OCTOBER 13-19 2013
OCTOBER 13-19 2013
Feature
Cover Story
Zinda Bhaag Three struggling young men from a small Lahori mohalla make it big, but things may not be as rosy for everyone else
Where Boys used to become Men Hujras were the equivalent of the sewing circle — not any more
20
Infographicc ƀuck
Meat the cow
Ribeye
Tenderloin
Sirloin
This Eid, experimentt with differentt cuts of meatt Brisket Shank
Ɖlet Mignon Short Plate
34 Health
How to save a life A majority of trauma patients who die could have been saved if given proper first aid
26
4
42 Regulars
6 People & Parties: Out and about with the beautiful people 38 Review: Rush and Breaking Bad
Magazine In-charge: Sarah Munir and Sub-Editors: Dilaira Mondegarian, Sundar Waqar and Manahyl Khan Creative Team: Amna Iqbal, Essa Malik, Jamal Khurshid, Samra Aamir, Munira Abbas, S Asif Ali & Talha Ahmed Khan Publisher: Bilal A Lakhani. Executive Editor: Muhammad Ziauddin. Editor: Kamal Siddiqi For feedback and submissions: magazine@tribune.com.pk Twitter: @ETribuneMag & Facebook: https://www.facebook.com/ETribuneMag Printed: uniprint@unigraph.com
Round
Alina Asif
Rashid and Sahar Ahmad Khan
Nisha Pagarani Aly Munir, Beenish Ayub and Sarah Munir
People & Parties The Anjalee & Arjun Kapoor Fashion store stocks up on new designers in Dubai PHOTOS COURTESY SAVVY PR AND EVENTS Gunjan and Dino
Maha, Fatima and Zulekha
Zaffar and Zarine Abbas
Razia Nazir
Saman Ansari
Sarah and Eram
Myra, Neha and Meera Pagarani
Sarah, Nosheen and Sadia
Ayesha and Tammana
Ayesha
Shafaq Habib
People & Parties Shafaq Habib brings her jewellery collection to Islamabad PHOTOS COURTESY REZZ PR AND EVENTS Faiza and Ruby Ghiaas
Tania, Nida and Abida
Ayesha and Seemi Ali
Neena and Sarah Raza
Asad and Riffat Shaikh
Nuzhat Asif Shah
Ayesha and Haroon
Saara and Arifa
Nadia Mehboob and Asad
PHOTOS COURTESY REZZ PR AND EVENTS
Sabra, Aliya and Sadaf
Tony
Mariam and Maria
Misha and Zainab
Moneeza Butt, T U Dawood and with a friend
Dr Diana and Indri
People & Parties
The 4th LADIESFUND速 Entrepreneurship Conference is held in Karachi Mrs Decy Widhi Yanti and Mrs Dyah Paramita Lestari Sadono
PHOTO COURTESY BUSHRA SHAH OF SYED BASIT PHOTOGRAPHY
Bachitiar John, Tucknott Rossalis Adenan, Mrs Rossalis and Ameena Saiyid
Maliha Bhimjee
Yasmeen Peeromohamad
Muriel de Saint Sauveur and Khushbakht Shujaat
Lubna Lakhani
Uzma Javeri with a guest
Khadija and Ubaid
Alaiha, Arif and Sidra
Xin and Yughuntian
Amna Kardar
People & Parties Al Haj and FAW Motors launch Sirius S80 in Lahore PHOTOS COURTESY BILAL MUKHTAR EVENTS & PR Sophiya Khan
Alyzeh Gabol
Khalid Sulman, Lubna and Farhad
Natasha
Where
Boys used to become Men Hujras were the equivalent of the sewing circle — not any more BY MUHAMMAD IRFAN ART BY JAMAL KHURSHID
The boys are cozying up in a corner, shooting marbles. One of them grabs another’s collar in a spirit of mutually shared camaraderie. A few yards away, teenagers are lolling back on charpoys or squatting by them, playing cards in the shade of an old tree. Discreet smiles are exchanged
from time to time as a village scandal quietly rolls off someone’s tongue. A little further ahead, a few middle-aged men sip tea and exchange thoughts on the Afghan drawdown while reminiscing about the good-old days. Preparations are underway for the night time tappay (singing) session as someone tunes the rabab strings. In the background, the caretaker, Kakhay, is keeping a watchful eye. The sense of community in the hujra is as real as the men sitting there. In the veranda right below, “Har kala rasha” is written on a wall. It loosely translates to “May you always come,” in the Khyber-Pakhtunkhwa region and is a phrase that usually indicates the space you are entering is a hujra. A community club of sorts, found in almost every village and mohallah, the hujra is an integral part of Pakhtun culture. Usually shared by the whole community, it may sometimes be a space owned by a person of means, normally an open area stretching up to 1,200 square yards. Most hujras have a clearly marked boundary but no door, signalling that everyone is welcome. While lively conversations dominate the course inside the hujra, the open terrace adjacent is occasionally used for communal gatherings such as funeral prayers or wedding ceremonies. Popularly known as a hujra or daira in Khyber-Pakhtunkhwa, it has been given various names throughout Afghanistan as well, ranging from kotta in Kabul, a sarachah in Khost,
jammah in Dera Ismail Khan and chawk in Lakki Marwat. Qazi Hanifullah, a teacher of Pakhtun culture for nearly 20 years at the University of Peshawar, explains that the hujra is an institution where men learn about life. Everything, from sensitive subjects such as sexuality, emotional and psychological problems to bigger issues such as succeeding in life, is discussed openly by the men who come from all ages and backgrounds. However, with the spread of popular technology and the rampant use of cell phones and computers, the hujras are gradually losing their usual crowd. While the older generation still congregates in these spaces, it has become almost impossible to attract the youth here. In Hanif’s opinion, this was slowly causing an erosion of Pakhtun culture. “The younger generation knows what is happening in Bollywood or Hollywood but no one is willing to listen to the poet who published his latest book,” he said. “They would know about the latest hairstyle but have no clue why the colour of a woman’s bangles changes as soon as she gets married. They don’t know these things because they are just not interested anymore.” There are others who believe that while it is not necessarily worrying that the younger generations want to keep up with the rest of the world, there is a risk of losing touch with your own roots. Salma Shaheen, a researcher and
professor of Pushto literature, said that while hujras still survive as a building in almost every village of Khyber-Pakhtunkhwa, they are losing importance as an institution. “Almost 80% of Pakhtunwali (the Pakhtun code of conduct) is related to hujras,” she explains. “Therefore, a decline of the institution means a decline in Pakhtunwali.” Comparing it to practices from the British era, Shaheen adds that the Pakhtunwali code was not written down but preserved through word of mouth and practice. A hujra is the only place where these traditions are learnt, acted upon and then passed on to the following generation. “Unfortunately, the former generation couldn’t pass on this tradition to the current one and I am afraid the next generation would merely know the word, but not its importance,” she says. In urban areas such as Peshawar, Charsadda, Mardan, Swabi and Nowshera, hujras are also being demolished and replaced by more modern structures. Shah Nawaz Ghamgeen, a resident of Jamrud, takes pride in his vibrant hujra which has survived all odds, including a militant bombing, and is still host to a daily congregation of the village tribesmen. In most areas, the modern drawing room seems to have replaced the hujra in terms of utility. But for seasoned elders such as Ghamgeen, the collective experience of good company and conversation is hard to replace. T
COVERSTORY COVERSTORY
Three struggling men from a Lahori mohalla make it big, but life may not be as promising for others like them in Pakistan BY SHER KHAN DESIGN BY ESSA MALIK & PHOTOS BY MALIK SHAFIQ
There is something very real about the new Pakistani film Zinda Bhaag. And that should not come as a surprise since the real lives of the actors who play its characters Khaldi, Chitta and Taambi are not very different from the ones shown in the film. Before the film’s release, hardly anyone knew or recognised actors Khurram Patras, Zohaib Asghar and Salman Ahmed Khan, who breathed life into the characters of the three struggling young men, desperate for a ticket to a better life. For these men, who belong to humble backgrounds themselves, these roles were too close to home. They knew the dejection which comes hand-in-hand with being born into poverty. The struggle, the grind and the lure of the dark side were uncannily reminiscent of their own lives. By using boys from the neighbourhood itself to tell the story, the filmmakers chose the best way show the essence of a Lahori mohalla — a place where conversations are colourful but dreams have faded.
From tiny mohallas to big screens Zinda Bhaag is the story of three young men struggling to break free from the shackles of everyday life. For them, leaving Pakistan is the answer to all their problems and they are willing to go to extra-ordinary lengths to achieve that. Something all three young men in the cast could relate to. “Before I got the call for the audition, I had already been sent back from South Africa and was trying to go abroad again,” says 24-year-old Zohaib Asghar who originally belongs to Samanabad, the location where the film is shot. But this was not the first time he was deported. In 2004, he was sent back from Kuwait due to paperwork complications. Much like his character Taambi, Zohaib also tried to leave Pakistan repeatedly until he succeeded. “People ask me why youngsters still risk everything to leave,” says Asghar. “The situation in the country is such that leaving seems to be the only solution for young men who dream of a better life for their families.” He was struggling to make ends meet by selling cell phone accessories, until his debut in the film. In tight-knit mohallas, like the one shown in the film and where Zohaib grew up, there is immense pressure on young men to make it. They are usually the ticket to a better life for the entire family. And the abysmal conditions in the country leave them little choice but to look for
I always felt that I should somehow go abroad since my parents had invested in me but I was never able to achieve that Actor Khurram Patras who plays the character Khaldi
ways to migrate to greener pastures and live the dream. But it doesn’t take too long for those dreams to turn into their worst nightmares when the law is by-passed and shortcuts are taken out of desperation. While in South Africa, Zohaib claims to have seen and heard of many young Pakistani men who ended up behind bars. His story, as he goes on to reveal, is very similar to the one of his character in Zinda Bhaag. He recalls his travel agent providing him with similar options such as staying in the country without a visa, which he flatly refused and returned to Pakistan. He often hears of friends from his neighbourhood whose families have not heard from them for months — a painful reminder of how he could have ended up too, had he not made the right decision. Raised in a small, dusty house in one of the katchi abadis in Lahore, Khurram Patras, who plays Khaldi, is no stranger to a tough life either. For Patras, acting and cinema
The situation in the country is such that leaving seems to be the only solution for young men who dream of a better life for their families Actor Zohaib Asghar who plays the character Taambi in the film
Chitta played by Salman Ahmed Khan is a luxury he cannot afford while raising a daughter and struggling to make ends meet as a garment salesperson. “Not many people in our mohallas go to the cinema, especially women are not allowed and not a lot of men go either,” says Patras. “A few relatives went to see this one because of me but generally it is not seen as something positive.” Following in the footsteps of his father who held a low-paying job in Dubai for nearly 14 years, Patras also tried to migrate abroad. With great difficulty, his parents managed to enroll
him in a small neighbourhood school but his heart was never in it. “There came a point when I told them that I didn’t want to study,” says Patras. “I always felt that I should somehow go abroad since my parents had invested in me but I was never able to achieve that.” But as the film turned into a raving success and his mother beamed with pride, some part of Patras’ payback dream came true. Patras is not the only one whose dreams shaped into reality through the film. For 26-year-old Salman Ahmed Khan, his job as a news producer at a
Chitta played by Salman Ahmed Khan
COVERSTORY COVERSTORY local channel, was a temporary fix until he got his lucky break as a singer. In fact, the desire to sing was what brought him to the audition but you can’t set a time and date for the tables to turn. He landed the role of Chitta and the rest, as they say, is history.
When lady luck strikes…
Actor Zohaib Asghar who plays the character Taambi in the film
It wasn’t just good karma that allowed these young men to become part of a mainstream box-office blockbuster. The openness of directors Farjad Nabi and Meenu Gaur to explore raw talent and give them a fair chance was a critical factor. By tapping into local neighborhoods through acquaintances, they unearthed several fresh faces, including Patras, Khan and Zohaib, who turned out to be the stars of the film. “People actually don’t know us. Initially, a lot of them assumed that we were from India and had returned to India,” Khan admits with a chuckle. Not only does the unconventional cast add a strong aesthetic to the film, it lends a sense of originality to the characters. But a lot of hard work and effort went into accomplishing that. The three young men had to go through individual acting workshops with seasoned actor Naseeruddin Shah (who plays Pehelwan in the film), working primarily on concentration and confidence-building techniques to bring the characters to life. “Naseeruddin saheb was very willing to work with new talent,” says Khan. “He said he wanted to work with new actors and that is a very positive sign for the youth.” The training and encouragement from Shah along with the support of the directors and the production team helped the new actors gain confidence and grow from strength to strength. The film has not only discovered fresh talent but also created space for veteran actors such as Naghma
Begum (Khaldi’s mother) who had abandoned acting due to dearth of quality roles. “No one could relate to the films that our industry was producing,” she says. ”They had become routine and I was looking for a change.” And the realistic plot and treatment of Zinda Bhaag provided her with just that. Model Amna Ilyas, who plays Khaldi’s love interest and the moral compass in the film, also feels that the diversity of the actors enhances the film’s richness.
Not every slum dog becomes a millionaire As much as everyone loves rooting for a happily ever after, some rags never turn to riches. In the face of a crumbling system, which has failed to provide for the youth of the country, the dreams of countless Khaldis, Chittas and Taambis are crushed every day in Pakistan. While politicians continue to pay lip service to youth development, there has been no real change. Inequality, a class divide, unemployment and poverty continue to fracture and weaken social infrastructures. According to Patras, unemployment is the biggest curse. Stronger currencies, better jobs and the promise of a better life bait young men to go to any lengths to leave the country which is the central theme of the film as well. And when the pressure is so intense, the distinction between right and wrong becomes murky. “When you are desperate enough to put your life at risk to make ends meet, the question of good and bad becomes less and less important,” says Zohaib. More and more young men will be forced to resort to this trajectory of short cuts if this situation continues. Singer Jawad Ahmed, who runs “Rise for Pakistan”, a youth-advocacy organisation, says that the youth has a minimal role in the economic process, and that is reflected
in the country’s dismal condition. “Even though we have a massive proportion of young people in the country, the young male in the middle to lower-middle classes is both unemployed and underemployed,” he says. Talking specifically about Lahore, which is often thought to have fared better than the rest of the country, Ahmad says that the government and ruling class has promoted a façade of development. “There is widespread depression and when you look at ground realities, especially with the recent lay-offs, there are countless stories of people wanting to leave,” he says. Actor Salman Shahid feels that Zinda Bhaag is a very reasonable attempt at articulating the angst of such young people. The idea of the angry young man, as portrayed in Hollywood or Bollywood, has a different tradition and background. He feels that in Pakistani cinema, there will be more of an attempt to connect with real and everyday issues. “You are seeing more films attempting to represent local issues and the portrayal of the young men has become gritty and realistic,” explains Shahid. And while Pakistani cinema maybe one step closer to reality, the reality of the country leaves a lot to be desired. With the film doing record business in Pakistani theaters and also set for release in the USA mid-October, the three young men are bracing for the multiple opportunities that have now opened up for them. While Khan has gone back to his old job, Patras and Asghar are testing the waters and hope to continue playing diverse roles. “Qismat say ziyada nahin, waqt se pehlay nahin,” says Shah’s character, Pehelwan during the film. Loosely translated it means ‘Not more than what is destined, not before the time is right’. But for Khaldi, Chitta and Taambi, this is their moment. T
INFOGRAPHIC
Meat Ÿe cow This Eid, experiment with different cuts of meat by following steak expert Daniel Panjwaneey’s guidelines BY MANAHYL KHAN DESIGN MUNIRA ABBAS
This year we try to reinvent the Eid menu by introducing the quintessential steak. Follow our ultimate meat manual and prepare the feast of all feasts. T
Temperature tantrums
If you’re someone who can’t tell how far along your meat is, invest in a meat thermometer. It really comes in handy. Here is an approximate guide for middle of the steak temperatures:
A cut above Ÿe rest
Some of the best restaurants in the country and the most popular steaks on their menu: Café Flo, Karachi: The undercut steak Covo, PC, Lahore: The rib-eye steak Texas Steak House, Islamabad: The undercut steak
Rare: approximately 125 Fahrenheit
ƀuck ƀuck ƀuc ck
Medium-rare: approximately 130 Fahrenheit
Rib-eye
Medium: approximately 145 Fahrenheit Medium-well: approximately 155 Fahrenheit Well-done: approximately 165 Fahrenheit
Ƈpert advice
Daniel Panjwaneey, a musician and a Food and Beverage Management graduate, shares his experience in the kitchen with some guidelines for steak enthusiasts: • Make sure your butcher knows his cuts. Telling him you want undercut for steaks will usually result in getting a tender but flat piece of meat. Get the tender filet mignon instead. • Don’t buy marinated steaks; be experimental and look up a nice recipe. Beef is amazing to work with. • Steaks should be cooked at medium heat on the griddle/grill. For best results, charcoal grill it. • Overdoing it means ruining it. Also, avoid steak sauces. The secret is to keep it simple and fresh.
342 OCTOBER 13-19 2013
Briskett Shank Sh Short Plate
Where is my cut?
The Rib-eye: A boneless cut found from the rib section of the cow that comprises mostly the Longissimus dorsi muscle (the rib primal of the steer). The Sirloin: A cut made from the rear back portion of the cow — the best cut being the top sirloin. The Tenderloin: The tenderloin spans two primal cuts, the short loin and the sirloin. It is found underneath the ribs, next to the backbone. The Undercut: Popular in Pakistan, the undercut is the tender meat of the loin muscle, found on each side of the cow’s vertebral column. The Filet Mignon: An easily available cut on most steak menus, it is a beef fillet cut from the smaller end of the tenderloin.
Sirloin Tenderloin
Round
Ƙere is no such Ÿing as a chicken steak
Daniel Panjwaneey, a Food and Beverage Management graduate. A steak is best made in beef
23,631 tons of animal waste from households and sacrifice sites were transported to garbage dumps by the Lahore Waste Management Company over the three Eid holidays in 2011. It went up to 28,000 the next year
This year the Karachi Metropolitan Corporation is expecting
1.2m
animals to be slaughtered during the three days of Eid
Marinate Meat
• According to Panjwaneey, to make the marinade get a bottle of Worcestershire sauce, a bit of mustard, dried or fresh herbs such as rosemary and oregano, crushed garlic, simple salt and pepper. For extra flavour, add grape and orange or lemon juice. • Marinate your beef for at least four hours — if not more — for best results.
Iron clad
1,086,000 Mignon Ɖlet Mi non
animals including goats, sheep, cows and buffaloes were slaughtered last year in Karachi, according to Karachi Metropolitan Corporation’s senior director of municipal services, Masood Alam
8m
animals were sacrificed in the country in 2011, according to the former chairman of the Pakistan Tanneries Association, Aziz Ahmed. It used to be 16m for a long time OCTOBER 13-19 2013
335
YOU METH ME CRAZY Five seasons on, satisfied Breaking Bad fans bid farewell to the meth mogul BY NOMAN ANSARI In what seems to be an unwritten rule for television shows, most TV dramas (see: Heroes, Lost, or 24) tend to peak within their first few seasons, eventually losing steam as they approach the finish line. When the fifth and final season of Breaking Bad was announced, fans doubted that anything on television could top the near-perfect equation presented by the fourth season of the show. They were dead wrong. Breaking Bad, of course, broke all rules and followed an altered, more ‘organic’ pattern. Produced by Vince Gilligan (The X-Files), the AMC crime drama began as an interesting show about a troubled chemistry teacher, Walter White (Bryan Cranston), who is devastated after being diagnosed with stage-three lung cancer. To generate cash flow to fund his cancer treatment and secure his soonto-be-widowed wife’s future, he enters dangerous and illegal territory. White partners with a former student Jesse Pinkman (Aaron Paul) to use his scientific mind to produce and distribute a pure form of the illicit drug, methamphetamine. The business soon takes off as the duo teams up to produce the highest quality meth in the world, getting them into trouble with drug dealing competitors and the law. In classic Breaking Bad style, the series continues to explore the consequences of a life of crime, especially inadvertent ones. Fantastic acting along with nail-biting suspense, action and character growth kept fans hooked effortlessly until the finale. Cranston convincingly sheds his comedic image
of the nice dependable father from Malcolm in the Middle, as his character becomes an all-round bad boy, adopting the feared street name of Heisenberg. His tremendous growth into the role is one of the most striking successes of the show. Stripped of almost all of his humanity, morphing into a manipulative and violent beast, he is barely recognisable from the warm and loving father of the first season. Even though he was guilty of occasionally over-acting in the beginning of the series, with shades of his previous comic role slipping through, he became a natural as the show progressed. Using subtle facial expression to convey strong emotions, he eventually mastered the complexity of the character. Now that Cranston is done with the show, one almost aches to see him play more villainous roles on a grander scale. Along with unforgettable characters, Breaking Bad showcased stellar cinematography, featuring parched desert landscapes through dry lens filters, designed to make viewers feel thirsty just from watching the show. Highly recommended, Breaking Bad has certainly raised the bar for TV drama and Sunday evenings for those hooked onto this meth-cooked thriller will no longer be the same.
From dregs to riches Weeds
Boardwalk Empire
Weeds is a dark comedy show revolving around a mother who deals drugs to support her family after the sudden passing of her husband. Her sons are soon sucked into the mess of marijuana dealing and their lives take many twisted turns. Weeds ended in September 2012 after completing eight seasons and winning two Emmy Awards.
Based on a book by Nelson Johnson on historical criminal kingpins, Boardwalk Empire has made its mark on its viewers. The Golden Globe Award-winning show pictures the Prohibition era in the United States where the production, sale and transportation of alcohol was banned. The show, set in Atlantic City, has been praised for its visual style and inescapable darkness.
The Wire A show written by a former police reporter, The Wire encompasses all aspects of the city of Baltimore, including illegal drug trade. It premiered in 2002 and ended in 2008 after completing five successful seasons. Though it never won any major awards, the show was highly appreciated by critics and fans.
38 OCTOBER 13-19 2013
Driven
Rush is an attempt to understand one of the greatest motorsport rivalries during the Formula One championship in 1976 BY SHER KHAN
Life can be explained through the idiom of sport. The famed-UCLA basketball coach John Wooden once put it this way: Win or lose, courage is what lasts. For those who follow the Formula One championship, one historical example of courage superseding the glory of victory came in the shape of the rivalry between Nicki Lauda and the late James Hunt in the 1976 season — a watershed in the history of racing. Now these men have been brought to life by actors Daniel Brühl and Chris Hemsworth in Rush, a biographical action film written by Peter Morgan and directed by Ron Howard. It documents the struggles of the two sportsmen as they compete for the greatest glory — the Formula One championship. The complexity of the rivalry between Lauda and Hunt is addressed in a relatively quick manner. We see the two drivers growing out of competing with each other based on mutual respect, despite the desire to push each other to the maximum 40 on the racetrack. Back then, each racing OCTOBER 13-19 2013
season, one or two drivers would routinely be killed and building a career in the sport meant making sacrifices and taking risks. The difference between both Lauda and Hunt, as seen by Howard, stems from their different approaches to life and the sport itself. Daniel Brühl is an effortless Lauda, emerging head and shoulders above the rest of the cast. He puts forward a wellcrafted performance, much like the racer himself. Hemsworth of Thor fame, too, fits nicely into the role of James Hunt with believable and passionate acting. Actor Olivia Wilde plays a small role as Hunt’s wife, Suzy Miller, whose character in the film is stunted in comparison with that of the support-system wife Marlene Lauda played by Alexandra Maria Lara. Director Howard, whose legacy as one of modern-day Hollywood’s greatest, has always been challenged by his inability to address nuance, skillfully presents the high-octane action sequences. They are invigorating as the background score thrills
the viewer to the edge of the cinema seat. The film’s success is based on its ability to accurately show and transmit the feel of the inside of a race-car, the surrounding track and the atmosphere around a heartstopping race. The storyline tends to veer towards the formulaic and Hollywood cliché, which as a result undercuts the rich theme of the rivalry between the two men who were closer to each other than what was popularly perceived. And so while the film fails to delve into their lives, it nonetheless beautifully interprets their struggles on the racecourse where the men are ultimately defined. Rush is packed with action, bravado, and glamour through savvy cinematography. The combination has probably brought viewers closer than ever to the elitist and male-dominated world of Formula One racing. It is a must-watch and will go down as one of the better sports films in recent times. Its action and cinematography alone will carry it far. T
Howto save a A majority of trauma patients who die could have been saved if given proper first response
You can lose up to two litres of blood from a femoral or thigh bone fracture. The human body has about 5 litres in total, giving you an idea of how dangerous it could be.
OCTOBER 13-19 2013
o tw s ) ve th ds Gi ea n br eco s (5
Small wonder then that orthopedic surgeon Dr Saeed Minhas knew it was a “do or die” situation when he got a phone call from the ER in the middle of his rounds at Jinnah hospital, Karachi. He was told that a 16-year-old boy had arrived with the facture and was bleeding profusely. The patient had arrived after being turned away from other hospitals. “He was transferred to JPMC from a number of other hospitals which insisted he could only be treated by a vascular surgeon,” says Dr Minhas. With 25 years of experience handling traumatic fractures, Dr Minhas knew that the boy may not make it in time. As he raced to the ER he started giving orders on the phone for the nurses to control the bleeding by applying direct pressure and treating the boy for shock by giving him oxygen and fluid resuscitation. But by the time he got 42 there, it was too late.
life
pl Sta ac rt on ing wi ch ha th es nd t
BY BUTOOL HISAM
The tragedy is doubled by the fact that the boy’s life could have been saved. He did not need a vascular surgeon to control the bleeding. Any trained first responder or emergency physician could have done that. “If only some[one] had just compressed the femoral artery with their thumb, the bleeding could have been controlled,” Dr Minhas laments. An ER doctor at a tertiarycare hospital in Karachi, Dr Haider, adds that cases of multiple traumas, for example gunshots or falls or road traffic accidents, come about once a day. “Victims are brought in a way that is so harmful that it causes
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, th t, ou lif n d m i to , ch e an h e t t s ov til o u M ad h n mo nd) he pinc pen eco o 1s (
more injuries,” he adds. “Their chances of survival are less than half.” A majority of trauma patients who die could have been saved if given proper first response. To address this problem, Prof. Rashid Jooma, a neurosurgeon and former director of Jinnah hospital, set up Primary Trauma Care (PTC) Pakistan in 2004. So far hundreds of workshops have been held in Sindh alone and about 6,000 doctors have been trained. “I learnt more in these two days of the workshop than in two years of medical school,” said one medical student, who participated. “Even though these are just the basics,
they make me feel more confident as a student and [a] future doctor.” Closely related to PTC Pakistan, is the First Response Initiative of Pakistan (FRIP). This organisation was set up by a group of young doctors, who witnessed the mishandling of victims at a bomb blast scene and resolved to intervene. “It was shocking to learn that although a majority of doctors may be able to quote the latest treatment of the rarest diseases, very few can actually resuscitate a dying victim,” says Dr Akbar Herekar, co-founder and president. “Simple skills, that take merely hours to learn, can make the difference between life and death if instituted on time. A doctor or paramedic is not always available when needed. At FRIP, we believe every human should know how to save a life.” FRIP trains medical students and young doctors not just in the basics of prehospital care, but to reach out to the people of Karachi to equip them with basic life-saving skills. Workshops have been held in Ibrahim Hyderi and Rehri Goth, for example. Doctors are not necessarily trained to deal with emergencies. As Dr Minhas puts it: “Previously only army doctors were trained to handle trauma, but now the war is here, on our roads. Every doctor should be trained if they are really to own the white coat.”