Absent today

04 Nov 2019


The writer is a member of staff.
The writer is a member of staff.

DEEPLY sad as it is, but unfortunately common in this benighted land, another person I know suffered tragedy due to the lack of adequate healthcare services.

The person in question, let’s call him H, is from a family I’ve known for three generations. He and his wife live in a village about an hour and a half from Islamabad, in the employ of fairly well-heeled people that have taken care, as much as is possible, of them. The patriarch of the employer family spent a childhood climbing trees with this young man’s father.

To cut a long story short, H’s wife fell pregnant with their first child. The doctor’s clinic in the area, as well as check-ups arranged in the capital, said that all was going well — the child was a healthy baby girl and given the parents’ ages, and lifestyles, there would ‘probably’ be no issue — because of course while medical science is precise, for a given value thereof, it is never definitive.

As is turned out, the lady went into labour at five in the morning, in the village, while the child was in the eighth month of gestation — which is reputed as the most dangerous month for premature births. The husband searched desperately for a way out — clearly a medical intervention was urgently required, his wife was in a massive amount of pain, and he was lettered enough to know that an intervention was possible. They had already been told that it would probably be a C-section birth, but there had been no indication that it would be premature.

Over the years, the state has abdicated even its basic responsibilities.

But in a village, in the wee hours of the morning, of course there was no medical help. The clinic was closed (not that it was a surgery in the first place), the doctor’s whereabouts unknown (whatever his qualifications may be). There were no buses and no taxis to get down to an urban area where perhaps it may have been possible for some good souls who took the Hippocratic oath to attempt some lifesaving medical intervention.

As is turned out, therefore, the very unfortunate young lady gave birth to a girl, on her own and without succour. The infant died a few hours later. Speaking to H last week, commiserating with the family for loss and bereavement, he of course had only one thing to say, that trope common in our culture: it must have been God’s will. She came from there, and it was her fate to go back; that might be so, but it’s heartbreaking that it had to happen so soon.

One cannot comment on the will of any greater power. What one can comment on is a total abdication of the state over the decades of its basic responsibilities that are an essential part of the contract with the citizenry (and, as a snide remark, may one add that this comes even as the Federal Board of Revenue drives for taxes, correctly, and the National Accountability Board runs after corruption? )

People need services by the state. That’s the basic social contract, as famously expounded upon by Hobbes.

But this country has slipped up — badly — in this department, and over the decades, it has become ever-failingly worse. Healthcare is one avenue — we all know the state of the public-sector institutions in the area, even though there is no dearth of medical professionals, and even as the country continues to spend vast sums on subsidising education in the field of medical education. Despite that, in too many cases, where intervention — succour — is urgently needed, it is not forthcoming. People are left on their own.

Another significant sphere from where the state has abdicated could be considered the education sector. The middle-income bracket, those families with aspirations for their children (though, of course, all parents have aspirations for their progeny), have the wherewithal in some cases to take recourse to private schooling, which comes at a cost and is not necessarily worth that cost. But speaking of the former issue, as is well known, the matter has come to a head to the point of intervention by the apex court, amongst others. And then there’s the matter of an utter lack of regulation or oversight, allowing institutions to function virtually as cartels. The reason behind it all is the depths public-sector institutions have been allowed to plunge to.

The point here is that currently our good prime minister is talking hifalutin about the desire for curricula across the country to be uniform, but what is really required means much more steeliness and strength of mind on part of officials of the state — those in positions of power, who could actually achieve something perhaps. With a population having crossed 200 million, affordable and quality education is a must — a constitutional reality.

The ostrich act does not work. Any child knows that.

The writer is a member of staff.


Published in Dawn, November 4th, 2019