Health

Disasters, dengue and local government

15 October 2011

By Raza Rumi:

In the past few weeks, the intractable crisis of governance has once again exposed the dysfunctional nature of the Pakistani state, and its inability to grapple with basic issues of citizenship. After all, the guaranteeing of people’s rights and entitlements is the responsibility of the state, which it simply cannot abdicate. In Sindh, 5.3 million people have been affected by flash floods, out of which 250,000 are now homeless. The floods had been predicted earlier but the provincial and federal authorities were shamefully ill-prepared like last year. In Punjab, over 5,000 people are battling against the dengue epidemic and there are indications that it may spread to other parts of the country.

The killings in Karachi have momentarily halted but as hundreds of citizens were butchered for no fault of their own, the politicians indulged in a macabre game of accusing each other of breaking up Pakistan. Pity that the discourse on Karachi came down to Zulfiqar Mirza versus the MQM and seldom did anyone debate the fundamental causes of ethnic conflict, social breakdown and the governance vacuum. The killings have been followed by the inundation of the megalopolis by heavy rains. The civic failures of Karachi and Lahore on drainage and public health have exposed how cities cannot function without effective, accountable local governments. (more…)

Devolution of powers: the challenges ahead

24 April 2011

The impediments to full provincial autonomy under the 18th Amendment need to be tackled despite the odds

By Raza Rumi

Perhaps the best thing about contemporary Pakistan is the way its governance arrangements are being restructured to undo the bitter, brutal legacy of centralisation. Had we undertaken such reform decades ago, Pakistan would have been a far better place. The 18th Amendment reflects a board political consensus on how Pakistan can actually evolve into a real federal state as opposed to the notional federalism of the past where provincial autonomy had become a residue of central patronage and not guaranteed by the Constitution.

Nevertheless, the devolution of powers in 2011 faces two major dilemmas. First, the provinces are currently operating as centralised bureaucratic apparatuses with little or no powers and accountabilities at the local levels. Second, and perhaps far more important, the provinces have to build their technical and political capacities to handle the new powers and functions, which are now flowing at an unprecedented speed. These two challenges are the real test of civilian governments and it remains to be seen if they can handle it lest another messiah or messiah-proxies enter the arena and reverse this process. Knowing Pakistan’s history, anything is possible. This is a country plagued by lack of political stability and policy continuity. We shall examine the pitfalls and challenges that lie ahead in this transitional process.

Progress so far: During the first two phases of the devolution, 10 of the 48 ministries at the federal level were to be devolved. The Committee set June 30th 2011 as the deadline for this process. Taking up these recommendations, the federal cabinet devolved ministries for special initiatives, Zakat and Ushr, population welfare, youth affairs, and local government and rural development to the provinces in December 2010. The provinces also inherited office buildings, equipment, development funds and projects for fiscal year 2010-11. All international matters of these ministries were transferred to the Economic Affairs Division (EAD) and some planning-related matters to the Planning and Development Division. However, overall planning of ministries that are being transferred or will be transferred in February 2011 will be the responsibility of provincial governments.

On April 5th, 2011 the second phase of the devolution process commenced, with the devolution of the ministries for education, social welfare, and special education, tourism, livestock and dairy, rural development and culture. According to reports, the Commission for Implementation of the 18th Amendment has also approved a plan for the transfer of three federal ministries, including sports, women development and environment, to the provinces in the third phase.

Unclear federal arrangements: While the centre has abolished ten ministries so far, there is a deadlock over the staff and resources. Provinces complain that they cannot pay the wage bill of surplus staff and centre has retained all the existing federal public servants, as any move to right size will be fraught with political dangers. Similarly, after June 2011, who will pay the staff? If the federal government continues to foot the salaries bill then it will not be able to rationalise its size and the temptation of recentralisation will remain. Secondly, the federal government’s move to shift attached bodies and autonomous organisations to Cabinet Division and such other dysfunctional ministries is even worse. There needs to be a more thorough assessment of post-devolution architecture of the central authority. It appears, with due respects to a great reformer, Raza Rabbani and his colleagues, patchy, ad-hoc and devoid of long term thinking. (more…)

Floods’ management: Perfect script for a black comedy

13 August 2010

As I write these lines, millions are stranded and vulnerable to disease in the wake of perhaps the greatest natural disaster of recent times. Communities in Khyber-Pakhtunkhwa are stranded, Sindh is facing the wrath of gods and parts of Muzaffargarh and Kot Addu have been washed away. Citizens across the country are perturbed and doing whatever they can. But the power centres including the free media are busy in point-scoring and blowing their little trumpets as if the devastation was a playground for political mileage.

They say that individual and collective characters are exposed in times of crisis. Indeed the Pakistan ruling classes have exposed themselves for their historical myopia and lack of vision. Political parties are fighting over optics, media perceptions and wasting their energies. TV channels and wise anchors on the other hand are competing who got there first to show the mammoth destruction and who fired more salvos at Asif Zardari. Adding insult to injury, the media remained busy for hours as to the alleged shoe-throwing incident at the president as if that was the topmost priority of this country. (more…)

On prescription medications

10 September 2009

People should have access to the prescription medications they need. Access2wellness is designed to help. As I stumbled on Access2wellness website, I wondered if such an arrangement was possible in developing countries. This website was launched as an easily accessible resource for patients, caregivers, health care professionals and hospital administrators. Others can also  join and extend this endeavour to bring better health within everyone’s reach.

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Looking for healing products – Compression garments?

6 September 2009

I have discovered Recovery Elements which is a place where healing begins. High quality services and products are available for those who want to use them. For instance on such product is Compression Garments. Also, if you are looking to treat scars, Compression Stockings & Armsleeves,etc, you can visit this site. The well structured program at this internet hub interacts medical professionals with patients so that there is a one-window service available. (more…)