Pakistan’s independent media? This is the greatest fiction of all. The media lends itself so easily to manipulation, at the slightest provocation climbing the high hills of sovereignty and then not knowing how to climb down, helping manufacture national security tales as in Memogate and, in the latest of such capers, lending a helping hand to provincial authorities in the demonization of young doctors.
The young doctors’ strike was not about doctors versus ailing and suffering humanity. In the Islamic Republic suffering humanity is a handy cliché, readily invoked to score a political point and as readily consigned to the upper layers of forgotten memory when the need passes. If anything, this strike was doctors versus a hidebound bureaucracy, one of the most ossified bureaucracies in the lands which can claim descent from the British Raj. And its significance went far beyond the agenda of demands presented by the Young Doctors Association (YDA).
For the plight or condition of the medical profession is central to anyone’s idea of a welfare state. No state can be a welfare state, and by extension an Islamic state, unless it fulfills three basic conditions: ensures law and order, provides free and quality education, free of charge to every child of school-going age, and provides free and quality healthcare on demand to everyone who needs it. And a fourth condition: quality tax inspectors...because no revenue, no welfare state. A fifth condition too: quality engineers. Without them nothing is possible. Possibly a sixth condition: holy fathers who know when to hold their peace.
Is this some kind of a chimera, an imaginative kingdom, I am talking about? No. Cuba under Castro had this. It may have had many other failings but none as regards health and education. Cuba still has one of the best healthcare systems in the world. The old Soviet Union had all of this – free education, free healthcare without any questions asked, without young doctors having to go on strike and without state governments investing a fortune in negative propaganda to malign members of the medical profession. China before it succumbed to the winds of capitalism had this. Health is an almighty issue in the United States. There were other issues but not this one in the bleak lands that side of the Iron Curtain.
What do we want in Pakistan? Either we ditch all our talk of Islamic welfarism or we give serious thought to education and healthcare – for each benighted citizen of this confused republic. Leaving teachers to one side because they were not at issue these past few days, what doctors were demanding was not the moon, or extended plots in defense housing authorities, but a service structure on the lines of what the ossified bureaucracy has and what is taken for granted in the armed forces.
What kind of a strange performance have we been witnessing in the holiest of all provinces, Punjab, over the past four and a half years? The pretense of mighty movement and thunder, the constant flitting from treetop to treetop but, when a final tally is taken, very little of substance or very little that will stand the test of time. The little money Punjab inherited when election change occurred in 2008 exhausted in a never-ending series of showy schemes – to name them all is to invite charges of heresy – but not a single step taken in the direction of fundamental education and health reform.
Public hospitals are a shame. To enter their portals without sifarish is an invitation to despair. But if our tall talk of serving suffering humanity is to mean anything at all, shouldn’t we be paying some attention to improving their condition? This is best done not by surprise visits and the suspension of medical superintendents, a practice much favored by chief ministers who want to look busy, but by giving young doctors who are the backbone of public healthcare a decent service structure. And then making them accountable, making sure that they deliver. (And after this is achieved, making sure that senior doctors, instead of carrying on private practice in smart private clinics do this in their own hospitals, with hospitals taking a cut from their exorbitant fees, as is the practice in army hospitals, much to the mutual benefit of hospitals and patients.)
Places of medical learning like the King Edwards Medical College used to be, in times not far distant, not just the pride of Pakistan but the pride of the sub-continent. Go atop the Eye Block in Lahore’s Mayo Hospital and look at the surrounding grounds and you will get an idea, perhaps a hazy one, that empire-building is no easy task. It doesn’t come just like that.
What do we have to show for ourselves? The British were around here for only 98 years, in the areas now constituting the Islamic Republic, 1849-1947. On the pages of history we have been around for 65 years. In their 98 years the British created so much. What have we done in the span of time at our disposal?
Go to Mayo Hospital, or Services Hospital for that matter, and see how young doctors live. Constables of the Punjab Police have comparable living quarters. If we want to keep our doctors this way, fine. But then let’s give a slight break to all our talk of Islam and a welfare state. Yes, doctors should not go on strike. Never. It would also help if they are not driven to desperate measures. But a word of caution: on no account must young doctors earn the reputation for hooliganism lawyers have so ably done.
The British laid the groundwork of empire by building institutions. We can’t build decent flyovers. They come down in two years and then we feel not the slightest compunction in declaring with solemn countenance that the fault was of the dumper which hit one of the pillars – no doubt the first such explanation in the history of construction.
Ah, but we are told, the financial cost of a service structure for doctors would be unbearable. Hand it to the ossified bureaucracy for muddying the issue so skillfully, and to the media for being so easily misled. Let us not talk of the money blown in fancy schemes over the past four years. Take just two projects: the Kalma Chowk flyover and the widening of the Canal Bank Road with its hideous iron railing (whose idea was that?). The money blown on these schemes would have been more than enough, with change left over, to meet all the demands of the YDA. But this would have required grace and understanding.
Our grim fate then: condemned to the politics of ad-hoc decision-making. So let us leave it at this. There will be more of the same, the same self-congratulatory oratory. The piquancy of Punjabi is often untranslatable. Aanian-janian – comings and goings – how does one catch the pithy flavor of this phrase? More of the same as the political cycle begins to revolve faster and we move into election season – provided of course all other things remain the same.
Tailpiece: The political class, with no small help from the judiciary, has been tempting 111 Brigade for some time now. But it is a measure of the new-found maturity of our Knights Templar, otherwise known as the corps commanders, that they are resisting this temptation. Or they are mindful of the new necessities and the unfavorable environment for what used to be their favorite pastime, the occasional coup d’etat. In times past, considering all the shenanigans going on, 111 Brigade would have moved by now, to sow the seeds of more disasters in the future. But that it is holding its horses is the one good thing in a situation getting more hilarious by the day: a new furor over the resumption of Nato supplies, the holy warriors of the right crying murder and the government ineffectual as ever. But if somehow we manage elections even in this fraught climate – this may well be the miracle we have long awaited.
(The writer is a Member of the National Assembly of Pakistan and a veteran columnist. This article was first published in the Pakistani newspaper The News on July 6, 2012.)