Healthcare rot
THE exploitation of the Sehat Sahulat Programme in Punjab by the medical community is both alarming and disgraceful. Designed to provide crucial health services to the underprivileged, the scheme has, instead, been hijacked by money-grabbing elements within the healthcare sector. An example of this greed is the disproportionate number of caesarean sections carried out in private hospitals, ostensibly for financial gain rather than medical necessity. From 2016 to January 2024, a staggering Rs16.36bn was claimed by private hospitals for caesarean and normal delivery procedures, with an overwhelming majority being C-sections. The stark disparity in the number of C-sections performed in private versus public hospitals is telling. In 2023, private hospitals conducted 197,376 caesarean procedures, compared to 97,390 in public hospitals. The years before saw similarly disproportionate figures, underscoring a concerning tilt towards unnecessary C-sections after the launch of the health card scheme in 2016.
Unfortunately, this is not an isolated case. It echoes a past scandal under the same programme, where the Punjab Institute of Cardiology was found redirecting patients to private facilities, compromising patient care for monetary benefits. In other incidents, cardiac patients were administered expired stents and several diabetic patients’ vision was compromised after they were treated with substandard injections. These scandals highlight a systemic rot within Punjab’s healthcare system, characterised by negligence, corruption, and poor accountability. Addressing these challenges demands more than ad hoc interventions; it requires a systemic overhaul to instil ethical practices and accountability in healthcare. The onus is on the government to undertake rigorous measures. An independent probe is required to ascertain why so many women underwent C-sections and whether they were even needed. To address graft, stringent oversight mechanisms must be instituted, besides comprehensive audits of healthcare programmes, and severe penalties for those found exploiting such initiatives for personal gain. It is crucial to ensure that such egregious abuses of trust do not recur.
Published in Dawn, March 7th, 2024
X disruption
DESPITE a court order directing the restoration of citizens’ access to popular microblogging platform X and past rulings against the blockage of internet services, the social media service has remained inaccessible in Pakistan for more than two weeks.
Though such decisions are usually officially ‘justified’ by the authorities based on some pretext or the other, this time, the state does not seem too bothered about providing any explanation as to why users are being denied access to X.
This ‘strategic ambiguity’ from the authorities has added to the confusion surrounding the status of the service in Pakistan.
For example, according to an account shared by one of the lawyers representing a case against the suspension of X, a representative of the Pakistan Telecommunication Authority — which, among other things, also regulates internet access — flatly denied that the service was blocked during a Tuesday hearing on the matter in the Sindh High Court.
He then attempted to convince the judge by pointing to an open X application on his phone as ‘proof’ of a claim that flew in the face of the findings of various international internet watchdogs.
The question arises: if the country’s top regulator is claiming that it is not doing the blocking, who, then, is preventing access to X?
The recently departed caretaker government had acted as if the matter was no big deal: none of the relevant ministers had deigned to comment on or explain why anyone within Pakistan’s territorial boundaries could not access one of the most popular social media platforms in the world without a VPN, even though they were posting on the platform periodically during their last days in office.
The silence from official quarters has continued even though new assemblies have been sworn in, which suggests that the authorities aren’t very concerned that a major internet service remains suspended, apparently without the knowledge of the country’s top regulator.
Given the state’s nonchalance, one would naturally assume that the authorities are either afraid to speak openly on the matter or are deliberately misleading the courts while hoping that the citizenry will quietly accept this new ‘status quo’ over time.
Neither is an acceptable scenario. X is a valuable source of information for millions around the world, and access to it cannot be denied arbitrarily. The state must, at the very least, explain itself.
Published in Dawn, March 7th, 2024
Justice denied
THERE have been many crises in Pakistan’s torturous history that remain unresolved, lacking closure mainly because the nation — particularly its institutions — failed to acknowledge the ‘whole truth’ of these events. Zulfikar Ali Bhutto’s 1977 removal in a military coup, and his subsequent hanging in 1979, are part of this list.
Both were epochal events that changed the trajectory of Pakistan’s history; their after-effects still haunt the system. In this regard, the Supreme Court’s observations on Wednesday, regarding Bhutto’s trial, are an important milestone in the nation’s legal and political history.
The apex court was hearing a reference filed by Asif Ali Zardari in 2011, when he was president, seeking the court’s opinion on Bhutto’s death sentence. The PPP founder had been convicted by a Lahore High Court bench of the 1974 murder of Mohammad Ahmed Khan Kasuri; the SC, in a split 4-3 decision, had upheld the LHC verdict, paving the way for the execution of Pakistan’s first popularly elected prime minister.
While noting that the law does not provide a mechanism to set aside the original judgement, the Chief Justice of Pakistan Qazi Faez Isa noted in the short order that the LHC trial and the SC appeal in Bhutto’s case did “not meet the requirements of the fundamental right to a fair trial and due process”. The SC’s observations have validated what legal experts have been saying for decades: that Zulfikar Ali Bhutto’s conviction was a travesty of justice — a ‘judicial murder’ as his party has put it.
It can be asked why an over four-decade-old case was dusted up when blatant injustice continues to be meted out today. Perhaps revisiting the Bhutto case is relevant because of these very injustices. It shows that even popularly elected prime ministers can be humiliated, incarcerated and even sent to the gallows when the state desires it, and that the legal system can be manipulated to suit the whims of powerful forces.
Similar criticism of the judiciary has followed Imran Khan’s iddat case, as well as Nawaz Sharif’s run-ins with accountability courts in years past. That is why, as the chief justice observed in the short order, the judiciary should, “confront our past missteps and fallibilities with humility, in the spirit of self-accountability”.
This need for internal introspection is required in all institutions: the judiciary, the establishment, as well as the political class. The SC’s observations on the Bhutto trial are a confirmation of the fact that in the past, the pillars of state — guided by the doctrine of necessity — have participated in undermining the constitutional order they had sworn to protect.
Though the grave injustice done to Bhutto cannot be reversed, state institutions can pledge to not repeat the wrongs committed during this sordid chapter of Pakistan’s history.
Published in Dawn, March 7th, 2024