Blind who -- state or citizens?

The girl was six or seven years old. She was brought from a remote village in Balochistan to Dr Idrees Adhi, the reputed ophthalmologist in Karachi. But her eyes couldn't be saved. Dr Adhi felt so helpless because the disease was fully curable if the girl had reached him in time. The parents told him that it took them ten days to reach Karachi from their village because after their daughter developed the infection, it took them a week to raise money for travel and treatment. Another three days were consumed in reaching Karachi. The poor citizens of Pakistan die or suffer from curable diseases and spend a large part of their meagre incomes on getting ineffective treatments. Scores of women die everyday in childbirth and the infant mortality rate is comparable only to underdeveloped African nations. Epidemics break out and people lose their lives. No regret or remorse is observed at the policy-making level. Therefore, no serious planning is seen to provide the citizens of this country a decent health cover.

Before discussing the health infrastructure and reforms needed in the dispensation of health services, it is important to highlight the issues of clean drinking water, sanitation, solid waste, fertilizers and pesticides in rural Pakistan, air pollution in cities and industrial effluents. What are we doing to prevent diseases from happening and epidemics from spreading? Nothing really, I'm afraid. To give an example, who doesn't acknowledge the inspiring work done by the pioneers of kidney treatment and transplant in Pakistan? But what makes so many people suffer from kidney-related problems and diseases? Little is done to address the cause. I do not fault the multinational companies for all our sins; the corrupt, selfish, anti-people and mediocre planners, policy makers and managers of the government are more responsible than international businesses. They have neither the courage nor the knowledge to negotiate investment and technical support on Pakistan's terms. It is common knowledge that the same medicine is sold at a price five to eight times higher in Pakistan than in India. The drug manufacturers, whether local or international, must be regulated in the country's interest as would happen in any civilized society.

Many lethal diseases in Pakistan including eye infections are water-borne. Access to clean water for drinking and other purposes is the responsibility of the state. In many countries around the world you can find bottled mineral water, fizzy or still, according to your taste. But that does not mean that people are forced to purchase expensive bottled water if they don't want to get sick or otherwise install water purification equipment. If an average household of seven drinks twelve to fourteen litres of water everyday, they would need at least six thousand rupees a month to buy drinking water. And the government has very generously revised the minimum wage to rupees six thousand: what a joke! Therefore, isn't it just common sense to invest more in the preventive side of health and hygiene, which would also mean improving the quality of life, and systematically plan the provision of fundamental municipal services to the cities, towns and villages of Pakistan. I strongly endorse the recommendations of the Pakistan Medical Association and conscientious health professionals who demand effective immunization from the grassroots level and enhanced capacity of basic health units, rural health centres, tehsil/taluka hospitals and district hospitals. The teaching hospitals in cities should focus on tertiary care. A national drug formulary in the country must be established to collect and disseminate information about life-saving and essential drugs with generic version only. Import of drugs should be limited to those that are not produced locally. The food and drug administration should ensure quality assurance.

Some of my readers must be parents of small children. Would they sleep all right after knowing that innocent children, who are of the same age as their children, lose eyes, limbs or lives daily in Pakistan because of the criminal negligence on the part of the state and our elite?



The writer is an Islamabad-based poet and rights campaigner. Email: harris@spopk.org