Prof Farakh A Khan (24.5.13)
I was appalled to see Imran Khan ‘carried’ to a truck by four people. Unfortunately none of the doctors or any one else highlighted basic requirement for shifting of the injured during their TV interviews. Anywhere else the people who were rushing him to a hospital would have been taken to the court. It is well known that shifting of the injured has to be done by professionals with proper gear. The way Imran was dragged could have converted his injuries into permanent paraplegia a dreadful complication in spinal injury patient. Imran was then taken to a private hospital to have his scalp wound stitched without investigation of more important injuries. This was again criminal since scalp wound was least important of his traumatic injuries.
Pakistan, Iraq and Afghanistan have daily bomb blasts for years and we see on TV the injured being dragged in a rush to the hospitals. It is pathetic to know that we have learnt nothing from these regular blasts or road traffic accidents. The public, first on the scene, is not educated in management of trauma victims. All over the world the public is taught as to how to deal with unconscious or semi conscious trauma patients. We use simple ABC priority for teaching lay public. The first for the layman is to see if the airway (A) is patent. To prevent swallowing of the tongue the patient is put on his/her side. The next is to ensure that the patient is breathing (B). Finally bleeding has to be stopped by pressure on the wound (C). To transport the patient paramedics put a collar on the neck and gently rollover onto the stretcher before being moved into the ambulance. These basic principals can be taught at school level.
Management of mass casualties is important for countries like Pakistan where bomb blasts and suicide bombings have become the norm. Mass casualties require high degree of coordination and backup of appropriate hospital facilities with trained staff. However this is a separate subject, which needs detailed discussion.
A word about Imran’s forklift accident. New combo photos of the accident on TV clearly show the cause of the accident. Imran with three others were standing on the left side of the forklift while a forth man in black was bending down on the same side. The photo clearly shows the man in black uniform was trying to lift another person on to the forklift platform. The weight was too much for the forklift platform and it lunged to the left throwing the standing occupants down. The accident was sheer negligence on the part of the organisers.
Pakistan has been compared with its non-functioning railways. Of our of 500 engines only 150 are in service (Walsh, Declan. Pakistan rusts, neglected, in its tracks. The Express Tribune International Herald Tribune. May 20, 2013). The collapse of PIA and Steel Mills are different subjects and not easily grasped by the Pakistani public. The failure of providing electricity is more pinching to the public. Nepotism, institutionalised corruption and line losses (mostly stolen estimated at Rs135 billion every year) are part of institutional failure linked to electricity supply. The government has so far put the burden of electricity shortage on the consumers by increasing the bills rather than address their institutional failure.
Over the years we have developed large number of policies and reforms documents. None of these efforts have worked. At the ground level in the past lawmakers were keen to have their loyal Thanidar/Patwari appointed in their constituency. Today they have graduated to DCO and Commissioner. In public political leaders claim to put an end to Thana/Kucharry ‘culture’ but in reality the civil servants and not the party cadre remain the power base of politics in Pakistan. Politicising of the bureaucracy started during the time of Ayub Khan’s Martial Law and speeded up during Zulfiqar Ali Bhutto’s tenure. Although all previous constitutions (1956,1962 and interim 1972) provided safeguards to the bureaucrats from political interference this was unfortunately withdrawn in 1973 constitution (Saadat, Syed. Civil service reforms needed. Dawn. May 21, 2013). In British times bureaucrats were loyal to the state. Today their loyalty is only to the ruler. The outgoing PPP leadership broke all time records in postings and transfers. Known corrupt were appointed CEO’s to large corporations and taken as ‘advisors’ with inevitable results. Even the prime ministers were tainted.
The collapse of government health service is shown by measles and ‘Gastro’ outbreaks in Pakistan. Between January 2012 and January 2013 recorded deaths due to measles were 413 children. Various reasons were given for inability of the health departments to immunise children including poor quality of the vaccine. The core issue here is collapsed institution.
It was disheartening to read that the civil servants are gathering in sweltering heat of Lahore at the residence of future rulers of Punjab and Centre for postings. This is a bad sign for the future of governance in Punjab and at Federal level. I predict that we shall have more of the same in future. (Manan, Abdul. Bureaucrats lobby Sharifs for plum jobs. The Express Tribune Lahore. May 20, 2013). I do hope that governments in other provinces do not repeat the same mistakes of the past and depoliticise civil servants. Perhaps this may happen in KP but is unlikely in Sindh and Balochistan.
Without functioning public institutions we cannot look forward to ‘Change’ for a Naya (New) Pakistan.