president and the prime minister)? They are the ones who have been attacked and need special protection. What is the justification for the other 70 cars? This is outrageous.
MS RAFIA MIRZA
Lahore
Is Bush sold on democracy?
Bush Jr. commenced his second term as US president repeating his old rhetoric about democracy, freedom and respect for human rights although half the American nation no longer believes him. These non-believers are not the only ones who doubt everything he says; the world as a whole doubts the honesty of his utterances.
Recently, a US journalist visited Europe to find out what the Europeans thought about Bush and the Americans. To his horror he discovered that the Europeans never believed in Bush's claims about democracy, freedom, human rights and, above all, Iraq's WMDs.
They considered his victory in the 2000 elections a one- time mistake by the American public but after his re-election in 2004 they believe something is fundamentally wrong with the American people and the values they claim to espouse.
Europeans and the rest of the world aren't wrong; what happened in Iraq convinced everyone that the US simply doesn't believe in democracy or freedom or human rights.
It will therefore not surprise anyone to know that when asked by a BBC correspondent to provide estimates of civilian deaths in the Iraq war and its aftermath, neither US administrator for Iraq George Negroponte nor the US general-in-charge of military operations in Iraq nor the puppet Iraqi premier nor grand Ayatollah Sistani's able lieutenant, Abdul Aziz Al-Hakim, could provide any figures. No one among this lot seemed bothered about civilian deaths.
This manifests how much the US and its prodigies care about human life, let alone democracy, freedom and the rest of that jargon. When asked about the possibility of a rapprochement with dissident Iraqis to achieve internal peace as a prelude to asking the Americans and British troops to leave, Abdul Aziz Al-Hakim firmly rejected the idea.
So much for the sense of patriotism and national honour among those "elected" Iraqis the US expects to stabilize and govern Iraq. This should leave none in doubt about the real aims of the US and its coalition members in Iraq.
They are out to divide Iraq into parts that will be pitted against each other to permanently weaken resistance to US occupation. Democracy is just a handy tool for achieving that nefarious end.
The questionable electoral process will weaken the position of even those factions who have "won" the recent elections. It's a pity the Americans don't see how their present government is destroying America's otherwise acceptable image in international politics. The damage being done by Bush and the neo-cons will be lasting. Let there be no mistake about that.
A.B. SHAHID
Karachi
Shoaib's departure
I dis agree with the suggestion of Mr Ejaz Iqbal (Feb 5) and Mr Rizwan (Feb 10) that Shoaib Akhtar should be kept out of the Pakistan cricket team for good. It is beyond any doubt that Shoaib Akhtar is a genuine fast bowler and a match winner.
However, his potential has not been utilized properly nor has he been trained to have as good a class as that of MacGrath and Gillespie, etc. The handling of players by the Pakistan Cricket Board authorities is not at all satisfactory.
They start pampering and protecting some players and then suddenly start neglecting and punishing them. This attitude has resulted in loss of many talented players and many others are on the verge of being mismanaged. May I request the PCB and all those at the helm of cricket affairs to please handle all aspects of the game professionally?
DR HASAN THARANI
Karachi
Written exams for classes I-III
This refers to the letter "No written exams for classes I-III" (Feb 10). In Canada there are no written examinations from grade one to grade eight and all children are promoted to the next grade based on their class participation, assignments, presentations, quizzes and attendance.
We have noticed that such children really do well in their studies in high schools and universities where they have to take written examinations. By that age they are mature enough to take studies seriously and are even confident enough to choose their career options.
NADEEM AHSAN
Mississauga, Ontario, Canada
Expo 2005
I was surprised and shocked to read an advertisement (Dawn, Feb 9) released by the Export Promotion Bureau (EPB) to outsource the event report writing of Expo 2005. Surely, after being headed by an ex-CEO of a multinational for more than five years, the EPB should have developed and possessed the capability of writing a report on events conducted by it.
And if at all the capability did not exist in the EPB to write such a report, should not the exercise have been done when the Expo was being planned, so that the out sourced company would have had the "hands-on" opportunity of collecting the data as and when things were happening and would not have to depend on data fed to it after the event?
NAZIM F. HAJI
Karachi
Commentary
Some Indian channels each day telecast programmes like "Sunny By Night" to analyze cricket matches. But PTV has failed to satisfy cricket fans by inviting former Test players.
This reflects PTV's lack of planning and vision to promote this sport which is loved by many. Cricket commentators must be invited to analyze each match.
ARSHAD MAHMOOD BUTT
Jhelum
Girls not women
Mr M. Rafique Zakaria of Karachi (Dec 12) made the fallacious statement that the world 'woman' does not stand for an older lady and thus has nothing to do with age but it just signifies the gender. His statement does not take into account the fact that life has to pass through various phases:
1. Neonate - just born baby up to one month
2. Baby - 2-3 years
3. Adolescents - boys and girls up to 21 years.
5. Men and women from 21 years onward.
This implies that the woman is older than the girl. So the girls in the Government Fatima Jinnah College for Women, Faisalabad, were justified in protesting when their professor called them women.
It is a fact that even a woman does not like to be called a woman. It is ridiculous to say that the word 'woman' has nothing to do with age. College and university girls are universally called college girls and university girls and not college women and university women.
That is why colleges for girl students affiliated with Indian universities are known as girls' colleges and not colleges for women as in Pakistan.
PROF S. MAZHAR HUSSAIN RIZVI
Lahore
Shifting of US consulate
I have come to learn with surprise that the government of Pakistan is considering allocating an area in the vicinity of the Karachi Grammar School to the US government for its consulate in Karachi.
This will expose our children to all sorts of security threats in particular and security and operational inconveniences in general. Neither the school nor the consulate will be able to function properly or securely.
As a highly concerned parent, an old Grammarian, and a resident of the city I would like our leaders to think and plan for the long-term before making any decision with such far-reaching consequences.
ZAHID MAKER
Karachi
Ban on dance and music
This is with reference to the presentation of two private bills in the NWFP assembly by an MMA member seeking a ban on music and dance at public places. I wonder why they did not mention cable TV and dish antenna in the bills. Will someone challenge their wisdom? Help God, the Taliban are back!
JOHN DAVID
New York, USA
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