The Real Face.....????

Crippled and Blind

The media should have been reporting – and celebrating – the eradication of polio from Pakistan years ago. We were almost polio-free as recently as three years ago, whereas today this dreadful and entirely preventable disease is spreading fast. It has just got a major boost in its bid to blight the lives of our children courtesy of the Tehreek-e-Taliban Pakistan (TTP) which on Sunday ordered all non-governmental organisations (NGOs) to immediately leave the Swat valley, including those agencies working on polio eradication. The TTP spokesman Muslim Khan said, “They come and tell us how to make lavatories in mosques and houses. I’m sure we can do it ourselves. There is no need for foreigners to tell us this.” When asked why the TTP was against polio vaccination, Khan said, “The TTP is against polio vaccination because it causes infertility” – thereby reiterating the old and entirely-without-foundation myth in the Muslim world that polio vaccination is some sort of vast western conspiracy to emasculate and impoverish Muslim nations. He concluded by saying that he was against any operation run by NGOs and that the polio vaccine was imported and therefore could not be trusted.

Membership of the comity of nations brings with it certain responsibilities. If we consider a nation as an individual, and that individual has a nasty communicable disease, we would not associate with them and would not appreciate attempts by our neighbour to infect us. This is precisely what happened in Nigeria in 2004. The Muslim northern states of Nigeria refused to participate in polio eradication programmes for the same reason that Muslim Khan is refusing to allow EPI teams into Swat. A rapid and catastrophic consequence was that polio quickly broke out, herd immunity in Nigeria was lost and neighbouring states were quickly infected. Benin, Burkina-Faso, Ghana, Nigeria and Togo, all polio free, were placed at risk and then quickly infected. They ‘caught’ polio from Nigeria because parts of that country refused to get themselves vaccinated. It took years and millions of dollars to bring the outbreak under control again. We now run the risk of doing precisely the same as Nigeria did to its neighbours. A viral reservoir will be quickly built up in Swat; herd immunity is probably already lost, and given the mobility of populations in that area the almost inevitable result is that the virus will find a ready means of travelling across borders, both national and provincial. The blindness of the likes of Muslim Khan is going to needlessly cripple the lives of many.

Let’s make use of these beautiful spots!

Pakistan has many pretty spots dotted all over the countryside that can be turned into attractive sites for domestic tourists to visit, either because they are attracted by their physical features or because they want to spend some time in the peaceful surroundings.

Many people, who live in urban areas where a concrete jungle is the only ‘jungle’ that can be seen for miles on end, like to get away for a while and drive to greener areas to spend a few hours soaking in the soothing sight of trees and grass.

Some of these areas can be turned into camping sites with facilities like a levelled piece of land to set up a tent, toilets, water for drinking as well as its usage for other purposes, and an outlet to buy essential items that might be needed in case they have not been brought along by the campers. These camping sites can be handed over to private entrepreneurs to run on their own terms and expertise, as anything run by the government eventually becomes a victim of neglect because of a ‘couldn’t care less’ attitude by the caretakers.

Where camping sites are not viable, these pretty places can be turned into clean and safe picnic spots that do not require too much effort or spending of huge amounts of money. A few benches and tables made of concrete - so that they are not stolen by thieves and drug addicts - with grass and bushes trimmed and kept that way, and you will have an attractive place for those who want to enjoy a picnic in peace. There are many such sites in Virginia and on weekends, where you can usually see many people out enjoying the fresh air in spite of the fact that most houses over there have a lot of greenery. They look for a change of scenery rather than a change from looking at the stone and bricks of a concrete jungle!

The site in the picture is located outside the limits of Rawalpindi city but within its district, just off the main highway, and like many similar spots to be found all over, its banyan tree is what draws your attention from a distance. These trees are hundreds of years old and can still be found outside the pale of developed areas where they have been chopped down to give way to highways and motorways. It’s a quiet place but has some garbage lying around, probably dumped by civic authority dumpsters, which is annoying but can be remedied if the spot is taken care of.

Youngsters ‘most prone to religious indoctrination'

Khalid Khan, President Centre for Research & Social Studies (CRSS), has said that the current drift towards political instability and gradual proliferation of obscurantist views in vast segments of society warrant an urgent intellectual intervention.

He was delivering a presentation on ‘Youth Radicalisation & Militancy’ as part of a seminar on ‘Societal Violence & Militancy and its Impacts on Youth’ organised by Youth For Change (Y4C), in collaboration with the Community Appraisal & Motivation Programme at the conference hall of the District Government Mardan Building.

Khalid Khan said we need an urgent intellectual intervention and an informed debate within the society to trigger a critical and conscious debate on fundamental religious issues. He emphasised the need to wean the people away from using their religious ideology as a political tool and should rather use it as a tool of knowledge.

He said the horrific acts of violence in Mumbai and the attacks on the Sri Lankan team in Lahore clearly established the undeniable link between youth, small arms and terrorism. “These incidents also highlighted the outreach of those non-state actors, who are out not only to destabilise states but are also capable of bringing states to the brink of war,” he said.

Youngsters, he said, are the most prone to fall pray to the ideologically-fired non-state entities whose educational institutions are providing the basic inspiration to tens of thousands of young people all over the country. “If we look at the people involved in criminal or terrorist activities, they are predominantly very young, usually aged between 15 and 25,” he said adding that the poor socio-economic conditions deliver these youngsters into the hands of criminal gangs or militant groups.

Religious indoctrination also lures scores of educated youngsters from affluent families into the ranks of Jehadi networks, he said and urged that all state institutions and civil society must intervene at whatever level they could to prevent the youth from falling pray to extremists.

Wasted opportunities

The largest contiguous irrigation system developed during the British Raj within the Indus River Basin became a victim of the partition, as many of the canal head-works remained with India. The ad-hoc division led to a serious water conflict, when India stopped the water supply to Pakistan on April 1, 1948.

The World Bank played facilitated diplomatic negotiations between India and Pakistan, backed with technical expertise. The resulting agreement, known as the Indus Waters Treaty (IWT), was signed in 1960. Under this treaty, Pakistan obtained exclusive rights to use 135 million acres-feet (MAF) of water of the Indus, Jhelum and Chenab. India retained the rights to use 33 MAF of the three eastern rivers: Ravi, Beas and Sutlej. The Bank also created the Indus Basin Development Fund (IBDF) of $895 million for Pakistan to develop dams and link canals on the three western rivers. (India contributed $174 million to the IBDF.)

Under a comprehensive master plan for the utilisation of its allocated share of the water, India constructed link canals and dams having a storage capacity of 17 MAF. In Punjab state alone, this led to the sown area increasing by 54 percent. Canal water supply was supplemented by simultaneously installation of tube-wells supported by power supply through hydroelectric projects on the rivers. Punjab and Haryana, once deficit in food grain, emerged as India’s “‘bread basket” in the mid-1970s.

In Pakistan, on the other hand, poor water policies led to salinity and water-logging problems. Meanwhile, due to high sedimentation, the three dams on the Pakistani side have seen their storage capacity reduced to from 16 MAF to 12 . At the same time, Pakistan allowed 35 MAF of water to escape into the sea every year. Pakistan’s ratio of storage to water flow is only 11 percent, against India’s 52 percent on the allocated eastern rivers.

India has a hydropower potential of 150,000 megawatt and is ranked fifth in the world. With the focus of India’s hydroelectric policy on the eastern rivers, the country has developed hydroelectric projects of about 12,500 MW, or almost 80 percent of the total potential of the eastern rivers basin. These hydro projects are mostly in Himachal Pradesh, which is now ranked as the second-richest state because of its supply of cheap hydroelectric power to other states. (In contrast, the Brahmaputra Basin, which has the potential of 66,000 MW, has remained relatively untapped because of India’s priority to the harnessing of its western rivers.)

After the IWT, India achieved the capacity of 4,181 MW on the River Beas alone, which is only 470 kilometres long. In comparison, the Pakistani rivers yield only 5,200 MW, against the identified potential of 38,000 MW. In 2002, the date for completion of projects having the gross capacity of 1,350 MW was fixed as 2006 by the ministry of water and power after deliberation two-and-half-a-years. But after seven years since then only one hydropower project, of 81 MW, was added. Pakistan faces a severe energy crisis, but instead of accelerating the pace of on-going hydropower projects, it is going to buy electricity from IPPs (independent power plants). IPP thermal plants are the most expensive option and have a high environmental cost. WAPDA has to buy electricity from IPPs at the Rs16 per unit while hydropower hardly costs Rs0.60 per unit.

The Planning Commission and the implementing bodies have delayed the development of hydropower, and given advantage to India on the Indus basin. According to the IWT, the country, which first completes its project on a river will get the complete rights of that river.

India’s planning commission has prepared a roadmap for acceleration of economic development, with a 50,000 MW hydroelectricity initiative and a plan to develop 16,000 MW in Kashmir on the western rivers of the Indus Basin. According to IWT annexes India can store water on its western rivers for several purposed, including for hydropower, but only up to 0.40 MAF on the Indus, 1.50 MAF on Jhelum and 1.70 MAF on Chenab basins. Nevertheless, this overambitious plan can potentially lead to conflict between the hostile neighbours. Talks to clarify such sticky issues are essential.

To settle disputes promptly, the Indus Water Commission (IWC) was established in both countries in accordance with of the treaty and its annexes. The objective of the commission is to provide a platform for better coordination and exchange of all hydrological data. This includes daily discharge data of river and tributary flows at all observation sites, daily rainfall, snow, and data of irrigated cropped area as defined in the catchments of the three western rivers in Indian Held Kashmir. The commission has been given the right to determine its own procedures for building trust. Unfortunately, even after 49 years this institution has failed to build the capacity to settle the disputes and to develop a fair, transparent mechanism of enforcement of the treaty.

The IWT has been a success, despite the ongoing rivalry between India and Pakistan. With water becoming increasingly scarce, it is essential to transform the commission into a well-endowed and effective technical body. It must reinforce real-time monitoring technologies to check the status of water quality and for quantity use of satellites to supplement ground information. Satellite altimetry technology is widely used now to measure surface water quantity. In Strymonas River basin that is shared by three European countries, the quantity of water for irrigation system is measured with the help of modern technologies, including satellite imagery analysis, to optimised agriculture production.

The World Bank had proved an honest broker in the IWT. Even today, the Bank supports a series of trans-boundary water issues with diligence and unbiased reporting for all stakeholders of shared waters, particularly in the establishment of the Nile Basin Initiative (NBI) and Danube River Basin. The NBI is sharing substantial socioeconomic benefits for promotion of regional peace and security among ten most water deficient and poor African countries depending on the Nile River. Bank has also developed a shared vision programme that focuses on building institutions, sharing data and information and providing training to develop water utilisation capacity. International bodies such as the World Bank ought to help rebuild the Indus Water Commission to build the trust and to avert any serious conflict between the two atomic powers.

Conserving water

In recent years the water crisis has emerged as a challenging reality that reflects severe problems and issues in the global context which will intensify unless proactive measures are taken to address them. The water problem is two fold, first there are standing environmental challenges in terms of water pollution, scarcity, and drought, and second, there are water crises in terms of international dispute over water right and use because of transboundary geographical extent.

Given the extent of transboundary river basins as well as transboundary groundwater resources and freshwater aquifers that cater for the needs of rural and urban communities over the globe, there are 263 transboundary lakes and river basins in 145 countries forming about half of the earth’s land surface. This has also rendered conflicts and issues volatised between states over water which need to share responsibilities and opportunities for cooperation and collaboration through transboundary equitable water management.

The Indus basin has transboundary location in Pakistan, India, China, Afghanistan and Nepal. The extensive glaciers of Himalaya, Hindukush, and Karakorum occurring in Pakistan, Nepal, Bangladesh, Bhutan, India and Myanmar serve as the major source of freshwater to people in China as well as South and Central Asia who derive a wide range of benefits from them such as irrigation, hydropower, drinking, daily consumption and transit. Water loss and mismanagement of this invaluable natural asset would herald water scarcity and food shortage affecting economic activities, agriculture and millions of people who depend on this resource in these countries at large. Similarly in Europe the Danube River is in a watershed that includes eighteen countries – more than any transboundary basin in the world.

Sharing the responsibility to manage transboundary waters for current and future generations has global implications and potential for prevailing peace and harmony in the world. The world’s available freshwater that transcends most political and administrative boundaries must be shared among and between individuals, economic sectors, intrastate jurisdictions and sovereign nations, while ensuring environmental sustainability.

Nonetheless, growth of economy and needs of human population have played leading and major driving factors of tension, conflicts and disputes over water within countries. Water-related conflicts and contestations may lead in the near future to water wars both in the developed and developing worlds. Because of its importance water has assumed geo-political status which is an essential instrument for economic and social development in the world.

Because of its diversified uses and extreme importance in our daily life, it is imperative to conserve water. We cannot imagine survival on the face of earth without water, whose consumption has almost doubled in the last 50 years. As a matter of fact, of the total water 97.5 per cent is in ocean, 2.5 per cent is freshwater (of which 68.7 per cent is in the form of glaciers, 30.1 per cent ground water, and 0.8 per cent permafrost), and surface/atmospheric water is 0.4 per cent (of which freshwater lakes constitute 67.4 per cent, other wetlands 8.5 per cent, soil moisture 12.2 per cent, rivers 1.6 per cent, atmosphere 9.5 per cent, plants and animals 0.8 per cent).It is our moral obligation to take care of this comparatively little available freshwater quantity of life-supporting resource, because there is no alternate option to switch over to such a free natural gift at all. It’s unethical to have this portion of the available water polluted and contaminated by and large.

Both quality and quantity of water is extremely indispensable for human health, animals and plant life. Water pollution and water-related diseases are not uncommon in developing countries because of poor institutional and structural arrangements for the treatment of municipal, industrial and agricultural waste. In developing countries inadequate access to water contributes to people’s poverty, affecting their basic needs, health, food security and basic livelihoods. Bettering the access of poor people to clean water would potentially contribute towards poverty eradication, good health, and uplift of livelihood of local people.

There is an intense need to conserve water resource for ourselves and millions of other ecological entities on the face of the earth. There is a saying that what we do on earth is mirrored in the water. It is the task of governments, environmentalists, conservationists, planners, institutions and, in fact, every individual to prudently mange and conserve water resources.

TB remains rampant in population

( The disease kills 4,400 people per day, two million people annually worldwide )

Tuberculosis (TB), the second leading cause of death from infectious diseases in the world, remains a major health challenge in Pakistan.

Even though Pakistan has achieved 100% DOTS (Directly Observed Treatment, Short Course) coverage, 80% case detection rate and 87% treatment success rate, the country still ranks 8th globally among the 22 high burden countries, and contribute 43% of the disease burden towards the Eastern-Mediterranean Region of World Health Organisation. In Pakistan, nearly 1.5 million people suffer from TB where as more than 300,000 new cases add up to the country’s escalating TB burden every year. The TB incidence in Pakistan is reported at 181 per 100,000 persons.

Health experts say that every year, thousands of people die of a disease, which is completely preventable, and 100 per cent curable. A large number of people, though infected with the TB bacilli, do not get diagnosed, either because of poverty, or lack of awareness about the seriousness of the disease, they say.

World TB Day falling on March 24 each year is designed to build public awareness that tuberculosis remains an epidemic in most part of the world, causing deaths of several millions people each year, mostly in the third world. ‘TB Se Nijaat, Naujawanon Key Saath’ (Getting rid of TB with the help of youth) has been devised slogan for the year 2009, along with 2008 slogan, ‘I Am Stopping TB’ to sensitise the younger generation to make efforts against eradication of the disease. Youth are the prime target of TB control in Pakistan where 70% of new TB patients belong to productive age group between 14 to 49 and 30% belong to the age group 14-24”.

63 per cent of total population of Pakistan consists of young people aged less than 25. According to WHO estimates, one third of world population is infected with TB. Someone in the world is newly infected with TB bacilli every second. Every year nine million people develop TB worldwide, more than 95% of which are in the developing countries. TB kills two million people annually, or 4,400 people per day. TB is the leading cause of death among people living with HIV.

There is a dire need to increase awareness among general public and especially among youth through mass media, TB weeks and advocacy seminars and to spread the message that TB is preventable and curable. “The WHO is working out to cut TB prevalence rates and deaths to half by 2015,” multi-drug resistant TB (MDR-TB), extensively drug-resistant TB (XDR-TB), HIV-associated TB and weak health systems are major challenges being confronted by countries in third world including Pakistan.

According to official data, women and children are most vulnerable to Tuberculosis. In 2001, the government of Pakistan declared TB a national emergency. If left untreated, one person with active TB might infect 10 to 15 people during one year.

TB is a disease of poor. “Malnourished, diabetics, smokers, prisoners, elderly, HIV infected individuals, healthcare workers, alcoholics and close contacts of infectious TB patients are at high risk to develop TB”.

General public should be educated that TB is spread from person to person through air. When infectious TB patients cough, sneeze, talk, spit, they propel TB germs into the air. When healthy persons inhale the air, they become infected. TB is not spread through casual contact, utensils, eating together, shaking hands, sharing clothes, bed sheets, books, furniture, marital relations and it is not an inherited disease, he said.The main symptoms of disease are persistent cough for more than three weeks, low grade fever (evening pyrexia), coughing up blood, night sweats, loss of appetite, loss of weight and feeling of tiredness all the time.

“If somebody has these symptoms, he/she should report to the nearest Health Centre/Government Hospital or TB centre and get his sputum tested free of cost,” if somebody is diagnosed with TB, he/she should not get upset, because TB is now 100 percent curable. “TB should be cured in order to stop TB.”

Patient should take anti-TB drugs as advised by the doctor under the supervision of health worker/some responsible person for eight months without interruption. The anti-TB drugs can be obtained free of cost from any healthcare centre, government hospital or TB Centre. Free diagnostic and treatment services are available at 5,000 public health establishments throughout the country.

Patient should not leave treatment without advice from a qualified doctor. “During anti-TB treatment, mother can also breastfeed her child. Patients should not be stigmatised and must receive full support from family and community. TB patient can lead an active normal life after receiving full course of treatment,” however, current default rate in Pakistani TB patients is still 11%, which leads to Multi-drug resistant TB (MDR-TB) and in some cases extensively drug-resistant TB (XDR-TB), the most dangerous form of TB with no treatment. “Remember! Complete TB treatment is the most effective means of TB prevention.”

On preventive measures, it can be prevented by BCG (Bacille Calmette Guerin) vaccination and by awareness raising campaigns on mass scale. “TB patients should be advised to cover mouth while sneezing or coughing and not to spit on different spots. Newborn infants must be immunized against TB with BCG vaccine immediately after birth.”

It is important that National TB Control Programme (NTP) has engaged 500,000 youth volunteers and students all across country to spread the basic information about various aspects of the disease.

Fighting TB means fighting poverty, treating patients so that they can resume work, reducing stigma, ensuring affordable access to drugs and promoting advocacy so that patients can have a voice. “With the will, the funds and the action, together we can Stop TB!”.