Dawn Editorials 12th June 2023

Medical crimes

AS humans fade into numbers, our white coats paint a grim image for the sick. Last week, two women were victims of a strange roulette — the namesakes were wrongly operated on at Independent Hospital in Faisalabad; the one with a leg infection endured gallbladder removal and the gallbladder patient underwent a leg surgery. As is tradition, the Faisalabad health authority head formed an inquiry committee for an inquiry. A fortnight prior to the swap, an infant died of burns in an overheated incubator at Lahore’s Children’s Hospital.

Sadly, our laws do not keep pace with recurring crimes of neglect. Section 318 of Pakistan Penal Code 1860 states, “Whoever, without any intention to cause the death of or cause harm to a person causes the death of such person, either by mistake of act or by mistake of fact, is said to commit Qatl-i-Khata.” The Pakistan Medical Commission Act, 2020, is similar to its antecedent; the licence of a doctor can be challenged on many counts, including medical oversight, but provision for compensation to the victim is omitted. Such lacunae give ample latitude to practitioners to create silent misery as scores of the affected are too poor and ill-informed to pursue justice and legal procedures. Also, before an ailing economy is blamed for these woes, Cuba, with its exemplary medical system, should be seen as an inspiration. Healthcare was central to Fidel Castro’s communist regime, resulting in a surfeit of medics — the island’s most viable export — and a higher life expectancy than US. Therefore, our plummeting health sector is a sign of the vast rot in medical training, which overlooks empathy and mind application. A revised approach to clinical tutelage is a step towards an effective supervisory framework to ensure ethical medical practice. As for accountability, it must mean more than inconclusive ‘inquiries’. The disease burden on the state rises with every medical mishap.

Published in Dawn, June 12th, 2023


Deadly bond

IT is not often the Afghan Taliban claim a major scalp on the terrorism landscape, considering they are seen as giving sanctuary to a number of violent extremist groups on their soil. But in the case of Sanaullah Ghafari, emir of the Islamic State’s Khorasan chapter, they got it right.

One of the most wanted terrorists internationally, Ghafari was reportedly killed in an operation by Taliban security forces, though some news reports claim he was executed in Kabul. The significance of this development can be gauged by the $10m reward the US State Department had offered for information about Ghafari’s whereabouts.

Pakistan too has reason to be pleased; last December, IS-K had carried out an attack on its embassy in Kabul to directly target the country’s envoy. The 14th report of the UN’s Analytical Support and Sanctions Monitoring Team dilates at some length about Ghafari, who was then alive, describing him as “the most ambitious leader of the affiliate”. Ghafari, it says, was different from other IS-K leaders in that he was well-educated and had recruited more educated individuals into the organisation and even extended recruitment to non-Salafists.

For Pakistan, however, the main source of concern is the TTP which has an estimated 4,000 to 6,000 fighters inside Afghanistan. Since it announced an end to the ceasefire with Pakistan, the TTP has carried out more than 100 attacks in this country.

But despite the Pakistan government making its displeasure known, to the extent of the defence minister warning of strikes on terrorist hideouts inside Afghanistan, the Afghan Taliban have yet to take coercive measures against the group.

Repeated admonishment from world capitals about the Kabul regime reneging on the counterterrorism measures it had pledged in the Doha talks has fallen on deaf ears. The UN report notes: “The Taliban [do] not consider TTP a threat to Afghanistan, but rather as part of the emirate.”

The Taliban’s main rival in Afghanistan is IS-K, which has carried out some high-profile attacks on international and domestic targets in the country. In the current climate, especially with key decisions increasingly being taken by the ultra-conservative, isolationist Taliban leadership in Kandahar, it appears unlikely the TTP in Afghanistan will be restrained in any significant manner.

Pakistan’s folly in not recognising how the Afghan Taliban’s ideological affinity with the TTP would play out will continue to haunt us.

Published in Dawn, June 12th, 2023


Agriculture woes

THE government has proposed a raft of incentives in the FY2024 budget to boost the productivity of the agriculture sector and encourage investments in the agro industry. Among the steps announced by Finance Minister Ishaq Dar on Friday is a significantly large increase in loans for farmers — from Rs1.8tr Rs2.2tr — the allocation of Rs50bn to shift 50,000 tube wells to solar power, the withdrawal of duties on seed import, and duty exemption on the import of combine harvesters. The budget also proposes the removal of duties on rice planters, seeders and dryers, in addition to setting aside Rs16bn for concessional loans and tax relief for agro-based industry. On the face of it, all these measures appear to be populist, aimed at pleasing a large electorate associated with agriculture. However, it remains unclear — and doubtful — whether these actions will have a meaningful impact on the lives of farmers, especially the smallholders. Nor is it clear if they are effective enough to address long-standing issues such as the rising cost of inputs, climate change, water shortages, etc, that are pulling down the farm sector and hampering value addition in a part of the economy on which depend, directly or indirectly, two-thirds of the population, for their livelihoods.

Agriculture is a large and diverse segment of the economy which remains criminally neglected, poorly organised and highly inefficient. Its problems are too complex to be dealt with the incentives announced in the budget. With the country trying to cope with a level of hunger that is described as serious by the Global Hunger Index, and having suffered massive damage to its farmlands last year due to climate change-induced floods, a complete rethink of obsolete agricultural policies that focus on fixing the prices of crops and doling out subsidies is needed. Studies have shown that the current policies protect the interests of big landlords, speculators and middlemen. Policies and fiscal interventions on behalf of a small group of large growers are the main reasons for growing rural poverty, low crop value addition, and rising food insecurity. No policy initiative or incentive can turn the agriculture sector around if it doesn’t put the smallholder farmers at its centre.

This means that the government must invest heavily in agriculture research, set up initiatives to encourage the formation of cooperatives and adoption of technologies, and mitigate the impact of climate change. It should also design programmes to enhance the small growers’ access to cheaper formal credit, give them crop insurance, and link them to the markets to eliminate the role of the middleman, thus raising their incomes. A well-developed agriculture sector can contribute a lot to economic development and alleviate poverty. For this to happen, the policymakers need to clean up the mess they have made in this important sector.

Published in Dawn, June 12th, 2023

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