Category Archives: Development and Poverty

Whose girl is she?

By Zubeida Mustafa

THE Sindh police are under fire, which is not something unusual as its performance can hardly be described as satisfactory. It is also alleged to be notoriously corrupt.

A fortnight ago, the Sindh chief justice rebuked the defenders of the law for their failure to recover 22 children who had been missing for several years. An NGO, Roshni Helpline, had filed a petition in the Sindh High Court on behalf of their parents.

In spite of the directive, the police had not set up a team to look into each case. Continue reading Whose girl is she?

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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

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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

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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

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It wasn’t English

President Mamnoon Hussain in a Group Photo during the Inaugural Session of Conference on South Asia arranged Pakistan Institute of International Affair at PC Hotel Karachi on 15-11-2017

By Zubeida Mustafa

AT the inaugural session of its 70th anniversary conference, the Pakistan Institute of International Affairs, Karachi, did us proud when the proceedings were conducted in Urdu. It was a pleasure to hear chaste Urdu perfectly articulated at an occasion not dominated by our Urdu litterateurs.

I was told that this was at the suggestion of President Mamnoon Hussain who was the chief guest. Masuma Hasan, the chairperson of the institute, confirmed it, adding that it was her idea as well. Urdu is Pakistan’s national language, so no one should challenge Masuma’s decision. However, the smooth sailing at the PIIA function made me wonder why the demand for other provincial languages being given the same constitutional status cannot be considered favourably. Continue reading It wasn’t English

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Whither feminism?


IS feminism changing in Pakistan? That is the question that should be asked by those who are interested in women’s issues. That is the question that I pondered over at the Women’s Peace Table I attended recently in Karachi.

Organised by Tehrik-e-Niswan (TN) and a few other civil society groups, this gathering was the third in the series that was launched in 2015 on the call of the Peace Women Across the Globe. The idea is to encourage women to be involved in the peace process in regions in the grip of conflict. Continue reading Whither feminism?

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Gender unit

By Zubeida Mustafa

THE Sindh government’s apathy towards gender inequity in education is almost proverbial. I was, therefore, taken aback when the minister for literacy and education in the province quoted the age-old adage: “When you educate a boy you educate an individual, but when you educate a girl you educate a family.”

It left me wondering why his party which has been in power in Sindh for a decade failed to achieve 100 per cent literacy in the province. Has wisdom been late in dawning on our policymakers? Continue reading Gender unit

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Dr Pfau’s leprosy miracle

By Zubeida Mustafa

Haleema Khan (a name used in this story to preserve her anonymity) is a health management expert who is head of the secretariat in a prestigious hospital in Karachi, Pakistan’s biggest city. Efficient, professional and confident, one would never guess that Khan reached the heights of success by starting from the lowest rung of the ladder.

Khan grew up in a shanty town in the backwaters of Karachi, where she was born to parents who suffered from leprosy. This concentration of humble dwellings was home to the outcasts of society, and Khan, who had never contracted the disease herself, inherited a lowly status by virtue of her parentage. The stigma attached to leprosy has haunted her all her life (and is why she was reluctant to reveal her identity for this story). Read on

Source: Truthdig

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Running where?

By Zubeida Mustafa

IN the introduction to Pakistan at the Crossroad, Christophe Jaffrelot labels Pakistan as a “client state” and a “pivotal state”. For long, we had been dubbed an ideological state and a security state.

None of these titles are too flattering, but they are not inaccurate. The status of being a client and a pivot stems from Jaffrelot’s observation about Pakistan’s “ability to navigate at the interface of domestic and external dynamics”. Continue reading Running where?

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Women are at the heart of development in Pakistan

The Garage School founder Shabina Mustafa at her desk in the educational center in Karachi, Pakistan. (The Garage School)

By Zubeida Mustafa

Three years ago, when Truthdig invited me to write an article on “How the women of Pakistan cope” for its newly launched Global Voices Project, it was a challenge for me. I wished to show the readers a face of Pakistani women that does not generally figure in the global media. They are the women who do not in the normal course create a sensation. But in their quiet way they are the change-makers.

The relaunch of Truthdig offers me the opportunity to take another look at the situation of women in Pakistan. Has it changed?

First, let us redefine the dichotomy in the women’s situation in Pakistan in terms of their achievements. The two classes I spoke about in my earlier article still exist: We still have a small, privileged class of the haves, and there is also the huge, underprivileged class of the have-nots. The world fails to recognise Pakistani women through this perspective. Read on

Source:Truthdig

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