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| October 11, 2005 | Tuesday | Ramazan 6, 1426 |
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Unsafe blood practices
If the peace process is to succeed
A momentous vote ahead
WITH the visit of Indian Foreign Minister Natwar Singh, between October 3 and 6, the second round of the composite dialogue, following the landmark 2004 agreement at the summit level to restart the peace process, has been concluded.
THE death toll from Saturday’s devastating earthquake still remains a guess, given the inaccessibility of the towns and villages in the mountainous areas rocked by the convulsion. The federal interior minister has put the death toll at 20,000, but a UN official told Dawn that in Azad Kashmir alone 30,000 had perished. The NWFP chief minister put the figure for his province at 8,000. This means that the overall death figure could be as high as 40,000. If, to this one applies the traditional principle of assuming 10 injured for every death, we have a frightfully high casualty figure — 400,000. As for those alive but injured and hungry and sleeping outside their destroyed homes in chilly weather, the number runs into millions. Whole villages have been wiped out, including the historic Balakot, while Muzaffarabad, Azad Kashmir’s capital with a population of 600,000, has been destroyed 70 per cent.
The greatest impediment now in the way of providing relief to the hapless is of a logistic nature. Landslides have blocked not only dirt roads but also motorable roads with asphalt tops. Given this harsh reality, medical supplies, food, and bedding can only be dropped from the air by C-130s or rushed through helicopters, which are in limited numbers. Even the expected arrival of American helicopters will make only a marginal difference to the situation, because ultimately it is road transport that can carry the bulk of supplies. All efforts must, therefore, be made to open the roads to the ravaged areas. The task is difficult because roads have not only been blocked; at many places they have developed huge cracks, and some bridges are in a precarious condition. Telephone lines have collapsed, and the cell system has been choked. To clear the roads of rocks and mud, fill up the cracks and restore the telephone system are huge tasks requiring hard work and dedication under an overall command. And that is where one notices the absence of a management disaster network.
As the Katrina tragedy in the US showed, even the most developed of countries can find itself helpless against the forces of nature. But America has a Fema — Federal Emergency Management Agency. Even though the hurricane forecast had been made weeks in advance, Fema still failed to save New Orleans and provide quick relief to the survivors. We do not have a Pakistani version of Fema, as October 8 clearly demonstrated. Hats off to Abdul Sattar Edhi. The man began his relief agency on a modest scale in Karachi and has over the years extended it to other parts of Pakistan. One can see Edhi ambulances and volunteers at sites of tragedies even before state agencies stir themselves. The government, thus, can take a leaf from Edhi’s book and learn a thing or two from him in calamity/relief work. Money is not the problem. The prime minister has announced a one billion-rupee relief package, Saudi Arabia has donated one million riyals, and more foreign help is on the way. At the same time, the people of Pakistan have swung into action on their own. Their spontaneous response to the suffering of fellow countrymen comes as a ray of hope in an otherwise dark scenario characterized by selfishness, greed and acquisitiveness. Among the political parties, the Muttahida was the first to react to the tragedy, while other parties have followed the lead. One can see relief centres and camps coming up in parts of the country not affected by the quake. People are rushing with donations in cash and kind. The issue, therefore, is one of taking supplies to the affected.
The northern belt stretching from the foothills of the Hindu Kush and the Karakoram to the Potohar plateau and even further east is prone to earthquakes. Saturday’s was one of the most ravaging to strike this region. A similar quake cannot be ruled out in the future. Down south, Karachi, the nation’s largest city, too, is on a fault line. Should a quake of even minor intensity jolt Karachi, we will have a tragedy of unimaginable proportions. Is the state apparatus ready for such an eventuality? Even Islamabad, the national capital, was caught unprepared this time, with heavy earth-moving machinery not immediately available for rescuing the people trapped under the debris of an apartment block. Thanks to a British team, over 100 people were pulled out from the rubble of the 11-storey building. What happened on Oct 8 was Pakistan’s mountain tsunami. While one must hope and pray that Pakistan is spared such a visitation again, the nation should nevertheless be ready for all eventualities. The collapse of the Islamabad building showed that it was not quake-proof and the construction may have been substandard. In future, the government must see to it that all such tall buildings are quake-proof, and the contractors violating the building code are held answerable. The post-quake inquiry must also ascertain whether the Tarbela and Mangla dams as well as the site of the proposed Kalabagh dam have been affected by the violent jolts. The disaster holds quite a few lessons for Pakistan, the foremost being the need for the country to have a nationwide disaster system that can swing into action at a moment’s notice.
THE closure of 15 blood banks in Sindh by the provincial health authorities is yet another warning to errant units to discontinue the unlawful and dangerous practice of storing unscreened and expired blood, or else face the consequences. While an ordinance amending the Safe Blood Act of 1997 was issued recently, a serious drive against the storage of unsafe blood has been going on for more than a year — although the campaign has been hampered by long periods of inaction. For any drive to be successful, the Sindh Blood Transfusion Authority will have to embark on a course of action that is sustained. Otherwise, it will send out the wrong message to blood units, many of which will revert to questionable methods of storing blood, once they feel that the SBTA has relaxed its watch and restrictions. Currently, only a handful of blood banks out of over 400 in the province are registered, making it difficult for the authorities to keep a check on all of them. This makes it all the more necessary for the SBTA to redouble efforts to ensure that the units are registered, that blood meant for transfusion is safe and that the medical history of all donors is documented.
As things stand now, in the absence of a culture of voluntary donation, blood banks rely on professional donors, including even drug addicts who use shared needles, thus compounding the risk of transmitting dangerous germs to unsuspecting patients through transfusion. The fact that this practice is not on the wane is evident from the growing number of recipients who are stricken by malaria, hepatitis B and other blood-borne diseases. It is necessary to point out that unsafe blood transfusions alone are not responsible for this and that the use of contaminated needles and equipment during other medical procedures is equally to blame. It follows from it that stricter checks should be kept on blood banks to ensure that they take blood from healthy donors whose medical history has been verified and that blood products are tested and screened. The latter may be a costly process but if blood banks pooled resources they could come up with a scheme to share screening equipment. It is equally important that catheters, needles and other lightweight medical equipment capable of transmitting deadly pathogens are destroyed immediately after use. Incinerators are available for this purpose and should be used regularly.
Both sides, the Indian side in particular, made an effort to present the outcome as positive, stressing the cordiality that prevailed, as well as the resolve of the two sides to pursue the process with sincerity and seriousness.
The effort to accentuate the positive, and to raise hopes for the future became necessary since the real progress made towards advancing the peace process has been minimal, and Indian statements and actions have shown greater concern for maintaining a hopeful outlook than for decisions that would mark real progress. In other words, the Indian side is more interested in “conflict management” than in “conflict resolution” which is of greater interest to Pakistan as the aggrieved party in most items of the agenda.
Natwar Singh, who has also served as India’s envoy to Pakistan, shows greater regard for maintaining the cordiality of the dialogue, even though Prime Minister Manmohan Singh has begun to demonstrate the hubris of a strategic partner of the sole superpower. Though the BJP, that started the dialogue in January 2004, has the reputation of championing Hindu extremism, the “secular” Congress government that succeeded it, has reverted to the intransigence dating back to the Nehruvian period, which was converted into a quest for hegemony reflected in the “Indira doctrine”.
The new factor in the equation is the role of the US, which attaches importance to Pakistan’s role in the war on terror, though it has clearly decided to build up India as its regional partner, to contain China, now seen as the most likely challenger to US hegemony. The US would like to foster a detente between the two nuclear neighbours, though eventually, if they do reach a modus vivendi, it is likely to argue that Pakistan does not need nuclear deterrence.
For the present, Washington attaches importance to the peace process being maintained, even though most analysts believe that the current US-Pakistan entente centres on a single agenda, i.e., the war against terrorism. This ignores the importance the US attaches to Pakistan as a leader, as well as an example of enlightened moderation in the Muslim world.
An interesting side issue, which has won over the once non-aligned Congress leadership to a total identification with US global aims, is the landmark decision by President Bush to transfer peaceful nuclear technology to India, in violation of the principles followed so far by the Nuclear Suppliers’ Group. This is seen as a deliberate blow to the non-proliferation agenda that has been followed since the signing of the Non-Proliferation Treaty in 1968.
India demonstrated its new loyalty to Washington, when it voted in favour of referring Iran’s violation of NPT provisions to the Security Council, at the meeting of the IAEA, much to the disappointment of Iran. The US had made the transfer of nuclear technology conditional upon India supporting the US stance.
This background has to be taken into account in anticipating the course the peace process is likely to follow. The Bush administration favours the peace process, and encourages it, mainly because hostility between India and Pakistan muddies the waters in a region of critical importance in the war against terrorism. As the unique superpower, it is staking its considerable influence on the dialogue being maintained. However, India’s stance, specially on the core issue of Kashmir, indicates that it does not expect the US to intervene, particularly as it has succeeded in persuading the US that the militants in Kashmir are terrorists, and not freedom fighters.
The peace process has consisted, from the very start of this phase, of two aspects, namely confidence building measures (CBMs) and negotiations on various items of the eight point agenda, that was agreed between the two countries in 1997. The two major items, to be taken up at the foreign secretary level, are peace and security (including nuclear risk reduction), and Kashmir. The remaining six issues, comprising Siachen glacier, Sir creek, Wullar barrage, trade and economic issues, cultural exchanges, and issues relating to travel and communications, are held at the expert level, with progress reported to the foreign secretaries, and foreign ministers, who meet at the conclusion of each round. Meetings are also held at the summit level, to give a fillip to the process.
The first round, that started in February 2004, and was concluded in August-September of that year, saw comparatively limited progress on substantive issues. The emphasis at this stage appeared to be on CBMs, with exchange of delegations at various levels to promote goodwill, and facilitate private level exchanges, for instance between traders, lawyers, media persons, women’s groups, poets and think-tanks. Some of the communication links severed by India in 2001 were restored, and travel facilitated through a more liberal visa policy.
Though preliminary talks were held on nuclear risk reduction, it was only a beginning, and India insisted that Kashmir was too complex an issue to make any decisive progress. However, both sides reiterated their commitment to take up all issues listed in the composite agenda, with Baglihar dam on the Chenab in Kashmir emerging as another dispute, that had to be referred to a neutral expert under the Indus Water Treaty.
The President met Mr Manmohan Singh in New York in September 2004, when both proceeded there for the UN General Assembly. Though the Indian prime minister had spoken publicly against any change in boundaries, the two leaders took the occasion to reiterate their resolve to take up all issues, including Jammu and Kashmir, in the dialogue with a view to ushering in an era of cordiality and cooperation.
The second round, which has just concluded, has been described as more productive. Two agreements were signed, one on notifying each other on missile tests, and the other on establishing a hotline between the coastal security forces of the two countries. Perhaps even more significant was the decision to revive the joint ministerial commission that had last met in 1989. This commission could supplement the work of various groups meeting in connection with the Composite dialogue.
From the Pakistani point of view, the very limited progress on the core issue of Kashmir is a source of disappointment.The only progress achieved during the current year has been the start of a bus service between Srinagar and Muzaffarabad, that has enabled members of many families, separated by the LoC, to meet each other after 50 years. The addition of other routes in Kashmir is being discussed, notably for trucks that could facilitate trade. However, India has been reiterating, at various levels, that no territorial changes would be acceptable. The obvious response from Pakistan has been to maintain that the LoC cannot be the solution, because it is the heart of the problem of Jammu and Kashmir.
The joint statement, issued at the conclusion of the second round, recorded the progress achieved, and specifically held up the prospect of forward movement on the issues of the Siachen glacier, and Sir creek, on which experts had reached a meeting of minds. The third round is scheduled to commence in January 2006, and be completed in August. The peace process is to be pursued with seriousness and sincerity and the two countries are expected to re-open their consulates in Karachi and Mumbai by the end of the year, with the Khokrapar-Munabao railway link being re-established around the same time. The project of an oil pipeline from Iran to India via Pakistan is to be taken up before long, though the objections of the US could become an obstacle.
India is keen to have transit facilities to Afghanistan, to benefit from Central Asian resources, and would like to expand trade relations. However, as Prime Minister Shaukat Aziz pointed out, progress on such matters that were to India’s advantage would have to wait for some progress on Kashmir. Kanwar Natwar Singh also met the president, who has been taking a keen interest in the peace process, but also believes that both sides will have to show flexibility to achieve durable peace that would facilitate the key task of poverty-alleviation. Pakistan has displayed readiness to move from traditional positions, and India will have to do likewise, if stability and peace are to be achieved in South Asia.
IRAQ stands less than a week away from a momentous vote on a new constitution, the first of a series of events that in the next several months will make or break the US-backed attempt to unite the country under a new political system.
A successful exit for US troops, or a deepening military quagmire, hangs in the balance. Yet serious discussion of the Iraqi political process in Washington seems to have faded to a whisper. President Bush answered only one question about Iraq during a 55-minute news conference Tuesday; in doing so, he again wrongly described the principal US challenges as defeating Islamic terrorists and training Iraqi forces.
Many administration critics, too, largely ignore the issues surrounding the constitutional referendum. Since they insist on portraying Iraq as an irretrievable disaster and a replay of Vietnam, they have little incentive to focus on the actual situation.
—The Washington Post