Pakistan generates about 20 million tonnes of solid waste annually, and its dumps have become a hub for child labour.
Farahnaz ZahidiLast updated: 11 Aug 2014
Some four million children, die each year from waste-related diseases in Pakistan [EPA]
|Karachi, Pakistan – In the economic hub of Karachi, Ali, an 11-year-old child, awakens at dawn while the rest of his family sleeps next to burners and barrels that will be used to disintegrate metal waste.
The barrels contain acid, and wires and circuits will be burned in the open air, releasing harmful emissions. But Ali’s impoverished family needs whatever money they can get from this dirty business.
Muhammad Ishaq, 12, is another child hostage to the rubbish he collects for a scrap dealer. In return, the scrap-dealer gives his parents fixed Rs 2500 ($25) a month.
“My shed broke in the recent rains. Where will I live now?” is his recurrent concern, as he refers to the shed made also of, ironically, pieces of wood and cardboard he finds in the trash.
A waste of a nation
Both Ishaq and Ali are among thousands of Pakistani children who work as scavengers, combing through piles of rubbish for a daily pay that maxes out at about $2.
Besides being out of school, these children face severe health hazards from the unsafe handling of waste.
“These children get food and clothes from NGOs or common people… They eat at charities and bathe in mosques. They are very susceptible to scabies and infected wounds. They suffer from diarrhoea all year round,” said Rana Asif, Founder of Initiator Human Development Foundation, that works for the welfare of street children.
Copper remains the most lucrative find for these boys. It is sold at Rs 500 ($5) a kilo, and aluminium at Rs 100 ($1) a kilo, and all of this is found in electronic waste.
These children – 95 percent of whom are male – are often found at Karachi’s biggest markets for e-waste in the Shershah, Lines Area and Regal neighbourhoods.
“We find computer monitors, and buyers buy them from us for a pittance, but sell it for much more. We get nothing,” said Yaargul Khan, 14, older brother of Ishaq.
Even as child labour remains rampant in Pakistan, almost 5.2 million people; including four million children, die each year from waste-related diseases in Pakistan.
A report by Triple Bottom-Line found that globally, many people did not know their old computers and televisions were shipped to countries such as China, India and Pakistan for “recycling”.
Manually dismantling electronic devices comes with a slew of health hazards, including exposure to toxic substances called furans and dioxins.
Burning these materials is even worse: A burning computer releases dioxins, lead, chromium and other toxic substances. Ali has no choice in the matter, and no gear to protect him from the fumes.
Pakistan generates about 20 million tonnes of solid waste annually, according to the country’s Environment Ministry, and that number is growing by about 2.4 percent each year. The waste management methods in Pakistan, however, remain poor.
The country’s most populous city, Karachi, generates an estimated 9,000 tonnes of waste daily, and garbage collectors cannot keep up.
Recycling is not widely practiced, and in many urban areas, dumping and trash burning are daily occurrences.
Asif Farooqi, the CEO of Waste Busters, a Pakistani waste management and recycling firm, says a big part of the problem is improper waste collection.
His team goes door-to-door collecting garbage bags – in Lahore alone, the company services 70,000 homes – and repurposes the contents. From inorganic trash, Waste Busters derives a form of fuel; from organic waste, they create compost.
“What we need from people is to stop open dumping and use garbage bags,” Farooqi told Al Jazeera. “And from the government all we need is administrative support. They should at least not create hurdles for us.”
Shifting the blame
While the administrator for the Karachi Metropolitan Corporation (KMC), Rauf Akhtar Farooqui said the solid waste management is the responsibility of the District Municipal Corporations and not of KMC, the Commissioner of Karachi, Shoaib Ahmed Siddiqui told Al Jazeera that it was, in fact, very much the responsibility of KMC.
“Sadly, no organised or satisfactory system of solid waste management has been developed till now,” he told Al Jazeera.
“The facilities are much too few compared to the waste generated.”
Siddiqui expressed hope that things will get better as a result of the recent formation of the Sindh Solid Waste Management Board.
“This applies to e-waste management as well,” he said.
In neighbouring Punjab province, where over half of Pakistan’s population lives, the Environment Protection Department openly acknowledges the shortfalls, stating on its website: “Environmental legislation is still not well developed in Pakistan, especially in comparison to the developed world. For example, there are no National Quality Standards for [solid waste management].”
Still some hope
The situation has created openings for environmental organisations such as Gul Bahao, which literally builds homes out of rubbish, using materials such as bubble wrap and thermocol.
“Attitudes are changing,” Gul Bahao’s Nargis Latif told Al Jazeera.
“Youth have joined hands with us. Students help us collect funds for this. I am very hopeful.”
Even as the south Asian giant struggles to manage its solid waste, its children continue to scavenge trash for petty income at the cost of their childhood, health and education.
Names of some children have been changed to protect their identity.
Follow Farahnaz Zahidi on Twitter: @FarahnazZahidi
Category Archives: Karachi
In a cup-sized chai dhaba, off a constantly flowing street near Shoe Market in inner Karachi, a deal is taking place. Agents of event organisers are talking to young men who have barely grown facial hair. These are the sons of the Qawwal bachchay, men who shoulder the task of taking forth a centuries’ old tradition.
This year the suffocating Karachi summer has coincided with the Islamic calendar months of Rajab and Sha’ban, which are peak season for the Qawwals. Rates and dates are being decided. Diaries are being feverishly filled and numbers are being exchanged on inexpensive worn-out cell phones. Paans pass from hand to hand in the spirit of sharing. So too are lines of spiritual poetry, effortlessly woven into the negotiations, for after all, this is part of creating amaahol or ambiance.
The paan-and-poetry infused sweet-talking is a particular form of marketing. The young Qawwals are vying for the prominent programmes and anxiously keeping an eye on who will be signed up the most. Name-dropping ropes in ancestors long dead who were in some way connected to the man who started it all: Hazrat Ameer Khusro. Also making an appearance in the conversation are celebrities and politicians who are the shaagird or students of the great Ustaads. It is also a source of pride that the artists here can say they have performed at Ajmer Shareef in India.
This is Karachi’s Qawwal Gali or lane, which actually refers to a neighbourhood of five streets. They are named after five of the most celebrated Qawwals: Munshi Raziuddin Qawwal, Moeen Niyazi Qawwal, Kallan Khan Qawwal, Jaafar Hussain Nizami Qawwal and Bahauddin Qawwal.
Its residents are the Qawwals who refuse to let this art form die. “That is what we want to do,” says Toqeer Ahmed, who is in his 20s and belongs to the Khurja Gharana’s Nohar Bani branch of classical singers. “I know of no one in my community who wants to leave this art. This is what I was created for.”
Thus, the Qawwal bachchay, as they proudly refer to themselves, fiercely guard their heritage. Indeed, conversation in Qawwal Gali always goes back 800 years. These families have been celebrities for centuries. They may physically live in the present, but live in the grip of a glorious past. Names of their ancestors are medals that they wear every day of their lives. Each family claims to be the gharana and most of them know their family shajra or tree by heart.
Housing in Qawwal Gali. PHOTOS: FAISAL SAYANI
Most of them moved here in the 1950s and 1960s from India. Every second person in this galiclaims to belong to an authentic gharana or household. Research shows that not all of them belong to the original 12 families, but have learnt the art from them. The mishmash of interconnected lineages and where they inherited the musical art form of the Qaul, all seem to lead back to Hazrat Ameer Khusro. The father of Qawwali, as he is often called, was a 13thCentury Sufi musician, poet and scholar and a spiritual disciple of Hazrat Nizamuddin Auliya. Qawwali, originating from the word Qaul or the uttered word was a form of expressing religious reverence. “Some 805 years ago, our ancestor Miyan Saamat learnt this musical art from Hazrat Ameer Khusro,” explains Saifuddin Qawwal, who is part of the Najmuddin Saifuddin Qawwal Brothers ensemble. “Twelve young Qawwals were trained by Hazrat Ameer Khusro. The original Qawwal bachchay are descendants of those 12.”
Qawwal Gali. PHOTOS: FAISAL SAYANI
Qawwal Gali is home to many families but according to Saifuddin, those who are the Qawwal bachcha gharanas are about five to six. Fareed Ayaz, the Saami brothers, Najmuddin Saifuddin brothers, Abdullah Niyazi, Subhan Nizami are the main names, he says. When asked how one can differentiate between the gharanas and Qawwals in general, he explains that it all boils down to lineage. “This heritage of all the genuine gharanas connects to our ancestor Tanras Khan; his time was about 134 years ago.”
As can be expected with the passage of such time the number of original families has changed as has the type of music performed. The Qawwali you will hear today is a much diluted version of the original shudh Qawwali. The new synthetic versions merely entertain or provide a quick spiritual fix and lack the original reverence and deliberation that was once a pre-requisite. According to Saifuddin, the modern audiences are mainly responsible for this sea change. “We give what they demand,” he says. “I am not satisfied with where Qawwali is going today; this is not what our ancestors introduced,” he adds. “Innovations are taking it to a point where we are losing the original Sama that was sung. Magar such baat hai, pait kee khaatir karna parta hai. The truth is that we have to do this to earn a living. Even those of us who are trained to sing the authentic Qawwali have begun innovating for commercial reasons.” He gives the example of his family’s Hamza Akram to argue that changes are still being seen as acceptable as long as they keep the art within the framework of original teachings.
Some of the activities in Qawwal Gali. PHOTOS: FAISAL SAYANI
Saifuddin’s assertion that audiences are to blame is generally shared. But qawwals such as Rauf Saami, the eldest son of the living legend Ustad Naseeruddin Saami, react differently to this reality. “We have to bring up the taste of listeners once again, and sensitise them to better listening,” he says as he believes that true Qawwali is an acquired taste. The responsibility of carrying forward and stemming the tide of degeneration of the art form is acutely felt. It is a collective responsibility, as Rauf Saami’s use of the pronoun ‘we’ indicates.
The sense of community runs parallel to the pride in heritage. Qawwal bachchay cannot and do not lead solitary lives or perform individually. They need each other, not just to provide the rhythmic background clapping and chorus, but also for moral support. And even if one member of a troupe is the star during a performance, the limelight will be shared. Qawwal bachchay survive in numbers, and they know it.
“Our survival is in community existence. We perform in packs,” says Rauf Saami.
Azeem, son of Ustad Naseeruddin Saami, with a taanpura. PHOTOS: FAISAL SAYANI
The Saami Brothers belong to one of the most renowned and authentic Qawwal bachchagharanas that is recognised for its repertoires, tans and alaaps. Rauf is the grandson of the world renowned Munshi Raziuddin Qawwal after whom a street is named here. Their ancestral house in Qawwal Gali has witnessed many changes. The architecture of the house is reminiscent of styles found in old Peshawar or inner Lahore. Other homes in the neighbourhood are located in apartment buildings typical of the over-crowded Saddar area in Karachi. The ground floors of each building are generally taken up by shops for paan, chai and groceries. As the Qawwals stand around and talk in the street, the women peek from balconies with shy smiles. Washed clothes hang out to dry on every balcony.
“Our women don’t sing. Just like women cannot enter a mosque, they are not allowed to sing Qawwali,” explains Saifuddin. “Our older women sometimes sing within the four walls of our house; but they should only sing tunes that are created by our family or ancestors.” The Qawwal bachchay do not marry outside the community either: “No one else will understand our sensibilities and lifestyle.” The young Toqeer sheepishly nods in agreement. “I will marry only within my community,” he adds. “Otherwise the girl will not be able to adjust to my family.”
A chai dhaba near Shoe Market in inner Karachi. PHOTOS: FAISAL SAYANI
This sense of protectiveness of a culture is understandable. As the epicenter of a complex art form, Qawwal Gali has become a hub of eager laymen who have a burning desire to learn the art, and enter the coveted space by apprenticing as shaagirds of the Ustaads. The sons who have learnt the techniques passed down for centuries become the teachers of these students across Karachi. They set off each day on their motorcycles to give “tuitions” after a late afternoon meal, which is breakfast for them, owing to a nocturnal lifestyle. But once in a while, a chosen student with potential will get a chance to visit the main Ustaad, usually the father or an uncle of the juniors, at their home in Qawwal Gali. The hierarchies here are well-defined.
The Qawwals are territorial; their turf consists of their students and fan base. They are fiercely competitive and will try and outdo the others on stage as well as in claims of authenticity. “Professional jealousy does exist among us,” concurs Saifuddin. “Like in a market if there are shops of many cloth-sellers, each will try and attract the customer.” The neighbourhood’s curiosity over a new visitor to one family is ample proof of this.
Ustad Ghulam Khusro Khan of the Nohar Bani family claims that to classify as a truegharana, one must have a grip of the 12 genres of classical singing. This is the criterion:Dhurpat, Saadhra, Hori, Tirwat, Chatran, Tarana, Tappa, Khayal, Chann, Parband, Sargam,Ba Maani Sargam — and one must know them all. “Those who don’t are just those who pretend to be genuine,” he says. Breadth of knowledge of the art form and its trajectory are also important markers of authenticity. He reels off the names of his ancestors, of festivals they have been invited to and of celebrities who are his students. Tough rivalry with other Qawwals and a feeling of being under-appreciated on television has left Ghulam Khusro bitter. The competition here is cut-throat.
Yet, as a community, they stand by each other in times of trial. The men travel extensively to perform worldwide, especially with the upsurge in global interest for Qawwali in the last decade or so. In their absence, the other men of the community are there to see that families are well protected.
Patrons of this devotional form of music world over reward Qawwal bachchay generously. Hence, most of them can afford to live in better, less crowded and cleaner localities but choose not to. Saifuddin explains it simply: “This is Karachi’s safest area. This part of the city never closes. We sit out here in the street all night. Our people are here. Why would we go anywhere from here?”
Farahnaz Zahidi heads the Features desk at The Express Tribune. She tweets @FarahnazZahidi
Published in The Express Tribune, Sunday Magazine, June 29th, 2014.
With a multitude of furniture shops in Karachi, Ebrahim, seven years into the business, is still operating from home and her workshop, with one to two exhibitions in a year. And to highlight the contributions of local artisans, Ebrahim and her partner Rubain Ali Amir make sure they hand a paper to each potential client titled ‘Celebrating our artisans’.
Owing to dependable quality of wood (mainly sheesham) of her pieces, connoisseurs of furniture are willing to pay even a slightly steep price for them. PHOTOS: JAMAL ASHIQAIN
It states the various techniques and forms of craft they use including wood inlay, brass inlay, and rilli qulits (quilts) from Sindh, which Ebrahim utilises as upholstery. “The rilli is whimsical in nature,” its says. When mentioning the blue Hala pottery, she makes a special mention of Jaan Soomro from Hala and other artisans like him.
The collection comprises chairs and sofas upholstered with kilms, rillis from Sindh, and Kashmiri and Swati embroidery. It also offers a variety of lamps, trolleys, wall hangings, almirahs, levitating corners and shelves, sofas and tables.
Owing to perfection in the finish and dependable quality of wood (mainly sheesham) of her pieces, connoisseurs of furniture are willing to pay even a slightly steep price for them. But what rivets their attention is the thematic and cultural influences in her work.
Owing to dependable quality of wood (mainly sheesham) of her pieces, connoisseurs of furniture are willing to pay even a slightly steep price for them. PHOTOS: JAMAL ASHIQAIN
With names such as Aztecs (Mexico), Khul Ja Sim Sim (Middle East), Dancing Gopis (India), Alhambra (Spain) and Tutankhamun (Egypt), her furniture pieces are analogous with travelogues.
A resident of Karachi, Ebrahim celebrates the sights and sounds of the metropolis through her work, for instance, a thematic set of trays with black crows, bougainvilleas and landmarks, which represent the city.
Seeing Persian and Arabic poetry and phrases carved on some of the pieces, one wonders how her clients respond to the presence of these inscriptions in a land where these languages, especially the latter, is venerated. “I have never had a problem because I make sure I use only vernacular phrases on my pieces and nothing religious,” she explains. The only place where she may make religious references is in wall hangings and lamps. “Usually, clients do not want anything like that on tables.”
Owing to dependable quality of wood (mainly sheesham) of her pieces, connoisseurs of furniture are willing to pay even a slightly steep price for them. PHOTOS: JAMAL ASHIQAIN
Also mentioned are woodcut or xylography and geometrical designs. When it comes to calligraphy, Ebrahim prefers the Kufic script. “The low vertical profile and horizontal variations in it are beautiful. I enjoy the vagueness in Kufic script, where the boundary between word and design disappears,” she says.
Published in The Express Tribune, June 5th, 2014.
By Farahnaz ZahidiPublished: March 23, 2014
A day ahead of the World TB Day, we look at the difficulty level of treating the disease.
Faces all around you are covered by masks, even your own, because the moment you enter the area you are handed a mask.
All you can see is eyes. Some red and tired, swollen after hours of coughing and staying awake. Others more hopeful and healthier, obviously recuperating from a disease that can kill but can be easily avoided. One way of avoiding it is this simple face mask that wards off communicable diseases like tuberculosis (TB).
The environment is airy and sunny. It has been designed in a way that germs will have a tough time surviving here. Scores of patients are waiting for their turn. Some are seen standing in queues and others napping on benches.
This is the TB clinic at Indus Hospital Karachi. Muhammad Zaheer is currently under treatment for DR-TB here (drug-resistant TB). Despite months of treatment and counselling, he still repeats out loud the myth he believes in. “Ye hamari khandani beemari hai. It is a familial disease. My father died of it. Lots of my relatives have it,” he says in a matter-of-fact way. The middle-aged carpenter knew he had TB even before he got married, but never exercised any precaution. His wife’s family never thought it dangerous she would be marrying someone who has TB. His four children have never been tested for TB.
Thus, lack of awareness remains a major challenge in the treatment of TB. “There are an estimated 300,000 cases of TB detected in Pakistan every year. Almost 20 per cent (58,000-60,000 kids) are children under the age of 15,” says Dr Ghulam Nabi Qazi, a public health scientist from WHO.
The WHO website cites a higher number, stating that approximately 420, 000 new TB cases emerge every year and half of these are sputum smear positive. Pakistan is also estimated to have the fourth highest prevalence of multidrug-resistant TB (MDR-TB) globally. Pakistan ranks fifth amongst TB high-burden countries worldwide.
“TB is common in both rural and urban areas, as it is a communicable airborne disease. Urban areas are crowded, leading to spread of TB. In rural areas there is more poverty; people can’t afford timely medical checkups and medicines and end up becoming victims of the disease,” says Dr Qazi.
Clinical psychologist Zainab Bari is one of the first people TB patients meet at the Indus Hospital’s TB clinic. “Lack of awareness is a major problem. Unless people understand their disease, controlling it becomes very difficult,” says Bari. At the clinic she sensitises patients about how to avoid catching the TB germs. TB, contrary to myth, is not a genetic disease. It is an airborne, highly contagious droplet infection. Bari informs patients about facts like mothers with TB can breastfeed their babies, so long as their faces are covered by masks to avoid infecting the children.
The same holds true for physical contact between couples, because TB is not a sexually transmitted disease. Counselling is also needed because of the stigma and discrimination against people with TB. People avoid TB patients, and sometimes the stigma leads to severe consequences like isolation and divorce.
Yet, Pakistan’s progress in the control of DR-TB in particular is seen as something of a success story compared to many other regions of the world.
Over the six years that the TB programme has been running at the Indus Hospital, a cumulative number of approximately 10,000 patients have registered for treatment here, of which 8,000 have been treated, shares research associate Rubab Batool of the Indus Hospital. “We have treated around 600 patients successfully for DR-TB until now. Currently, 264 patients are enrolled with us for DR-TB.”
The food factor
“We somehow see a lot of female patients here,” says Dr Sana Adnan, who is one of the doctors at Indus Hospital treating TB patients. In Dr Adnan’s opinion, the reason is that women are generally not nutritionally well-fed in our patriarchal set-up and are hence more susceptible to catching TB due to low resistance. “TB is very directly related to food and a strong immune system. The doctors working with TB patients are advised not to come in contact with patients on an empty stomach, because if they have been eating enough, their chances of catching the germs are reduced.” The doctors here call it an informed decision to work with patients of this highly infectious disease. “At least we are aware of what we are working with and can take precautions. One could catch the TB germ anywhere in an enclosed space where people come in close contact, even at a shop you go to for shopping,” says Dr Adnan from behind her mask.
Doctors estimate that most Pakistanis have been exposed to TB germs, but our immune system stops it from becoming full-blown TB.
TB remains more common in the lower socio-economic groups. In easier words, it is a disease of the poor, very directly related to malnutrition and food insecurity. “One reason why patients willingly keep coming to us for regular treatment is because we provide food baskets to many of them, as well as vouchers for transport so that they can come to us even from far flung areas. This acts as an incentive. They are getting treated and their families are not going hungry,” says Dr Maria Jaswal, assistant clinical coordinator of the Susceptible TB Programme at Indus Hospital.
Dr Amanullah Ansari, provincial technical officer for TB Control, Global Fund, shows guarded optimism when it comes to MDR TB in Pakistan. “Some 200,000 cases of MDR TB are still not in our fold and are undiagnosed in Pakistan; there are an estimated 55,000 in Sindh alone. But yes, there is success, because we have begun detaining MDR TB cases, and treating them. But till people keep going to quacks for treatment due to lack of awareness, our challenge remains,” says Dr Ansari.
More than 30 per cent which is a whopping three million cases of TB remain undiagnosed worldwide. The WHO’s slogan currently is to reach these missed cases.
Published in The Express Tribune, March 23rd, 2014.
By Farahnaz ZahidiPublished: February 8, 2014
In a country where maybe just three per cent of the population can truly read, reflect upon and understand literature written in English, is it worrisome that the best minds of the country are increasingly tilting towards writing in English.
KARACHI: Intelligent looking men engrossed in animated conversations with women clad in crisp pure cottons with motifs inspired by Pakistan’s traditional arts, wearing kolhapuri chappals and sporting white stylised hair, the venue is teeming with Pakistan’s intelligentsia. For once, even if for a short three days, the topics of discussion here are education, language, literature and the arts.
But the bigger issues Pakistan is plagued with, like security and sectarianism, have a way of sneaking into the books being sold and the conversations taking place. For Pakistanis, there is no escape from certain acetone realities.
Inside the room labeled “007” at the Beach Luxury Hotel, the answers to some tricky questions are being handled by the participants. And why not. This particular session at the 5th Karachi Literature Festival (KLF 2014) is titled “Identity and literature: New trends in Pakistani writing in English”.
Pakistani writers writing in English are making a mark globally. Books from the most beautiful minds of Pakistan, arguably, are from names like Muhammad Hanif, Kamila Shamsie and Mohsin Hamid. A concerned member of the audience says that these books talk about a girl slapping her grandmother, a woman having a full-fledged extra marital affair and detailed accounts of a rape. Are these books depicting the average Pakistani’s thought process? Are the characters of these books ones the average Pakistani can identify with? Are Pakistan’s cultural sensibilities being taken into account here or are we seeing the emergence of literature targeted at a specific readership?
Pakistanis realities are fast changing. This is reflected in the works of its writers. Participant Claire Chambers whose expertise is in Pakistani writing in English, talked briefly about how 1971 onwards, Pakistan saw a surge of literature inspired by the Fall of Dacca, and later by the Zia regime. Not long after came what Chambers explained as being literary works that were pre-cursors to 9/11. These are interesting times for writers, it was discussed, with genre-blending being done.
In a country where maybe just three per cent of the population can truly read, reflect upon and understand literature written in English, is it worrisome that the best minds of the country are increasingly tilting towards writing in English, asks a concerned member of the audience. The moderator, writer Bilal Tanweer, and speaker, writer Rukhsana Ahmed, tend to disagree, debating that some of the best literary work in Pakistan is probably being produced in Urdu and regional languages but the money is in works produced in English, and works in English end up bagging the spotlight.
In the words of Ahmed, writing in English has grown exponentially and these works are not disconnected from the identity and realities of Pakistanis, with young writers like Tanweer handling tough subjects like violence in a visceral manner. There is palpable optimism about works of these writers. But the optimism remains cautious.
Read more: KLF2014
By Farahnaz ZahidiPublished: January 11, 2014
“Karachi is going back to tribalism,” said Dr Irsan. PHOTO MOHAMMAD SAQIB/EXPRESS/FILE
Karachi’s is a “Hobbesian society” declared Dr Manzoor Irsan of the Shaheed Zulfikar Ali Bhutto Institute of Science and Technology at the South Asian Cities Conference on Friday.
“No arts; no letters; no society; and which is worst of all, continual fear, and danger of violent death: and the life of man, solitary, poor, nasty, brutish and short.” This terribly apt reference to philosopher Thomas Hobbes, the architect of social contract theory, surely carried a double meaning for the academics and their audience as it came a day after one of Karachi’s toughest crime-fighters was killed in a bomb attack. Indeed, crime was on their minds as the thinkers also pored over demographic transitions, bulging populations and infrastructure solutions for the throbbing metropolis that is Karachi.
The session titled “Urban Institutional Development & Governance” kicked off with Peter Ellis, a lead economist at the World Bank, sharing his experience of Indonesia’s urbanization and its implications for Pakistan. With 54 per cent of Indonesia’s population now in urban areas, the similarities between Karachi and Jakarta are jarring. But there are lessons to learn as well, as Indonesia has seen that districts with better connectivity show higher income growth.
In contrast was Dr Irsan’s presentation whose disgruntled tone was obvious from its title: “Karachi: The administrative black hole of Pakistan”. In his opinion, politics shape institutions, and unless the politics of any city is cleansed of ethnicity and sectarianism, cities and life in them cannot improve. “Karachi is going back to tribalism. If this continues, people like you and me will escape, because humans need peace to thrive,” he said. “Extractive societies like Karachi’s don’t grow. Karachi is stuck in a Malthusian trap.” (Roughly put, it is the idea that gains in income per person through technological advances are inevitably lost through subsequent population growth.)
Other speakers such as Shahnaz Arshad, a senior urban specialist with the World Bank, focused on incentives to improve local governance performance for municipal service delivery. Urban planner Farhan Anwar spoke of “Visioning a sustainable City Karachi: Landmarks for a new urban governance construct”.
Perhaps the most fascinating part of the session came from research associate Adil Sohail from Iqra University who talked about E-governance through enterprise resource planning. He explained ‘electronic governance’ as the use of information and communication technologies to enhance governance. His solution-oriented approach described phases of implementing E-governance models and ways in which they can facilitate local bodies in particular.
Published in The Express Tribune, January 11th, 2014.
Pneumonia claims an innocent child’s life every 30 seconds, making it the number one cause of childhood mortality. DESIGN: MUNIRA ABBAS
In this part of Pakistan, cell phone technology is being put to good use, often ending up saving precious lives. Under the “Save Life – Zindigi Mehfooz Hai” programme by Interactive Research and Development (IRD), a system has been set up to not just treat children with pneumonia, but track them and their progress by using Radio Frequency Identification (RFID) technology.
In a country where reportedly some 92,000 children under-five die annually of pneumonia, which contributes to 18 % of the total child deaths in Pakistan, this is good news indeed. It is also encouraging that there is no refusal by parents of children when it comes to the pneumonia vaccine. “We have immunised 15,000 children in the last one year in Korangi alone, and not had a single instance of refusal,” says a proud Dr Subhash Chandir, director of vaccines program at IRD. The Pneumococcal conjugate vaccine (PCV) was introduced in Pakistan’s Extended Programme on Immunization in October 2012. “What fundamentally changed the game in Pakistan was not medical advancement but the fact that the price of vaccines came down,” says Dr Aamir Khan, IRD’s executive director , adding that a big part of the solution lies in social business models.
This use of RFID technology started with small water-proof, rugged looking bracelets given to children, which were scanned by assigned health practitioners to get a medical history of the child. Now, a small chip is placed within a sticker on the child’s vaccination card. Through that the child’s progress is tracked and reminder texts are sent. “Apnay phool jaisay bachay ki hifazat karain. Jamal Khan ka agla hifazati teeka aaj lagna hai (Protect your flower-like child, Jamal Khan’s next vaccine is due today).” Standardised texts like these serve as reminders.
To incentivise it further, a “lottery” is set-up whereby one in five mothers with children under the vaccination program may win grocery.
Pneumonia claims an innocent child’s life every 30 seconds, making it the number one cause of childhood mortality in the world. In the 2010 World Health Assembly, a resolution on the prevention and control of childhood pneumonia was passed. The UN MDG 4 states that childhood mortality should be reduced by two-thirds from 1990 to 2015. However, even now, globally an estimated 22 million infants are not fully immunised with routine vaccines.
The PCV vaccine costs around Rs1500 for Pakistan, but people can get their children vaccinated for free. The Hib (Haemophilus influenzae type b) vaccine was introduced in Pakistan even earlier.
Unicef shared with The Express Tribune that “The World Pneumonia Day serves as a call to action for parents, caregivers, and healthcare providers to ensure that infants are fully immunised against all vaccine-preventable diseases. Immunisation prevents between 2 and 3 million deaths globally every year by protecting against the nine deadly diseases of the childhood including pneumonia under 5 years of age.”
While the vaccines are there, they don’t seem to be reaching all Pakistani children who deserve to be vaccinated. “We have a grudge. We are pumping vaccines into a broken system. What needs to be corrected is vaccine delivery,” says Dr Khan. He feels routine immunisation needs to be strengthened, and it is wasteful to introduce new expensive vaccines into a system which is unable to deliver them.
Dr Chandir goes on to explain that the reasons include issues with the “Cold Chain”. Vaccines have to be stored at certain temperatures, but by the time they reach children, they may have lost their effectiveness. “EPI may have a network of vaccinators but often doesn’t have its people in strong positions at district levels. The human resource may not be enough, or is, may be, not being used effectively.”
“It is a crime because it is a right of these children to be protected against these diseases. Usually media stories focus on the vaccines — and not on the system. We need a better system in the country,” says Dr Khan.
Facts about the disease
• More than 99% of deaths in children due to pneumonia occur in the developing world, with half occurring in five countries – India, Nigeria, Democratic Republic of Congo, Pakistan and Ethiopia.
• Only 61% of children with pneumonia are reportedly taken to a qualified health practitioner in developing countries.
• Globally, pneumonia kills more children under five than any other illness.
• Infants not breastfed are 15 times more likely to die due to pneumonia than those who are.
• Using a clean cook stove results in a 50% reduction in the risk of a child contracting pneumonia.
Source: World Pneumonia Day website
Published in The Express Tribune, November 12th, 2013.