Category Archives: Health

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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The dilemma of cancer caregivers

By Dr Zeba Hisam

DIAGNOSIS of cancer in any patient is not only stressful to the patient but also the family who looks after the cancer patient. Here in our country the patient and the attendants receive no counselling. When the oncologist suggests the line of treatment — surgery, chemotherapy or radiotherapy depending on the type and stage of the cancer — the  patient and his family have no inkling of the outcome. They are not told about the suffering the patient will undergo or his/her survival rate. Continue reading The dilemma of cancer caregivers

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Integrity above all

ZM with renowne playwright Haseena Moin

By Beena Sarwar

When a pioneering journalist pens her memoirs, you pay attention. Especially when she is Zubeida Mustafa of Pakistan, a long-time feminist and champion of social causes who, from her editorial perch at the daily Dawn, witnessed momentous transitions in the country’s media and political landscapes for over three decades. Beyond being a witness to change, she has also, as she realises with a thrill, “been a part of it, at times driving it and at times being driven by it.”

The narrative in this slim hardcover, My Dawn Years: Exploring Social Issues, is quintessential Zubeida Mustafa: direct, understated, deep, nuanced, thorough — and meticulously indexed. Black and white photos, though somewhat grainy, are well captioned, providing a pictorial reference to many of the events and people mentioned in the book. Continue reading Integrity above all

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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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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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The minimal role of the medical professionals in preventive medicine in Pakistan

By Zubeida Mustafa

A recent report issued by the British Heart Foundation said, “More than 20 million people in the UK are physically inactive. Inactivity increases the risk of heart disease and costs the NHS around £1.2bn each year.”1

Seventeen years ago in 2005, the British Medical Association and the Irish Medical Organisation had warned in a public statement that a million British children accounted for a third of the cases of obesity seen in children in the European Union countries. The BMA called for strong action by member governments and the EU health commissioner to stem the rising epidemic of obesity in under-16s.2

This was followed by a report in July 2015 in which the BMA  called on the government to impose a tax of 20 per cent on sugar sweetened drinks to pay for subsidies on fruits and vegetables in an effort to slow down the “obesity epidemic”.3 Continue reading The minimal role of the medical professionals in preventive medicine in Pakistan

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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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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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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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How we grow

By Zubeida Mustafa

IS the world really waking up to the population crisis that received a lot of international publicity at the London Summit on Family Planning last week? One wishes it were. But all the noise seems to be emanating from the developed states which have managed their own demographic affairs very well while generously supporting the Third World countries’ population programmes. Their success is to be attributed mainly to their strategy of working honestly within a holistic socioeconomic framework.

Unfortunately, developing countries, which are the biggest contributors to the galloping global population growth and that have restricted resources, have shown a poor record. According to the UN, the current world population stands at 7.6 billion and is expected to be 8.6bn by 2030 and 9.8bn in 2050. The world has roughly 83 million new mouths to feed every year. Continue reading How we grow

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