Private investment in the health sector is imperative, because the government does not have the resources to cater to related needs of all the population
By Dr M Javaid Khan
The recently-constituted Health Policy Task Force has notified a working group on health care financing to devise a policy for raising sufficient and sustainable revenue, which will be included in the forthcoming Fourth National Health Policy. A proper health care financing policy, which is the mechanism of raising and pooling money for health expenditures, is central to performance, because it affects the resources available for quality and equity of access.
This article, therefore, attempts to contribute to the policy through analysing the issue, clarifying the concepts and putting forth recommendations. It is particularly relevant in the context that no health care system, whether privately- or publicly-financed, can afford to pay for every service it wishes to provide. For instance, even 15 percent of the United States' huge gross domestic product (GDP) is unable to provide health services to its entire population of about 300 million; and 45 million Americans have no access to health cover.
But why discuss financing of health care? Why not leave health care services to the market mechanism? We buy tomatoes, groceries, and television sets from the market, but we do not discuss methods for their payment. A buyer is free to choose certain commodities and pay for them. What makes health care different that warrants scientific debate, especially in Pakistan where 75 percent of the health expenses are borne by the patients themselves? Let us first briefly look into the peculiarities of health care financing market that makes it obligatory for the government to intervene to save the patients from the ravages of market phenomenon!
Direct expenditure on medical care has been proved to be one of the major causes of families drifting into poverty. Illness brings poverty and poverty eradication is now the goal of every civilised country. Private markets fail to look after population's health, thus resulting in increasing poverty. Pakistan Safety Net Survey 2005 found that among different shocks, health-related shocks were the most common -- constituting 55 percent of all the shocks, and triggering very high losses and coping costs. Coping with a health shock cost families Rs13,000 on average in health care costs and lost income, while the average cost/loss resulting from economic and agricultural shocks was Rs7,700 and Rs12,300, respectively.
Not only that health is considered as a basic human right, a good investment in health has been proved to be the foundation for social and economic development through increased worker productivity and improved utilisation of natural resources. It is also am investment in our future generations, because health enhances enrollment of children in schools and improves their learning abilities. An interesting phenomenon that economist describe is that of supplier-induced demand.
If we want to buy a computer or a pair of shoes, we know what our needs and resources are and decision is made accordingly. But in the case of health, it is the physician who decides what we need and what is good for us. The only way a patient can know whether he or she needs to see a doctor is to actually see a doctor. This lack of information by the patient has the potential for exploitation by the providers through over-servicing. These peculiarities distinguish health care from other commodities. But this brings us to second question: what is the problem with existing system of financing -- the government raising money through general taxation?
Government health facilities in Pakistan are currently financed through general taxation money. This could be an equitable mode in developed countries, like Sweden or the United Kingdom, where the system is progressive ñ the rich pay more than the poor. But in developing countries, especially Pakistan, the taxation system is such that the poor pay more than the rich. The UK or Sweden does not have statutory health insurance (SHI), but these countries managed to establish a tax-based health financing system that Pakistan has failed to set up since its independence in 1947.
That is why Pakistan leaves 75 percent of the patients to out-of-pocket payments, the most inequitable of all health financing schemes. According to a Social Policy and Development Centre (SPDC) report, released in 2004, the poor pay more tax than the rich in Pakistan -- the poorest 10 per cent of the population contributes 16 per cent of its income in taxes, compared with 12 percent by the richest 10 percent. The taxation structure takes away from the poor and passes on to the rich, hence the growing rich-poor disparity.
Moreover, in Pakistan the tax base is very low -- only 11 per cent. On average, high-income countries maintain this ratio at 40 percent, middle-income countries at 25 percent and low-income countries at 18 percent. Reliance on tax money is also vulnerable to vicissitudes of changes in political priorities and annual budget formulation. Money to provide public services coming from taxation is invisible to consumers and, therefore, they do not see health services as a right but a privilege.
In addition, the subsidised health care services are primarily used by middle- and high-income households in urban areas, because of access problem for the rural poor. The poor tend to use less expensive local facilities, whereas the rich disproportionately use more expensive hospital services. With this backdrop, Pakistan should no longer dream of tax-based schemes, but look for viable alternatives to raise and pool funds to pay for health care in a sustainable, efficient and equitable manner. Since SHI is already on the agenda of the government, let us discuss it in detail!
SHI is a system based on principles of solidarity and shared responsibility for uncertain events, the rich paying for the poor and the healthy paying for the sick. Starting in Germany in 1883, it has rapidly spread to countries like Yemen, South Korea, the Philippines and Ukraine. In this system, the law requires employer / employee to pay a percentage of monthly wages for health to be paid to a SHI fund. The strength of the system is that not only the payments are earmarked for health, but the visibility of payment to consumers also empowers them. Besides social insurance fund acts as an effective and prudent purchaser of health services to gain public support, reduce cost and improve quality of health care.
SHI promotes good health by lowering the personal cost of services and also by inducing individuals to seek medical care earlier than they otherwise would, thereby heading off potentially serious consequences. The side benefit is that the government tax funds could be diverted to take care only of the primary health care services, which have to be the most important concern of the state. With the work of insurance companies not only job opportunities are created, but with the marketing approach the awareness regarding health in general public is also enhanced.
Often people tend to confuse private health insurance with SHI; the former usually being for-profit. Though private health insurance has its own benefits, it does not involve cross subsidy across income levels or health status. Because it is for profit; therefore with incentive for over-servicing it becomes expensive, thereby excluding the poor. The forgoing discussion makes an argument for exploring alternate modes to the tax-based and out-of-pocket financing of health care in Pakistan, which are adversely impacting the poor.
One approach could be defining an essential package of health services targeting the poor to be financed out of tax revenues, with rest of the services to be financed through SHI. Harnessing the potential of revenues of private out-of-pocket spending by directing huge sums into pooling arrangements of SHI provides an ideal opportunity. SHI is a decent, respectable and dignified way of providing safety nets to the insured people, while helping them through charity funds, such as Zakat, has the potential to hurt their self-respect. Private health insurance should be encouraged to give more choices to those who can afford, at the same time releasing pressure from the publicly-financed services, thereby indirectly benefitting the poor.
International experience suggests that it always started with the formal sector, followed by gradual expansion to the informal sector. Germany took 80 years to attain 99.5 percent population coverage and the Philippines achieved 65 percent population coverage in 35 years. As has happened globally, SHI could be started in Pakistan from the formal sector. In tandem with this, a card / voucher system could be launched for the poor and the marginalised groups. However, both should be implemented in such a manner that they ultimately merge into a universal SHI scheme.
writer is the senior technical advisor of GTZ-SHSR Project.
Merchants of death
If politics makes strange bedfellows, politics and drugs produce even stranger ones
By Huzaima Bukhari and Dr Ikramul Haq
The international drug mafia is estimated to be involved in a business whose total transactions cross $600-800 billion a year, according to Drug Report 2007, prepared by the United Nations Office of Drugs and Crime. The partnership between drug trafficking and national politics in many countries has taken a truly bizarre turn in the fight against the presumed threat to the capitalist system, roughly since World War II.
The history of control of drugs is seldom unfolded, because it can unveil the forces that actually helped the pharmaceutical industry to earn huge profits and helped spawn a whole generation of pill-takers hooked on drug-related habits. The Western civilisation has thrived on looting the colonies' wealth and imposing drug wars of the subjugated in the same way as in the post-colonial era they are waging economic warfare in the name of globalisation and the so-called 'war on terror', to promote arms and drugs trade and control oil and gas resources of the world.
Great Britain waged two wars in the mid-nineteenth century to force the entry of opium into China, which had banned it. It may seem strange and shameful that a mighty nation should have picked on a weak one and sided with the smugglers of a forbidden drug, but that is what the politics of drug trade is all about. A larger issue was, of course, the opening up of China for commercial purposes, but the immediate cause of war was opium.
It was not out of character for a colonial power of those days to rely on drug behaviour as a major source of revenue for its treasury, as the British colonial government did in India. Practically all colonial governments in the East did it and the practice continued until the dissolution of the colonies in the mid-twentieth century. The effect of such fiscal policies on the production and consumption of the drug concerned should be fairly obvious.
The United States early in this century took the lead in the attempt to stop the international traffic in opium, partly as a gesture to win over opium-plagued China for economic purposes. When heroin, an opium derivative made several times more potent by technology, was declared illegal in the US in 1914, it went underground and attained apotheosis as the most forbidden fruit. This opened the doors for elements of organised crime to get involved and start feeding the growing habit in the US and in Europe.
Then, after World War II, the US found itself having to defend an empire against rising challenges to its politico-economic system on the periphery. In turning back these challenges, the US more than once turned for help towards organised criminals and unpopular dictators who enriched it through illicit means, including drug trafficking. Pakistan is one such example. The US government spends millions of dollars annually to halt the flow across the border of illicit marijuana, heroin, cocaine, etc, and even to shut them off at the source in well-publicised campaigns.
These operations involve seizures worth billions of dollars, arrests of traffickers, death of drug smugglers and forceful crop eradication of the poor peasants in far away countries. At the same time, various agencies are in political partnership for the spread of the same drugs. Either the right hand does not know what the left is doing, or it does not care. Since the US-led invasion of Afghanistan in October 2001, the Golden Crescent opium trade has soared.
According to the US media, this lucrative contraband is protected by Osama, the Taliban, not to mention, of course, the regional warlords, in defiance of the international community. The heroin business is said to be "filling the coffers of the Taliban". In the words of the US State Department: "Opium is a source of literally billions of dollars to extremist and criminal groups. Cutting down the opium supply is central to establishing a secure and stable democracy, as well as winning the global war on terror."
The reality is otherwise. In fact, the US foreign policy supports the workings of a thriving criminal economy, in which the demarcation between organised capital and organised crime has become increasingly blurred. The heroin business is not "filling the coffers of the Taliban", as claimed by US government and the international community. Quite the opposite! The proceeds of this illegal trade are the source of wealth formation, largely reaped by powerful business / criminal interests within the Western countries.
These interests are in fact sustained by US foreign policy. Decision-making in the US State Department, the CIA and the Pentagon is instrumental in supporting this highly profitable multi-billion dollar trade, third in commodity value after oil and the arms trade. This is in the nutshell the crux of the so-called 'war on terror' being used as a tool to promote sales of arms and drug trade. The heroin trade is part of the war agenda.
What this war has achieved is to restore a compliant narco-state, headed by a US appointed puppet. The powerful financial interests behind narcotics are supported by the militarisation of the world's major drug triangles (and trans-shipment routes), including the Golden Crescent and the Andean region of South America (under the so-called Andean Initiative). Afghanistan produces more than 80 percent of the global supply of heroin and heroin represents a sizeable fraction of the global narcotics market, estimated by the UN to be of the order of $600-800 billion.
The proceeds of the drug trade are deposited in the banking system. Drug money is laundered in the numerous offshore banking havens in Switzerland, Luxembourg, the British Channel Islands, the Cayman Islands and about 50 other locations around the world. It is here that the criminal syndicates involved in the drug trade and the representatives of the world's largest commercial banks interact. Dirty money is deposited in these offshore havens, which are controlled by the major Western commercial banks. The latter have a vested interest in maintaining and sustaining the drug trade.
The history of so-called 'drug control' is more of a cosmetic war. During the last two centuries, the Golden Crescent has been the primary source of opiates supplying the world's ever-widening circle of addicts. The actual production sites within the long crescent have frequently shifted with the time and political tides. The 'centre' of opium production has alternatively flared up along the Crescent -- now in India, now in Pakistan, suddenly in Turkey, then Afghanistan and finally in China.
The politics of drug trade has made millions of people a most helpless lot. This is a war against the people and humanity. Our present day civilisation faces a great threat of annihilation if the rising tide of drug culture is not stemmed. Awareness alone can bring light to overcome the darkness caused by the drug traders, who are merchants of death and destruction.
writers specialise in narco-terrorism and global heroin economy.
A gory tale of domestic violence
By Abdullah Khoso
Ali Muhammad Themore, 22, was still persistent to stay longer besides her mother's grave in Ismail Themore village, about 50 kilometers to the south-west of Badin. He and four dozen other people -- including his maternal aunt, uncle and human right activists -- were waiting for the arrival of a board of doctors and police for the autopsy of Rahiman Themore, 45. But they did not turn up on the day and sent message to Ali, the son of Rahiman, that due to some personal problems they cannot make it and will now come on June 8.
Ali's hope for the justice had increased when after a month-long struggle the Badin Sessions Court judge had ordered not only the registration of Ali's first information report (FIR), but also ordered for the postmortem of his mother. Now with this gesture of medical board members, his hope has again changed into pessimism. "What if the doctors had come to examine my mother and had helped us to get justice," he says sadly.
Rahiman, mother of seven children, had died on April 22. "My father, Jumo alias Chitto, tortured my mother some months ago and did not let anybody to take her to hospital. As a result, she passed away on April 22," Ali informs. He adds that Chitto (which means 'mad' in Sindhi) had always tortured his mother in his absence: "I used to argue a lot with him and fought too, but could not save my mother. My father had placed a ban on my entry into our home."
Ali informs that when her mother died, his father did not tell anybody and buried her with the support of a few friends and relatives without any rituals. He tried persistently to get his complain lodged with the Shaheed Fazal Rahoo Police Station, but the concerned deputy superintendent of police (DSP) did not entertain him. One of the reasons for this was that the Chitto's brother, Adam Themore, is a worker of the ruling Pakistan People's Party (PPP). Besides his political affiliation, Adam is also famous for his criminal activities.
On May 30, after the Badin Sessions Court judge's order under the CRPC A&B, the DSP asked the station house officer (SHO) of Shaheed Fazal Rahoo Police Station to register Ali's FIR. Still the police have as yet not taken any action against the accused, who are free to harass those family members and human rights activists who want to bring them to the justice. Also, Rahiman's relatives have migrated from the village due to continuous threats from Chitto and other accused in the case.
In response to a complain from Ali and his maternal uncle, the Badin Sessions Court judge ordered the Hyderabad Director General Health on June 7 to form a medical board for conducting Rahiman's autopsy. On June 14, the DG formed a medical board comprising five members to examine the dead body on June 23, but this did not take place either and drove Ali to desperation.
Abida Jamali, a local human rights activist, says, "Rahiman's son Ali has been running from pillar to post to get the justice for the wounded soul of his mother." Abida adds that she has come across several physical torture and murder cases in the vicinity, but she has hardly seen anyone else pursue the case like Ali. "There is a dire need that all men join us to eliminate physical torture against women," she stresses.
Salam Memon, another social worker of the area, tells that physical torture against women is not uncommon in neighbouring villages. Women are tortured with punches, kicks and sticks. In his view, about 60 to 70 percent women in the neighboring villages are tortured. "We have been working to raise awareness about the rights of women, but it requires large-scale mobilisation. Rahiman's murder merited just a few words in the local newspapers," he laments.
About two years ago Pakistan became a member of the United Nations Human Rights Council, but sadly it has as yet not ratified its Convention against Torture (CAT). Only signing a convention does not make any difference and a lot of work needs to be done for curbing heinous acts taking place against women in our country. According to unofficial figures provided by the Lawyers for Human Rights and Legal Aid (LHRLA), in 2007 about 2,300 cases of violence against women were reported in Pakistan. Of these, 1,739 fell under the category of physical abuse, while 72 women were brutally murdered.
Rahiman's murder can be looked from two aspects. One, her son is determined to pursue the case irrespective of the fact that his father would go to jail as a result. Two, the system of getting relief and justice is very painstaking. Initially Ali struggled to get the case registered against his father, because the DSP did not entertain him. Finally, after an unremitting hue and cry, he got the case registered but even this seems to be of no use. "Chitto is openly roaming in the area for two months, but the police have not arrested him yet," Ali laments.
The tourism sector in Pakistan has not been provided with the incentives needed to realise its full potential
By Rahimullah Yusufzai
With violence spreading to newer areas in Pakistan and intensifying, the country's modest tourism sector has suffered a severe setback. The number of foreign tourists was already negligible but now even domestic tourism has declined, because Pakistanis too are afraid of visiting violence-prone and militancy-hit places, like the scenic Swat valley in the NWFP. In short, despite its huge potential, the tourism sector in Pakistan has failed to prosper because of the country's image as an unsafe tourist destination.
The situation was not that bad till the 1970s when Pakistan was part of the so-called 'hippie trail', and small-budget tourists seeking fun, adventure and drugs were able to travel safely across borders between India, Pakistan, Afghanistan, Nepal and Iran. The communist takeover in Afghanistan in April 1978 and the subsequent invasion of the country by the USSR in 1979 made the region insecure. This resulted in a drastic reduction in the number of tourists using this route to travel between Europe and Central and South Asia. The Islamic Revolution in Iran in 1979 led to further decline in the tourist inflow, because border controls increased.
The events of 9/11 made matters worse as the US invaded and occupied Afghanistan in 2002, and provoked the Taliban to launch a resistance movement that has brutalised the society and destabilised the region since then. Pakistan is increasingly suffering from fallout of the war in Afghanistan, because homegrown militants inspired by the Taliban are now able to strike at will. Suicide bombings have further damaged the country's image as a safe tourist destination. As a result, only the most daring foreign tourists now come to Pakistan.
The tourism sector in Pakistan has been a victim of neglect in the past. It took successive governments years to respond to demand by tour and travel operators and hoteliers to declare tourism as an industry, so that it could be offered incentives, tax holidays and official patronage. By the time tourism was finally declared as an industry a few years ago, Pakistan had already become unstable and violent and foreign tourists had stopped coming in big numbers. When the previous government declared 2006 as 'Pakistan Tourism Year' and fixed the target of luring one million tourists to the country, critics predicted that it was a tall order bound to fail. Time proved that they were right.
In 2007, another effort was made by then-Tourism Minister Senator Neelofer Bakhtiar, and a yearlong calendar of events was drawn up and publicised to attract foreign and domestic tourists. It was a commendable effort and all major tourist events taking place in the country -- from the northern mountainous region to the southern deserts and beaches -- were included in the tourism calendar. Some of the events, however, proved to be an exercise in futility due to the presence of VVIPs who need a lot of security, thus keeping away ordinary tourists and people.
Besides the poor law and order situation, other reasons that have kept foreign tourists away from Pakistan include inadequate infrastructural facilities, poor marketing, strange and obsolete legal restrictions, and the incompetence and lethargic attitude of tourism department officials. In addition, certain strange laws of the British era exist to this day; for example, the ban on taking pictures of archaeological and other historic sites. This annoys tourists who want to take pictures to carry home as mementoes. In short, it is clear that the government is not doing enough to promote the tourism sector in Pakistan.
In many respects, Pakistan's tourism potential has remained largely hidden and, thus, under-realised. With a vast area blessed with nature's bounty, the country can offer something to all types of tourists. Pakistan is home to some of the tallest mountain peaks in the world, including the second highest, K-2; archaeological treasure troves, such as Moenjodaro, Harappa, Mehrgarh, and Gandhara civilisation's Buddhist sites in Taxila, Takht Bhai, Jamal Garhi, Shahbaz Garha and Swat; beautiful lakes, including Haleji, Mangla and Tarbela; and architectural wonders, such as in Lahore, Multan, Peshawar, Hunza and Skardu.
Then there is the legendary Khyber Pass, linking Central Asia to South Asia; the Nawa Pass, through which Alexander the Great passed on his way to the Indian subcontinent, and the Silk Route, now exemplified by Karakoram Highway (KKH), an engineering miracle sometimes referred to as the eighth wonder of the world. Mountaineering and trekking in Pakistan's Northern Areas -- where Deosai Plains, Shangrila and many glaciers are located -- offer an attraction for the more adventurous foreign tourists. Similarly, trophy hunting of ibex, deer and mountain goats is an attraction for hunters from mostly Western countries.
Despite all this, most foreign tourists still find it risky to come to Pakistan. Figures show that only a few foreigners visit Pakistan for purely tourism-related purposes. To boost the figures, even those Pakistani diaspora living in the West and elsewhere abroad, and visiting their families and relatives in Pakistan during their annual vacations, are classified as foreign tourists. Also included in this list are Sikh pilgrims who visit their holy sites, such as Nankana Sahib -- where the founder of their religion, Baba Guru Nanak, was born -- and Panja Sahib in Hasanabdal.
In fact, most of the holiest Sikh sites are located in Pakistan. These places have a pull that brings thousands of Sikhs from India and elsewhere in the world to Pakistan every year. Their number has grown manifold since the easing of restrictions on travel between India and Pakistan, and the introduction of railway and bus service between major cities of the two countries. Still the true potential of tourist exchange between India and Pakistan has not been exploited.
Currently, insecurity is the biggest hurdle in the way of promoting tourism in Pakistan. Speaking at a recent promotional event in Ranikot, which boasts of the largest forts in the world, Sindh's former Chief Minister Dr Arbab Ghulam Rahim appealed to the people of the Jamshoro and Dadu districts to change their attitude and help put an end to the menace of kidnapping-for-ransom in the area, so that tourists could visit the famous forts in peace. He argued that this would generate income for their area and help the economy.
The heavenly Swat valley -- often referred to as the Switzerland of Pakistan due to its pleasant summer climate, rivers, streams and green mountainous locations -- has also lost tourists due to insecurity. A radical movement agitating for the enforcement of Shariah in Swat and adjoining districts of the Malakand division has made the beautiful valley insecure for both foreign and domestic tourists since the last few years. Late last year, the movement became violent and now Swat is facing an insurgency that 20,000 Pakistan Army troops are trying to put down. The soldiers are using gunship helicopters and long-range artillery guns to overcome Taliban militants, while the latter are resorting to suicide bombings and roadside explosions to target the troops and their allies.
The militants also tried unsuccessfully to dynamite the rock carving of Buddha in a mountainside in Swat. They were trying to emulate the Taliban in Afghanistan, who destroyed the two priceless Buddha statues in Bamiyan despite international outcry. Tourism was the mainstay of Swat's economy and all those dependent on it for their livelihood have been the biggest losers. Not long ago, newly wed couples from all over the country used to spend their honeymoon in Swat, and its peaceful conditions and friendly people were praised by all and sundry. Now many Swatis are migrating to Peshawar and other urban centres in search of peace, and for the sake of education of their children.
Similarly, the example of the Haleji lake in Sindh is pertinent in the context of neglect and poor infrastructural facilities. The lake -- called the "bird lovers' paradise" by the Duke of Edinburgh, Prince Philip, the former president of the Worldwide Fund for Nature (WWF) -- now is in a state of despair. A large portion of the lake is silted up, while a big part of it is covered by grass. The Haleji lake used to attract thousands of visitors when it was full of water. In winters, it used to host more than 100,000 migratory birds. But now the number of these birds has gone down drastically, because the water has dried up and infrastructural facilities have deteriorated.
The artistically and beautifully carved stones at the historic Makli and Chowkandi graveyards, also located in Sindh, also suffer from neglect. The stones have been defaced and are crumbling. Fortunately, the provocative and strange idea floated by a former Sindh culture minister was not put into practice; otherwise, the priceless cemetery in Makli would have been destroyed. He wanted rides and swing boats installed at the graveyard to entertain tourists, who would have normally come to see the rare carved gravestones had the infrastructure been better.
Ancient forests at hill-stations of Murree and Ayubia have been damaged by erecting chairlifts and buildings. The forest cover in the country is depleting due to the cutting of forest trees for use as wood in buildings and as firewood. This in turn deprives some of the summer resorts of the beautiful forests that lure tourists and keep the weather pleasant. It is obvious that Pakistan has failed to market and exploit its tourist potential. It has not been able to motivate foreign tourists or improve its image as a tourist-friendly destination. Therefore, a lot needs to be done to sell Pakistan as a country that is capable of offering protection to tourists and providing them the basic infrastructural facilities.
The Karakoram Highway has strategic significance for both Pakistan and China
By Sibtain Raza Khan
Despite the development of new communication linkages, traditional trade routes have not lost their significance and are still playing a meaningful role in enhancing regional trade cooperation as well as integration. Karakoram Highway (KKH), also referred to as Friendship Highway, continues to contribute significantly to overall Pakistan-China relations, not only in terms of trade and commerce but also at political and cultural levels. Therefore, the expansion and widening of KKH would not only boost trade cooperation between China and Pakistan, but would also augment bilateral relations at large.
The KKH is the highest international trade route and the highest paved international border crossing, connecting Pakistan and China across the Karakoram mountain range, through the Khunjerab Pass. The KKH passes through many paths of the ancient Silk Road, giving it a unique importance. It passes through hundred of villages and towns of the Northern Areas, and most of the road is overshadowed by towering barren mountains of Himalayas and Karakoram.
The strategic significance of KKH is that it cuts through the collision zone between the Asian and Indian continents where China, Tajikistan, Afghanistan, Pakistan and India come within 250-kilometre of each other. In this regard, this highway has a potential to play a meaningful role in regional trade cooperation. The KKH is also referred to as the eighth wonder of the world, because of its altitude and the difficulty its construction entailed.
Both Pakistan and China have started work on the expansion and widening of KKH through a joint venture worth $327 million that would significantly upgrade the highway and improve its capacity to act as a conduit for regional trade. The expansion and upgradation of 335-kilometre section of road from Raikot to Khunjerab would be completed by 2011. The planned upgradation would widen KKH from 10 to 30 metres, making it suitable for heavy and long vehicles and allowing it to remain functional throughout the year.
The expansion of KKH might be a step towards the realisation of the long-sighted prediction, made in 1894, of the imperial mountaineer, Martin Conway: "Gilgit must grow to be an important trade centre and, possibly, a railway junction on the line from India to Kashgar, where the Samarkand branch will turn off!" In this context, KKH have a potential to link Pakistan to China, Tajikistan and Afghanistan; and form an integral artery of the National Trade Corridor and a vital component of the Asian Highway Network.
A developed communication infrastructure is a pre-requisite for economic development of any region. In the case of the Northern Areas, an important geo-strategic location, a developed communication infrastructure needs to be made functional to transform the country into a true hub of trade. If this dream comes true, it would definitely alter the socio-economic condition of this region and make it a centre of trading activities.
Steps have already been taken to boost economic activities. The most important among these is the inauguration in 2006 of the Sust dry port facility near Pakistan-China border, a joint venture of the two countries. The port will bolster economic ties and help in enhancing Pakistan's trade and commerce linkages with other countries in the region, particularly China and Central Asian Republics (CARs). With improved communication linkages through KKH, the Sust port is likely to attract great trade activity.
There are also proposals for development of railway link along with oil and gas pipelines and a fiber optic communications link, in addition to the expansion of KKH, which would lead to enhanced economic cooperation and greater trade linkages. These economic activities have had a positive bearing on the political relations between Pakistan and China. The Chinese ambassador to Pakistan has reportedly said that his government would consider establishing a consulate in Gilgit. These steps will facilitate enhancement of not only trade but also tourism along the highway.
Despite the trade and economic benefits the expansion of KKH is likely to bring, there are apprehensions in some sections regarding certain negative implications that the project is likely to have. For instance, according to environmentalist Aziz Karim, geo-physical impacts of this project would be physical scarring of the landscape, increased \risk of land slippage, accelerated soil and rock erosion, alteration of soil quality by loss of top soil, and blockage of natural drainage.
The local people think that the project would bring new opportunities as well as risks. According to them, with increased accessibility and transport of goods, people and ideas, the Northern Areas would gain a lot; however, some social, environmental, cultural and economic costs are also associated with this opportunity. In order to address their concerns, there is a need to develop the capacity of natives, so that they can anticipate changes and assess risks. In addition, mitigation measures should be properly put in place to reduce the impact of these risks and challenges.
As far as strategic importance is concerned; KKH has historical significance for the 'new great game'. Till 150 years ago, this region was the most connected region with borders opened in all directions: Xingjian, Wakhan, Chitral, Kohistan, Taxila, Kashmir and Tibet. With the British colonialism and later the Cold War, all these borders were closes. After the construction of KKH, this region has the potential to once again become the hub of trade cooperation and attract international economic activity and foreign investment. The expansion of KKH will enable Pakistan to play its due role as a trade corridor, in both inter- and intra-regional trade, while also having positive implication for its economy.
With improved communication linkages, Pakistan will become a much more influential and important actor in various regional groupings. With improved communication facilities, economic interaction and trade interests of the member countries of these groupings will be better served through Pakistan. Different trade routes discussed for enhancing trade among member countries will benefit from an improved KKH. Therefore, the expansion and widening of the highway has broader implications for Pakistan's economy and the region at large.
The ongoing 'military operation' in the Khyber and other agencies has been completely rejected by a wide section of the society, because it clearly represents Washington's agenda
Aasim Sajjad Akhtar
As the situation in the tribal Pakhtun areas worsens, a clear divide has emerged within progressive circles as to the appropriate response to the conflict. At the heart of this divide are contrasting perspectives on the recent geo-political history of Pakistan and the wider region, and how it affects the present. Needless to say the impact of divergent historical perspectives on political positions is considerable, and which of the two major perspectives wins out will determine which political position progressives should take on the matter.
In short on one side of the divide are those who say that the biggest enemy of the Pakistani people and a progressive vision for Pakistan is the American Empire, while on the other are those who argue that, even if imperialism is an anti-people force and is intervening in the region for its own self-serving reasons, religious 'extremists' are at least as big a threat to 'civilised' society and in fact are the most immediate menace that Pakistan faces.
As such therefore, the 'military operation' that is ongoing in the Khyber and other agencies is completely rejected by the first camp, because it clearly represents Washington's agenda and is said to be targeting a large number of innocents. Conversely the latter group supports the operation under the guise that it is high time that 'Talibanisation' be stopped. Indeed those opposing the military operations are called 'apologists' and accused of not having the stomach to stand up to the Taliban.
Of course I paint in broad strokes quite deliberately to highlight the basic differences between the two camps, but in reality the situation is far more complex. As big a player as the American Empire and the militants is the Pakistan Army, which maintains a relationship with both. And to get to the bottom of this divide and establish the merits of both perspectives, it is necessary to recall how the relationship between the Pakistani Army, imperialism and Jihadi forces has evolved (I have undertaken very similar analyses in the past on these pages, but the current renewal of interest in the debate demands a revisiting of these themes).
It is now a well-known fact that Washington and ruling classes in the Muslim world started patronising 'political Islamists' from the late 1950s onwards. The objective was simple: the secular, radical anti-imperialist political currents that prevailed in many Muslim countries needed to be undermined. Groups such as Hamas and Muslim Brotherhood were given covert support by Arab governments and their imperial patron, with many cadres often kept in the dark about the source of assistance.
In Pakistan, as early as the 1970 election, Islam-pasand parties were given funds and other institutional support by the military establishment to defeat the secular PPP and Awami League. Indeed Jihadi groups were being explicitly cultivated by the establishment with the knowledge of the Empire by the early 1970s, well before the start of the Afghan Jihad. It was of course after 1978 that this policy took off, but it would be a mistake to think that Jihad was systematically promoted only to serve Pakistan's perceived foreign policy needs. Indeed 'Islamisation' under the Zia regime served the explicit purpose of demobilising what was then a very politicised society.
It is now also a well-known fact that Washington proceeded to abandon its Afghan War proteges following the Soviet pullout in 1988 (a fact popularised by Hollywood depictions such as Charlie Wilson's War). And this is where the story starts to get hazy. In fact the mainstream press only picks up the story again following the September 11 attacks when George W Bush is said to have 'encouraged' Pakistan's military rulers to stop patronising Jihadi groups and indeed assist Washington in doing away with them entirely.
In fact successive American administrations after 1988 were not only well aware of the ongoing patronage of religious militancy in Pakistan and Afghanistan, but were actually part and parcel of the whole game. Scholars have documented how the US initially welcomed the Taliban regime into power, only to turn against it due to a combination of bad press and divergent interests. So when the Americans started bombing targets in the Pak-Afghan border region in 1998, they knew quite well that they were attacking elements hand-in-glove with the Pakistani establishment.
Now almost seven years after the start of the so-called 'war on terror', the American press and a segment of Washington's political establishment are up in arms over the Pakistani military's dubious performance in undoing the 'terror' nexus, some of the most outspoken commentators even declaring that the Americans are being taken for a ride. But of course the military establishment in Washington has known exactly what has been happening all along, unless one argues that the most lethal intelligence service in the world has suddenly become completely impotent.
In other words, regardless of the public pronouncements of the Bush administration and the American press, within the American establishment the analysis of the situation has probably been something like this: recognise that the Pakistani establishment has intricate ties with its Jihadi proteges and it continues to pursue well-established foreign (read strategic depth to the west and bleeding India to the east) and domestic (read weakening secular and potentially radical political trends) policy objectives through Jihad. Accordingly, the Americans have pursued a mixed policy of coaxing a break from the patronage of Jihad (by doling out large amounts of aid, mostly military) and some old-fashioned arm-twisting (in the form of the occasional strike inside Pakistani territory).
Of course in recent times patience has started to wear thin, at least partially because public opinion within the US has turned sharply against Pakistan's generals, particularly after the sacking of the Chief Justice Iftikhar Muhammad Chaudhry last March. Thus presidential hopefuls like Barack Obama have adopted hawkish postures so as to play to the gallery, while the Pentagon has ordered more direct action. But still there is no immediate sign that the Americans have completely lost faith in their Pakistani counterparts.
This necessarily raises the question: what exactly is the whole 'war on terror'? Discerning observers will note that the Americans are currently more concerned with attacks from Pakistani territory than 'extremists' in Afghanistan itself. In general, the American strategy in Afghanistan has not been to eliminate militancy but only to regulate it to its self-perceived benefit. Thus as has been pointed out ad nauseam, the American-backed Karzai administration controls only a fraction of Afghanistan's territory, whereas the rest of the country is subject to old colonial-style 'indirect rule'. whereby many 'extremists' are being co-opted into vaguely accepting the sovereignty of the Kabul-based regime. In other words, there is no such thing as 'terror', only ex-proteges that cannot be tamed. And the 'Pakistani Taliban' are currently top of the list of 'terrorists', because they are not necessarily dancing to Washington's tune.
Meanwhile the Pakistani military -- or at least fragments of it -- are quite clearly continuing to patronise Jihadi groups, cracking down upon them in highly publicised 'military operations' only when the pressure from Washington reaches a crescendo. But short of saying as much, Rawalpindi (this is, of course, the home of GHQ; the political leadership in Islamabad is virtually a non-actor) has made it clear to Washington that its long-standing ties with Jihadi groups cannot be severed, or at least not yet. Thus supporting a 'military operation', such as that currently underway in the Khyer Agency -- like the one that previously took place in Swat and earlier ones in other parts of the Pakhtun belt -- without actually understanding who the antagonists are, indeed, if they are actually antagonists, is quite naive. If nothing else, it reflects an ignorance of just how little power has shifted away from the military towards the newly elected coalition government.
Then there is the question of the Jihadis. Many people rightfully point out that even if 'Jihadi group' were created by the establishment and imperialism, many may now have turned against their former masters. This is true and this is why the state of affairs on the ground is so complex. Having said this, recently released reports on individuals and groups that have renounced Jihad violence prove that in many cases, Jihadis were being manipulated by forces external to them, even if they themselves believed in their cause. In any case, supporting 'military operations' against Jihadis led by the very forces that have given rise to millenarian violence and are far from committed to its elimination is simply an untenable option in light of the history outlined above.
Of course indiscriminate violence perpetrated by Jihadis is unacceptable (or should one say, violence perpetrated by Jihadis at the behest of shadowy forces associated with the intelligence agencies), and must be condemned. Neither can progressives tolerate the obscurantist vision of social change that Jihad groups propagate. But Jihadism and the machinations of the establishment cannot be separated. Besides the overwhelming evidence from around the world is that 'surgical strikes' inspired by the Empire always produce 'collateral damage', rather than successfully hitting 'military' targets.
It is not a coincidence that Jihadi violence, military operations and Washington's prodding always follow a predictable pattern. Of course it is not a total conspiracy either, but it is definitely more complex than the narrative posited by those who insist on the necessity of 'military operations'. Only when the Empire and the military's stranglehold over the politics and economics of the region is undone, can a meaningful policy of isolating the Jihadis take root. And isolating Jihadis is a far more successful strategy than launching sporadic military operations will ever be. If we have learnt anything from history, it is that imperialism and its client colonial Pakistani Army cannot be trusted, and the spectre of millenarian violence will only decrease when we reclaim Pakistan and the region from the American and Pakistani military establishments.
Peshawar was the only big city in Pakistan where my religion was of no consequence
By Murtaza Shibli
After more than two decades in newspaper and magazine writing, and more than 2,000 articles to her credit, Farzana Versey still cannot be categorised as a journalist -- she makes even outside events seem like her own, as she did in her recent book, entitled A Journey Interrupted: Being Indian in Pakistan. She has written columns and features for many publications, such as The Asian Age, Illustrated Weekly of India, Times of India, Sunday Observer, Gentleman, Deccan Chronicle and CounterPunch, but then she has also taught the visually-impaired, worked among the children in red-light areas, and as she says, "these have given me a sense of loss as well as hope."
It is evident that Farzana Versey enjoys interacting with people. She has interviewed several well-known personalities from politics, arts, literature, academia and the underworld. She is currently working on the biography of former Indian Prime Minister VP Singh. Most of her articles deal with contemporary political issues of the Indian subcontinent, communalism, gender, culture, society and the media. She makes no secret of her clear-cut views on issues and sometimes her self-professed "healthy disregard for objectivity" generates a lot of heated criticism. Accordingly, she tends to bring out extremes in both fan loyalty as well as adverse criticism, including abusive feedback and threats.
To leaven the straightforwardness of her political writings, Farzana Versey pens poetry. In her own words, "Words are my weapons, they are also my shield. They are a blessing and they are a curse." Open about herself, many of Farzana Versey's writings have an autobiographical element, including her travels. The News on Sunday interviewed her recently. Excerpts follow:
The News on Sunday: You recently visited Pakistan for the fourth time in the last six years and now a book on the county. Why Pakistan?
Farzana Versey: A more appropriate question would be why not Pakistan for all these years and why now? I have spoken about the fear of visiting that country and being stuck there in the event of a war. That fear remained. In some ways, the first trip was to purge that fear; the subsequent visits were to understand the hurt of the statement I begin my Prologue with when the retired army general said, "You need to be deported." I sensed a deep resentment in his voice and tone. Moreover, it was directed not against India, but against the Indian Muslim. He was hitting out at my identity.
TNS: The subcontinent's partition is prominently placed in your discourse. Is it still that relevant?
FV: I would say the partition resonating in my book A Journey Interrupted: Being Indian in Pakistan is more psychological. I have compared the attitude of the pre-partition generation, which has now taken on a soft-focus, let us forget it all and get over it attitude, with that of our generation and, more importantly, the younger generation. We are, as I wrote, living contemporary history. The youth is finding absolutely no connection with us. The geographical partition, however gruesome it was, at least had the advantage of bloodshed. The suspicion the Indian Muslim faces both at home and in Pakistan is without this benefit of catharsis. The fissures are only being fossilised with every stereotype.
TNS: Can the ongoing peace process between the two countries heal the wounds?
FV: As I have already said, we are not talking about those old wounds as much as about the new arrows being aimed blindly from both sides. Political peace is impossible and will never happen. I am afraid if this is a pessimistic view. I would call it freedom from delusion. It would suffice if the ordinary people kept up a semblance of civility and left politicians out of the peace process. When you want to sup with your neighbour you do not seek the permission of the landlord, do you?
TNS: Was it possible to do a book without Kashmir in it?
FV: I tried, but Kashmir was like a shadow tailing me. The reason is simple: the Pakistani interest in India is centred on Kashmir. Not the Kashmiri people, mind you, but Kashmir as real estate, as a brownie point. And this will continue to be a hotbed, because the most important thing is that this one state keeps the armies of both countries occupied. It has probably become a symbol to judge how patriotic one is.
TNS: Why did you choose Indian Muslim identity to set the narrative?
FV: Because it happens to be my identity. And this book is about the identity question in large measure -- my identity, the Pakistani identities. You forgot to add the 'woman' identity too. This was crucial because a female perspective put me in the real conflict with the terrain. Given that Pakistani society is considered misogynistic, I got to see it in action in my encounters with men from different strata. I do not think a man would ever write about Peshawar the way it has been written and I do believe I have shown the women of the Frontier as I saw them without wearing blinkers. If I saw an amazingly courageous rebel in a village here, I saw the complete helplessness of the so-called liberated woman in a big city too. There cannot be fixed ideas. Incidentally, Peshawar was the only big city in Pakistan where my religion was of no consequence.
TNS: Despite placing your Muslim identity at core, why are you seen as an infidel?
FV: This must be seen in the context of my various fractured selves that came along as baggage. I do tend to travel heavy! I referred to feeling like an emotional mulatto in the land of the pure where my supposed impurity hit me. This personal aspect was to take off on other marginals.
TNS: You are using a limited set of people to comment on the society. How exhaustive can this be?
FV: I am not a bird, so there was no sense in giving a bird's eye-view. I had not set out to write the definitive book on the Pakistani society, with a title that had every word in caps and footnotes that ran into pages. Interestingly, while researching some aspects it would take me to many of my earlier articles, so a bibliography would have ended up as an exercise in vanity that I can ill-afford beyond a point. To answer your question, it may not be exhaustive, which is why it is not exhausting. However, it is most certainly relevant because those people are an intrinsic part of the country; they are its voices. Mores and norms are formed by lived experiences, not pontification.
A Bengali Muslim talking about Bangladesh makes more sense to me than my quoting ten experts. That information is available from any search engine. And will anyone be able to replicate the sheer anguish of people's personal lives by not empathising with it? I could have written a nice sensational chapter on Heera Mandi, but as I stated I am not a western sociologist 'doing' a place; my sensitivity is different; not better or worse, just different. I have a background in working among children of commercial sex workers, so I cannot take those images away. What I have instead is a more touching account about a real person who is hiding her past. We again come to the identity question. What is hidden is often more potent.
TNS: How would you compare Indian and Pakistan identities?
FV: I called Pakistan an amputated nation; some would see it as trashing. I see it with anguish. Therefore Pakistan, as I believe and several people there do, is restructuring its identity to deny its roots. This is a tough call. The Indian identity is about the memory of what has been taken away. India does act like Big Brother, but it is surprisingly insecure about the loss. The constant sloganeering about 'India Shining' is really an attempt to gloss over that.
TNS: The current struggle for democracy in Pakistan is generally seen as an intellectual one. Do intellectuals and civil society feel trapped in the milieu that has shaped the country?
FV: The intellectuals are not of one stripe, as they ought not to be, so there are differing versions of democracy. An Ahmed Faraz has a vastly different take from a Sheema Kirmani. Faraz is attached to his passport, Sheema does not even believe in the concept of nationalism. The section on dissenters was mainly to question them about the Pakistani identity and many felt there was none. I would like to add here that it is easy to term liberals dissenters, but I have included the Jamia Hafsa women because in many ways they set the tone of the current crisis of rebelling against the system. I find this most interesting because in an Islamic society you have bunch of Muslims, women at that, going around with sticks. We really need to broaden our way of looking at the idea of dissent.
TNS: What kind of India lives in the public memory of Pakistan?
FV: The India they can still conquer! Besides Indian films and soaps, Pakistanis think India is a Hindu nation. Perhaps they are trying to justify their Islamic nation call. This was my major grouse as an Indian Muslim.
TNS: Your interaction with gays and minorities is interesting. How do they cope in the supposedly harsh Islamist settings?
FV: The gays are doing fine as long as they stick to their groups. Let us not forget that homosexuality is illegal in India; in Pakistan, there is no such law. It is against sodomy. So you can feel up a guy and no law can do a thing, unless someone is there to watch you in the act. The more touching aspect is about gay women, and they do exist. Religious minorities have their own problems, but they have found canny ways to deal with it. Say 'Allah Hafiz' and all is well with the world.
TNS: Your book is wanting for any interactions with Islamists. Why didn't you try to meet any?
FV: If by Islamist you mean the totems that have made it their vocation, then no, I did not attempt to meet any. The very idea about debunking stereotypes is to first understand them. My understanding is being an Islamist is not a profession. Therefore, if you look carefully there are traces of all the types you mentioned. I cannot identify some for obvious reasons. For me the genesis is more important, and I found it in the person who joined the Tablighi movement or the atheist who completely changed. What prompts those changes? That leaves more room for exploration.
TNS: Is there any difference in pre- and post-9/11 Pakistan?
FV: If there is anything that should tell Pakistan that it is not an Arab country, it is this. Before 9/11, the bookshop owner in Peshawar was not enthusiastic about selling Osama's biography to me. Post-9/11, Osama was lionised with posters everywhere. And in 2007, when I last visited Pakistan, his posters were peeling and no one cared for him. But anti-Americanism is perhaps more prominent as indeed are American accents. A society full of contradictions...
TNS: As Indian Muslim, how different did you feel from the cousins of your extended family in Pakistan?
FV: Completely different. Mainly because unlike the pre-1947 elders, like my mother here and aunt there, we do not share any memories. And memories make all the difference.
writer is a Srinagar-based journalist.
of an "emotional mulatto"
Being a Muslim in India is a tough job. Threatened and terrorised by a growing number of Hindu militant extremists, and constantly looked at with suspicion and treated with a certain degree of caution, the Muslims are believed to harbour a certain desire to separate from the union and create a country of their own a la Pakistan, which a modernist Jinnah created but has since been usurped by the dubious Islamist agenda. The suspicion is so institutionalised that the Muslims are hardly represented in the country's million-plus armed forces.
This suspicion turns into contempt when an Indian Muslim travels to Pakistan. In the popular Pakistani imagination, India is a country of Hindus and if at all there are any Muslims, they are seen as infidels. Farzana Versey's encounters in Pakistan are replete with her confrontations with such stereotypes. However, as her expedition of exploration furthers, she finds fascinating contours of a human society with diametric contradictions where 'personal becomes political'. Reading her account in the book under review it seems that the Indian Muslims face more suspicion in Pakistan, because they are not treated on par with the Indian Hindus in the country that is supposedly Muslim.
In A Journey Interrupted: Being Indian in Pakistan, Farzana Versey weaves a collage of her experiences that she acquired during her four visits to Pakistan in six years -- a journey of exploration with continuous negotiations and constant reconciliation with her own identity of an Indian Muslim woman. "When I was on the soil of the land of the pure, my impurity struck me. I was the emotional mulatto," she writes. She travels through the cities of Karachi, Islamabad, Lahore and Peshawar and meets a vast array of people -- common tea-sellers, prostitutes, actors, poets and retired army men -- to find out strange and contrasting factors of the Pakistani identity, if at all there is one.
Despite dancing to the tunes of Bollywood films and replacing the peeling posters of bin Laden with the likes of Shah Rukh Khan, being anti-Indian is an important part of the Pakistani identity. Kashmir fits perfectly in that quest for a national narrative that has been interrupted by army dictatorships, political mismanagement and Islamist Jihadism. In order to sustain the rationale of a struggling identity, Farzana Versey writes, "every few years Pakistan writes a new fiction". The book is "about Pakistan, but it is also about India. It is about Them and Us, Her/Him and Me," she contends.
Though not a 'conventional' travelogue, A Journey Interrupted: Being Indian in Pakistan could not escape the trap of Kashmir -- the place that defines the 'convention' between India and Pakistan. "Kashmir was like a shadow tailing me," the author told this scribe. The reason is simple, she adds, "the Pakistani interest in India is centred on Kashmir. Not the Kashmiri people, mind you, but Kashmir as real estate, as a brownie point. And this will continue to be a hotbed, because the most important thing is that this one state keeps the armies of both countries occupied."
Farzana Versey terms the ongoing peace process "designer process", observing that "political peace is impossible and will never happen." She describes her observation as "freedom from delusion", but adds, "it would suffice if the ordinary people kept up a semblance of civility and left politicians out of the peace process. When you want to sup with your neighbour you do not seek the permission of the landlord, do you?" The book under review is written primarily from an Indian Muslim perspective, which subtly tries to debunk a few stereotypes that exist about both Pakistanis and the Indian Muslim 'affiliation', a cause to which both the Hindu militants in India and the Islamist extremists in Pakistan are wedded.
As India and Pakistan are trying to overcome the legacy of Partition and build new bridges, Farzana Versey -- while watching from the Pakistani side of border at Wagah -- feels unsettled by the "unsheathed anger and the charade of candle-lit peace", and finds proximity and not the distance "disturbing". A wonderfully written account, the author uses terse language in effective idiom, imagery and poetic observation. In these times of political and social unrest in Pakistan, this is a timely book -- one that delves into the Pakistani mind and traces the chasms in its recent history.