Quest for plan to cope with drought

A view of the Rawal Dam spillways (above) as the water level decreases due to a prolonged dry spell. Water storage in two dams – Mangla and Tarbela – is said to indicate a situation similar to the drought year of 2002

With river flows down by 21 per cent and water storage having declined by 34 per cent over the past year, the Indus River System Authority (Irsa) has sought details of an advisory of the meteorological department forecasting emerging agricultural drought conditions over the next six months. Irsa sources told DAWN on Sunday that total water flows in the country’s four major rivers had declined by about 10,000 cusecs to 37,000 cusecs, compared with 47,000 cusecs last year. The sources said the total storage in two major reservoirs – Tarbela and Mangla – stood at about 1.5 million acre feet (MAF) on Jan 23, compared with 2.26 MAF last year, down by about 34 per cent.The sources said that Irsa was convening a meeting of its advisory committee on Feb 1 to prepare a revised water management plan for the remaining period of the current cropping season and put in place a future course of action to cope with the water shortage.

The sources said the water availability was better last year and yet Irsa had to close down Chashma-Jhelum and Taunsa-Punjnad canals in February and March to overcome shortage. “The water availability situation is much worse this year and would need drastic water management steps to overcome the crisis-like situation,” an Irsa official said. He said that Irsa did not agree to the Met department’s drought forecasts and had sought rationale behind the calculations. He said Irsa had estimated an overall water shortage of about 33 to 34 per cent this year against earlier estimates of 30 per cent, but Met department’s 40 per cent shortage estimates appeared to be on the higher side.

In a fresh advisory on weather conditions, the Meteorological Department has said that the country has already crossed two stages of drought - meteorological and hydrological drought – and was now entering the emerging agricultural drought stages, resulting in crop failures in barani areas and drought conditions in irrigated plains.

According to the Director General of Pakistan Met Department, Dr Qamar-uz-Zaman Chaudhry, “most parts of the country are experiencing extremely dry conditions mainly due to the prevailing El-Nino conditions in the Pacific Ocean”. The El-Nino conditions which developed in June last year and reduced Pakistan’s monsoon rainfall by about 30 per cent, were likely to continue till next summer, he said.

Dr Chaudhry said that meteorological drought occurred when rainfall was fell 40 per cent less than expected in any area for an extended period – a stage already surpassed because most parts of the country were under severe meteorological drought conditions as no appreciable rainfall has occurred during the last four months.

The second stage, hydrological drought, was already being experienced because there was a sustained deficit in surface runoff below normal conditions as the availability of surface water in major reservoirs had aggravated due to 30 per cent below normal rains during monsoon and persistent long dry spell afterward and no significant improvements was expected in the reservoirs during coming weeks.He said that the country was entering the third stage of emerging agricultural drought which occurred when rainfall amount and distribution, soil water reserves and evaporation losses combined to start affecting crops. He said water storage in two dams – Mangla and Tarbela – when compared with the 10-year average data indicated the situation was similar to the drought year of 2002.

State Bank of Pakistan Report

In the absence of a major recovery in the manufacturing and agriculture sectors, the bank claims that the impetus to growth will come from the services sector. In claiming so, the bank fails to see that growth in the services sector is largely dependent on growth in manufacturing and agriculture.

Pakistan’s economy has come a long way in the last one year. Many acknowledge that the PPP government took several politically tough decisions like the abolition of power and oil subsidies to successfully stabilise the sliding economy it inherited. By implementing its macroeconomic stabilisation programme it has brought back the economy from the brink. Fiscal and external account deficits have narrowed, foreign exchange reserves have improved and inflation has declined significantly. The country’s sovereign ratings have also improved.
Naturally, the State Bank of Pakistan’s report discusses all these positive trends in detail. But full economic recovery will take some more time in spite of the positive spin the SBP has sought to put on the state of the economy in its first quarterly report for the financial year 2010. This is mainly because the government has failed to address the structural bottlenecks stalling economic recovery and growth. A persisting energy crunch continues to distress the industry; water shortages are preventing the country from exploiting its full agricultural potential; and failure to tax the rich and powerful lobbies is once again threatening to destabilise the fiscal stability achieved in recent months. The result of these failures is evident: the economic outlook remains weak.
Yet the SBP is hopeful that the nation’s GDP will increase by around 3.3 per cent, the target set in the budget for the current fiscal year. However, few subscribe to the bank’s optimistic view. In the absence of a major recovery in the manufacturing and agriculture sectors, the bank claims that the impetus to growth will come from the services sector. In claiming so, the bank fails to see that growth in the services sector is largely dependent on growth in manufacturing and agriculture. Unless the commodity-producing sectors improve, there is little that the services sector can do to push growth.
At the same time, threats to macroeconomic stability are resurfacing. Inflation is projected to resurge on increased power and gas prices. Fiscal slippages could make it hard for the government to meet the fiscal deficit target, and the delay in the realisation of pledged aid/loans/grants from the Friends of Democratic Pakistan group is impacting liquidity and preventing the government from spending on social and economic development. The external side, nevertheless, is expected to improve over the last financial year due to generous funding from the IMF and the US under the Kerry-Lugar act. Therefore, it is difficult to expect a major pick-up in growth, at least in the foreseeable future. Unless obstacles to growth are removed, it will be futile to expect sustainable growth even over the long term.

A cry for help

According to statistics suicide in Pakistan is on the increase. This is not surprising. Given the insecurity, unemployment, inflation and political instability that grip Pakistan today, it is a major challenge for even the most stable person to retain his or her sanity. Suicide is the result of the interaction of a number of factors — biological, genetic, psychological and environmental. It is important that all of these are addressed to help a person overcome suicidal tendencies.
While the government has an important role to play in addressing the causes of suicide, the main element in the prevention of suicide is general awareness. It is important that families understand the symptoms and take seriously any change in the behaviour of another member and his/her threat to kill himself/herself. Depression too must be addressed preferably by a mental health professional. Help-lines can serve as a band-aid measure until proper help arrives.
While those suffering from mental disorders — which can lead to suicide — need professional help, a collective effort by members of society can go far in making life a lot easier for those with depressive tendencies in these trying times. Reaching out is after all a sign that a cry for help has been heard. At the individual level, the acquisition of skills in stress management can help alleviate symptoms of depression. Where the stress agent cannot be changed people must learn to address the issues that are hurting them and devise strategies so that they can learn to cope with their problems without letting these dominate their lives. Sometimes even a change in perception can release stress. Needless to say a healthy lifestyle — diet and exercise — are the key elements in facilitating good health, both physical and mental, and the medical community must promote this as far as possible.

Born of superstition

It is symptomatic of the retrogression in Pakistani society that heinous crimes are committed under the influence of misplaced notions of culture, religion and superstition.
The recent case of infanticide in Karachi is an example. A raid on a Korangi house led the police to the remains of a six-month-old girl buried in a shallow grave and her four-year-old sister trussed up and starved. The girls’ parents told the police that their house had fallen under the influence of ‘evil spirits’ and that a ‘pir sahib’ had appeared in their dreams to guide them towards this course of action. A case of premeditated murder has been registered against the couple, and further investigation may well lead to other reasons — such as poverty or insanity — which led to the crime.
However, there is no doubt that in Pakistan’s deeply conservative, illiterate society, holy men and pirs often exercise a pernicious influence over the credulous. There have been cases where such so-called religious men have raped and tortured or incited followers to commit inhumane crimes — the victims have generally been women and children. At the very least such pirs use their influence to extort money or goods. Unfortunately, only a few cases are highlighted, and even then little action is taken.
A two-pronged strategy is needed to counter this phenomenon. First, the public must be made aware of how they can be taken advantage of by crooks or sadists masquerading as holy men. Superstition and gullibility must be countered at every level for they affect the rich and poor alike. Secondly and more importantly, the role of the pir in the perpetration of violent or criminal behaviour must be recognised and treated as collusion in or incitement to a crime. The pir in the Karachi case may have been a figment of the couple’s imagination, but there are too many real pirs at work in the country.

Violence in Karachi

Interior Minister Rehman Malik stated on Friday that there are no similarities between the situation in Karachi and Swat. This statement of the obvious is in some ways the best response by the authorities to the recent spate of violence in Karachi.
Acknowledging that the dynamics of violence are locally defined and steeped in histories and circumstances particular to certain places and events is the first step towards effectively maintaining peace and stability.
Karachi has a long history of ethnic conflict, sectarian violence, land mafias and intra- and inter-party tensions. All these have been in play during this past fortnight, making it abundantly clear that a discerning approach to Karachi’s violence is required. Policing and investigations into recent incidents must be informed by knowledge of ‘local’ social, political and economic factors, which in this city of 18 million differ from locality to locality. For that reason, the MQM’s request for the Rangers, the army and intelligence agencies to maintain law and order in the city is akin to slapping a band-aid on a deep, infected wound.
Violent incidents since the last week of December have confirmed that Karachi is facing a hydra-headed threat. Rather than work towards tearing apart the different types of violence and addressing each systematically and comprehensively, the authorities are operating in a muddle.
The Ashura blast which had apparently been claimed by the Taliban was denied by the latter. On Friday, Malik linked Jaish-i-Mohammad, Lashkar-i-Jhangvi (LJ) and Jundullah with that attack. Earlier in the week, an FIA report had claimed that a new militant group was responsible for the blast. Even as it became clear that the Taliban may not have been involved in the Ashura attack, US ambassador Anne Patterson announced a grant of Rs1bn for affected traders, all the while decrying the Talibanisation of Pakistan.
A similar confusion prevails regarding the actors and reasons behind the killings of several people in the last few days. Political parties in Karachi have been asking the Sindh government to intervene and prevent targeted political killings, of which there have been over 250 in the past six months. Malik, meanwhile, has accused ‘actors’ not affiliated with political parties of trying to fracture the ruling coalition. With particular reference to violence in Lyari, Malik has dismissed it as a familial dispute surrounding a girl’s ‘illicit relations’ while city government officials have pointed to long-running gang warfare in that area. For their part, the police, in many incidents, claim no knowledge about the perpetrators’ identities, motives or their access to arms.
Complicating this scenario is Friday’s Baldia Town blast, possibly related to a Manawan-like attack on a police academy, which indicates that militants with ties to the TTP may be operating in Karachi (interestingly, LJ and Sipah-i-Sahaba stickers were retrieved from the site). The fact is, since June last year, when one of Baitullah Mehsud’s aides was apprehended, the police have been detaining TTP-linked militants in Karachi with some regularity. However, the criminal investigation department (CID) officials have been careful to reiterate that the situation here is murky, with many militant groups uniting under the Taliban banner and drawing recruits from Urdu-, Pushto-, and Punjabi-speaking communities as well as the Bengali community.
Given this complex situation, the authorities’ responses to violence seem poorly thought out. It was recently proposed that the Rangers be given powers to detain suspects implicated in violent incidents for up to 90 days under the Anti-Terrorism Act. This measure coupled with the MQM’s invitation to the paramilitary force to control Karachi could lead to arbitrary arrests and prolonged detentions. These would further fuel resentment among the local population rather than address the city’s disparate causes of violence.
Similarly, Malik’s warning to illegal immigrants to promptly vacate Karachi seems like an ad hoc, knee-jerk reaction. Most unregistered migrants to this city — including Afghans and Bengalis — have been here for decades and have nowhere to go. Moreover, they cannot be held solely responsible for the recent violence, especially in the light of intra-party disputes and the CID’s evaluation of broad-based militant recruitment.
No doubt, all illegal labour in Karachi should be documented, but that process must be systematic and gradual. Despite an ongoing initiative under the Foreigners Act, only 78,000 of the city’s 250,000 Afghans have been issued ‘proof of residence’ cards. Afghans and Bengalis regularly complain that they are harassed and discriminated against when they apply for registration. And the papers of documented migrants are regularly dismissed as fakes. The government will have to address the flaws in its registration system before issuing ultimatums.
If anything, by placing the burden of Karachi’s problems on its two million migrants (who will now find themselves forced out of jobs and persecuted), the authorities are creating a larger community of disaffected, marginalised and jobless Karachiites, all the more prone to violence for a host of separate socio-economic reasons.
Some of these misguided solutions are explained by the city government’s reliance on the federal and provincial governments and federally overseen paramilitary force to solve Karachi’s problems. National bodies cannot address disturbances that are local and particular to Karachi (and, indeed, its unique localities) as effectively as the city government and capital city police.
Rather than depend on an interior ministry committee, based at the National Crisis Management Cell, to investigate charges of targeted killings in Karachi — or even continue calls for a Supreme Court commission to investigate the Ashura blast — the city government should prioritise expanding, training and equipping Karachi’s police force and revamping the flawed Police Order 2002.
The very term ‘policing’ implies systematic scrutiny at a minute, street-by-street level. Stationed in particular localities, police officials — far more than army or paramilitary forces — are in a position to develop understandings of hyper-local communities, identify stakeholders, map criminal trends, and thereby launch effective investigations and help inform sophisticated policymaking. As such, better policing is the best, long-term antidote to urban crime and chaos.

Tourism policy 2010

THE government has said that the National Tourism Policy 2010 is on the anvil. One hopes it will be unveiled soon. The fact is that there is a lot of potential for tourism in Pakistan if it is properly tapped, given the rich cultural, archaeological and natural heritage the country possesses. These have drawn travellers from all over the world, and can attract more if the tourism infrastructure is efficiently organised and vigorous promotion campaigns are launched. Tourists, although greatly reduced in number, have continued to visit this country in spite of a weak tourism strategy and the dangers of terrorism. It would be criminal now to neglect this sector. The number of foreign tourists entering Pakistan grew steadily in the years 2003-06 when it touched a record high of almost 900,000. Thereafter it has been on the decline. Earnings from this source fell from $260m in 2006 to $243m in 2008. It is, therefore, an encouraging sign that the government is seeking to rebuild the infrastructure destroyed by conflict — especially in Swat — and is offering incentives. Since there are many areas that are relatively secure, such as the Kalash valleys, Gilgit, the Galiyat, the archaeological sites of the Indus valley, the Gorakh hill station and the beaches of the Arabian Sea it is important that the new policy focus on them to give a new fillip to tourism in Pakistan. The strategy should aim at bringing domestic tourism in its loop by promoting modest travel costs and adequate board and lodging facilities. The revival of tourism can offer many advantages apart from the increased economic earnings it would fetch the country. A rise in the number of tourists coming from abroad would help improve the country’s image. Both domestic and foreign tourists would also boost the sectors related to tourism, such as local crafts and the catering industry.

A doctor’s duty

Huma Wasim Akram, Imanae Malik and Faiz Muhammad Khan. The tragic and untimely death of each has sparked a vehement debate on the state of the medical profession in Pakistan.
While the National Assembly and the courts try to ascertain the cause of each death and the media clamours for accountability of doctors, the toll of accidents and deaths at the hands of doctors continues to rise throughout Pakistan.
Hearing these reports the average Pakistani planning to visit a doctor fears for his life, wondering perhaps whether the doctor will cure him or maim him or kill him. It is fair to ask, if this person is irrational and expects too much, and the only way to answer this question is to examine the nature of the duty a doctor owes to his patients and to consider means through which the law can compel him to perform it.
The first and most succinct formulation of the duty owed by a doctor to his patients is contained in the Hippocratic Oath written in Greece sometime in the fifth century BC by Hippocrates, the man recognised as the father of western medicine: “I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.” Although the language of the oath has evolved through the ages, its essence remains the same and continues to guide modern medical ethics throughout the world.
This duty has been recognised by law as a doctor’s (and other medical practitioners’) ‘duty to take care’ and applies irrespective of whether he has signed a contract of service with the patient, incorporating or excluding such duty.
The underlying assumption is that a person who offers medical advice and treatment implicitly states that he has the skill and knowledge to do so, to decide whether or not to take the case, to determine the nature of the treatment and to administer the treatment. If, therefore, in his treatment, a doctor deviates from accepted standards of practice and causes injury to or death of a patient he is guilty of professional negligence and liable to pay damages to the patient or his heirs.
The law on medical negligence has developed considerably in the West where doctors maintain professional liability insurance to offset the risk of claims brought against them for professional negligence. Across the border, Indian doctors may also be held liable under consumer protection laws (unless they have provided the service free of charge), or under the general civil and criminal law. In all instances, however, a doctor can only be held liable if the person suing him succeeds in proving — or the situation is so clear that it speaks for itself — that the doctor is guilty of a failure that no doctor with ordinary skills would be guilty of if acting with reasonable care. Doctors cannot, nor are they expected to, guarantee either their skill or the outcome of the treatment. All they can do is act with reasonable care.
In Pakistan, the law relating to medical negligence is at a nascent stage and the concept of professional insurance for doctors almost non-existent. The few cases decided by the high courts endorse the duty owed by a doctor to his patient. Of particular interest is Justice Mushir Alam’s judgment in the case of Mrs Rahat Ali v. Dr Saeeda Rehman in which he states, “a … doctor is to take all due care, take necessary precaution, give proper attention while extending advice, treatment or when operating upon”.
He goes on to state, however, that “[in the case of doctors] general presumption is attracted that they have performed their duties to the best of their abilities and with due care and caution [unless] it is established through cogent evidence that [they]…failed to take necessary precaution, due care and attention or acted carelessly and negligently”.
A judicial opinion such as Justice Mushir Alam’s offers some hope to the patient and his heirs: if a person suffers at the hands of a doctor, or dies due to the treatment, he or his heirs may sue the doctor and claim damages either from the doctor or from the hospital or clinic that employs him. However, the rigours of litigation are such that only educated and reasonably affluent urban dwellers are likely to venture into it whereas others would find themselves at the mercy of doctors and, worse still, of quacks masquerading as doctors.
One solution is to enable persons to seek redress through consumer courts, as is being done India. These courts are located in smaller districts and a person may appear before them without a lawyer. Here too, however, he would still need to establish that the injury or death was a result of an act or omission of the doctor. It is unlikely that a layperson would be sufficiently savvy or have access to necessary materials, to make the legal connection between the outcome, of which he complains, and the treatment he was given.
In any event, redress through the courts is a remedy after the fact and offers little comfort to a person facing the prospect of losing a limb or his life. Therefore, more important than allowing greater access to courts and enhancing the penalties for negligence is to take steps to prevent negligence from occurring in the first place.
Perhaps this calls for reform of the Pakistan Medical & Dental Council Ordinance 1962 to ensure that the council is a lean, efficient and independent body run by medical practitioners for the benefit of the profession and the public and which is diligent in improving the standard of medical education, training and licensing throughout Pakistan. At the very least the power of the council to restore the licence of a medical practitioner once it has been revoked needs to be carefully reviewed to eliminate any potential of abuse.
While recognising not only that doctors owe a fundamental duty of care to their patients but also that there is need to reform the present legal framework of the profession, it is essential to ensure that the focus of all reform is on distinguishing those doctors that act in good faith and to the best of their ability from those that are negligent, rash or reckless and on punishing only the latter with appropriate and objective severity. A solution lacking this balance will drive out any good doctors that may still remain in the country and leave the field open to their less vigilant peers to play with the lives of patients according to their whims.