Missing factors in health education

By Zubeida Mustafa
Source: Dawn

THE good news from the medical sector is that Dr Azhar Faruqui, the enterprising director of the National Institute of Cardiovascular Diseases, Karachi, has taken the initiative to establish a paediatric cardiology unit at the NICVD.

This will be the first of its kind in Karachi. Lahore already has one such unit. Until now, infants needing cardiac surgery did not have many choices and many of them went abroad for simple corrective surgical procedures if their lives were to be saved.

Some medical professionals resent it that patients are taken to India when similar procedures can be performed here. But the fact is that the facilities here are very limited. Recently, Shabina, who runs the Garage School for children of the katchi abadis in Clifton and also arranges for the healthcare of her students and their families when needed, took Maxwell Happy, aged 14 months, to Chennai for a congenital heart problem that needed corrective surgery. Doctors in Karachi had refused treatment saying they did not have the post-operative care facilities to perform the operation on such a young child.

It is therefore heartening for children like Maxwell that the NICVD will be setting up a unit for paediatric cardiology. Dr Azhar Faruqui told media representatives that he plans hiring the services of foreign surgeons and anaesthesiologists for the paediatric unit.
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War as Eqbal Ahmad saw it

By Zubeida Mustafa
Source: Dawn

EQBAL AHMAD, the academic, writer and activist, died over seven years ago. But even today, in the words of the American intellectual activist, Noam Chomsky, it is a “fascinating experience” to view major events of the past half century through his (Eqbal Ahmad’s) discerning eye”.

The Columbia University Press has facilitated this exercise by publishing The Selected Writings of Eqbal Ahmad (produced in Pakistan by Oxford University Press).
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Teaching in mother tongue

By Zubeida Mustafa
Source: Dawn

NADIA is a bright and intelligent child of eight. Her mother — a housemaid — has a dream. She wants to educate her children so that they can lift themselves out of the grinding poverty that has been their parents’ lot. Happily that is what President Pervez Musharraf says he also wants. But probably, he does not have a clue as to how to go about it.

Take Nadia’s case. She attends a private school (charging a monthly fee of Rs300) near her home in a low income locality of Karachi. With her mother’s help she has learnt to read and write Urdu fluently. I talked to her about the moon and the stars and explained the concepts of tens and units – in Urdu. She understood what I told her perfectly since this is a language she is familiar with. That night she even went out in the courtyard to explore the celestial bodies.
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Armed to the teeth, yet insecure

Reviewed By Zubeida Mustafa
Source: Dawn

THERE was a time when wars were fought by standing armies on the battlefield. If a state had a sufficient number of well-trained soldiers with high morale who were well-armed with the best weapons available, its citizens felt secure. No power could undermine their strength or invade their territory as long as their men in uniform held firm. But this notion changed when the concept of total war entered the science of military strategy with the introduction of weapons of mass destruction. Populations became vulnerable. They could be invaded and occupied. But more importantly, their strength enhanced national power. An educated, healthy and productive population became an asset for a state fighting a war to defend itself. This also made governments gradually aware of the importance of unconventional means of security that did not depend on arms and ammunition.

In due course, it came to be recognised that human resources counted as much as, if not more than, military power in the defence of nations. It was then that strategic thinkers and economists began to link the security of states to the quality of life of their people, their intellectual and moral calibre, and the sense of personal safety that comes from economic and social welfare. In fact Dr Mahbub ul Haq, Pakistan’s finance, planning and commerce minister under Ziaul Haq and the architect of UNDP’s human development reports, was one of the early protagonists of this concept of human security. Distinguishing territorial security from human security, he gave the latter a comprehensive definition: “security of income, employment, food, health, education and environment”.

It is therefore a befitting tribute to him that this is the central theme of the Mahbub ul Haq Centre’s report titled Human Development in South Asia 2005. Set up by the late Mahbub ul Haq himself in 1995, the centre has been publishing a report on different aspects of development in South Asia since 1997. These reports are important, inter alia, from the regional perspective.

In the latest report, the regional aspect assumes greater significance because territorial security — which falls essentially in the purview of governments — presumes the presence of an enemy. But on the contrary, in South Asia the majority of the people now yearn to live in peace and harmony within their societies and with their neighbours. If anything, their desire is obstructed by politics, ideologies of a minority and the greed of captains of industry — and, of course, those in the corridors of power.

The failure to resolve international tensions has affected human security in South Asia. It has robbed the region of the peace dividend that would have allowed the use of the resources saved by reducing military expenditure for social development. Ironically, the insecurity of people rises not so much from their fear of foreign enemies as their concern at violence within the household and societal injustice. Human development is closely linked to security because it equips people to defend themselves in adverse situations.

The report makes seven key observations about the state of human security in South Asia:

· economic policies have promoted unequal growth with the majority living in deprivation and extremely vulnerable to shocks;
· most conflicts that beset South Asia today rise from a sense of injustice among the affected people;
· economic insecurity is usually at the heart of these conflicts;
· a weak health infrastructure adds to human insecurity;
· environmental degradation has reached extremely high levels, affecting people’s lives and security;
· the ill-treatment of women and children adds to the insecurity of a large section of the population; and
· institutions of governance have failed to serve the people and provide them security.

It may be difficult to identify any single factor as the key element promoting insecurity. In many cases, different issues form a vicious circle with one reinforcing the other. But there are two which, if addressed independently, can help break this cycle. One is the high level of militarisation which leaves little resources for the social development of people. Some data revealed here is quite shocking. For instance, the number of personnel in the armed forces of some countries have escalated phenomenally between 1991 and 2002. In Pakistan, this number has gone up by 39 per cent while Sri Lanka has shown a growth of 36 per cent. Pakistan’s defence budget as a percentage of GDP is the highest in South Asia — 4.1 per cent.

This has an adverse impact on the social sectors and is reflected in the low spending on health and education. According to the statistics available, Pakistan spends six dollars per capita on health, ten dollars on education and $21 on defence. India’s figures are seven dollars, $21 and $12 per capita respectively. Sri Lanka, which a few years ago was held up as a role model for planning for the social development of its people, now spends $17 per capita on health and education each and $35 on defence.

If the institutions of governance had developed as independent, honest and dynamic bodies representing the will of the people, they could have served as a corrective mechanism to check the overemphasis on territorial security. In Pakistan’s case, there have been long periods when it has not even had an elected parliament.

What is, however, most surprising in this report is that there is no emphasis on education, the key tool for social development. True, an earlier report (Human Development in South Asia 1998) had focused on the education challenge in South Asia. But to study the issue of education in the context of human security is most essential as it would lead to interesting findings on the basis of which constructive recommendations could be made.

This report should be compulsory reading for the military leaders in the five countries of South Asia where armies constitute a significant force in national life — India, Pakistan, Bangladesh, Sri Lanka and Nepal. It is time they understood that security means something more than just building up arsenals to guard borders. As the survey at the end of the report unambiguously states, most people perceive security as the “ability to live free” (India), and life and self security (Pakistan and Bangladesh).

Human Development in South Asia 2005: Human Security in South Asia
Mahbub ul Haq Human
Development Centre in collaboration with Oxford
University Press, Plot # 38, Sector 15, Korangi Industrial Area, Karachi
Tel: 111-693-673
ISBN 0-19-547363-9
218pp. Rs450