The Express Tribune Editorial 30 September 2019

The many perils of Afghanistan


Millions of Afghans braved the odds to cast their ballot in the country’s fourth and most flawed presidential election, which has the potential to drive the war-torn country into worse chaos.
Saturday’s poll allows President Ashraf Ghani to seek a final five-year term in an overcrowded field of more than a dozen other candidates. The process to elect the next Afghan President has never been smooth nor easy. And the current election cycle is no exception. Allegations of fraud and misconduct, along with
widespread violence, have dogged the entire voting exercise.
Attacks all over the country have left a dozen people wounded and forced millions to stay at home. Perhaps that’s what the Taliban wanted. But despite all the odds, there were two clear winners in the process — the Afghan people who defied death to cast their vote and the security forces who were able to prevent absolute disruption of the voting process. However, one unwanted chapter remains unchanged for Afghanistan. The 18 year-long battle with the United States will continue, and so will the cost that Afghans pay every passing day.
The real victory for the Afghan people in this election would be to elect a leader, who unlike the incumbent, is credible, sincerely invested in the peace process, and is willing to flex for the greater good of the nation and the Afghan people.
The current government in Kabul came together after the Obama administration intervened to end the deadlock that surfaced after the last presidential poll. Its legitimacy has waned over the years, and so has its credibility. And if the outcome of last week’s election is stitched by force or by foreign intervention, there is a significant chance that Afghanistan will plunge into an endless cycle of violence which is not what the Afghan people deserve.


Doctors, K-P govt on warpath


The Khyber-Pakhtunkhwa government and the medical fraternity appear to be on warpath after Friday’s violent incident outside Peshawar’s premier health facility – the Lady Reading Hospital. The doctors were protesting against a new piece of legislation which, they apprehend, will give the authorities the power to dismiss medical practitioners with the stroke of a pen. In a violent response, police roughed up and rounded up the protesting doctors and paramedics. In a sign of deepening trouble, the medical community announced it will extend its strike across the province’s state-run hospitals while authorities in Peshawar shifted 15 doctors and paramedics it had arrested on Friday to the Mardan Central Jail for one month.
An order issued by Peshawar’s deputy commissioner said the detainees had been sent to the jail under 3-MPO for making a violent entry to the LRH, blocking a major road, paralysing activities in the provincial capital, and badly damaging property.
The doctors and paramedics announced that the strike would continue until the detainees were freed and their demands were met. Their representative body, named the Grand Health Alliance, demands that the government reverse the enactment of the Regional and District Health Authorities Bill (RDHA), and remove health minister Hisham Inamullah Khan. The alliance claims that the Medical Teaching Institutions Reforms Act enforced across the province in 2015 had caused ‘great harm’ to the teaching hospitals, while this new bill – RDHA – would do the same to the district health facilities. The Pakistan Medical Association has also thrown its weight behind the protesters and asked the government not to enforce the new legislation without consulting stakeholders, especially doctors. We hope the government resolves the matter by speaking to the protesters instead of trying to impose its will by force.


The vaccination dream


Pakistan’s healthcare crisis continues to be a cause for serious concern with the government’s Demographic and Health Survey stating that only 66 per cent of the country’s children aged between 12 and 23 months received all basic vaccinations in 2017-18. This is despite the fact that the country’s Expanded Programme on Immunisation (EPI) offers free vaccination for 10 deadly children’s diseases and that Pakistan had launched its first national vaccination initiative as early as 1980.
There are several major challenges that must immediately be addressed. First and foremost, the lack of awareness regarding vaccines’ effectiveness as well as well-known myths regarding ‘foreign conspiracies’ and their ‘harmful’ effects propagated by extremists must be countered via a concerted awareness campaign launched through the media. Such campaigns must also include religious scholars and, where applicable, tribal elders. Secondly, the 18th Constitutional Amendment had, in 2011, devolved social services, including health, to the provinces. However, due to the programme’s unstructured handover to the provinces, EPI’s performance and coverage have suffered. There is thus a dire need to take a close look at the planning and organizational mechanisms of the provincial programmes and revamp them as necessary to improve performance. Thirdly, the federal government spends a colossal amount on global vaccine procurement every year. Instead, the significant current national potential to produce quality vaccines must be exploited to focus the limited available resources on improving EPI performance. Additionally, EPI must engage with physicians so that they urge their patients to immunize themselves, and also encourage private sector involvement which currently amounts to less than 5% of the total immunization effort. Unless these measures are implemented, the dream of achieving full vaccination coverage for our children will remain as elusive as ever.

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