Education brings 180 degree change in lives

By Fatima Sheikh |16 May 2018

KARACHI: The occasion was the golden jubilee of the Montessori Teachers Training Diploma course in Pakistan. Sixty excited and smiling fresh graduates stepped on the stage to place tapers in a neat row, as a female voice introduced them as “the bearers of the flame of education” that have guided children through the ages.

This course is conducted in Pakistan by the Montessori Teachers’ Training Centre (MTTC), Karachi, The MTTC trains teachers to work with children aged between two-and-a-half to six years. It is the only training centre in Pakistan recognized by and affiliated with AMI, Amsterdam. The MTTC was established in 1999 and is governed by a Board of Governors. It is registered with the Government of Sindh under Section 42 of the Companies Ordinance. Continue reading Education brings 180 degree change in lives

Desperately seeking donors

By Zubeida Mustafa

As the country teeters on the brink, many of the socio-economic and political evils of yesteryears are making a comeback in a big way. One of them is the reprehensible organ trade. Rearing its ugly head at the turn of the century, the sale of kidneys was somewhat suppressed when the Transplantation of Human Organs and Tissues Ordinance was promulgated in 2007. This criminalised the sale of human organs and tissues. Thereafter, the opponents questioned it on several grounds, leading to yet another round of legal struggle.

This ended successfully with Parliament enacting the Transplantation of Human Organs and Tissues Act in 2010, amidst a lot of rejoicing. Its credibility was established when some rogue elements in the medical profession and their accomplice vendors were arrested. Thus, good was deemed to have won over evil. One didn’t realise at the time that this was a case of misplaced hope.

Some recent reports (especially two write-ups by Naziha Syed Ali) in Dawn made it clear that the criminals were back in business. This time they were careful and  avoided media publicity. The papers were not flooded, as they were a few years earlier, with images of rows of people in rural areas photographed with their shirts pulled up displaying the incision marks across their torsos – the tell-tale sign of surgery for kidney harvesting.

Matters came to a head when Dr Adibul Hasan Rizvi, director of the Sindh Institute of Urology and Transplantation (SIUT),   wrote to the Supreme Court and drew its attention to what was happening, mainly in Punjab. In support of his contention, he sent the emails he was receiving from foreign doctors complaining about their patients having travelled to Pakistan  and having been trapped by the organ traders. They had returned home mortally ill.

Under the coordination committee set up by the Supreme Court, the SIUT organised a seminar and workshops last month to formulate recommendations to step up deceased organ donation (DOD). Dr Rizvi believes this  to be necessary to change the pattern of demand and supply of organs and thus the economics that drives the heinous trade. Since human organs are in short supply, they can be sold at fabulous prices to desperately ill, wealthy patients. There is grinding  poverty in some regions of the country, in many cases created by exploitative landlords and brick kiln owners, leading to the compulsion for impoverished people to sell their organs. There are also surgeons whose greed knows no bounds and they have chosen to forget their Hippocratic Oath to serve ailing humanity. These three factors have combined to give rise to   perfect conditions for the commercialisation of organ transplantation in Pakistan.

What is equally appalling is the minimal public awareness about health and illness and the general apathy towards the burden of disease among the people. It is only when a person falls ill that he begins to learn a thing or two from his own experience. With a media that has forgotten its key function of educating the people, it cannot be expected to take too passionately to  health education programmes that have little commercial value. This public ignorance provides the medical profession its huge clientele. The fact is that the burden of disease in Pakistan can be considerably reduced by taking a few preventive measures. Spread more public awareness about healthy living. Provide sanitation and potable water to the people. The healthy environment thus created will cut down the incidence of disease.

That would explain why kidney problems are on the rise in the country. Since the deceased organ programme has not taken off, the demand and supply gap has widened making organ trade  such a lucrative venture.

Will  this exercise of drawing up recommendations produce any fruitful results? It all depends on the will and the capacity of those working for the implementation of the suggested measures.  The transplantation law that was drafted by the late Justice Sabihuddin Ahmad is still believed to be a good law. Changes in the rules could finetune it further. As for putting a halt to the odious  organ trade,  the present law is sufficient for the police to take action and for the courts to act if they want to.  The crime is committed so blatantly, that concerned authorities can crack down on the criminals – even those with powerful connections – if they want to.

The SIUT’s conference and workshops, however, served a useful purpose in another way. They underlined the need to change our social attitudes and culture towards organ donation which Zehra Nigah, our top ranking poet, described as “Tuhfa-e-Hayat-e-Nau” (Gift of a new life) in the poem she recited on the occasion.

There is, undoubtedly, a need to create the infrastructure, train medical professionals in how to handle life-and-death issues, in communicating with the patients and their relatives, and also define, in layman terms, issues like brain death. The recommendations address all these.  Dr Rizvi also brought up the issue of capacity. He pointed out that  the existing number of ICU beds in Pakistan cannot provide sufficient organs – even if consent has been given – to meet the needs of the country. Setting up a centralised registry for donors and patients in need, would facilitate the smooth and efficient working of a transplant programme in Pakistan.  This can be accomplished by the numerous professional medical bodies, working closely together and with the government.

The real challenge is to create public acceptance of deceased organ donation. In this context, the recommendations for the media and for education campaigns to create public awareness and popularise legal organ donation, are most pertinent. Some suggestions for the media, such as integrating the subject of organ donation in TV plays and programmes and including the theme in school textbooks, has the potential to be effective.

The need is to analyse the basic factors that have hampered the awareness of deceased organ donation. Religion is no longer an obstacle. Islamic scholars in Pakistan, and in other Muslim countries, unanimously agree that deceased organ donation  is sanctioned by Shariah.

Superstition, ignorance and the fear of death that have given rise to a negative attitude to deceased organ donation in our society. People need to be told about death and grieving – especially of the need to talk about these phenomena. There is a need to help people see the beauty in the idea of saving lives.

What better strategy can be adopted than what the SIUT itself opted for, when it needed to popularise organ donation by living donors related to each other. Initially, this idea was too radical for people to accept. The battle had to be won if the SIUT’s kidney transplant programme, that was launched in 1985, was to succeed.

After the first few patients and their families had been persuaded to accept this miracle of modern medicial science, it became easy sailing. The patients and their donors became motivators for those who followed. The high rate of recovery of those with transplanted kidneys, along with the care and compassion the patients and their donors received, and the guarantee of life-long free medical cover, proved to be major incentives.

I remember Rasheed, Transplant Patient #1 who came from Azad Kashmir with his brother, who was the donor. They became the agents of change for patients visiting SIUT. There was Rukhsana, the medical student and Transplant  #9, whose sister helped her out. She went on to become a doctor.

Such cases became an inspiration for other patients and their families. There was a lot of interaction among the various patients and donors, but there were also the unfortunate ones who didn’t have a donor. How could their lives be saved?  The answer was:  by  deceased organ donation.

That is what the SIUT’s conference was all about. Pakistan has had five deceased organ donors,  now rightly described as  national heroes by SIUT. The first such donor was Naveed Anwar,  a student who was fatally injured in a  road accident. When he was certified as brain-dead by a team of neurologists, his family – progressive and enlightened – decided to fulfil his oft-expressed wish to be an organ donor if he met such a fate. Dr Razzaq Memon was another and his family also donated his organs in keeping with his will, in spite of some reservations from the biradari.

I mention these two because I have met their families and they have repeatedly endorsed deceased organ donation and their own role in the programme. And so it was that deceased organ donation made a debut in Pakistan. It should be noted that the first three donations were made even before Parliament had passed the law, which certainly helped in promoting the concept.

The inspiration provided by the five heroes, needs to be brought to the fore. The families should lead this campaign. They have experienced the pain of losing a loved one. They have also felt the inner satisfaction and peace that comes from saving a life. Their words will carry weight, just as the SIUT’s presence on a high moral ground in Sindh has kept the organ traders away from this province.

Zubeida Mustafa is a senior journalist. She writes on a variety of subjects but her i

By Zubeida Mustafa

As the country teeters on the brink, many of the socio-economic and political evils of yesteryears are making a comeback in a big way. One of them is the reprehensible organ trade. Rearing its ugly head at the turn of the century, the sale of kidneys was somewhat suppressed when the Transplantation of Human Organs and Tissues Ordinance was promulgated in 2007. This criminalised the sale of human organs and tissues. Thereafter, the opponents questioned it on several grounds, leading to yet another round of legal struggle.

This ended successfully with Parliament enacting the Transplantation of Human Organs and Tissues Act in 2010, amidst a lot of rejoicing. Its credibility was established when some rogue elements in the medical profession and their accomplice vendors were arrested. Thus, good was deemed to have won over evil. One didn’t realise at the time that this was a case of misplaced hope.

Some recent reports (especially two write-ups by Naziha Syed Ali) in Dawn made it clear that the criminals were back in business. This time they were careful and  avoided media publicity. The papers were not flooded, as they were a few years earlier, with images of rows of people in rural areas photographed with their shirts pulled up displaying the incision marks across their torsos – the tell-tale sign of surgery for kidney harvesting.

Matters came to a head when Dr Adibul Hasan Rizvi, director of the Sindh Institute of Urology and Transplantation (SIUT),   wrote to the Supreme Court and drew its attention to what was happening, mainly in Punjab. In support of his contention, he sent the emails he was receiving from foreign doctors complaining about their patients having travelled to Pakistan  and having been trapped by the organ traders. They had returned home mortally ill.

Under the coordination committee set up by the Supreme Court, the SIUT organised a seminar and workshops last month to formulate recommendations to step up deceased organ donation (DOD). Dr Rizvi believes this  to be necessary to change the pattern of demand and supply of organs and thus the economics that drives the heinous trade. Since human organs are in short supply, they can be sold at fabulous prices to desperately ill, wealthy patients. There is grinding  poverty in some regions of the country, in many cases created by exploitative landlords and brick kiln owners, leading to the compulsion for impoverished people to sell their organs. There are also surgeons whose greed knows no bounds and they have chosen to forget their Hippocratic Oath to serve ailing humanity. These three factors have combined to give rise to   perfect conditions for the commercialisation of organ transplantation in Pakistan.

What is equally appalling is the minimal public awareness about health and illness and the general apathy towards the burden of disease among the people. It is only when a person falls ill that he begins to learn a thing or two from his own experience. With a media that has forgotten its key function of educating the people, it cannot be expected to take too passionately to  health education programmes that have little commercial value. This public ignorance provides the medical profession its huge clientele. The fact is that the burden of disease in Pakistan can be considerably reduced by taking a few preventive measures. Spread more public awareness about healthy living. Provide sanitation and potable water to the people. The healthy environment thus created will cut down the incidence of disease.

That would explain why kidney problems are on the rise in the country. Since the deceased organ programme has not taken off, the demand and supply gap has widened making organ trade  such a lucrative venture.

Will  this exercise of drawing up recommendations produce any fruitful results? It all depends on the will and the capacity of those working for the implementation of the suggested measures.  The transplantation law that was drafted by the late Justice Sabihuddin Ahmad is still believed to be a good law. Changes in the rules could finetune it further. As for putting a halt to the odious  organ trade,  the present law is sufficient for the police to take action and for the courts to act if they want to.  The crime is committed so blatantly, that concerned authorities can crack down on the criminals – even those with powerful connections – if they want to.

The SIUT’s conference and workshops, however, served a useful purpose in another way. They underlined the need to change our social attitudes and culture towards organ donation which Zehra Nigah, our top ranking poet, described as “Tuhfa-e-Hayat-e-Nau” (Gift of a new life) in the poem she recited on the occasion.

There is, undoubtedly, a need to create the infrastructure, train medical professionals in how to handle life-and-death issues, in communicating with the patients and their relatives, and also define, in layman terms, issues like brain death. The recommendations address all these.  Dr Rizvi also brought up the issue of capacity. He pointed out that  the existing number of ICU beds in Pakistan cannot provide sufficient organs – even if consent has been given – to meet the needs of the country. Setting up a centralised registry for donors and patients in need, would facilitate the smooth and efficient working of a transplant programme in Pakistan.  This can be accomplished by the numerous professional medical bodies, working closely together and with the government.

The real challenge is to create public acceptance of deceased organ donation. In this context, the recommendations for the media and for education campaigns to create public awareness and popularise legal organ donation, are most pertinent. Some suggestions for the media, such as integrating the subject of organ donation in TV plays and programmes and including the theme in school textbooks, has the potential to be effective.

The need is to analyse the basic factors that have hampered the awareness of deceased organ donation. Religion is no longer an obstacle. Islamic scholars in Pakistan, and in other Muslim countries, unanimously agree that deceased organ donation  is sanctioned by Shariah.

Superstition, ignorance and the fear of death that have given rise to a negative attitude to deceased organ donation in our society. People need to be told about death and grieving – especially of the need to talk about these phenomena. There is a need to help people see the beauty in the idea of saving lives.

What better strategy can be adopted than what the SIUT itself opted for, when it needed to popularise organ donation by living donors related to each other. Initially, this idea was too radical for people to accept. The battle had to be won if the SIUT’s kidney transplant programme, that was launched in 1985, was to succeed.

After the first few patients and their families had been persuaded to accept this miracle of modern medicial science, it became easy sailing. The patients and their donors became motivators for those who followed. The high rate of recovery of those with transplanted kidneys, along with the care and compassion the patients and their donors received, and the guarantee of life-long free medical cover, proved to be major incentives.

I remember Rasheed, Transplant Patient #1 who came from Azad Kashmir with his brother, who was the donor. They became the agents of change for patients visiting SIUT. There was Rukhsana, the medical student and Transplant  #9, whose sister helped her out. She went on to become a doctor.

Such cases became an inspiration for other patients and their families. There was a lot of interaction among the various patients and donors, but there were also the unfortunate ones who didn’t have a donor. How could their lives be saved?  The answer was:  by  deceased organ donation.

That is what the SIUT’s conference was all about. Pakistan has had five deceased organ donors,  now rightly described as  national heroes by SIUT. The first such donor was Naveed Anwar,  a student who was fatally injured in a  road accident. When he was certified as brain-dead by a team of neurologists, his family – progressive and enlightened – decided to fulfil his oft-expressed wish to be an organ donor if he met such a fate. Dr Razzaq Memon was another and his family also donated his organs in keeping with his will, in spite of some reservations from the biradari.

I mention these two because I have met their families and they have repeatedly endorsed deceased organ donation and their own role in the programme. And so it was that deceased organ donation made a debut in Pakistan. It should be noted that the first three donations were made even before Parliament had passed the law, which certainly helped in promoting the concept.

The inspiration provided by the five heroes, needs to be brought to the fore. The families should lead this campaign. They have experienced the pain of losing a loved one. They have also felt the inner satisfaction and peace that comes from saving a life. Their words will carry weight, just as the SIUT’s presence on a high moral ground in Sindh has kept the organ traders away from this province.

Source: Newsline May 2018

Food paradoxes

By Zubeida Mustafa

HAS the sight of a child scavenging for food from an overflowing garbage bin made your heart bleed? This is common in Karachi, where kitchen waste containing a lot of cooked food is thrown away. This child is one of the 31.5 per cent of under-fives in Pakistan who were found to be underweight by the 2011 National Nutrition Survey. Nearly 43.7pc were categorised as ‘stunted’. The figures are expected to rise in the NNS currently under way. Continue reading Food paradoxes

A professional odyssey

Zubeida Mustafa’s book is not just for the practitioner and lover of journalism, it’s been written by someone who has worked on raising awareness about social issues

“I also discovered during this phase what the newspaper reader’s habit means. I had been told that it was one of the most difficult habits to break — even more than cigarette smoking,” writes Zubeida Mustafa in her almost-autobiographical book My Dawn Years — Exploring Social Issues. With her work as an editor and a journalist spanning more than three decades, and her columns continuing to appear to date, Mustafa, then, is also a hard-to-break habit for the Pakistani newspaper reader.

Continue reading A professional odyssey

Justice for all

By Zubeida Mustafa

THE judiciary in Pakistan has traditionally been viewed as a rubber stamp for coup-makers who intrude into politics. Justice Iftikhar Chaudhry showed the courage to defy Gen Pervez Musharraf — albeit seven years after the army chief had entrenched himself as head of state. In the words of The Economist (August 2009), “Most people do not care to remember that Mr Chaudhry and his colleagues also took their oaths after Mr Musharraf’s first coup … and owe their promotions to him”. Justice Chaudhry won popularity as a David who took on Goliath.

Today Chief Justice Saqib Nisar’s judicial activism has found some supporters too. And one can understand why. When a vacuum is created in any area of national life, it is inevitable that it will be filled by one or the other force. Matters of governance have deteriorated to such an extent in all sectors that people here are in a state of despair. Continue reading Justice for all

Cure or perish

Behbud’s mobile TB clinic

By Zubeida Mustafa

A SHORT skit and a poster exhibition by children of the Behbud School on World TB Day came as a stark reminder that the scourge of tuberculosis continues to menace our society.

I wondered how many of those young artists and performers had had a personal encounter with the disease. This was likely because the incidence of TB in Pakistan continues to be pretty high, with 518,000 new cases being diagnosed every year, making it the fifth largest TB-infected country in the world. There is no way of knowing how many cases are not even detected. Continue reading Cure or perish

The party goes on

By Rifaat Hamid Ghani

IT disconcerts political interventionists that political parties—be they cultist or ideological—do not come and go by virtue of registration paper alone. They have a ground reality. Disqualify the leader, even ban the party, but adherents adhere. Popular support—overt or covert; subverted or repressed—will always remain a challenge for reformists who need to oust superfluous leaders/parties that have yet to be democratically nullified by the voter. Continue reading The party goes on

Illusory happiness

By Zubeida Mustafa

THE recently released UN-sponsored World Happiness Report 2018 ranks Pakistan 75th out of 156 countries in terms of how happy their citizens are. That is progress. Last year, we stood at the 80th position. There has been rejoicing at what is seen as Pakistan’s superiority in the ranking table above all its neighbours which includes China and India.

This made me wonder because statistics — objectively compiled one presumes — have a different story to tell. The Sustainable Development Solutions Network, the author of the report, bases its findings on six indicators, namely, income per capita, life expectancy, social support, generosity, freedom and corruption. At least two of these are calculated objectively by many UN agencies (World Bank and UNDP). Continue reading Illusory happiness

A woman of quiet influence

By Zohra Yusuf
A book review of Zubeida Mustafa’s My DAWN Years – Exploring Social Issues.

I recently told Zubeida Mustafa that I had an issue with the subtitle of her memoirs. I feel her years at DAWN were more meaningful than simply the pursuit of social issues, important as they are and clearly close to her heart. With over 30 years at DAWN, many of which were in the position of a senior editor, Zubeida had a more significant impact on the newspaper than perhaps she cares to lay claim to – out of her inherent modesty. Her years at DAWN did see a shift in editorials, from ambivalence to clear positions on issues that matter – democracy, pluralism and rights of the marginalised, to name a few. If Ahmad Ali Khan (the editor for most of her years at DAWN), was her mentor, Zubeida too, in her own quiet way, exercised a significant influence on the newspaper’s journey. Continue reading A woman of quiet influence

Guns or books?

By Zubeida Mustafa

THE infamous legacy of ‘enforced disappearances’ that the Chilean military dictator Augusto Pinochet left behind has, unfortunately, been picked up by Pakistan. This phenomenon is today a source of great human agony in the country with thousands believed to have been abducted, many for political reasons.

Balochistan has suffered much. One cannot be certain about who is behind this torturous form of suppression of the freedom of expression. One hears of the ‘agencies’, Baloch dissidents, RAW agents, religiously inspired militants and others being involved. Continue reading Guns or books?