THERE have been conflicting accounts in the western press about President Musharraf’s press conference.

The Washington Post highlighted his ‘grim expression’ throughout the press conference and mentioned his ‘evident irritation’ when he expressed the hope that his election announcement and his explanation for the continuance of emergency rule would end “the aspersions, distortions, rumours and doubts about my intentions”.

The New York times deemed it “a tense, combative news conference where General Musharraf sweated visibly”. The Times of London however felt that he appeared “much more confident than the floundering image he had presented when announcing the emergency measures last Saturday”.

The one message that came across loud and clear in the reaction however was that while the announcement of the election date was a positive step, the lifting of the emergency was essential if these elections were to be fair and free. Condoleezza Rice speaking hours after the president’s press conference in an interview with the ABC television channel spoke of the imposition of the emergency as being a ‘bad decision’ and called for “ the lifting of the emergency, the taking off of his (Musharraf’s) uniform which signals a return to civilian rule, and then the holding of free and fair elections”.

Unlike many in Pakistan I had not expected that the Commonwealth Ministerial Action Group (CMAG) would decide to suspend Pakistan’s membership of the Commonwealth. It was my view that the meeting would be used to back up the international demand that President Musharraf lifts the emergency long before the scheduled elections. In the event the CMAG went a little further than I had expected and gave the Pakistan president up to Nov 22 when the CMAG would meet again to lift the emergency. It is however likely that if by that date there is movement towards the other demands made by the CMAG namely the restoration of “the constitutional rights of the people and the political parties and the independence of the judiciary” there will be no suspension at the Nov 22 meeting.

From the perspective of the lawyers who have been calling, with a great measure of public support, for the restoration of the pre Nov 3 Supreme Court however there was little comfort to be derived from the international reaction. While calling for the independence of the judiciary the CMAG made no demand for the restoration of the dismissed judges while the question of the dismissed judiciary and its future position in the Pakistan power structure found no mention in Rice’s initial reaction.

This was expected. A Supreme Court decision holding that Musharraf was ineligible would have upset the game plan on which the Americans and their allies had been working on ever since the suspension of the Chief Justice revealed the depth of Pakistani middle class disillusionment with military rule under Musharraf.

The protesters could however view as positive the fact that the Americans were no longer referring to Musharraf as an ‘indispensable ally’. Instead Rice in an interview on Nov 9 after the president had said that elections would be held by Feb 15 emphasised that the USA wants to ‘remain engaged with Pakistan’. She recalled that after the Afghan war against the Soviets the USA had “disengaged from Afghanistan and Pakistan” and paid the price of “a failed state in Afghanistan” and “a greater extremist presence in Pakistan” and went on to say that “this is not about Musharraf or the Pakistani government, even, its engagement with the Pakistani people…”

She said virtually the same thing in her ABC interview when she said, “This is not a personal matter about President Musharraf. This is about the Pakistani people, and the United States has been dedicated to helping the Pakistani people come to a more democratic path.” The change of tone and tenor had in fact come a little earlier in the week when the State Department spokesman had said, “We encourage moderate political forces in Pakistan to work together. Now if that means President Musharraf and former Prime Minister [Benazir] Bhutto or others, then that is a decision for those people to make. It’s a decision for the Pakistani people to make.”

I do not however believe that the expression of these views or the distancing from Musharraf that they ostensibly reflect will have a decisive bearing on the thrust of American policy in coming days unless the domestic situation in Pakistan takes a dramatic turn for the worse (from the governments point of view) and unless it is seen that despite having his own protégés in key positions in the army the president has lost the support of that institution. The administration has been under pressure for some time from Congress and other sources to have more than one “telephone number to call in Pakistan”.

They have responded with these statements and by publicising the fact that their embassy is in touch with various groups and officials. Particularly noteworthy was the report that western military attaches have been meeting with Pakistani generals presumably to assess how firm a base of support Musharraf has.

The hard reality in Bush’s Washington is that virtually every one of the officials contributing to the decision making process remains unsure about “what after Musharraf”. Some argue pushing Musharraf towards democracy was tantamount to inviting the same sort of disaster as befell US interests in Iran. On a more practical plane they argue that while an advance towards democracy was the surest medium and long term safeguard against the further ‘Talibanisation’ of Pakistan they needed, in the short term the unstinting or even reluctant cooperation of a Musharraf controlled army -- the only still stable institution in Pakistan -- to persecute the war in Afghanistan.

The Hamas analogy is also evoked. Analysts have not forgotten that one reason many Pakistanis had welcomed and the Americans had tolerated the 1999 coup was the announced decision of former Prime Minister Nawaz Sharif to become Amir-ul-Momineen as soon as he had the requisite majority in the Senate. They note the view that the PML-Q, largely made up of former Nawaz supporters, is the “B” team of the MMA. Certainly they would not have found reassuring the insistence of the PML-Q to include the religion clause in the passport or indeed the very lukewarm and in many ways distorting support the PML-Q leadership offered to the women’s rights bill.

Lastly, on Sunday The Washington Post and The New York Times carried long and relatively authoritative articles on the dangers to the security of Pakistan’s nuclear arsenal that could be posed by instability in Pakistan and the breakdown of the present order. The thrust of the articles was that clandestine exports of nuclear technology occurred in times of political instability and rogue scientists may in future find it personally lucrative to sell nuclear material to terrorists even if the command and control system did not break down.

While the focus on the nuclear issue needs to be analysed further it is clear to me that the Americans will continue to press for transitional rather than transformational politics in Pakistan and if this means pressing only for the lifting of the emergency sometimes before the elections but no restoration of pre Nov 3 Supreme Court than this is what it will be.

THE year 2006 was important for people suffering from diabetes. An aggressive campaign by health professionals won diabetes recognition from the United Nation as a disease that is a serious threat to global health. This was long over due. Today the world has 246 million diabetics and their number will grow to 380 million in 2025 if no intervention is made.

The UN’s Landmark Resolution (61/225 of Dec 20, 2006) recognises diabetes as “a chronic, debilitating and costly disease associated with major complications that pose severe risks for families, countries and the entire world”. It designated Nov 14, the day of birth of Frederick Banting, the Canadian researcher who identified insulin, as the UN day for diabetes to be observed every year beginning in 2007. The International Diabetes Federation and World Health Organisation had introduced the day in 1991.

Thus diabetes is the first non-communicable disease to receive a status similar to that accorded to malaria, tuberculosis and HIV/AIDS. Governments have been called upon to develop national policies for the prevention, care and treatment of diabetes.

This should prompt the health authorities in Islamabad to address the issue at the policymaking level given the fact that the country faces a serious epidemic of diabetes. In 2003 the estimated number of diabetics in the 20-79 years age group in Pakistan was 8.5 million. This is projected to rise to 22.5 million by 2025. Lack of awareness, insufficient medical care and the absence of social security structures in the country are major factors contributing to the prevalence of the disease.

With 26 per cent of the people (according to government sources) – though the number is believed to be higher -- living below the poverty line and a low literacy rate, diabetes does not get the attention it merits. It is not just the challenge high levels of blood sugar poses that is worrying. Equally hazardous are its devastating and insidious complications ranging from serious heart and kidney problems to amputations, strokes and blindness. Yet health programmes in Pakistan have conventionally focused on the control of malaria, tuberculosis and HIV/AIDS, maternal and child health, immunisation against communicable diseases, prevention of hepatitis, cancer treatment and drug abuse but overlooked diabetes.

This issue must now be addressed and the government can help in many ways. The dietary factor plays a major role in the prevalence of diabetes because the disorder is attributed to the burden of the genetic factor of central obesity that leads to insulin resistance, a precursor of diabetes, found in Asian adults and children.

Obesity acts as a trigger in those who are genetically disposed to diabetes. Today more and more children and adolescents who are obese are being diagnosed with diabetes. There are no countrywide figures on childhood obesity and type 2 diabetes in Pakistan. Only one survey by Jafar et al has been reported which finds 25 per cent of the population in Pakistan to be overweight. More worrying is the estimate given by a survey supported by the Higher Education Commission that 20 per cent of children from affluent families studying in private elite schools are obese and potential victims of diabetes. Nearly four per cent of children from low-income families were also found to be overweight and malnourished.

The rise of obesity is linked to a sudden change in lifestyle. Consumption of dense calorie foods and decreased physical activity are the major factors. Karachi, a city of 15 million, has only 15 public and four private parks, many of which are not properly maintained and are under constant threat of encroachment by builders and developers. The inaccessibility to open spaces as well as cultural constraints discourage many people from taking physical exercise. Health awareness is low due to illiteracy which along with inflation promotes wrong eating habits.

The obesity epidemic has entered Pakistan and has to be curbed by efforts from all quarters. The city governments should plan more secure open areas for exercise. There is need for awareness campaigns against obesity and stricter laws requiring packaged foods to be labeled with the ingredients listed. High caloric foods should have a warning similar to the one carried by cigarette packets. Schools should work out programmes for healthy eating and discourage canteens from serving fast food, the curse of modern living. It is time the authorities rethink their approach towards the advertising of food and drinks on bill boards, television and newspapers. We could learn a lesson or two from the anti-smoking lobby which had cigarette advertising banned.

It is time the responsibility of health professionals is shared by leaders of opinion such as teachers, the clergy and NGOs who interact with people at the grassroots. The importance of physical activity, consuming simple food and keeping one’s body weight in the normal range can not be overemphasised.

It is not too late in the day to launch joint campaigns in which the government, the people -- children and adults-- health professionals, educators, religious leaders and media should participate to fight against the obesity epidemic. The future of the next generation is at stake and has to be secured.

Those who have already crossed the red line and are suffering from the disease, especially those who are poor, need a helping hand. Many can manage on tablets but others need insulin. These drugs can be termed life-saving for a diabetic cannot survive without them. Since there is no cure for diabetes, the drugs have to be taken for life. On an average a person on insulin has to spend 2500 rupees a month on his medicines which include those for high blood pressure, heart disease and raised blood cholesterol. A patient who needs tablets spends less – about 1500 rupees per month. These drugs are more costly in Pakistan than in India and a family of modest means can ill afford to spend that much on drugs to keep one member alive. Usually more than one are affected. These are minimum costs. More is spent on laboratory tests, syringes, and other procedures. The price of insulin and tablets can be brought down if the government were to drop the taxes on these drugs and subsidise their cost.

The writer is consultant diabetologist at the Sindh Institute of Urology and Transplantation, (SIUT), Karachi

fatema@super.net.pk

SINCE her return from exile a month ago, Benazir Bhutto has been able to gradually dissipate the clouds which had surrounded her in the wake of her yet unconfirmed ‘deal’ with General Musharraf.

If the ‘deal’ ever existed, its terms were very flexible and ill-defined, which probably suited both, especially Benazir. The first sign of her deviation from the spirit of the deal was when she rejected Musharraf’s advice to defer her departure on Oct 18 in view of the terrorist threats.

Benazir gave a strong signal that she was not going to play second fiddle to him. Whether Musharraf’s advice was well-intentioned or not will never be known until an impartial inquiry is instituted on the bomb blast on Benazir’s rally ­ a subject which has now been overtaken by other events.

The success of the rally – which was heightened rather than diminished by the bomb blast killing over 150 people and injuring over 500 others – encouraged, rather than deterred Benazir to deviate further from the deal’s unwritten script. It created panic among Musharraf’s political allies, who discouraged him from making any further overtures to Benazir, beyond the passing of the National Reconciliation Ordinance, which they had accepted with utmost reluctance and with sinister innuendos and not in the promised spirit of reconciliation.

They sabotaged any prospect of a peaceful transition to civilian rule by openly asserting that Benazir had been tricked into accepting the deal and by making the ridiculous accusation that she may have herself engineered the bomb blast on her rally to gain public sympathy.

Musharraf caved into the blackmail of the Chaudhrys who became scared at the high profile reception accorded by the Establishment to Rehman Malik, Benazir’s interlocutor with the regime, who himself is an ex-bureaucrat and had intimate connections with the major apparatchiks negotiating the Benazir-Musharraf deal.

This sent shudders in the spines of the potential losers in case the deal went ahead. Musharraf could have dealt with his increasingly restive political, though otherwise subservient supporters if he had been certain about the verdict of the eleven member Supreme Court bench deliberating on the validity of his Oct 8 election as President in which only the members of his own party voted, with eight of them voting in favour of the last minute entry of a former Supreme Court judge, who was persuaded by the lawyer community to challenge his uncontested election.

As the date of that decision approached, the regime became increasingly nervous and began seriously working on a Plan B, which was aired earlier as a trial balloon a few weeks ago but was shot down by a 2 a.m. telephone call from Condoleezza Rice. This time although a US Admiral was sent to personally dissuade General Musharraf, an extra-constitutional national emergency was imposed by him in his capacity as the chief of army staff, which is tantamount to martial law.

The amendment of the Army Act, whichwould enable it to try civilians under court martial, echoing the notorious Patriot Act of the US introduced after 9/11 and a throwback to Zia’s days, makes the intention even scarier. Thus General Musharraf staged yet another coup ­- this time against his own regime ­- after the original sin of Oct 12, 1999 and a mini-coup against the judiciary on Mar 9 when he sacked and humiliated the Chief Justice in his Camp Office.

While Benazir was content with driving a wedge between Musharraf and his political associates, some of whom she had accused of being involved in the conspiracy to kill her in the Karachi bomb blast, it became impossible for her after Nov 3 to continue the deal, as her main demands -- giving up the uniform before Nov 15, announcing an election schedule were supplanted by the emergency. Despite this, she insisted on making an attempt to hold her party meeting in Liaquat Bagh Rawalpindi on Nov 9 which she had announced before the declaration of the emergency. Similarly, she appears determined to attempt a 250km-long march from Lahore to Islamabad.

While the government succeeded in thwarting the PPP meeting in Rawalpindi and briefly incarcerating her in her home in Islamabad, it could not prevent her from emerging from behind the barricades and barbed wires blocking the access to her house to make a bold speech, providing her an iconic opportunity to project herself as a leading champion of democracy, a la Aung San Suu Kyi, before the world media which had gathered in full force in front of her house on the morning of Nov 9.

Capturing the imagination of the outside world and the attention of the western governments, who consider her to be an indispensable complement to Musharraf in the war on terror, may be an important weapon in Benazir’s armoury, but it is insufficient to help her dislodge him from power.

Ms Bhutto’s historic challenge, especially if she wants to completely erase her tainted past, is to galvanise all the forces which feel incensed by General Musharraf’s Nov 3 declaration of emergency, promulgation of a PCO, a frontal and full-scale attack on the superior judiciary, as well as civil society members, including educationists.

Both Ms Bhutto and General Musharraf are being pulled in opposite directions to prevent the actualisation of the deal.

While the PML and its allies are afraid that the official patronage which will be their life-line in the next elections would be shifted in Ms Bhutto’s favour, the opposition parties and the civil society, whose collaboration is essential if political power is to be wrested from the military and a genuine democratic dispensation instituted, would like Ms Bhutto to take the general head on.

Their conditions for collaboration, however, include Ms Bhutto’s unequivocal snapping of any ties with General Musharraf, the reinstatement of Supreme Court judges, freedom of the press and electronic media, the reconstitution of the election commission, as well as the formation of a neutral interim government with the consensus of all parties. Ms. Bhutto has moved considerably closer to these demands, as a result of her interactions in Islamabad, although she remains ambivalent on most issues.

General Musharraf’s announcement in his press conference on Sunday, attended by and focused primarily on visiting foreign correspondents, to advance the deadline for general election from Feb 15 to Jan 9, without lifting of the emergency, may relieve the pressure on the US administration to curtail US aid to Pakistan. But it is far less likely to enhance the chances of the survival of the Benazir-Musharraf deal.

Ms Bhutto’s tactics can be faulted on many counts, but if she succeeds in pushing the military back to the barracks, she will be lauded in history for her somewhat convoluted strategy of first engaging and then cornering an inveterate enemy of democracy in Pakistan.

However, after the tough stance shown by General Musharraf in his press conference and his determination to continue the extra-constitutional path and to subdue the judiciary, the question of early elections, has become secondary and its prerequisites, namely, independence of the judiciary, freedom of the press, civil liberties, and basic economic and social rights have gained primacy.

Although it appears dead, the deal, like the proverbial cat, may have multiple lives. Yet it is time to look beyond.

smnaseem@aya.yale.ed

WHATEVER one may have to say about Sheikh Rashid Ahmed as a politician, there is no doubt that he makes an active and articulate minister, irrespective of the portfolio allotted to him. It is said that he was very unhappy when he was shifted from information to railways, but he seems to have made a good job of the change.

The government had been promising Pakistan’s travelling public for more years than you can count that there would be a complete overhaul of the railway administration and the network presided over by it in order to bring it back to its old efficiency and punctuality, with the buzzword modernisation thrown in for good measure. Unhappily, the promise was never kept.So, with the measures brought about by the Railways Department under the Sheikh, it seems that the old, stale joke will no longer apply to it about a particular train in a Third World country which was always late and one day was seen to have arrived on time. When everyone expressed pleasant surprise over this strange happening, they were told by the station master that it was yesterday’s train!

“Making the best of a bad bargain” is the idiomatic expression for resorting to compromise because either the circumstances do not favour us or we feel helpless in moulding a situation to our satisfaction. Most of us are doing it all the time when we have to make do with whatever we can get out of life. In this piece, I shall be referring to certain faults of the railway system because that will help focus on the changes for the better brought about in recent times. Actually railway is a metaphor and you can read anything in its place.

Let me first say that our government is only an extension of our psyche and our way of life and doing things. It too is always trying to make the best of a bad bargain in its day-to-day business. This is when it fails to strike a good bargain because of its inherent incompetence arising out of the moral laxity and ineptness of its officials. One example of the old days was that since the railway could not run its trains on time, the situation should be officially accepted as irremediable. One might as well relax and enjoy, as they say of dealing with the inevitable.

Old reports cite cases of popular trains which on some days not only arrived late at their destinations by several hours but also could not leave the starting point on time. Among the reasons recorded for unpunctuality were failure of locomotives, a defective signalling system and division of authority resulting from frequent reorganisation.

I have never worked in the railway in Pakistan in any capacity. Though once, just before Partition, I was an apprentice in the Junagadh State Railway (length 210 miles) where I was given a disused wheel-less goods wagon to sleep in during office hours. With that nostalgic experience at my back, I cannot be called an expert. So don’t ask me what should be done about Pakistan Railways. I would rather let Sheikh Rashid do his best, although the government is chockfull of administrative geniuses, any of whom would love to take on the railway and make some money out of it.

My motive in choosing the railway as a topic was merely to enlarge on the idiom with which this piece was opened, i.e. making the best of a bad bargain. Without being conscious of it, we are living up to this idiom in letter and spirit in our interaction with the government and its politics and policies. Hardly ever receiving honest service from any of them, we console ourselves with the thought that we can’t have everything perfect all the time and that it is better to make do with whatever we can get rather than mope about it.

It is the same in our reaction to the government itself. Having only heard the expression “good governance” we just imagine what god governance must be like by reading about advanced democracies of the world – even countries of the Gulf – and sighing at our fate that not even the imposition of a state of emergency brings about any improvement. Why is the Almighty so frugal in giving us good leaders?

So we make the best of a bad bargain, hoping that the next ruling lot will be more thoughtful about the sorry plight of the common man and the intellectual needs of the uncommon man – the thinking man – and the facilities and amenities that they believe are their birthright. So we raise loud cheers when they tell blatant lies about their achievements and noble intentions (actually ignoble intentions) over Radio and TV and in contrived rallies where their rostrum is at a distance of some 200 yards from the audience.

Ever since the return of democracy in the country, and with every successive regime, half of us have consoled ourselves with the thought that the present government, bad as it is, is at least an improvement on the one that was dismissed by a “people-loving” head of state in uniform. But the other half believe that, crooked as it was, the previous dispensation was better than what we have today. These latter are the types who are always complaining instead of thanking the Lord for not making it worse, while the majority are trying to make the best of a bad bargain.

The question remains (for nobody can ask the Almighty and get an answer) why we are always condemned to face bad bargains. Is it that we are incapable of using our good sense and electing unselfish leaders and are therefore unfit for democracy? The trouble is that we do not always elect our leaders, for many of them (you know who I mean) elect themselves, believing that God made them to save Pakistan and its people.

We are just not equipped to find an answer to these questions, and political analysts in Pakistan and outside are still trying to figure it out. So, in the end it is better to blame fate, fortune, destiny, circumstances and whatever other word you can think of – even God’s will – and go on making the best of a bad bargain. In all this rigmarole we have lost sight of the fact as to what is a good bargain and what it looks like. But what can I do about that?