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| September 13, 2007 | Thursday | Sha'aban 30, 1428 |
Lull after storm?
Protecting pre-Islamic relics
Fate of the ordinance
President’s lip-deep promise
To spray or not to spray poppies?
“MENTALLY ill people in the developing world are being badly neglected. Mental illness makes up about 14 per cent of global disease, more than cancer or heart disease. Up to 800,000 people commit suicide each year, mostly in poorer countries. Ninety per cent of sufferers in developing countries receive no care — and in some cases are chained to trees or kept in cages.” (BBC Sept 4)
FOR the last three fiscal years, high food inflation — an over-arching issue both for any economy and vulnerable consumers-- continues unabated. The food prices rose by 8.62 per cent in August as compared to the same month last year and 12.5 in fiscal year 2005, 6.9 in 2006 and 10.2 per cent in 2007 Contrary to the oft-repeated official claim that food was cheaper in Pakistan than other countries, it has now emerged that kitchen items are generally more expensive here than in India and Bangladesh. An analysis of regional prices of critical consumer items presented before the Economic Coordination Committee recently shows that in case of the 31 essential items compared, prices of 16 items were higher by 32.7 per cent in Pakistan than in India. In the case of Bangladesh, 16 basic food items of a total of 27 compared were cheaper by an average margin of 45 per cent. India has a higher economic growth with relatively low inflation than Pakistan — which underlines a more successful inflation management policy.
The prices of a wide range of kitchen items have gone up on the eve of Ramazan and the upward trend is likely to continue. The flour prices are up by an average of Rs2 per kg for different varieties of wheat, which the federal government blames on the slow and delayed release of stocks held by the provincial governments — now directed to expedite supplies to the flour mills. The government has also decided to build a buffer stock of 400,000 tonnes of sugar for facilitating supplies and ensuring price stability. This is a sensible move for in the past the government has intervened belatedly to stabilise prices after the hoarders and speculators have succeeded in making a windfall. The sugar mills lobby with an easy access to the corridors of power is more of a problem than building up of strategic reserves. Food inflation in particular and hike in consumer prices in general can be attributed largely to badly executed faulty policies and market failures.
An immediate step that the government should consider taking is to set up a cell in the prime minister’s secretariat to monitor prices on a daily basis and take remedial measures promptly, till medium and long-term measures like increasing agricultural yield or reducing cost of farm output can produce desired results. The government also needs to further curb its inflationary borrowings. Inflation is a key concern worldwide and is the responsibility of the central banks. The State Bank lays claim to a tightening of monetary policy. But the risk of higher inflation has been enhanced by the increased money supply — an increase of 19.3 per cent, 5.8 percentage points higher than the annual target set for the last fiscal year. The State Bank should consider instituting selected and temporary food-related credit controls to tame inflation when required.
A SUPERFICIAL political calm has descended on Pakistan in the wake of Mian Nawaz Sharif’s stormy arrival and a rather anti-climactic departure to Jeddah to complete the “remaining term” of his exile. The suicide bombings notwithstanding, the political stock market is currently markedly bearish. Now politics will be confined to press conferences and talk shows on television, besides the routine calls for strikes. The government, thus, has achieved a temporary respite, but that is not the end of the story. The truth is that both the government and the opposition are in tatters. The motley lot that is our opposition has never been able to forge unity. The Charter of Democracy had aroused much hope when Mian Nawaz Sharif and Ms Benazir Bhutto signed it in London in May 2006, but it died a natural death when the rumours of “the deal” were confirmed after the Benazir-Musharraf meeting in July. As was bound to happen, this also served to create fissures in the ARD.
Whatever life was left in the ARD was snuffed out when the grand multiparty conference convened by Nawaz Sharif in London only served to highlight the differences between the PPP and the PML-N. The next day the APDM, a new alliance minus the PPP, was born. This alliance-making spree has not advanced the opposition’s cause. If the government is in trouble, it is not because of the opposition but because of the countless blunders it has made, including the reference against the CJ. The issue was exploited by a very determined legal community, and the opposition merely played second fiddle to it. Once free, the judiciary snubbed the military again on the Sharifs’ right to return home, the understanding with the Saudi government and the Hariris notwithstanding. It now remains to be seen how the government fares when the Supreme Court gives its judgment on the uniform issue. What happens if the verdict goes against the general? That is when the real drama will begin.
The opposition will do well to ignore minor temptations and forge unity on one point — a fair and free general election. A president “elected” in a general’s uniform is an outlandish concept. Those wielding power must have the common sense to realise this. Let Gen Musharraf discard his uniform and contest the presidential election as a civilian, but from new assemblies elected after a fair and free election. It is better that he be allowed a chance to fight an election with a level playing field and win it if he can instead of manipulating a victory. It is also important that the government should stop resorting to strong-arm measures as it is doing at the moment. Tactics such as throwing party workers in prison, holding opposition leaders in detention and banning their entry into one city or another will only backfire.
THE attempt by Islamist militants to blow up the historical Buddha statue near Mingora in Swat reminds one of the madness the Taliban government of Afghanistan had wrought at Bamiyan in 2001. This particular relic belonging to the Gandhara era (400BC-200AD) is not only a national treasure but also a world heritage that the entire humanity shares. It was by sheer luck that the statue remained intact in the attack even though the explosives managed to bring down a sizable portion of the rock. This should serve as a wake-up call for the authorities concerned, for there are hundreds of such statues and other Buddhist-era relics spread across much of the Frontier and the tribal areas bordering Afghanistan, where religious extremists of the most morbid mentality now hold sway.
With its ancient capitals at Taxila and Pushkalawati (present-day Peshawar), Gandhara civilisation’s relics adorn the entire region. These include ruins of monasteries, castles, stupas, original and votive (those built as offerings at shrines by rich pilgrims) and hundreds of statues. Some of the last mentioned continue to be present to this day, albeit in their faded glory, at the original historical sites where they were placed, while many others have been shifted to museums around the country. The latest attempt to destroy the Swat Buddha statue calls for stricter vigilance of such sites everywhere. The Butkarra ruins in nearby Saidu Sharif, the city’s museum, the Chakdara museum and the Takht-i-Bahi ruins are particularly vulnerable and must be protected from any possible targeting by the misguided zealots. The obliteration of history to serve the cause of bigotry must be condemned at the official level and meaningful efforts made to secure all such endangered, silent sentinels of a heritage built on tolerance and respect for a shared past.
These stark facts clearly reflect the conditions of the mentally ill in Pakistan as well. Only a handful has access to medical care. They too are at the mercy of a system which is not held accountable at all. Shocking stories of the brutal treatment meted out to the mentally ill continue to be repeated day in and day out. The mentally ill are still being subjected to the wicked ways of traditional faith healers. They are viciously detoxified at commercial drug centres, and are chained and abused at home.
It is common to see them being forcibly dragged for treatment at the hospitals or put behind bars for crimes that they are not responsible for. They are sadistically deprived of their basic rights and their property is seized by malicious relatives. Even today, children in the streets insult and attack them. Quite clearly, the mentally ill need to be protected. There is a much greater need for legislation for them because of their unique vulnerability.
Mental illness affects the way people think and behave and, sometimes but not always, their ability to make decisions. Therefore, they may not always seek and accept treatment. They face stigma, discrimination and marginalisation in society. As a result, they are offered service of inferior quality, if at all there is one. Such marginalisation and discrimination obviously increases the risk of violation of their civil and human rights.
Infrequently, they may pose a risk for themselves or the safety of others due to the impairment of their judgment and associated behavioural disturbances. Hence there is a need to protect them, their family members, neighbours and society at large.
Legislation helps achieve an adequate balance between individual rights to liberty and society’s need for protection. It ensures that those with mental illnesses receive appropriate healthcare, and protects their rights when care is either offered voluntarily or enforced compulsorily.
But legislation provides for much more than just ensuring treatment of the mentally ill in hospital. It provides a legal framework to address critical mental health issues such as access to treatment, provision of high quality care, full integration of people with mental illness in the community, protection of their civil rights and promotion of mental health in different sectors of society.
Some developing countries still do not have relevant laws while others continue to rely on obsolete ones dating back 80 to 90 years. Until 2001, Pakistan was no different. The Lunacy Act 1912 regulated everything to do with the mentally ill.
In view of the urgent need to update and consolidate the legal provisions for all related issues, a comprehensive legislation was promulgated in Feb 2001 known as the Mental Health Ordinance 2001. This was not easily achieved. It came about as a result of a long struggle waged by psychiatrist bodies in the country. One had hoped that this would prove to be a landmark in the history of mental healthcare in Pakistan.
Unfortunately, it did nothing much to change the situation on the ground. It failed to ameliorate the condition of the mentally ill because six years have passed and it still has to be implemented. The machinery that was to be set up is still waiting to be created. This delay is disconcerting.
Since mental health has low political priority and is competing with other health needs for the authorities’ attention and for national resources, it tends to be relegated to the backburner.
The first meeting to plan the implementation was held on April 21, 2001. It was admitted that the promulgation of the Mental Health Ordinance was by itself not enough. It had to be implemented in a worthy and meaningful manner to create a positive impact on the common man. Action, therefore, needs to be taken immediately in the appropriate direction.
As an immediate step towards implementation, the Federal Mental Health Authority (FeMHA) was constituted and its functions were clearly defined. The first meeting of FeMHA was held on December 29, 2001. The agenda included plans to develop national standards for treatment; prescribe procedures for the setting up of mental health services; develop a code of practice; define the registration procedure for psychiatrists and initiate the setting up of a board of visitors at the provincial level.
By the end of that meeting, committees were formed to delegate the agenda tasks. In the last six years, this authority may have held a few meetings but that is about all. The authority had a clear agenda, well-defined strategies and a possible timeframe. So what went wrong? Did it not have the mandate? Was the task beyond its capacity? Did they lack the necessary administrative and financial support to deliver? Did it need consensus-building?
The other stakeholders who are involved, but “not involved”, in the process include politicians, policymakers, government ministries (health, social welfare, law, finance), professionals including psychiatrists, psychologists and social workers, service users (patients and their families), advocacy groups, service providers including non-governmental organisations, civil rights groups, religious organisations and congregations of communities.
A broad consensus amongst various stakeholders is necessary before any further steps can be taken. There have been occasional debates about the content and strategies for implementation at professional forums. Although the legislation was drafted with care, it may not be perfect. If there are any concerns relating to the legislation, these must be addressed.
Public education and awareness campaigns to highlight the substantial provisions of the legislation, more particularly the rationale and philosophy underlying these changes, are required. Media strategies can be most useful in raising awareness. Mental health advocacy groups can also play a major role. It is important to lobby key members of the government, ministries, legislature and political parties.
Key informants and focus groups with users need to be interviewed to identify the main barriers towards implementation. If there is shortage of mental health manpower, or resistance from professionals, training programmes should be arranged for key groups. If there is insufficient funding to develop the mechanisms needed to implement the law, partnerships with key stakeholders must be established.
Has there been lack of coordinated action among various stakeholders, lack of awareness, limited manpower resources or financial and procedural issues? Or is there simply a lack of will to bring about a change? Whatever the obstructions in the way of further action in adopting this legislation, we must realise how crucial its implementation is.
The promulgation of an ordinance is only the beginning of a process and not an achievement in itself. Achievements come only when the common man benefits.
The writer, an assistant professor of psychiatry, worked on the drafting of Mental Health Ordinance 2001.
Wahdat
PAKISTAN’S out-of-whack economy would be put back on the rails and dollops of foreign investment would pour in, President Musharraf assured the nation when Shaukat Aziz was sworn in as prime minister. The price spiral would be kept in check and employment opportunities created for the educated youth, he pledged while extolling Aziz’s fiscal husbandry and economic vision. But the presidential promise sounds empty now that the premier is on the verge of completing his tenure, which can at best be described as a mixed bag.
The upshot of the exploitative economic regime is that today the purchasing power of millions is at its nadir. Many children hit the sack on an empty stomach, die of curable diseases for want of medicine and carry scrap bags instead of schoolbags on their backs to supplement the income of their pauperised parents. A lower middle class worker earns Rs100 a day but his/her family needs Rs300 to make ends meet.
If the neglect of the downtrodden continues, their resentment could cause an implosion that will also ruin palaces and power centres. There is a clear danger to the country’s sovereignty, but all is not yet lost ... if the rulers strike a balance between guns and butter. The disintegration of the ex-USSR has proved beyond doubt that military might alone cannot guarantee a nation’s strength. — (Sept 9)
Hewad (Kabul)
THE first vice-president has come up with a demonstrably dangerous recipe for containing poppy cultivation in Afghanistan which accounts for more than two-thirds of the world’s total opium production. Ahmed Zia Massoud, writing in the mass-circulation Sunday Telegraph, has proposed chemical spraying of the crop to rid the impoverished country of the drugs scourge. At odds with the position of President Karzai and his cabinet, the suggestion drew a knee-jerk reaction from the generality of the masses including landowners, sharecroppers and official circles.
Around $800m, just a fraction of the annual income from opium, goes to the Afghans while the lion’s share running into billions of dollars is stashed away in foreign banks. Areas controlled by coalition and Nato forces have witnessed a constant surge in poppy cultivation, but the provinces under the government have largely been free of the illicit crop.
Growing cotton can be an effective alternative in the embattled province of Helmand, where more opium was produced this year than the rest of Afghanistan put together. The government and the world ought to offer Helmand farmers a package of inducements to wean them away from poppy to cotton cultivation. — (Sept 6)
–– Selected and translated by Syed Mudassir Ali Shah