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DAWN - the Internet Edition


May 29, 2007 Tuesday Jamadi-ul-Awwal 12, 1428



Features


Majeed Lahori’s Karachi
Can we stem the scourge of hepatitis?



Majeed Lahori’s Karachi


By Dr Rauf Parekh

MAJEED Lahori was a poet-satirist, a humorist and a journalist. Born in Gujrat (Punjab) in 1913, Majeed worked in some Karachi-based Urdu newspapers before partition. Around 1946-7, he wrote a humour column in ‘Azaad’, an Urdu daily published from Lahore and edited by Shorish Kashmiri, the renowned journalist and author. Majeed soon came back to Karachi and joined ‘Jang’, one of the leading Urdu newspapers of the country, in which he wrote his humour column ‘Harf-o-Hikayat’ and satirical poetry.

He simultaneously launched his own humour magazine ‘Namakdaan’ from Karachi and gave a light-hearted talk titled ‘Waghaira Waghaira’ on Radio Pakistan. ‘Namakdaan’, an anthology of his satirical poems, and ‘Harf-o-Hikayat’, a collection of his columns, were published posthumously.

Majeed’s portrayal of the ethnic communities living in Karachi — Memons, Pathans, Makranis, Sindhis — with their dialectical accents of Urdu, is something to cherish. Gujrati seths, Pathan moulvis and Mohajirs — Urdu-speaking refugees who migrated to Pakistan from neighbouring India after independence — are characters that explore the mood of Karachi in the late forties and early fifties of the last century.

There is a character named Ramzani who symbolises the common man, presenting his dreams and frustrations. Majeed invented this character not only to throw the spotlight on the poor man’s woes but also to pour scorn on capitalism.

Moulvi Gul Sher Khan is a caricature of ostentatious religiosity. This character shows how religion is used to cover up immoral practices. Seth Tyre Jee Tube Jee is greed personified. Money-making is only what he wants out of life. And then there is Sain Sulaiman Badshah who is a majzoob and Majeed presents him in such a way as to ridicule so-called religious figures who advocate apathy and inactivity.

These characters not only depicted different segments of society but were also, to some extent, real as they were drawn from society and based on actual persons.

Majeed’s poetry and prose capture the mood and spirit of Karachi, the former capital of Pakistan, where everyone is trying to eke out a living. The milieu appears to be very familiar: corrupt politicians, inefficient bureaucracy, lethargic civic bodies, grumbling common man, rampant nepotism and bribery.

In Majeed’s writings, one can see this grim situation annotated with words like permit, plot, allotment, One Unit, Muslim League, constitution, Jamaat-i-Islami, aanso gas, Mohajir, Safety Act.

Dr Waheed Qureshi had it right when he said that after the birth of Pakistan, Karachi, its capital, became a nursery of humorist-poets because the situation then obtaining here was very conducive to humour.

Political chaos and anarchy threaten the very fabric of society and generate enough material for a discerning humorist.

The intellectual level of Majeed’s humour may not be high as he was not an intellectual type, but he gets to the crux of the matter and puts it in a lively manner, with satire thrown in for good measure.

Just to let you have the feel of it, I would try my hand at rendering into English a passage from one of his columns (the scene is a barber’s shop and the author is getting a shave): “The barber put the safety razor at my neck and asked, ‘Do you support Muslim League or Awami League, sir?’ I said, ‘My dear barber, before I answer this question, for God’s sake, remove this razor from my neck as in the presence of the Safety Act I cannot reply’ (Majeed Lahori Ki Harf-o-Hikayat, compiled by Shafi Aqeel, page 36).

Majeed died on June 26, 1957 in Karachi. He was born in Gujrat, and yet he called himself Lahori. He worked and died and was buried in Karachi. He was a Lahori, a typical Lahori; lively, cheerful, carefree but compassionate. He was a Lahori Karachiite, I must say.

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Can we stem the scourge of hepatitis?


By Aileen Qaiser

DATELINE ISLAMABAD


SHAHID and his family were devastated when he was diagnosed with chronic hepatitis C over a year ago. The young civil servant, who is in his forties and married with three children, was puzzled as to how he got infected, since he never did drugs, never had a tattoo done nor he ever had a blood transfusion or dialysis, and none of his close relatives had the disease.

You could have got it from an infected razor at the barber’s or improperly sterilised equipment at the dentist’s, suggested one of his doctors. Shahid was surprised to learn that one could even contract this blood borne virus by sharing a toothbrush with a person who already has hepatitis C and is experiencing bleeding gums.

After a year of countless blood tests, endless trips to and stays at hospitals, and bearing with the strong side effects of the therapy of weekly protein injections and daily oral medication to combat and prevent the hepatitis C virus from multiplying, Shahid’s perseverance paid off. His liver enzymes are back to normal and the dreaded virus is undetectable in his blood.

But for many other patients who have been similarly diagnosed, specially those without any employment medical benefit or medical insurance cover, they have not been as fortunate as Shahid in getting treatment. The plight of some of these unfortunate patients at the Pakistan Institute of Medical Sciences (PIMS) was highlighted in the press last week.

This is despite the prime minister’s Rs2.59 billion 2005-2010 Hepatitis Prevention and Control Programme (but launched only in August last year) which envisaged, among other things, giving free treatment to 5,000 new hepatitis patients annually.

If not properly treated once diagnosed, chronic hepatitis C sufferers are likely to die from cirrhosis (chronic disease of the liver) and cancer, unless they get a liver transplant.

According to conservative estimates based on studies in our various hospitals, hepatitis C infection is prevalent in 5 to 6 per cent of our population, while another debilitating blood borne hepatitis virus, hepatitis B, is estimated to have a prevalence rate of 3 to 4 per cent. This means that about one out of every 10 people is suffering from either hepatitis B or C, equivalent to about 15 million people in total.

Such statistics would have been viewed with alarm in many developed countries where major communicable diseases have been successfully controlled, like the US where the prevalence rate of hepatitis C is 1.8 per cent of the population, while it is only 1 per cent in France and 0.05 per cent in the UK.

Even with these relatively low prevalence rates, hepatitis B and C continue to be priority public health problems in these countries, as compared to developing countries like Pakistan, where the prevalence is much higher and its health impact even greater.

More recent studies on hepatitis infection in Pakistan based on the general population in specific localities have revealed even more alarming statistics. According to a report by a local news agency last week, based on data from the ministry of health, 33.4 per cent of the population in Bara Kahu in the Islamabad Capital Territory suffer from hepatitis, with 26.8 per cent from hepatitis C and 6.6 per cent from hepatitis B.

Other areas with high hepatitis prevalence rates include Jaranwala, 41.8 per cent (37.8 per cent hepatitis C and 4 per cent hepatitis B); Jacobabad, 37.7 per cent; Jhang, 28.4 per cent (19.6 per cent hepatitis C and 8.8 per cent hepatitis B); Faisalabad, 27 per cent (22 per cent hepatitis C and 5 per cent hepatitis B); and Mardan, 21 per cent.

A major cause of the high hepatitis prevalence rates in Pakistan is the lack of proper preventive measures, even at the institutional level. Nothing less than an aggressive national immunisation programme is the most effective way of controlling the spread of hepatitis B (including compulsory immunisation at birth, in schools, colleges and universities, and for all high risk groups like healthcare workers, prison staffers, renal dialysis and haemodialysis patients, intravenous drug users, etc.).

Controlling the spread of hepatitis C is much more difficult, since there is no likelihood of a vaccine in the near future. Preventing exposure to the virus through diligent implementation and practice of preventive measures is the only proven method of controlling and bringing down hepatitis C infection rates.

These preventive measures include screening of all blood donors and testing of all donated blood for hepatitis B and C virus; testing of all organ donors for hepatitis; proper sterilisation of equipment and safe waste disposal practices at all public and private hospitals, clinics (both medical and dental) and laboratories; safe and hygienic practices at renal dialysis and haemodialysis units, beauty parlours/barber shops, and acupuncture, ear piercing, tattooing and cosmetic surgery establishments; precautions by healthcare workers to avoid occupational exposure to hepatitis infection; and the banning of all quacks, whose unskilled medical practices are major instruments of transmission of diseases like hepatitis.

Another major cause of the high prevalence rates of hepatitis is the lack of awareness, both public and professional, of the significance of hepatitis and how rapidly it can spread. We need to launch a national campaign through the electronic media, in educational institutions, workplaces, etc., to raise public awareness of hepatitis among the general population and provide information about avoiding infection.

The promotion campaign should be designed to encourage those at current risk and those who may have been at risk in the past to come forward for testing, and treatment if necessary. Timely diagnosis and proper treatment can give many hepatitis patients a new lease of life, like Shahid has got.

Two other factors determining the success or failure of the Hepatitis Prevention and Control Programme are: correct information about the incidence rate of the types of hepatitis among the local population and adequate deployment of resources for vaccination, testing and treatment. Reports in the press about shortages of injections for hepatitis treatment therapy are therefore worrying.

If the programme only provides for free treatment to 5,000 new hepatitis patients every year while the existing population already infected is estimated to be 15 million — most of whom are not as fortunate as civil servant Shahid in getting proper and affordable treatment — it is difficult to imagine Pakistan being able to bring down the prevalence rate or curtail the existing hepatitis infection rate in the near future.

Unlike other common illnesses in the country like heart disease, diabetes, thalassaemia and cancer, hepatitis is a communicable disease which has been spreading quickly and widely because we have not taken the necessary precautions in time.

Local experts have already warned that if hepatitis is not controlled at this stage, half of our country’s population will be cirrhotic in the next 15 years.

Meanwhile, it is little wonder why a successfully treated patient like Shahid continues to be fearful about getting re- infected with the dreaded virus.

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