Category Archives: General

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

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So sorry Zainab

By Zubeida Mustafa

DEAR Zainab,

I am writing this letter to you a whit too late. Your sparkling pretty eyes have been shut for ever. And you are not there to read my words which are an outpouring of my grief, my anguish, my shame, my anger and, above all, the deep remorse that I feel for having let you down. True, I did not harm you directly. I wasn’t the one to hurt you. Yet I plead guilty because I failed to  create the environment that every child needs. If I had given attention to this aspect of life, you wouldn’t have had to pay the price for my failure. You would have been saved.

So I will not indulge in the blame game I see that is being playedout  around me by politicians and opinion leaders alike who derive some kind of perverse pleasure from accusing their rivals for whatever goes wrong. Continue reading So sorry Zainab

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Pakistan Has a Health Care Solution Worth Exploring

Patients in a waiting room at the Sindh Institute of Urology and Transplantation in Pakistan. (SIUT)

 

By Zubeida Mustafa

In a Third World country, “health for all” cannot be taken for granted, given the iniquitous provision of welfare and health care, combined with rampant poverty. So it comes as a surprise to me, a citizen of Pakistan, that health care should be the subject of such a fierce debate in the United States, where many of the problems faced by Pakistanis do not exist. This world power, after all, has the resources to provide the best health care for its people, if it wants to.

Yet Truthdig’s search engine brought up 708 results for the last few months when I keyed in the words “health care.” It was eye-opening. It is clear that, despite the heated argument surrounding the Affordable Care Act, or “Obamacare,” that marked the advent of the Trump administration and the president’s failed efforts to repeal it, the controversy has not been laid to rest.

Michael Winship’s article titled “One Nation in Sickness and in Health” very cogently sums up America’s health care problem. “It’s a given that our health care system, one-sixth of our nation’s economy, is a nightmare,” he writes. Winship attributes this “nightmare” to the “stinkers out there so quick to abuse the system and make a quick big fast buck, especially in the pharmaceutical and health insurance industries.” Winship argues that reforms are necessary to attain the ultimate goal of making “universal health care a right for every one of us.”

Ironically, we in Pakistan face somewhat similar problems to the U.S.—albeit on a humongous scale: The factors that have led to a flawed health care system in Pakistan are different. They are mainly scarce resources, an expensive private sector for a handful of elites, no feasible medical insurance and a government that lacks political will and sensitivity to upgrade the existing ramshackle health care system

Health reforms in Pakistan have met equally formidable resistance as in the U.S., where reforms in the health sector have always triggered major political battles. We in Pakistan have done slightly better at creating health care reforms from time to time, some of which were perfect on paper. But alas, these reforms were never implemented, even decades later.

So our quest for a health utopia continues. In an ocean of despondency, ill health and morbidity, we Pakistanis, however, have a few islands of excellence. One institution in particular has the greatest potential when it comes to offering health solutions in universally challenging circumstances: the Sindh Institute of Urology and Transplantation (SIUT). The SIUT, a tertiary care hospital based in Pakistan’s most populous city, Karachi, has been sustained for more than four decades, during which it has grown incrementally in size and reach. The principles that underpin the SIUT’s model of health care could be adapted, adjusted and modified by any country to suit its own circumstances.

As a starter, one needs full commitment to the precept spelled out by the World Health Organization: “Health for all.” Many Americans fight to uphold this concept as a universal right. And health care should be seen as a fundamental right of all human beings and be the ultimate goal of all states. Dr. Adibul Hasan Rizvi, founder and director of the SIUT, labels it the “birthright of every person.” This translates into his institute’s motto: “We will not allow anyone to die because he cannot afford to live.”

Rizvi adds, “We offer health care free with dignity to every one irrespective of colour, creed, caste or religious beliefs.”

Dr. Adibul Hasan Rizvi, founder and director of the SIUT. (SIUT)

And he means it. This is proved by the presence of mammoth crowds that throng the SIUT’s premises in search of succour. All treatment is free, despite the state-of-the-art technology involved, which is expensive. As might be expected, the overwhelming majority of the patients are poor, coming from the 39 percent of Pakistan’s population classified as suffering from multidimensional poverty, who have traditionally been denied adequate health care. At the SIUT, even the most costly laboratory tests or surgical procedures are provided for free, and the ailing are treated with compassion and dignity. “This approach hastens the healing process,” a bladder cancer survivor confided in me after he was pulled out of the jaws of death in this hospital. The SIUT’s Hanifa Suleman Dawood Oncology Centre offers cutting-edge technology for cancer treatment, and last year treated 34,420 patients free of charge.

In 2016, the last year for which consolidated figures are available, 1.1 million people received treatment at the SIUT. Services provided included 8.8 million laboratory tests, 367 renal transplantations and 302,037 dialysis sessions. These can be frightfully expensive, especially transplantation and post-transplant medications, which have to be taken for life. By making its services available and free of charge, the SIUT, with its high success rate, has saved hundreds of thousands of lives. By adopting this approach it has also intervened in the illegal organ trade in Pakistan. The southern province of Sindh, where the SIUT is located, has never experienced the ignominy of hosting an organ bazaar.

How has the SIUT’s miracle worked? The institute is a partnership between the government and the common man. The government facilitates the working of the institute, an autonomous body in the public sector, by partially funding it through budgetary allocations, physical infrastructure where available and project grants. The community’s role is crucial. While the affluent members of the public donate generously, the poor also drop a five-rupee coin in the collection box—such boxes are scattered all over the city. Businesspeople and industrialists have donated buildings and medical equipment worth millions. This combined effort makes it possible for the SIUT to expand—it now has 12 premises under its wings, with three outside Karachi. Donations enable the SIUT to provide free treatment to the community, which reciprocates by showing a sense of ownership toward it.

To instill this confidence in the public, the institution must be seen as delivering on its promises. Any health care system that benefits the underprivileged inspires confidence in the donors and becomes sustainable in due course of time.

People gathered outside the outpatients department of the Sindh Institute of Urology and Transplantation in Pakistan. (SIUT)

No donor wants to feel cheated, which is why wastefulness and profiteering are the biggest enemies of such a relationship. To sustain confidence, expansion at the SIUT is incremental and strictly need-based. It has grown from its initial six beds to 900 beds today. Other health care facilities have tried to emulate the SIUT, but after many adjustments, Rizvi says the viability of the SIUT model is successful because it has been sustained for 42 years, expanding even while the national economy has shrunk. In 1975 the Pakistani rupee was worth almost 10 to a dollar. Today, it is 110.

It is, however a young woman—Aymen Khan, 19—who is the best ambassador for the SIUT. Born with bladder exstrophy, a rare and dangerous bladder condition, Aymen commented, when I first interviewed her five years ago, “To God I owe my birth and to SIUT I owe my health.” Had it not been for the SIUT, Aymen would not have the normal life she leads today as a university student and sports enthusiast. Her family could never have paid her medical bills at a private health care facility.

Source: Truthdig

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The legendary Ahmad Ali Khan

LAUNCHING THE ISLAMABAD EDITION OF DAWN: (R-L) Ahmad Ali Khan, Saleem Asmi and M.Ziauddin (2001)

By Zubeida Mustafa

DAWN of Karachi is 70 this year. Over the decades, scores of people have joined hands to help the paper sustain its standing and standards. But there is one man whose contribution was singular. Without the direction he provided, Dawn could not have risen to the heights to which it has, notwithstanding the numerous crises it has had to weather in its eventful life. Continue reading The legendary Ahmad Ali Khan

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Syed Adibul Hasan Rizvi: Book Review

By Zeenat Hisam

THE reading habit needs to start being cultivated in early childhood through stories of fantasy, fairy tales and folk sagas as these ignite the imagination and the curiosity of children. Every culture and every language has its own heritage of such stories. And so does Urdu. However, what was missing was biographies of renowned people written for younger readers in Urdu.

The Oxford University Press is now filling in this gap by bringing out a few series devoted to the genre. Under the series Azeem Pakistani and Tasveeri Kahani Silsila, biographies of notable figures highlighting their contributions to the country have been published. Roshni kay Meenar is the third series focusing on biographies of prominent personalities of Sindh who have made valuable contributions either before Partition or since. The three biographies published earlier under this series presented the lives and works of Mirza Qaleech Baig, Hasan Ali Effendi and Ruth Pfau. Continue reading Syed Adibul Hasan Rizvi: Book Review

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The magic crop


By Zubeida Mustafa

THE existential threat that Pakistan faces today is the insidious devastation of our human resources. It is a silent crisis, yet to be recognised, as an entire generation of children faces a slow death by malnutrition.

Denied basic nutrients — especially protein — essential for their physical and cognitive growth in the critical first 1,000 days of life, the majority of children never enjoy the same health and mental growth as that of a normal well-fed child. Paediatricians tell us that the damage done during this window of life — from conception till the second birthday — cannot be reversed. We have been warned, but nothing stirs us out of our complacency. Continue reading The magic crop

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May 12th 2007-17

By Rifaat Hamid Ghani

May 12th   2017 is as good as come and gone. As I recall 2007—the year of CJP Iftikhar Chaudhry, for his persona was at once the catalyst and dynamic—that May 12th anniversary marker’s mood-content would be anachronistic today. Its villains and martyrs have squirmed and shifted, and are no longer held firmly within the mould of that year’s context.

Which also indicates its characters are operative: vital and politically relevant, not merely historical.   Continue reading May 12th 2007-17

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A friendship that will never die

Khalida Qureshi 1961

ONE never writes an obituary of a friendship. Friends may pass away but friendship never does. That is how I feel about Khalida Qureshi — a friend who departed 34 years ago on 23 February 1983. My friendship with her lives on. I asked poet BADRI RAINA to send me a poem on friendshp. Here are some lines from Badri’s poem:

Friendship is the touch of truth

In a world of  camouflage—

A plain-speaking toddler

That never comes of age. Continue reading A friendship that will never die

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Education: ill-prepared for globalization

By Zubeida Mustafa

The recently-released Mahbub ul Haq Centre’s Human Development in South Asia, 2001 report, which focuses on globalization and human development, points to a disaster looming on the horizon for countries like Pakistan.

The report correctly states, “Globalization is driven by knowledge and new technology. Thus there is a need not only to provide good quality primary, secondary and technical education but also to spend more on higher level of professional education. But in South Asia a trend of declining or stagnant tertiary enrolment rates is emerging.” (p.55) Continue reading Education: ill-prepared for globalization

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Message of hope?

 

By Zubeida Mustafa

IN these times of despair, even the dead can give us hope and inspiration. That is the powerful message that emerged from the Orangi Pilot Project-Research and Training Institute’s forum on Jan 22. It was organised to commemorate the birthday of Perween Rahman who was shot fatally in March 2013.

Why was Perween killed? It might sound bizarre but the fact is that there are vested interests in our society who feel threatened by people who work for the poor. That was confirmed by SP Akhtar Farooqi who said on the occasion that the murder was not motivated by personal enmity but by economic factors. Continue reading Message of hope?

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