health
Swine flu on the loose
The fact that physiotherapist Iftikhar Ahmed died of swine flu should alert the health authorities on risks ahead
By Aoun Sahi
Iftikhar Ahmed, 38-year-old father of three and chief physiotherapist in the Nawaz Sharif Social Security Hospital Lahore, was admitted to the emergency of same hospital on December 3 with symptoms of swine flu -- cough, high fever, headache and flu. He died on December 7.

The day we surrendered
East Pakistan tragedy happened on December 16, 1971, when the making of Bangladesh was officially announced and Pakistan's army fighting in Bengal was asked to surrender
By Waqar Gillani
It has been 38 years of Bangladesh's coming into existence. Keeping the current situation of the country in their minds, many former soldiers, who remained Prisoners of War (PoWs), think the 1971 lesson is forgotten.

It was a widely held belief that a successful military operation in South Waziristan, considered to be the hub of all terror activities, would lead to a considerable reduction in acts of subversion. But a renewed surge in violence is being witnessed across the country that has created a deep sense of fear and anxiety among the masses.

By launching a full-fledged military offensive in the rugged mountainous terrain of South Waziristan, the security forces have been able to dislodge militants associated with the Hakimullah-led Tehrik-i-Taliban Pakistan (TTP) from that restive border region and hundreds of the miscreants have been either killed or injured.

The command and control structure of TTP in its stronghold has been destroyed, but some of its cadres are still able to strike in different parts of the country and terrorise people by taking their lives and destroying their properties.

On December 4, the militants attacked a mosque in Rawalpindi attended exclusively by high-ranking army officials. The assailants killed several senior officers and their relatives in this gory act of terror, which left the whole country in a deep shock and state of mourning.

Those killed in Rawalpindi mosque attack included a director general of the armoured corps, Maj. Gen. Bilal Omar, a brigadier, several colonels and a major. Among those killed was also the only son of Lt. Gen. Masood Aslam, corps commander Peshawar.

The alarming fact about this assault was that terrorists once again hit a highly sensitive area in the Rawalpindi cantonment only days after attack on the army's General Headquarters (GHQ).

After that it was twin bomb attack on a commercial centre in Lahore, in which over 50 people were killed and another 180 injured. It didn't stop there and on Tuesday last, at least 12 people, including military personnel, were killed when militants carried out a suicide attack in Multan, which is the headquarters of the army's second corps.

Before these recent attacks, there were many acts of subversion in Peshawar and other parts of NWFP. But what is significant about terror attacks in Lahore and Multan is that these two cities are among the most important urban centres in Pakistan and the militants defeated in tribal areas are trying to shift the war theatre to major cities of the country.

Many analysts like Dr. Hasan Askari believe that it is an attempt by the TTP-linked terrorists, whether they are from tribal areas or linked to the like-minded Jihadi outfits, to lessen the pressure they are coming under in Waziristan and other tribal areas. It is also argued that these acts of terror would decline with the passage of time as the centres of refuge of miscreants in South Waziristan have been done away with. "The recent acts of terror clearly reflect that the militants have been dislodged successfully from South Waziristan and now they have moved to the urban centres where they are using all of their resources to disrupt peace and stability," he added.

However, Dr Askari said the ongoing acts of violence could partially be the result of intelligence agencies' failure to timely pass on information to security apparatus. But at the same time it's also very difficult to stop suicide bombers. "Even if a suicide bomber is stopped at a certain checkpost somewhere, he could explode himself right there," he said.

Another noted analyst, Brig (retd) Mehmood Shah, believes the surge in terrorist attacks across the country could be an act of desperation on the part of TTP-linked militants who have been deprived of their stronghold in South Waziristan.

The government functionaries, on their part, are trying hard to meet the challenge of ensuring durable peace and stability across the country in the face of new wave of terror attacks. In order to stem the rampant violence, it has also been decided to involve religious scholars, who are held in high esteem across the country. It was part of this strategy that Interior Minister Rehman Malik recently flew to Karachi and met noted Ulema like Mufti Rafi Usmani and Mufti Taqi Usmani.

"The government is trying to seek the help of Ulema to control the unbridled violence and the initial meetings between different scholars and the interior minister have ended on positive note," said a senior government official here requesting anonymity.

The official said the security circles believed if the Ulema, especially those from the Deoband school of thought, which is also followed by Taliban, clearly denounced the path of violence that the TTP had opted for in Pakistan, it could make a great difference in achieving the goal of isolating terrorists before their elimination.

The frequent terror strikes seem to have caused visible shifts in public opinion. Militants and their political supporters are losing popular support against the backdrop of an emerging anti-private jihad consensus in the country. But the fact is people are afraid of the invisible enemy and avoid making open statements against insurgents for fear of reprisal.

Analysts say there are several positive signs. The security establishment has shunned its earlier policy of appeasement or support to militants. Much of the political leadership has also given up its familiar reluctance to act against the militants. Religious-political parties, forced by the heat of anti-extremist sentiments, have reconciled their strategies and abandoned their Jihadi tones. There is increasing support to the security forces in militancy-hit zones. Jihadi charity boxes have disappeared from markets. Religious scholars avoid Jiahdi sermons. Most of the illegal FM radio stations, the biggest tool of extremist propaganda, have gone silent and so on.

Until recently, new year nights' programmes, cinema houses and billboards with women pictures were attacked. Music functions were forcefully stopped. Students were openly enticed to volunteer for 'Jihad' first in Afghanistan and then in Kashmir.

However, situation has changed now. Religious parties that once talked of hoisting national flag on the Red Fort of Delhi and threatened suicide attacks against foreign naval ships avoid similar outbursts.

"Save a minority comprising a few right wing/religious parties, majority population is no more interested in the Jihadi rhetoric and culture. This could be the beginning of a new era in Pakistan marked by more tolerance and moderation," argued a political activist wishing not to be named.

Renowned analyst and religious scholar Dr Mohammad Farooq Khan said it was a happy development that around 99 per cent of population and military and political leadership were on the same frequency on how to tackle the threat. "We had been advocating for the last 15 years that private jihad is not only against Islam but is also a dangerous strategy. We are happy that finally the establishment and religious parties have realised it.

"Musharraf and the previous MMA-led NWFP government had shown criminal negligence vis-à-vis the Taliban in Malakand which made things difficult. But happily the operations- 'Rah-e-Rast' in Swat and 'Rah-e-Nijat' in Waziristan- have been the most successful ever operations of the world history," Khan added.

Former chief secretary FATA and security expert Brigadier Mehmood Shah agreed that an anti-private jihad consensus was developing in society. "Swatis are now openly supporting the government but the situation in Waziristan is not that encouraging. There is fear amongst the people there militants might come back in the area."

"But one thing is for sure that people have overwhelmingly turned against the misuse of religion for political motives. It is in this background that the religious parties have shunned militant approaches. They simply cannot go against the tide. To save society from the threat of extremism and terrorism, a civil society movement like the one for restoration for judiciary is needed. Live media has exposed the religious parties to the nation," he commented.

Dr Begum Jan, chairperson Tribal Women Welfare Association, didn't see any positive outcome any time soon. "We are just harvesting what we had sown years ago. Security situation is worse despite claims of victory in Malakand and I think the announced surge in US troops in Afghanistan would just add fuel to fire," she lamented.

Begum Jan said the people of Waziristan and other agencies had suffered badly and they would never ever support the mullahs. "Now we should save our children in the given scenario from religious seminaries and offer them religious education at home. The government should bring FATA at par with rest of the country through fast track and corruption-free development schemes. It should provide jobs to the youth in the region to save them from extremists who give them lucrative offers in return for support," she said.

Militancy-hit areas like parts of Malakand division are experiencing shifts in general perceptions. Security agencies are having the greatest ever popular support. Former federal minister and nationalist leader Afzal Khan Lala said people had supported the militants not out of love but for fear because they killed their opponents. "They may give even more support to army and the government if they are emboldened and ensured safety. There is not yet hundred per cent support to security forces. For example, one of the two main tribes in Shah Dheri Kabal has formed a lashkar against the militants but the other is reluctant to do so. The security forces have more communication and interaction with the general public," he opined. Lala also chastised the religious parties for not opposing militants. He praised army for getting the area rid of insurgents.

Amir Muqam, president of the Pakistan Muslim League-Q NWFP and a parliamentarian, said how the nation could support those who killed their children, brothers and destroyed their businesses. Muqam said that the army had established writ of the state for which the nation stood indebted to it. "But this now will have to be maintained by the civilian forces. Basic amenities would have to be provided and problems solved. There should be a sound plan to deal with the post-operation situation. There is still a fear of return of militants. Militants after all have not been eliminated altogether. The government must safeguard those who side with it," he said.

Sadullah Khan from Buner said, "The army has won us the area back. It has done that in Swat and Waziristan too. The notion of invincibility of militants has been buried for ever." An old man from Kabal Swat, wishing anonymity, said Swatis followed the extremists because they talked good. "They disappointed us when they took over the area. We will never support them and would rather support the government," he said.

There is a growing national pride. "The tragedy was huge. The state acted like a mother. Had it not come up to the expectations, the tragedy would have been more devastating. The militants wanted to create disbelief but miserably failed," argued Shakir Khan, a former IDP from Swat.

There were frequent desertions from the army and police in initial days. Around 80 percent personnel in Swat and Buner had deserted for fear of militants. That trend has reversed. And recently there has been a new urge in the youngsters to join the security forces.

"When enemies are bent upon destroying the society, why should I lag behind? Though I didn't want to join army or police in the past, I now am for it. I want to fight Pakistan's enemies and take them head on," declared Saeed Khan, a college student in Charsadda.

Numerous FM channels were in the air before the latest onslaught against extremists in Malakand and the tribal belt. These were blatantly used for anti-state and extremist propaganda. Almost all of these stand closed now.

Siraj-ul-Haq, former senior minister and ex-amir of Jamat-e-Islami, however declined to accept that Jihadi culture had weakened and that new developments had forced them shun Jihadi tenor. "Jihad continues in Afghanistan. We think that US interference there and in Pakistan is the root-cause of the problem. We have started our jihad against the US - the go America go campaign- by organising political rallies and train marches."

Haq said JI believed in political and constitutional means. "JI never had any military wing. We don't believe in under ground activities. If any one thinks JI is a B-team of agencies, he should remove this misconception."

Email: tahirkatlang@yahoo.com

Iftikhar Ahmed, 38-year-old father of three and chief physiotherapist in the Nawaz Sharif Social Security Hospital Lahore, was admitted to the emergency of same hospital on December 3 with symptoms of swine flu -- cough, high fever, headache and flu. He died on December 7.

Dr Javed Akram, principal Allama Iqbal Medical College, who checked Iftikhar a day before the death, says the deceased had the symptoms of swine flu. "I sent a special messenger with his blood samples to National Institute of Health (NIH) in Islamabad for his medical tests. I also sent his blood samples to Jinnah Hospital Laboratory. On Monday afternoon, around an hour after his death, reports from both the laboratories confirmed he was H1NI (swine flu) positive," he tells TNS, adding that Iftikhar had no history of foreign travel or any known contact with a swine flu patient.

"Definitely, he got the virus from some carrier in his surroundings which means we have many unnoticed patients in the society. Though he had all the symptoms of swine flu, the doctors treated him like a normal patient of influenza -- because they do not know much about swine flu. The present weather, with winters having set in, is favourable for the spread of swine flu," the doctor said, stressing the need to educate doctors and people about the epidemic.

"The disease is not very dangerous and can be easily controlled in early stages. At present we do not have a good surveillance system at our airports, ports or borders to check the entrance of swine flu virus carriers. We need to establish a good system because the epidemic is very much present in our neighboring countries, America, Europe and Middle East. So far more than 600 people have died of swine flu only in India, mostly in Delhi, 300 in China, 140 in Iran and 15 in Afghanistan. So, we are also at high risk," he says.

The ground situation seconds Dr Javed Akram's argument. In Karachi, reportedly 20 patients have been found HINI positive so far. The tests have been done by a well-known private laboratory, the only facility available to residents of the city of over 10 million.

According to Iftikhar's colleague and family friend Nazia Ali, he died because doctors were unable to diagnose his problem. "He had slight cough and flu since November 18. He kept on taking antibiotic and also consulted senior physicians of the hospital, but his condition did not improve. He developed upper respiratory chest infection with high fever. He also complained of blood in sputum with severe breathlessness. But doctors, both chest and medicine experts, had no clue what was going on with him and kept on giving him antibiotic. He was also kept along with other patients in emergency and even in the intensive care unit (ICU)," she tells TNS.

A senior doctor at Nawaz Sharif Social Security Hospital told TNS on condition of anonymity that Iftikhar was kept along with other patients in the hospital. "We were not sure about his disease because there was no documented case of swine flu before him in Pakistan and that is why we had minimal information about the disease. Then we do not have the facility to check the presence of swine flu in Lahore. Only NIH laboratory has the facility," says the doctor who was also among the panel of doctors taking care of the late physiotherapist. According to him not only the patients but the doctors, who were looking after him, were at the risk of getting the virus. "We are giving anti-viral medicines to all those who were involved in the treatment of Iftikhar," he says.

Punjab Additional Health Secretary Dr Mushtaq Ahmed, confirming Iftikhar died of swine flu, said, "We have a facility to test swine flu at Jinnah Hospital Lahore but it is not as accurate as NIH, so we are dependent on NIH for the final report on swine flu.

"The said case has clearly indicated that we may have more swine flu patients in our society. We have also directed all public hospitals to establish separate wards for suspected patients of H1NI and have sent guidelines to doctors on how to treat such patients. Special medical camps had been set up at Allama Iqbal Airport for screening Haj pilgrims returning from Saudi Arabia," he says.

According to a senior official at Epidemic Investigation Cell NIH Islamabad, who does not want to be named, the institute has the only laboratory in the country to check swine flu. "We have received 150 samples of suspected NIHI patients from across the country out of which 20 have been tested positive and six have already died," he says.

Dr Arif Zaka, National Programme Manager of National Influenza Control Programme (NICP) of Federal Health Ministry, thinks Pakistan is as vulnerable to the epidemic as any other country in the region. "But prevention of the disease is very simple. People should try to avoid crowded places, wash their hands frequently and consult doctors if they observe symptoms of the disease. We have already dispatched the basic information about the disease to all provincial health departments. Anti-viral medicines and technical instructions regarding the usage of these medicines have also been distributed throughout the country. The high risk group of the epidemic includes pregnant women, children and elderly people. The thermo scanners on airports or ports are not the solution to the problem. We have placed scanners at Islamabad, Karachi and Lahore airports, but we do not have the facility on seaports. Only a laboratory test can check the patients of swine flu," he says.

An official of Federal Health Ministry tells TNS unlike bird flu test, swine flu test does not need a highly sensitive laboratory to scan the virus. "The mortality rate in bird flu virus is 70 percent while in swine flu it is not more than three percent. To test the presence of swine flu, only basic training is needed to operate the special kit," he says, adding the ministry does not have an exact data on the epidemic in the country. "There is no authentic record on swine flu carriers in the country and so far the Health Ministry has not come up with an elaborate plan to fight the epidemic," he maintains.

Executive Director of NIH, Dr Farnaz Malik says, "NIH has the capacity and enough trained staff to carry out swine flu tests." She does not agree that it is the responsibility of NIH to set up laboratories all over the country. "But we are ready to offer technical expertise to the staff of other public sector laboratories free of cost. We have already proposed the construction of international standard laboratories to the provincial governments. Punjab and NWFP have already started the construction of such laboratories and we have sent them latest equipment. The Balochistan government has also identified land in Quetta to set up such a laboratory, but the Sindh government has not even identified the land for the purpose so far," she says.

- Fever, which is usually high

- Cough

- Runny nose or stuffy nose

- Sore throat

- Body aches

- Headache

- Chills

- Fatigue or tiredness, which can be extreme

- Diarrohea and vomiting

Signs of a more serious swine flu infection may include pneumonia and respiratory failure.

It has been 38 years of Bangladesh's coming into existence. Keeping the current situation of the country in their minds, many former soldiers, who remained Prisoners of War (PoWs), think the 1971 lesson is forgotten.

East Pakistan tragedy happened when on December 16, 1971, the making of Bangladesh was officially announced and Pakistan's army, fighting in Bengal against insurgents and enemy forces, was asked to surrender. It is a day when one country celebrates its victory and the other mourns its debacle.

The East Pakistan (Bangladesh) liberation war started on March 26, 1971 and ended on December 16, 1971 when Pakistani armed forces surrendered. Bangladesh celebrates its official Independence Day since the war was started (March 16) and December 16 is observed as Victory Day.

This December 16, the 38th anniversary of this debacle, The News on Sunday spoke to a number of prisoners of war (PoWs). Looking back, they recalled some of their memories and experiences. There were as many as 90,000 Pakistani soldiers and officers who were taken as prisoners by the Indian army.

These former PoWs are of the view that past lessons are unlearnt. They believe that political leadership can strengthen Pakistan by building relationship between the provinces and the federation.

Brigadier (retd) Hafeez Malik, who retired in 1995, served in East Pakistan as a captain and remained a prisoner in Indian jail for two-and-a-half years. For him, it was a terrible experience. "I was appointed in Jesore when the war was going on. I was with my brigadier Muhammad Hayat, who passed away recently, at Khulna point when we got the message from the command to surrender," he said, adding, "It was a terrible moment. We were in a trench where my boss started striking his head with the wall protesting this message as we were committed to fighting to death."

The former army officer believes the situation was not as it has been made part of the history. Considering the whole nation collectively responsible for the debacle, he says many things are said about East Pakistan but mostly are rumors.

He said it was difficult to compare today's situation with that of the 1971. "East Pakistan was far from Pakistan. However, sense of deprivation was there," he recalled. "There is blame game on the political front, but as a soldier I know there were a lot of discussions, research and analyses within the army after this terrible experience," he added. Recalling his memories in prison, Hafeez said, "That was a terrible period. I spent two-and-a-half years in a jail in Agra where there was a lot of interrogation and many efforts to escape."

Lt Col (retd) Abdul Ghafoor, who was posted in Bengal in mid 1970 as a grade one staff officer, has almost similar views. "It was terrible. I was rounded up. It was really a bad time. Our morale was down," he said, adding that he remained in Gawaliar for two years where there were two camps for PoWs. "Being prisoners, we did not expect a positive treatment. We were expecting repatriation. Meanwhile, some of the camp members (PoWs) ventured escape by digging two tunnels but these were detected. The Indians reacted very harshly. They locked us (about 10 colonels) up in two small rooms with bare floors and no electricity. It was a sizzling summer. We got one dry chappati each for the entire day. Thereafter, almost daily at midnight we were pulled out of our beds asleep, made to fall in outside, were counted by Indians and then dismissed," he recalled.

"As PoWs' repatriation started, I too was hoping for my return. But instead I, along with dozen other officers, was handcuffed and pushed in an army truck and were brought to Agra Central Jail at night after nearly 10 hours of a grueling journey. We were put in two small cells -- brick-floored with iron fences and no doors. Next morning, we were shifted to large-sized barracks inside the jail where some 100 PoW officers were already there. We stayed there for four to five months, mentally prepared that we would be tried in Bangladesh. However, with Pakistan's recognition of Bangladesh, our repatriation materialised."

He thinks the then central government was responsible for the debacle. "This was Yahya regime and of course Zulfikar Ali Bhutto and Sheikh Mujibur Rehman, the Awami League leader, shared the tragedy. They all were in the saddle." Ghafoor said though the existing problems of the country are quite different from that of the 1971, the situation is more complicated now." He said political leadership would have to get together and find a solution.

Inayat Masih, a former sweeper of Pakistan army, was sent from Karachi to Bengal during the war. "I was in the plane among many other soldiers and officers. Our plane was not being allowed to land," he recalled, adding, "Later, guerilla forces intervened and managed the landing of the plane." The fight was already going on and we were very far from Dhaka. He said they were willing to fight even without any heavy ammunition. "Later, we heard that our commander General AA Niazi had asked the force to surrender. We listened to the message of the command aired on the radio and surrendered in pain. The Bengali army covered our eyes. We were sent to India and I was in Breli camp along with hundreds of other army men. The way the Indian army subjected the prisoners to torture was horrible," recalled the poor sweeper, who is living in a local Christian colony in miserable conditions. He is still dreaming of a better future, good governance and unity in the country.