Even today conmen sell exotic "cures" to people suffering all kinds of ailments. Most of us are familiar with such quackery.

But in the rapidly changing world of the 21st century, medical fraud has assumed bigger dimensions -- capitalising on the promise offered by therapies of the future such as stem cells. While today, stem cells are accepted treatment for a few conditions, "clinics" cropping up around the world bank on the desperation of those suffering incurable disease. Such clinics exist in India, China, Mexico and elsewhere. The trail to some may lead from Karachi.

"I contacted the people offering stem cell therapy at a private hospital in Karachi, about two or three years ago, to seek treatment for my daughter who has thalassamia. I met Mr. Tariq Mumtaz, the representative of Dr. Ilham Saleh Abuljadayel. He was a persuasive talker, but I was not comfortable with the meeting. The price quoted was Rs. 3 to 4 lakhs per session. I needed proof, so I asked for contacts. They did give me two or three numbers for patients, but none of the people I spoke to were even literate. I think they didn't know what the company was doing with their kids," Zaini Suhail told TNS. Afterwards she dropped the matter believing it was a scam.

The story of "stem cell therapy" in Karachi is complex. It begins with former president Pervez Musharraf. In July 2005, Musharraf, then head of state, inaugurated a joint study by Pakistani and Saudi researchers on a therapy termed "retrodifferentiation." The technology had been developed by a UK-based company, Tristem, [http://www.tristemcorp.com/index.htm] owned by Saudi-born biologist Dr. Ilham Saleh Abuljadayel and her husband, Ghazi Dhoot. Dr. Abuljadayel said she had, in the early 1990s, discovered a technique that would convert adult blood cells into stem cells that could give rise to brain cells, heart cells or other kinds of cells. Conventional stem cell technology harvests stem cells from the body and carefully nurtures them in the laboratory to coax them to grow. The swift conversion of ordinary white blood cells into stem cells was a novel claim.

Dr. Farhat Moazzam, Chairperson, Centre for Biomedical Ethics and Culture (CBEC) at the Sindh Institute of Urology and Technology (SIUT) told TNS "Stem cell research, including retrodifferentiation, where adult cells are reverted to an immature state continues. Various studies are on, but it is not yet an approved therapy for use on patients."

The technology, and a mobile machine that carries out the conversion process according to Tristem, were both patented. In late 2004, Dr. Ilham was permitted to conduct research on a plastic anaemia by the Indian Medical Research Council. According to Indian doctors quoted at the time, none of the four patients treated did well. The company was asked to leave India shortly afterwards due to ethical violations -- and re-located itself in Pakistan.

Approval for research was granted by the Pakistan Medical Research Council (PMRC), which reviews proposals for research and clinical studies and monitors progress. Tristem began work with a local partner, a private, commercial company, Healthcare Solutions International (HIS), owned by Tariq Mumtaz -- who has described himself to clients as a banker or businessman. He has no known medical expertise. Ads were placed in newspapers, offering hospitals the "RetroStem" machine to "treat thalassaemia and other diseases". Concerns were raised about the ethics of treating patients with an unproven technique. Soon afterwards, Tristem and Dr.Ilham pulled out of Pakistan.

Dr. Aamir Jafarey, from CBEC told TNS "Research explores questions while therapy aims at providing a cure. In the case of HSI, it was ambiguous. Also, there were reports the patients who were a part of this experimental treatment were paying. Were the patients even told this was experimental?"

"I only took part in the research for pediatric thalassemia around 2005. It was an experimental treatment. It showed great hope but since it was not carried out to its logical conclusion the final result could not be known," Dr. Shakil Rizvi, a paedritician associated with the research in its early days, told TNS.

Dr. Huma Qureshi, Executive Director of the PMRC, told TNS the approval given for Tristem's work was justified. "Tristem's research was going very well. But because of internal rivalries they pulled out of the country. Other doctors and also the media began criticising them, so they asked why they should work in this environment."

"The question is did the PMRC look into the Indian fiasco. And if doctors and researchers insist the treatment is beneficial, why isn't it open to testing?" asked Dr. Jafarey.

HSI however carried on treating patients, with the RetroStem machine set up till recently in a room rented at the private Park Lane Hospital in Karachi. A former HSI employee told TNS the machine could be "set up or taken anywhere. We based ourselves at a hospital only because it had an ICU and other facilities." Those who have seen the machine operate say a vial of blood is placed in it, and "retrodifferentiation" takes place.

The Chief Medical Officer of Park Lane Hospital, Dr. Nadeem Ahsan, told TNS "Park Lane had a partnership with HSI. Tariq Mumtaz was the focal person and saw potential clients himself. HSI was using our set-up but the treatment was offered by their people, including some doctors. They left some six to eight months ago and are misleading people by placing our address on their website."

The company's website www.hsipl.com, offers the "retrodifferentiation therapy" for a host of diseases. Costs range from US$6,900 to US$18,000 and claim to treat conditions including diabetes, congestive heart failure, Parkinson's disease, ALS (Amyotrophic Lateral Sclerosis) and Spinal Cord Injury. Remarkable successes are claimed on the website in the cases of all patients treated. Whether intentionally or not the impression given is that "retrodifferentiation" offers a cure. The HSI website states they are offering therapy "to treat several previously untreatable indications." Patients, who lack knowledge, with some coming in from far-flung areas, are most likely to hope for a cure.

"There is currently no known cure for Parkinson's, Motor Neuron Disease or Multiple Sclerosis, though treatment is available. Finding a cure would amount to a major medical breakthrough with huge benefits for many," neurologist Dr. Nadir Ali Syed told TNS.

A prominent Karachi-based businessman, 69, who requested his name not be used, told TNS "I was left paralysed after a stroke some ten years ago. In 2005 I got in touch with Dr. Ilham. I was told I was good candidate for the retrodifferential treatment but by the time things started moving, Dr Ilham had left.

In 2007, I was contacted by Dr Ilham's people again for treatment, this time at Park Lane Hospital. However, I did not press for it after a doctor on her team told me that it might not work. With each infusion costing Rs 12 lakhs, and at least six sittings before I saw any results, I decided I would rather save my money."

Other desperate patients have sunk into debt to finance "treatment."

Speaking to TNS from London, Dr. Ilham Saleh Abuljadayel said "We are no longer in Pakistan, because of the political turmoil and personal reasons." Tristem in London gives its correspondence address as 571 Finchley Road. According to investigations by TNS, there is no visible sign indicating the presence of the company and no other details on its website as to where the company which states it is engaged in major scientific research may be physically located. The address could be a collection point for mail.

"Stem cell transplantation is indicated in a number of disorders. Common indications are aplastic anemia, thalassaemia major, lymphomas, acute leukemia, chronic myeloid leukemia and multiple myeloma," Dr Salman Adil, consultant haemotologist and bone marrow transplant surgeon at the Aga Khan University Hospital in Karachi told TNS.

"Stem cell therapy offers a lot of hope but how is it justified to cash in on it? HSI was asking for money for this experimental treatment which has not been proven and remains a mystery. It takes years for research to show results. How can Dr Ilham and company say their study was successful? How is it that the research that was subsequently published only focuses on thalassaemia while HSI was claiming to treat everything under the sun?" Dr Jafarey said.

The story has since grown more mysterious. It appears that while HSI is still based in Karachi, it has moved out of Park Lane and treated its last patient there some eight months ago. Its Chief Executive Officer, Tariq Mumtaz, is believed to be currently located in Saudi Arabia and not available for comment. There are indications patients are treated in Saudi Arabia and Jordan.

Dr Ilham told TNS, "We are working on retrodifferentiation. Of course it was a success. We are no longer in research but applying it clinically to various fields not just haemotology and have seen very positive results in neurology, in diseases like Parkinsons, Motor Neuron Disease, Multiple Sclerosis etc." When contacted at her London number to seek treatment for a Multiple Sclerosis patient, she said "It's not a problem. We have treated many people with MS." She proposed Jordan or Saudi Arabia as venues for treatment. She said she would send the details through email but this did not happen.

With the HSI website still mentioned on multiple global sites for patients suffering a variety of incurable illnesses, it seems certain queries are received at the Karachi office. It is unclear what role is then played by the company, which in February this year renewed its membership of the Karachi Chamber of Commerce and Industry.

"Tariq Mumtaz was the financial backer for the project. Dr. Ilham had the know-how but not the money. HSI was the local partner for Tristem," Dr Huma Qureshi confirmed. Other sources say Mumtaz and HSI held a franchise to use the Tristem technology.

The Tristem website continues to give a link to HSI, with a disclaimer distancing itself from third parties engaged in "human studies."

TNS spoke to a man identifying himself as "Javed" at the HSI Karachi number. A small, run-down office, registered as the Tariq Mumtaz Health Centre, is located at the address given for HSI at 82-C, 11th Commercial Street, 3rd Floor, Defense Authority Phase II Ext., Karachi. Files fill much of the space. When TNS visited the premises, Javed said they no longer offered stem cell therapy, suggested contacting Dr Ilham and said "Why should we tell you what we do now."

Over the phone, Javed told TNS "We are no longer conducting treatment in Pakistan. We are now doing so outside the country, as it is very expensive in Pakistan. He declined to provide details. Persons who contacted HSI in the past reported being asked for Rs 3,000 merely to see Mumtaz.

TNS knows of patients treated in Jordan, with Dr. Ilham -- not it must be noted a physician -- overseeing files and patients going across from Egypt and other countries for treatment.

Ahmed Nadeem Akbar, registrar of the Pakistan Medical and Dental Council said that under a 1962 law titled, "Misuse of allopathic medicine" provincial governments were empowered to check medical fraud. In practice this does not happen. He also said the problem was "there is no law to register or regulate anyone setting up a private clinic or other such concern and offering treatment."

But solemn is the silence

on the silvery haze

That drinks away their

voices in echoless repose,

And dreamily the evening has

stilled the haunted braes,

And dreamier the

gloaming grows.

The stanza from The Fairy Thorn by Samuel Ferguson best describes the overall mood of Aasim Akthar's "And dreamier, the gloaming grows", which is a series of his recent drawings that went on display at Rohtas II, in Lahore. The series uses the minimalist choice of materials -- 15 drawings framed in white, graphite on paper, with a couple of pastel works, and hung on white walls.

At first glance, some of the works look like a continuation of Marvin Bileck's etchings and engravings; not just for the choice of the title of the show but also for the choice of forms used, like the ones in the Heart to Heart, with which the show begins. However, it goes beyond that where the narrative begins with a metaphor from nature, and then goes on to engage metaphors of the nature. The varying tones of grey, and the choice of intimate instances -- personal, telluric, or the marriage of both -- is divulging the subconscious. It is nature that creates attraction between the two opposites and connects the organic forms of existence, or even the inorganic ones. The show is like a journey through the colourless mist of melancholy, where the images seem like reflections from a very lonely place. The place where subtle is part of the obvious, and obscure is rendering clarity.

Most of these drawings are like whispers, almost motionless, and embedded within them are the fine suggestions of the ineffable; while some are meandering through the moonlit landscapes of carnal desires, from a perspective that is slightly drifting towards the Other side, away from the land-of-the-sane-and-the-sure. A place where tall peaks of human passion are laden with tales that need to be told, and the walls of deep gorges are painted with shades of concupiscence. The interplays between the positives and the negatives, and the animate and the inanimate -- especially in the case of the five Bodyscapes -- are giving birth to the new and the more meaningful.

The Wind of Desire beautifully portrays the classic contest between the pull of desire and the vast abyss that is filled with myriad obstructions impeding the former. Along with that, the desire to break free from it, and glide over this chasm towards the ultimate bliss, intensifies this contest. The distorted torso with the bloated chest seems to be filled with the immense burden and pain that is precipitated by this conflict, as if desire is a deity and human flesh its ambrosias, struggling for survival yet defenceless and being sacrificed for a 'sacred' and inevitable cause of making the desire immortal.

In the Poppy Seed, poppy buds, flowers, and stems are rendered and composed in a manner in which they are dancing to the tune of life, depicting the never ending attraction between the pollen and the carpel, present in almost all living beings, in one form or the other, and a major thesis of life itself. The pale coloured petals of the blossoming flowers are the only objects that have used some hues in the entire body of works displayed in the show. Such a limited and careful application of colour, in this context, is apparently suggesting, or desiring, the feminine as a source for brining the colourfulness into the grand scheme of existence.

Apart from the individuality of each work, the discourse created by the titles in a particular order, and parallel to that the catharsis produced by the visuals in that order, further add on other meaningful layers to the set in totality; like characters in a finely woven plot where each individual is signifying the other while at the same time asserting its own identity, and carrying multiple themes along the way to the final act.

Sonia Chundrigar's paintings on show at Lahore's Drawing Room Gallery raise some interesting questions about the fate and future of abstract art in Pakistan. Like her previous exhibition, the present one too comprises abstract canvases made with loosely applied brush strokes, drops of colours and spreading or smudging of paint. These works, created with layers of enamel and oil paints, affirm the unmistakeable aesthetics of Sonia Chundrigar -- vivid hues, gestural marks and non-representational imagery.

These ingredients make her work unique because apart from a few 'commercial' painters (such as Mashkoor Raza who supposedly prepares a canvas in a day based on the client's requirements), there are not many abstract painters in the country. Even Gulgee in the later years of his career switched from abstract to a readable imagery -- the text from Holy Quran.

Before Gulgee, many Benagli artists as well as Rummana Hussain and Kamil Khan Mumtaz were engaged with non-representational abstract imagery. But, after the creation of Bangladesh in 1971, Pakistan witnessed a decrease in the number of abstract painters. Only Zubeida Agha continued painting abstract canvases.

Besides losing a substantial number of abstract artists to Bangladesh and a change in the trends in American/Western art, when Abstract Expressionism and Action Painting was overtaken by other movements, other factors too were responsible for the decrease in the number of abstract painters. For one, in case if the painter preferred abstract images, some of the frequently asked questions about the nature of imagery, its meaning and reason remain unanswered. So perhaps the general public's demand -- for meaning and recognisable visual references -- compelled Pakistani painters to adopt a reasonably realistic vocabulary (even in its stylised guises) and calligraphy -- a readable substance.

With this background, painters who choose to work with non-representational aesthetics, even if following the American art of 1950s and 1960s, challenge the norms of art-making and art-viewing. To begin with, they negate the notion that a work of art, like a piece of literature or poetry, must be 'understood'. They believe that visual art can be enjoyed without necessarily venturing into the labyrinthine pursuit of meaning and explanation; a characteristic that connects art more to music than any other creative expression.

This aspect of abstract art deals with the fabrication and composition of formal elements without replicating or suggesting something recognisable. It is challenging, because once the painter is determined to produce a non-representational canvas, he has to rely on his sophisticated sense of aesthetics and judgment. Also, success is not apparent, easy and familiar, as unlike 'realistic' art, the abstract surfaces cannot be matched to a real person, physical setting or actual scene. So, without any pre-existing example, it is the artist's inner vision that defines the outlines of his artwork. So whatever is produced is purely (or partially, if the artist is influenced by others) a creation of one's mind, imagination, emotions -- and craft.

Undoubtedly, Sonia Chundrigar seems inspired from Jackson Pollack who introduced drip in painting and opened up other possibilities than easel painting. Her treatment of surface, act of mark-making and method of constructing composition are like Pollock's, but apparently Sonia is trying to find her own voice within this magnified (and magnificent) means of expression. On a few canvases, the combination of colours, interplay of matt and glazed pigments, and contrast of planned (in the form of chequered section of painting) and spontaneous scheme of putting colours reflect her individual approach in this genre.

With this kind of abstract art, one is able to analyse the development of Chundrigar as an artist. In some works her imagery appears contrived, controlled and contained -- for example, in works with specific ideas and explanations like the diptych that represents sound vibrations or other paintings with window-like shapes dominating the compositions. Although hard to detect, yet one suspects these canvases are conceived to convey certain concepts and meanings.

A number of works convince the viewer with the loose and spontaneous characteristics, especially the painting with the blend of planned imagery and fluidity of mark-making. Even though some works are more resolved than others, the very fact that Chundrigar has been pursuing abstract vocabulary is surprisingly pleasant. She is seeking to explore a personal idiom out of this seemingly tried-out diction -- regardless of the fact that the viewers are still searching for a meaning in her artwork. Basically, this tendency to locate meaning in a piece of art is derived from representational works in which a horse resembles a familiar animal, a house appears like a common structure and a flower is immediately seen as a plant. But in reality even these obvious meanings change with the passage of time and with every spectator. So, in essence a description is not specific to a particular artwork.

Paradoxically, the abstract art of Sonia Chundrigar may generate some other meanings which will be read, recognised and retained in future. Like our meaningless life which, in its physicality, is meaningless but we seek to put a meaning in our existence -- through our art also!

Dear All,

Isn't Rock & Roll Jihad (RRJ) a clever title? Not only has Salman Ahmed managed to put 'rock and roll' and 'jihad' into the same title he also manages to put 'Muslim' 'revolution' and 'rockstar' together in the subtitle. The title is that of his memoir (as well of an album which is being released at the beginning of next month), and I have to say it does rather aptly sum up his story -- about growing up as a music loving, desi boy straddling diverse cultures and trying to make sense of life as a a musician in an increasingly intolerant world.

I admit that even though Salman is a dear friend, I approached the book with a healthy degree of cynicism partly because of the increasingly 'love and peace' tone of his emails over the years and partly because the book's foreword written by the American rock singer/song writer Melissa Etheridge is rather drippy (you know: phrases like "I had the blessing to meet Salman" and "I sent out a prayer to the cosmos"). But as it turns out, I was pleasantly surprised because this is a great story and told straight from the heart.

RRJ is Salman's story: a story of trying to find balance and meaning in life, of trying to make sense of the present in the context of the past and the hope of the future. The book is actually great fun because it is written with candour as well as humour: there are some wonderful laugh out loud anecdotes -- Mick Jagger dancing in Lahore's Hira Mandi watched by a dancing girl who has no idea who he is except 'that he looks very old'; Salman's courtship of his wife Samina and the hilarious confusion caused by her garrulous mother calling him Mansoor; Nawaz Sharif's stubborn batting at the Lahore Gymkhana etc etc…

The book also paints an interesting picture of how much Pakistani society has changed over the last few decades: when Salman returns to Pakistan to study medicine after a few years abroad he is shocked by how different and joyless Zia's Pakistan is and cannot understand what happened to the Waheed Murad era he remembers from his childhood. He experiences culture shock when an altercation between Lahori boys and Iranian students results in them flinging insults at each other that he has never heard before: "Shia! Sunni!"

Salman's story is that his personal jihad is to try to make the world a better place without sacrificing his own passion, his junoon -- his commitment to music. An uncle's early disapproval of his wanting to become a mirasi reflects his family's misgivings about music as a profession, and these doubts haunt him every time there are stumbling blocks, insults and humiliations in his musical career. His accounts of his association with Vital Signs and of his putting together Junoon and taking his music in a different direction give interesting insights into the behind-the-scenes happenings of these musicians and their creations. He chronicles the surreal reactions of various authorities to various events and writes that Junoon was banned after a remark he made in India after Pakistan's 1998 Nuclear explosions: "I repeated the words I'd seen on a banner held by audience members at our show in Delhi -- "we want cultural fusion not nuclear fusion". Upon their return to Pakistan they received a letter from the Ministry of Culture to answer to, among other charges, that of belittling the concept of the ideology of Pakistan and of "citing cultural similarities between the two countries."

Salman Ahmed roots himself in a compassionate, sufi mode of Islam and his belief in the strength of a loving, caring God who listens to your prayers underpins the narrative. But surprisingly this does not result in very cloying prose, it is all actually quite heartening and the message of 'believe in yourself and do not despair" is rather encouraging and will appeal to new generation who may only have heard of the Vital Signs in the context of history mentioned by their parents.. (My 14-year-old has appropriated my copy which she is reading and has become very possessive about).

This is an interesting memoir, a very personal recollection of an interesting journey and even though you might not agree with a great many of Salman's assessments (he seems quite charmed by General Musharraf whom he refers to as 'cool'), the book is definitely worth reading as the portrait of a place and time as well as a compassionate reflection on the meaning of life…

Best wishes

Umber Khairi