T-Magazine 11 APR 2021

SUNDAY April 11, 2021

ECONOMY & BUSINESS Page 3

Online grocery growth has been exceptional because it is convenient — Tooba Iqbal

37% households in Pakistan are afflicted by food insecurity

HEALTH & FITNESS

LAW & JUSTICE

Page 4

Page 8

People focus more on curative health and not on preventative health — Javed Akram

Virtual hearings are a long overdue step to overhaul the legal system — Atira Ikram

By Ishrat Ansari

As poverty, social pressures and lack of mental health awareness drive up cases of suicides in Sindh, experts and officials share how better govt attention and timely therapy can help reverse a mental health epidemic in the making

S

oon after she was married, R* discovered the demons her husband often struggled with. Not only would he take out his anger and frustration on the people around him, he would sometimes target small animals as well. Still, R never dreamed her husband’s final victim would be his own self.

R had planned to leave for her hometown of Kohat to look after her then seriously ill mother in the days leading to her husband’s suicide. Right as she departed, her husband, who sometimes showed a tender side too, handed her a lunch box lovingly. “It’s a long way… don’t starve yourself,” she recalls her husband saying. She had no inkling those would be the last words she heard from him.

“When I reached Kohat with my sister, we received the news the same day. My husband had killed himself,” R said. “I had left three teenage kids at home. They told me their father was dejected when I left.

They told me he said I didn’t listen to his pleas to stay.”

According to R, on the best of days her husband would tell her how lucky he was to be with her. “But when he was ill, he would torture us… me, my kids and everyone else at home. He even ended up killing the cats in our neighbourhood,” she shared.

R’s marriage took place nearly two decades ago. Only 16 at the time, she tied the knot with a distant relative living in Karachi. Now 40-something, the resident of Karachi’s Labour Colony says neither she nor her parents had any inkling of her husband’s mental health issues.

“His family hid his condition from my parents when our marriage was arranged,” R said. “But a few days into our marriage, it dawned on us all how severely troubled he was.”

One of the first troubling episodes R experienced took place after a stray cat intruded their home just a few days after the wedding. “It bothered him quite a bit. The next day I woke up and saw the dead cat hanging from a gas pipe near the kitchen,” she recalled.

“It shocked me to the core and I was speechless,” R said.

“I was so young back then, and it took me years to understand that he had serious mental health issues. My inlaws used to take him to spiritual healers for treatment but that only made his condition worse.”

Later on, Saleem’s family had no choice but to take him to a psychiatric facility where he remained hospitalised on and off for a long time. According to R, she left her husband’s house many times to seek refuge at her mother’s house but there was no support for her there either. “I already had four daughters to marry off so I had no choice but to go back to my abusive husband,” she shared.

Mounting deaths

767 cases of suicide were registered in Sindh between 2016 and 2020 R’s husband worked at a towel factory where he would hurl chairs and tables at other workers. When his condition grew worse and he was no longer able to work, R also began working at a factory to make ends meet. Her story, however, is no different from that of many other women in the country who have no choice but to spend their entire lives with mentally ill spouses, whose illnesses go untreated because of lack of awareness, poverty and many other such factors.

An epidemic in the making According to a recently published report by the Sindh Mental Health Authority (SMHA) titled ‘A study of registered cases of suicide in Sindh between 2016 and 2020’, a

total of 767 cases of suicide were registered in Sindh during the last five years. In a gender-wise classification of suicide cases, 462 men and 301 women took their lives across the province.

The data included only those suicide cases that were registered at the district health office and the police department. It revealed that Tharparkar district had the highest number of suicides with 79 reported cases. It had the highest number of women suicides with 48 more women taking their lives and 31 men taking theirs. The report also revealed that Tharparkar, Badin, Dadu, Mirpur Khas, Sanghar and Umerkot had the highest rate of suicides.

In the other districts, out of the total 70 cases of suicides reported, the number of women is 36 - slightly higher than the number of 34 cases of suicides reported of men.

Similarly, the number of suicide cases in other districts during the period were: Badin (77), Dadu (73), Sanghar (66), Umerkot (64) were found to have the highest number of cases followed by Tando Allahyar (40), Tando Mohammad Khan (33), Naushahro Feroze (31), Hyderabad (28), Malir (24), Shikarpur (23), Karachi West (19), Shaheed Benazirabad (18) and Sujawal (18). Furthermore, Jamshoro had (14), Thatta (13), Karachi East (12), Karachi South (12), Ghotki (12) Matiari (10), Karachi Central (8), Jacobabad (7), Qambar-Shahdadkot, (5), Khairpur, (4), Larkana (3), Sukkur (3) and Kashmore (1).

According to the 2018 Human Rights Commission report, in Pakistan, various reasons such as lack of necessities of life, lack of peace and political instability, unemployment, health issues, poverty, homelessness, family disputes and a range of social pressures are causes for mental illnesses.

Psychiatrist and Assistant Professor of Psychiatry at the Liaquat Medical University of Health Sciences (LMUHS), Hyderabad and author of the report, Dr Jamil Jonejo tells The Express Tribune that because of the rising number of suicide cases in Sindh and especially in Tharparkar, we came up with the idea to compile a report. “The aim was to bring the government’s attention towards mental health illnesses being faced by the people and also to promote a suicide prevention programme,” he explained. Dr Jonejo also says there is an acute shortage of psychiatrists and psychiatric facilities in the province.

When Pakistan was created, there was Lunacy Act by the British for the purpose of regulating mental health laws. While India repealed it in the early 1980s and suggested some reforms, in Pakistan, unfortunately no sufficient work was done. Before the 18th Amendment, mental health was the federal government’s subject and during Parvez Musharraf’s era, the Mental Health Ordinance 2021 was introduced.

The reason for under-reporting of suicide is that it is considered a criminal offence under the Pakistan Penal Code with punitive laws imposed for attempted suicide punishable by a fine of Rs10,000 and/or imprisonment Professor Dr Raza ur Rahman In 2013, Sindh Mental Health Act was introduced and Sindh Mental Health Authority (SMHA) was established in 2017 and in all provinces, Sindh took the lead in addressing the problems of mental health but has faced financial constraints since then. “We ensured people who made blasphemous remarks and committed suicide must fall under the Mental Health Act. Under Pakistani law, suicide is still a criminal act that needs to be decriminalised,” he emphasised. “The Sindh Mental Health Act 2013 has documented suicide as an illness and cry for help rather than a crime.”

Dr Jonejo said that for the report, the research team didn’t include attempt-to-suicide cases as those were not registered.

“The reason of under-reporting of suicide is that it is considered a criminal offence under the Pakistan Penal Code with punitive laws imposed for attempted suicide punishable by a fine of Rs10,000 and/ or imprisonment,” says the professor and former chairman of the Psychiatry Department at the Dow University, Dr Raza ur Rahman.

CONTINUED ON PAGE 2

COVER STORY

Suicide rate in Sindh according to gender Male

Female

Badin Sanghar Dadu Umerkot Mirpurkhas Tharparkar

Hyderabad Shikarpur Malir Noshero Feroz TM Khan Sujawal Karachi West Shaheed Benazirabad Jamshoro Ghotki Karachi East Karachi South Matiyari Karachi Central Thatta Jacobabad Khairpur Qamber Shahdadkot Kashmore Larkana Sukkur

0

APRIL 11, 2021

Sharing details of the report, Dr Jonejo says SMHA members often discussed that there was a need to carry out a proper study to record the number of suicides, but it wasn’t happening because of the paucity of funds.

Later, the authority launched this report of registered cases only as it didn’t require huge funding. Two years ago, the Sindh government granted only Rs200,000 to SMHA for the pilot project, so the authority members had a meeting and spent the funding on the report of registered cases instead of spending the amount on the pilot project, says Dr Jonejo. Therefore, the authority involved health centres and the police department.

“We figured out mostly police declares death cases as suicides, but we also involved health centres. We found police data reliable because health department was also reporting to the police department.”

Dr Jonejo says they had various limitations but SMHA Chairman Dr Karim Ahmed Khuwaja wanted them to publish data of registered cases at least, and they did successfully.

An epicenter in Tharparkar

Tando Allahyar

2

Official constraints

5

10 15 20 25 30 35 40 45 50

According to SMHA report, 49.8% of suicide cases were registered in Tharparkar district in 2020. However, Pakistan Peoples Party’s (PPP) Tharparkar District President, Samtra Manjiani tells The Express Tribune that 80 per cent of the suicide cases in Tharparkar are actually murders. “Both the police and doctors are involved in the crime,” she claims.

“Also, parents also issue statements saying that their children committed suicide because of cognitive disorder or depression but that is not the case most times,” she says, adding that soon as she learns about a suicide case, she reaches the spot and look for evidence herself and in most cases, she comes to learn that it is actually a murder case.

She shares one such recent incident that took place on January 01, 2021, in which bodies of a married man and his sister-in-law were found hanging from a ceiling fan in a house owned by ASI Gul Muhammad Sand in Fakeer locality of Mithi, Tharparkar.

The neighbours had cast doubt on the suicide of 39-year-old Doongar Meghwar and his sister-in-law, 20-year-old Babita Meghwar. “Doongar worked for an NGO and was friends with ASI Sand but they had developed some differences over some matters, thus, Sand hatched a plot to have him killed. In order to present the double murder as suicides, ASI Sand invited Meghwar’s sister-in-law to his house for some urgent work and had them killed and told people that they had an affair and that’s why they took their lives,” she says, adding that the neighbours informed media that it is unlikely that Doongar, who was the father of four and was married to Babita’s elder sister, would choose to take his own life.

Manjiani shared that just as the news of the double murders broke out, she visited the place and found their bodies hanging from the ceiling fans. “I also doubted they committed suicide because the house looked like a brothel. I collected various things such as creams and condoms etc from there,” she said. “The police had already declared it a suicide, saying Doongar and Babita had a love affair and wanted to get married.”

Manjiani says she insisted there is a need to carry out a proper investigation but they did not listen to her. “Six days after the murders, the victims’ families and I staged a sit-in outside the Mithi police station.

Later, the police were forced to register an FIR and took the bodies for a postmortem.

The postmortem reports showed the victims were beaten up and their ribs were broken.

So, my suspicions of murder were true. ASI Sand was running a brothel and was arrested later,” she shared.

Doongar Meghwar’s cousin Mendhro Valasai, who is now looking after the case and works at Jinnah Hospital as an MRI technologist in Karachi, told The Express Tribune that a new investigation officer was appointed to deal with the case but despite the passage of three months no further development had taken place in the investigation.

Dr Jonejo, on the otherhand, refutes Manjiani’s claim and says that he cannot believe that 80 per cent of the suicides in Tharparkar are murders. “I am running a clinic in district Badin and have also been running a Sunday clinic for the last 13 years where almost 50 per cent of the patients come from Tharparkar district. Many of them have clinical depression and bipolar disorder,” he said. “80 per cent of the people who take their lives have serious mental disorders.”

Dr Jonejo says Meghwar’s murder was a high-profile case as ASI Sand was involved in the case. “It was a criminal act and the family should be provided justice,” he says, adding that there is no denying the fact that murders are presented as suicides many times. “Take the example of Dr Maha Shah’s

case,” he points out and says they didn’t include her case in the report because the police did not verify it.

“When police shares their data with us, we had to trust them otherwise things could go against them. At this stage, we cannot afford to have any kind of confrontation with anyone. There is a need to talk about the problems of mental health without indulging in any kind of confrontation,” says Dr Jonejo.

It is believed that poverty is a major reason behind the high suicide rate in Tharparkar however, Manjiani refutes this claim. “I was born and brought up in Tharparkar.

Back in the day, I have seen many families that spent days without food but they didn’t commit suicide so how come these days people are taking their lives while they are not as impoverished as people were before.

I believe people are financially much better than their families in the past,” she says, adding that there are many social ills behind these murders.

“Most of the murder cases take place in Hindu communities in Tharparkar district.

The communities in which most cases occur are Kohli, Meghwar, Bheel and then Muslim community,” she claims.

Downward spiral Dr Rahman tells The Express Tribune that when a mentally ill person develops extremes of pessimism and feels helplessness, then he or she begins to get suicidal thoughts. If the condition remains untreated, the persons ends up taking his or her life.

The number of women committing suicide not only just in Pakistan but also across the world, is higher than men. According to Dr Rahman, in most cases, women are more willing to admit to depressive symptoms than men. Moreover, most depressed men resort to abusing alcohol and drugs, and thus are diagnosed as alcoholics or drug addicts rather than depressed.

Dr Jonejo however states that depression is more prevalent in women than men but that the number of men die by suicide is higher than women. He adds that more women attempt suicides but most men die because their selection method to kill themselves is usually lethal, for instance, they shoot themselves to death, hang themselves or jump into a river or sea while most women gulp down five or more sleeping pills if they want to die. He points out that family social bonding has been damaged in the society due to huge urbanisation.

Prevention and treatment Dr Rahman explains that psycho-social intervention includes effective management of mental, physical and substance use disorders, easy accessibility of different clinical interventions and support for those seeking help, restricted access to lethal methods of suicide, availability of family and community support, learning skills for problem solving, can save many lives in the country.

“There is a need to have legislation on suicide prevention, otherwise we won’t be able to pursue this issue successfully,” says Dr Jonejo. He adds apart from Giddu Hospital in Hyderabad, there is no big psychiatric facility in Pakistan. There are no psychiatrists in 17 districts in Sindh province, therefore, the government needs to take an initiative.

According to Student Wellness Counselor at Ghulam Ishaq Khan Institute of Engineering Sciences and Technology, Swabi, Sumira Siddique, there is a need to create awareness among the masses about the importance of a healthy lifestyle. “The chances of clinical depression reduce if we sleep well, eat well and exercise regularly.

Also, youths should be encouraged to share their thoughts and feelings with their loved ones instead of dying in silence,” she suggests. She adds if personality build-up, history, sexual abuse and environment causes someone depression, then there is a need to seek professional help.

Timely therapy Sumira says therapy definitely helps because depressed people want themselves to be heard. There is a need to listen to their grievances and understand the cognitive behaviour that they have developed over time. Cognitive Behaviour Therapy (CBT) and Rational Emotive Behaviour (RBT) are wonderful tools to break the faulty or irrational thinking patterns but family should also be involved, she says.

Siddique was of the view that these days most youths spend their time on social media and don’t involve themselves in healthy activities. “Routine life can also cause sadness so there is a need to add some fun to it,” she advises.

In May 2020, the Sindh Mental Health Authority also launched a mental health helpline for psychological counselling during the Covid-19 pandemic. *NAMES HAVE BEEN CHANGED TO PROTECT IDENTITY.

Photos: Agencies

ECONOMY & BUSINESS

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As Covid-induced social distancing measures have changed spending habits, a road away from traditional brick and mortar stores has opened up in Pakistan’s major cities A YUSRA SALIM KARACHI

Like most everyone around the world, the past year has taken most Pakistanis for a ride. Forced to take drastic measures to control the pandemic, the country’s already ailing economy took a massive hit.

When a nationwide lockdown was imposed in March 2020, people were forced to reevaluate their daily practices, including those that applied to work or consumption habits such as spending on necessities like groceries. While the corporate world was compelled to reexamine work practices, Pakistanis, who had previously been on the fence bout online shopping, were now faced with either the choice of exposing themselves to the potentially life-threatening virus by stepping inside grocery stores or taking the road less travelled and giving online shopping a try.

As a result, the country saw a boom in online grocery shopping and changed the dimensions for many. Right now, there are dozens of businesses that are providing such services with most having their supermarkets as well as an online store and some specifically providing purely online services. Few new ventures also hit the market during this time and managed to use to pandemic in their favour to cash out.

Monetary incentive

Rs40,000 is the amount a full-time Pandamart rider can earn per month, apart from incentives and bonuses offered weekly Customer response “I was so scared to step out and buy groceries as I have my parents at home who are above 50 and younger siblings as well. I didn’t want to be the carrier of the Covid-19 for my parents,” shared Asim Khan who started looking for options to order online grocery items to avoid going to supermarkets.

He also said that after being skeptical at first, using a phone app for the very first time, to be on the safe side he ordered just a few items for his first order. “I obviously can’t order everything but the major chunk of my monthly grocery is now covered by these services. I order via different platforms; few have a website, some are mobile application based and some of them just have a call centre or social media-based ordering techniques.”

Just like Khan, Muhammad Saleem, a senior citizen, has also opted to order online and prefers ordering his monthly groceries via mobile applications now.

“People of my age were at high risk so my family stopped me from going out to buy groceries despite many markets implementing very strict of the SOPs. So I started ordering a few items of need and now I keep ordering everything. The service is easier as I don’t have to go out and don’t even have to carry huge heavy bags myself.”

However, while ordering grocery items such as flour, sugar, cooking oil, pulses etc is still very common, ordering fresh products such as meat, milk, fruits, and vegetables are still a far-fetched thing in the Pakistani household.

Shaheen Naz shared how she can never rely on online services for fresh products. “How can I buy fruits and vegetables without checking how fresh they are? Same goes with meat too. I can’t believe how clean and fresh it is until I go and buy [the products] myself”.

Naz also added that the exchange policies offered by online services are not good in Pakistan. “Customers have to keep making calls and complaints, which is additional added stress and can be completely avoided if one sidesteps online ordering altogether,” she said.

Another customer who started using online ordering last year when the lockdown was imposed, was of the view that people in the country have trust issues for the past few years they have been facing different kinds of frauds through online scams. “I ordered a dress for myself worth Rs8000 and it was nowhere what was posted on the social media, so I guess with food items, expiration date, local copied products and all such issues are the reason why it is difficult to trust buying something without seeing it,” said Kiran Najeeb who has stopped buying her groceries online since the lockdown has been lifted.

Platforms in vogue When the country was closed last year, the need was felt for a retail shop that can provide groceries to custumers on their doorstep. One such initiative is OctoberNow, which is a mobile application for online grocery shopping that provides household items at the lowest prices from nearby local stores.

CEO of the company, Hunain Ahmed while talking to The Express Tribune, said how Pakistan properly started investing and understanding the retail industry in 2018 while our neighboring countries were on it since 2012. For example, India started implementing these changes way back when Pakistan’s economic structure was still realising it. Sharing the whole idea behind the OctoberNow application, he said that it was to provide a platform where the economy can be documented and make the efficiency of products and services better since it is not in good shape in Pakistan.

The idea to launch OctoberNow, as the name suggests, came about in October 2020 as a result of the March lockdown, the whole country came to a standstill due to the Covid-19 pandemic. “We decided it was the best time to launch,” said Ahmed.

And how are people responding to his business model? “People are accepting this new way of grocery shopping. Initially, they had trust issues which is very much understandable, as online shopping in Pakistan is not upto the mark and many people have experienced fraud but with time and through maintaining a

good standard of services, the customers started trusting us.”

Sharing how in lockdown their sales were the highest, Ahmed said that last year the sales kept increasing which was due to multiple factors. The main reason was engaging with customers, hearing their complaints and resolving them at earliest. “We also offered different programmes and discounts to build trust with the products. It is unfortunate to say it this way but the pandemic has helped a lot in establishing our market. Last year, in July, which was the peak of of the Covid-19 pandemic in Pakistan, was also the peak of our sales,” the CEO claimed.

OctoberNow uses two types of delivery riders: One, who are paid a fixed amount of salary, while the others get commission on several orders that they deliver.

A vast majority and a comparatively older generation are not as comfortable with such services yet however the trend is changing. Sharing how they cater to such customers, he said that orders for items such as meat, fruits, vegetables, milk, or yogurt are not very common but a specific number of customers do consider ordering fresh items.

“It has pros and cons, such as a lot of standard meat providers help in delivering fresh meat but the product rate changes in local area shops and that can sometimes cause problems as the amount changes on a daily basis. Customers can be very sensitive; when they demand fresh items they want at the lowest rate so what we do is we keep uploading recent pictures and rates, as well as offer exchanes, so the delivery can be as hassle-free as possible,” he said adding that with such changes, the whole perspective of shopping will change. “Even the lifting of lockdown has not affected our business and loyal customers are still availing ourr services.”

When Covid-19 hit the country, not only did it lead to the emergence of new businesses but older ones also amended their ways to provide services. People were scared of going out but at the same time, they wanted to make sure that they wouldn’t run out of essentials so some started stocking up. With the lockdown, daily wagers were the highest affected amongst others. However, businesses, which were quick to adapt to the change, were able to survive: “During lockdown when services were halted, we repurposed our business models and introduced PandaMart and shops, added groceries, while ensuring safety hygiene standards and no human interaction,” shared Corporate Communication Officer of FoodPanda, Tooba Iqbal. Sharing the details of their expansion from food delivery to grocery delivery, she added, “We are now expanding to cloud kitchens, a delivery-only restaurant that has no physical space for dine-in. It relies entirely on online orders placed through our app. In the next quarter this year, we will also be experimenting with drone deliveries and will be testing out the concept in Pakistan.”

To a question about how the market is responding since the lockdown is lifted, she said that the lockdown situation is still pretty uncertain.

“Even with the availability of the vaccine it can be seen that the country has been hit by the coronavirus variant in some regions due to which some provinces have imposed a lockdown again so whether things will ever get back to normal is still a far-fetched idea.”

When Covid-19 hit the country, not only did it lead to the emergence of new businesses but older ones also amended their ways to provide services “For Pandamart specifically, soft drinks, bread, eggs and meat are the highest sold items. When the lockdown began and indoor dining was closed, millions of Pakistanis staying at home were relying on Foodpanda for safer deliveries and to support its vendor partners, our company has waived off onboarding fees and commission for selected restaurants and home chefs last year,” she said. “To reach more customers in the most popular areas, the delivery radius was enhanced for a temporary period, to derive larger order volumes. To encourage higher revenue growth, marketing support and discounts were also being provided,” shared Iqbal.

Sharing about rider’s perks, she said that riders’ earnings vary as per the distance and their performance. “On average, our full-time rider earn more than Rs40,000 per month, apart from incentives and bonuses offered weekly,” she said.

Other than these businesses, a representative of Imtiaz Supermarket said that currently they are not offering online grocery shopping but that they are just providing home delivery services on orders placed through social media.

The CEO of HumMart, Faisal Qayyum also said that their business received an intial boom when the lockdown first happened but that for now, they have stopped offering their services.

Pakistani people have already accepted and adopted online shopping as part of their lifestyle Foodpanda representative Tooba Iqbal few years but this is the future of supermarkets,” said Ahmed.

Talking about the challenges of being an online grocery provider Ahmed said that there are market challenges as well because of the type of grocery experience OctoberNow is providing. “We are only ones who we provide groceries even from your nearest grocery store,” he pointed out.

“Growth of online grocery or e-commerce in Pakistan is exceptional.

One of the major reasons for that is that it’s convenient,” said Iqbal.

There is a lot of untapped potential in this market and more avenues can be explored and for any e-commerce business there are three major fundamentals in the growing e-commerce business. One is online payments - Pakistan is digitising very quickly with debit cards, mobile wallets, credit cards and the like. Second is the internet and mobile penetration. Pakistan is going 100 per cent on mobile and internet penetration with over 40-50 million 3G, 4G and broadband users. So that is quite phenomenal. Lastly, logistics are. “Pakistan is ready to absorb e-commerce, that is evident from the rise of online shopping. Pakistani people have already accepted and adopted online shopping as part of their lifestyle,” she concluded.

Each business has its ways of catering to customers and so does the online market. “The main target customers are mostly educated people or those who have internet access and know-how to use a smartphone so that they can order easily but we are expanding our services to ease out customer issues such as including card payment and online transactions as well,” said Ahmed.

Operating in a grey area So what body regulates such online stores and businesses, and what happens should business violate those rules? According to Commissioner Karachi Navid Ahmed Shaikh told while talking to The Express Tribune, “There is no provision of any provincial law available for regulating online businesses. At the federal level, there is Prevention of Electronic Crimes Act, 2016, and the National Response Center for Cyber Crimes (NR3C) of FIA, which is mandated to implement this legislation while Home Depertment has issued directions for online sales during Covid-19.”

While appreciating the online grocery shopping trend during Covid-19 and lockdown situation, he pointed out that from the administrative standpoint in times of pandemic, it’s a very positive trend and it should be encouraged.

Commenting on what regulatory authority is in a better place to take action against such business if they violate any laws or if any citizen lodges a complaint against fraud, Commissioner Karachi said, “The National Response Centre for Cyber Crimes and FIA are the ones who deal with such cases as we do not have any such law in place.”

Shaikh also shared the notification and rules which were formed after the lockdown to ensure the delivery services are following proper Covid-19 SOPs. The notification, which dated back to April 14, 2020, listed around 49 business who were delivery-based and asked to operate only under certain conditions. The document lists 16 conditions under which delivery can be allowed.

Few of those conditions for instance stipulate that only registered riders should deliver items. The riders should always wear a helmet and uniform to differentiate themselves in public. Riders from courier companies must always carry valid ID card from companies on their persons while making deliveries, all riders must also masks and gloves, and maintain social distance. The document also advises minimizing of cash handling and receipts. The permission for these businesses is also likely to be cancelled if violations are seen.

E-commerce here to stay

The service is easier as I don’t have to go out and don’t even have to carry huge heavy bags myself Senior citizen Muhammad Saleem

Photos: Creative Commons/Files

In Pakistan, the e-commerce business is gradually rising and the market is beginning to accept it now. The trends and ideas have also drastically changed in the last year. “E-commerce was going to the hit the country no matter what. If we did not have to bring it this way it could have come another way. The system would have changed if not in 2020 then after

APRIL 11, 2021

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HEALTH & FITNESS

Unequipped to feed the under-fed

By Nabil Tahir

Design by: Ibrahim Yahya

There is a dire need to address malnutrition across the country but without a proper policy, awareness or trained dietitians, children across the country will continue to suffer Over a third of all children in Pakistan are chronically malnourished (stunted), while 30 per cent of under children under the age of five are acutely malnourished (wasted). This situation contributes to high mortality and morbidity rates among children under the age of five, undermining their mental and physical growth and leading to a significant economic impact on their development and prosperity.

Malnutrition of this nature occurs when the mother or the child do not get the right amount of nutrition increase with every year. While the government has been building healthcare centres, it has been unable to cope with this situation due to the unavailability of qualified dieticians and the lack of a unified policy on this across the country.

Pakistan is not the only country facing the malnutrition issue but many countries worldwide have taken measures to tackle these issues.

The reasons and levels of malnutrition in children, however, differ between Pakistan and other countries. The Director of Global Health Economic Outcomes Research and Policy at Abbott, Suela Sulo, who has been studying these issues for years, told The Express Tribune, “Malnutrition occurs when the body doesn’t get the nutrients it needs and can happen in both underweight and overweight individuals. It is a common issue affecting children and adults in both developed and developing countries worldwide – including Pakistan and its neighbouring countries.”

Akram, Vice-Chancellor University of Health Sciences, Lahore, and the founding President of the Pakistan Society of Internal Medicine, people focus more on curative health and not on preventative health.

Clinical malnutrition Many factors combine to stifle the development of better nutritional care in Pakistan. The problems begin when the patient enters a healthcare facility, for most patients are not screened for malnutrition upon admission. As a result, many commence their stay facing a hurdle, and more than two-thirds of patients with malnutrition decline further during their stay.

The EIU report states that malnutrition is also found in hospitals and other clinical settings in Pakistan and worldwide. It is estimated that globally, malnutrition affects almost 50 per cent of patients admitted into the hospital. And yet, only 7 per cent of these are typically diagnosed, leaving millions potentially undiagnosed and untreated, while other patients can develop the condition while in hospital. Clinical malnutrition can lead to the need for high-dependency clinical care, lengthen recovery times, and increase the likelihood of high-risk complications.

Lacking nourishment

30%

Higher mortality risk

Food insecurity

As people don’t get the right amount of food and nutrition, they end up with malnutrition-related health issues. According to Professor Javed

Deficiency among children Under five 18.6% 28.6%

A dearth of nutritionists and dietitians Moreover, a lack of nutritional knowledge among clinical staff in Pakistan is a persistent issue. “Hospitals are not very receptive towards a dietitian,” laments dietitian Lieutenant Commander Anwar, a practising dietitian and former President of the Pakistan Nutrition and Dietetic Society - a

NC

Preventative over curative healthcare

Clinical malnutrition also has consequences for hospitals and the broader health system: increased costs resulting from longer lengths of stays, more intensive clinical care and higher readmission rates can cripple health system administrations.

On the other hand, based on this new evidence, the series presents a new framework for categorising nutrition actions into direct and indirect interventions and health and non-healthcare sector interventions.

This framework highlights that evidence-based interventions continue to be a combination of direct interventions (example, micronutrient supplementation and breastfeeding counselling) and indirect interventions to address the underlying determinants of malnutrition (example, family planning and reproductive health services, cash transfer programmes, and water, sanitation and hygiene promotion). Nutritional interventions delivered within and outside the healthcare sector are also equally crucial for preventing and managing malnutrition.

ZI

Both the reports discuss food insecurity, a condition in which households lack access to adequate food because of limited money or other resources, which afflicts almost 37 per cent of Pakistan’s households. As a result of this insecurity, malnutrition — when a person’s diet does not contain the right amount of nutrients — is commonplace. About half of adult women in Pakistan suffer from anaemia, over a third of children are stunted, and about 30 per cent of children under the age of five are underweight.

AKU faculty Professor Zulfiqar A. Bhutta and Dr Jai K. Das are senior and lead authors of two papers in the Lancet series. They noted that Pakistan, like many developing countries, faces the challenge of the triple burden of malnutrition where stunted growth and deficiencies of essential nutrients are prevalent alongside a trend of rising overweight and obesity.

“More than half of Pakistan’s population is food insecure and many essential nutritional interventions such as breastfeeding and complementary feeding indicators are far below the desired levels. Pakistan needs to reinvigorate its focus with a sustained viable strategy for ensuring improved health and nutrition for all to meet global targets soon,” the report states.

of children in the country under the age of five are underweight

62.7%

VITAMIN D

A new finding shows that nearly 5 per cent of children are simultaneously affected by both stunting and wasting - a condition associated with a 4.8-times increase in mortality. The incidence of stunting and wasting is highest in the first 6 months of life but also exists in part at birth. For maternal nutrition, although the prevalence of undernutrition (low body mass index) has fallen, anaemia and short stature remain very high.

The Lancet published the latest series on Maternal and Child Undernutrition Progress, which reiterates that previously highlighted interventions continue to effectively reduce stunting, micronutrient deficiencies, and child deaths and emphasise the importance of delivering these nutrition interventions within the first 1,000 days of life.

However, despite this evidence, programme delivery has lagged behind the science and further financing is needed to scale up proven interventions. Another research report by Economist Intelligence Unit (EIU) indicates the current state of clinical nutrition in Pakistan’s hospitals and clinics and how outcomes can be improved for patients. The report discusses food insecurity, a dearth of nutritionists and dietitians, the underprioritising of nutrition and the fragmented policy landscape in Pakistan.

body that is dedicated to upgrading the professional knowledge of dietitians practising in Pakistan. “Those practitioners who are locally educated in Pakistan don’t support dietitians. They want to prescribe their own diet, and they tell the dietitian to only make the menu for it,” he said.

Some hospitals do focus on nutrition—about 10-15 per cent Anwar estimates—and those hospitals are getting results. “They have reduced complication rates, length of stay, readmission rates, mortality and cost of care. They have seen the overall benefits,” says Anwar. She also adds there are fewer readmissions if discharged patients’ nutritional status is good.

“It is not humanly possible for me to do a malnutrition assessment of every patient,” laments Anwar. “We have minimal staff in hospitals.

Some hospitals have more dietitians, some of the hospitals have fewer dietitians, so it is not universal here.”

Often the terms nutritionist and dietitian are used interchangeably.

However, the Pakistan Nutrition and Dietetic Society require a dietitian to have dietetics qualifications and training, whereas a nutritionist does not. As a result, all dietitians are nutritionists, but not all nutritionists are dietitians.

Dr Rubina Hakeem, Principal, RLAK Government College of Home Economics Karachi and founding chairperson of Nutrition Foundation of Pakistan, says that the problem begins with a lack of appropriate education programmes. “Many of the colleges continue to run high-quality dietetic programmes, producing home economics graduates with specialisation in nutrition. However, because of the limited supply of graduates from these colleges, many programmes have been founded in Pakistan were few, if any, of the faculty has studied or practised dietetics or clinical nutrition. These programmes can vary in the content and quality of education. “That is a very, very concerning area because those new graduates are now a huge number,” she states.

IRO

N

More than half of Pakistan’s population is food insecure and many essential nutritional interventions are far below the desired levels

51.5%

VITAMIN A

Prevalence of Malnutrition (Children Under Five) 40.9%

Boy

39.4%

Girl

29.3% 18.4%

28.4%

17% 9.7%

9.2%

40.2% 17.7%

STUNTED 4

APRIL 11, 2021

WASTED

28.9% 9.5%

UNDERWEIGHT

OVERWEIGHT

HEALTH & FITNESS Suela Sulo, talking about the importance of dietitians, says that, “Dietitians play a critical role in providing nutrition care, addressing malnutrition requires a multidisciplinary team approach, especially when personnel or resources are limited.

Growing evidence shows the importance of malnutrition screening, which can be done by asking two questions and can take less than five minutes upon hospital admission or at a clinic visit by a nurse. Quickly and efficiently identifying individuals at malnutrition risk can help streamline the nutrition care process, allowing dietitians to complete a nutrition assessment and work with a physician to treat individuals found to be malnourished.”

The nutrition strategy of Pakistan Pakistan has included supplementation in its multi-sectoral nutrition strategy, which began in 2018 and spans to 2025.

The strategy aims to create economies of scale in the areas of procurement, capacity building and logistics. As a result of its multipronged strategy, Pakistan hopes to reduce anaemia among women of reproductive age by 50 per cent, low birth weights by 30 per cent,

needed, but regulation of the sector too. There is no regulatory body that can regulate the practice of dietitians.

Clinical malnutrition also has consequences for hospitals, like increased costs resulting from longer lengths of stays

A potential solution

and stunting in children under age the of five by 40 per cent. They also hope to stabilise the rate of overweight children.

But there remain big gaps in the plan, including clinical malnutrition and there is little on the monitoring and evaluation of whether the strategies are effective and if the desired outcomes are being met. Dr Achakzai acknowledges this gap. “We have a strategy on nutrition in emergencies. We have a strategy for micronutrient deficiencies. But clinical nutrition, as policy measures, so far we have not addressed that.” But it’s not only policies which are

To tackle the situation, the Pakistan Nutrition and Dietetic Society is encouraging hospitals to make a conscious approach to hiring nutritionist specialists. “Our society is actually networking with all hospital managements to hire only registered dietitians in the hospital so that medical nutrition therapy can be successful,” says Anwar. Subsequently, the Government of Pakistan is now developing accreditation for nutritionists and dietitians. Doing this will help ensure standards of practices for these professionals, that there is a regulation set in place for what they do and how they do it. It will also, it is hoped, lead to better dietary practices in clinical settings.

The evidence suggests that a multidisciplinary approach to care improves outcomes. Suela Sulo says that “While healthcare policies focusing on elevating the role of nutrition care are needed, optimising nutrition care is everyone’s job and responsibility – and only by working together can governments, hospital systems and healthcare professionals in public and private sectors manage and alleviate the significant burden malnutrition poses on society.”

Prevalence of Malnutrition by Locality (Urban/Rural) 34.8% 24% 16.2%

URBAN

STUNTED

WASTED

9.6%

UNDERWEIGHT

OVERWEIGHT

43.2% 31.6% 18.6%

RURAL

9.4%

STUNTED

WASTED

UNDERWEIGHT

OVERWEIGHT

44.2%

46.6%

19.1%

9.4%

KP

28.4%

GB

21.3%

15.75%

32.6%

12.2%

12.1%

39.3%

ICT

19.2%

16.1%

AJK

5.8%

36.4% 15.3%

PUNJAB

46.6%

16.7%

13.4%

23.5% 9.9%

18.9% 31%

21.9%

45.5%

BALOCHISTAN

STUNTING WASTING

23.3%

SINDH

41.3% 5.2%

UNDERWEIGHT OVERWEIGHT APRIL 11, 2021

5

TRAVEL

The diary of a motorcycle journalist

By Ali Ousat

Traversing through hilly mountains and scenic lakes, one journalist describes his journey by motorcycle from Lahore to Skardu

Forced to retreat from K2 to a remote area of Skardu, mountaineer and philanthropist Greg Mortenson in his his book ‘Three Cups of Tea’ has this to say about the beauty of the region and its people: “Here we drink three cups of tea to do business. The first you are stranger, the second you become a friend and the third you join our family, and for our family, we are prepared to do anything — even die.”

Until one wanders into this area, it is impossible to fathom how true those words ring true in describing the warmth and charm of people who live here. The hilly area surrounded by beautiful lakes, encircled by dramatic waterfalls and rolling farmlands that produce fruits and vegetables, is also an area of artistic villages and towns that possess historic architectures.

Despite their less than privileged living conditions, people in these areas are considered to be the happiest people in the world. Moreover, the traditional foods and the mountain peaks that glitter in the night sky, always impress the visitors. The region also attracts the hikers, mountain climbers and thrill seekers who explore the region and want to fill their souls.

Three decades earlier, an Irish nurse named Dervla Murphy felt the same tug to these mountains. Murphy, who crisscrossed the Karakoram in the deep winter on horseback, later wrote in her book ‘Where the Indus Is Young’: “None of the adjectives usually applied to mountain scenery are adequate here. Indeed, the very good scenery is comically appropriate. Splendor or grandeur are useless to give a feeling of this tremendous

ravine that twists narrows and dark and bleak and deep mile after mile after mile. Only the jade-green Indus sometimes tumbling into dazzle of while foam relieves the gray brown of crags and sheer precipices and steep slopes.”

To follow the footsteps of these tourists, I and Kifayat Ali Shah, a fellow journalist, uploaded our two wheelers onto the train leaving for Lahore from Karachi.

As a preference, I never try to see an entire region in one visit. This way, each visit offers a distinct and vibrant world all on its own. My companion and I both decided to reach Skardu directly and enjoy the mountainous peak in the region.

However, riding a bike in hilly areas is not an easy task. Hassan Ali Khan, another biker from Karachi, whom I encountered in Mansehra precisely described the journey: “We just need ‘dil’ and ‘gurda’ (heart and kidney) to ride the bike all the way in order to explore the

6

APRIL 11, 2021

mountainous area of the North.”

When I started my ride from Lahore, it took seven hours to reach Islamabad, where after having dinner I again took off for Mansehra. After we reached Abbottabad, we stayed there for a few hours and after dinner we took off again, finally reaching Mansehra at around 12 o’clock.

After 17 hours of travelling, when I staggered to bed, I was so exhausted that I fell immediately into a comatose sleep that likely even a bomb going off in the nearby area would not woken me up from.

The night journey by motorbike from Kaghan and Naran enhanced our sense of adventure People in the northern areas are so loving but they desperately yearn for education and economic prosperity.

“People in recreational areas around the world have been living privileged lives but in Pakistan the situation is worse,” said a hotel waiter in Mansehra.

The second day, I started my journey with Kifayat at 3pm in the afternoon and when we reached to Kaghan valley, the sun was setting. After eating Kaghan’s famous Shahbaba Chapli Kebab, I began my ride again and reached Naran by 9pm. The night journey on my bike between the mountainous hills and trenches from Kaghan and Naran also heightened the adventure as people usually avoid traveling on these treacherous mountains after dark, due to fear of driving off of them.

The next day we reached Babusar Top, 13,700 feet high from the sea. After taking some and photo shots our actual journey began from Babusar top, when we reached dangerous slopes called ‘Babusir ki utrai aur charhai’ (Babusar’s climb and descent).

Babusar Pass is at a distance of 80 km from Naran. It is on the way to the pass that the Kaghan Valley’s scenery becomes most dramatic. Battakundi is at a distance of 16 km from Naran and provides access to Lalazar Plateau, lake Dodiputsar and lake Lulusar, which is the biggest natural lake in Hazara and the source of Kunhar river. The road is wide and accessible for all kinds of vehicles.

I crisscrossed the Chilas district on my way to Raikot,

Babusar Pass is at a distance of 80 km from Naran. It is on the way to the pass that the Kaghan Valley’s scenery becomes most dramatic

where I encountered natives who complained about the misbehavior of the visitors who come to the area.

Usually, people avoid staying in Chilas due to its hot weather. An incident that took place some years ago, when extremists shot down more than 14 people, is also a deterrent to visitors from a security perspective. However, the people of Chilas maintain their charm and are always ready to help anyone in need. They believe in convincing people to visit again without any fear using the strength of their hospitality.

While driving on the Karakoram highway after crossing Raikot we reached Juglot city. From there, we turned towards Astore city. The road towards Astore is in a bad shape and at some places roads do not exist at all. Rama meadows is 10 km away from Astore and after passing Rama valley we were on a road that is quite steep.

The valley itself is thickly forested with huge pine, cedar, fir and juniper trees.

Once in Rama meadows, where locals made some makeshift arrangements for the visitors, the humble Abdul Latif greeted us and gave us a tent for us to rest.

Abdul Latif briefed us that the valley is about 3,300 meters (10,800 feet) above sea level and thus is covered with snow for seven to eight months of the year. In summer, the valley transforms into a lush green.

After spending a night at Rama tent city we started our journey again to the lake. I can say that it was an extreme thrill as not many travellers would have chosen to make their journey to the lake on their bikes and while the lake is great, it is the mountains surrounding it that are just as mesmerizing as the lake itself. If you enjoy a good, long trek, you can choose to go around and come down to the pine forest instead of going back the same way.

Helena Norberg Hodge, who spent 17 years living in these mountains and wrote, ‘Ancient Future,’ argued that Western development workers should not blindly impose western ‘improvements’ onto ancient cultures. She wrote that a close relationship with the land can enrich human life beyond all comparison with material wealth or technological sophistication: “I have learned that another way is possible.”

Tajamul Hussain, a businessman from Gilgit, who also came to Rama Lake, said while talking to The Express Tribune, that the area was rich in minerals but people in the area need stability and need to be accepted. “You see, the people are keen to learn the education but

The people of Chilas maintain their charm and are always ready to help anyone in need. They believe in convincing people to visit again through the strength of their hospitality current political and economical conditions have made nothing for them,” he said, adding that “People are highly educated here and they are not of an extremist mindset but just need political certainty.”

After tasting the flavor of Rama Lake, I began my journey to Skardu through the Deosai plateau. The Deosai Plateau is one of the world’s most wildernessrich areas. With its unobstructed views and countryside, dotted with cabins, it is one of the more picturesque landscapes.

Also in the north there is the face of Nanga Parbat, the greatest single unbroken pitch of rock on earth. But it is my most unfortunate that I could not reach Deosai due to snowfall, so I decided to go there on my next visit as well as Skardu.

There is a famous saying that, “Jobs fill your pockets, adventures fill your soul.” So after filling our souls, Kifayat Ali Shah and began our journey back to Karachi.

Photos: Kifayat Ali Shah

ART, MEDIA & LITERATURE

By Asad I. Mian

If there is just one book you get to read this year, there are at least five reasons why it should be Yuval Noah Harari’s ‘21 Lessons for the 21st Century’ Upon reading Homo Deus, I was mesmerised by the mind of Yuval Noah Harari - or brain perhaps I should say, as he believes much more in the objective nature of the latter. In an attempt to summarise what I had learned from the book and to create a cheat sheet for myself, I wrote a blog on Homo Deus. I listed the five most important reasons from my perspective for reading the book, and concluded the blog with three actionable steps for the reader, which to me seemed organically linked to those five points I had raised about the book.

Those three were: (i) reinvent thyself, (ii) go forth and create/innovate, (iii) allow yourself to be multi-talented.

Fast forward a few years, and I find myself in an even more dystopian world, with a pandemic raging unabatedly and unabashedly. Being an ER physician, I find myself caught at the frontlines of the Covid-19 tempest. After almost a year of being grounded because of severely restricted travel, the first opportunity I get to fly and I find Harari’s third book ‘21 Lessons for the 21st Century’ sitting in the airport’s book store. It is a sign I tell myself and I promptly obtain the book as my preferred travel companion. Soon after delving into it, I realize the wealth of treasure that the 21

Lessons represent.

As had happened in the past, upon reading and reflecting on Harari’s latest book, I had an intense urge to pen my thoughts. Hence, similar to the previous blog, you may think of this one too as more of a book report versus a review, since I’m still not a literary critic. Ergo, the primary reason for this blog remains extoling the greatness of Harari as a thought leader with a brilliant mind that is able to guide us lower mortals in this dysfunctional century.

If there is just one book you get to read this year then make it 21 Lessons, and listed below are five reasons, in no particular order, as to why I say that.

1. True to his no nonsense, evocative and provocative style of writing, Harari continues to critique all kinds of governance, religio-political viewpoints, and institutionalised practices, ranging from (confused) liberalism of liberal democracies to (jingoistic) nationalism of dictatorships, and everything in between. Although he throws into that milieu atheism, secularism, religious fundamentalism, dataism, and other -isms, it is his effective explanation of various facets of liberalism that I found deeply insightful. Likely because I associate myself most with liberal humanistic values. However, Harari made it quite clear through his diatribe

against (pseudo?) liberalism that for the 21st century what we consider liberal and equitable will likely require a redefinition.

2.

Harari continues to build our world view with regards to the exponential rise in humanity’s biotechnological prowess coupled with the ever rapid rise in our abilities for information technology. Thanks to big data, AI/ML and such, algorithms will become more powerful than ever before. Super smart algorithms will simply take over the menial jobs of their human masters. This will yield success vis-àvis humanity’s progress in some ways, especially with newer jobs being created for humans that will require them to achieve novel skillsets. However, for the global community, particularly for the countries on the lowest rungs of the economic ladder (South Asia, Sub-Saharan Africa, etc.), it will likely sound the death knell for job and gender equity and parity – even if there was any to begin with. In other words, relevancy in the 21st century will require humans to redefine their contemporary work and education best practices, keeping in mind the kind of future they want to seek for their next generation.

We can sustainably fix our issues — at the level of either the individual or race — by first humbly accepting that we indeed have created the problems that we need to solve 3. Harari describes an interesting relationship by the formula b X c X d = ahh, where b=biological knowledge; X=multiplied by; c=computing power; d=data; ahh=ability to hack humans.

This is ominous to say the least, because the formula is essentially telling you that the aforementioned tools can be used to manipulate and coerce humans. With the great strides in data science, bioengineering, InfoTech, AI/ML, etc. the question will always remain: is the data that is being collected by governments, organizations, Amazon, Google, etc. used for or against me?

Keeping in mind the (mis) information overload one is faced with daily (“not all data is useful”), in a world of irrelevant information how does one put to good use information that is relevant? And who decides what is relevant – Trumpian or other governments, big companies, religious institutions, schools/colleges, someone else? Although data is much needed to make informed decisions, it is equally important, if not more, to be aware of the rise of Orwellian global digital dictatorships with their potential to restrict universal human liberty and equality.

4.

Harari’s discourse on humility piqued my interest a lot. Initially I was surprised to find a whole chapter dedicated to it. But upon reading and reflecting on it, I realized the utmost importance of humility as a virtue worthy of being pursued by all of humanity, regardless of wealth of the individual or nation (or lack thereof), religious or political affiliation, etc. I mean human beings are quick to say “with utmost humility blah blah blah” or “I am truly humbled by blah blah blah”, yet few of them are truly humble or actually show humility. I believe that a person who is really humble does

not need to broadcast his or her humility. Anyhow, Harari simplifies this by stating “you are not the centre of the world”. And he goes on to say “humans of all creeds would do well to take humility seriously”.

Well said! By being less egocentric we may allow real humility to come through. This is quite important as a starting point; because we can sustainably fix our issues – at the level of either the individual or race - by first humbly accepting that we indeed have created the problems that we need to solve. And that we humans are not at all at the center of ‘all cosmic drama’.

5. Another fascinating thing that resonated with me was Harari’s discourse on meditation, and just prior to that on not obsessing about finding a meaning or purpose to your life or doggedly pursuing your desires. He makes the point that regardless of the life purpose or meaning you convince yourself of, it is storytelling after all. And you are merely being a story teller. Nothing wrong with that I suppose, as long as it doesn’t generate more angst and confusion within you or those around you. We can also stop obsessing about our emotions, feelings and desires, because we aren’t free to control them. I think this opens our mind for introspection/reflection and that’s rather well described in the chapter titled meditation. Real meditation in the current chaos of 21st century living, the pandemic notwithstanding, will help slow things down albeit in our minds.

From the 21 Lessons, I have tried to distill the aspects that I felt relatively comfortable summarizing. It should not be assumed that those are the only important points being raised by Harari in his book. I may have only covered five of 21, although in my reading of the book I felt overlap existed between several of those lessons. And in many places, 21 Lessons was reminiscent of Homo Deus’ messages. Both books pontificate on the escalating pace of change of everything, be it global biotech, InfoTech, tolerance, empathy, animal rights, environmental degradation, climate change, and so on, and we are well aware that not all change in the above has been positive.

In the final analysis, I have found Harari’s 21 Lessons to be both timely and crucial to help me make sense of a seemingly mundane, meaningless and random world where human stupidity knows no limits. This age of confusion or bewilderment that I find myself in is shared by my peers, such as Harari. Furthermore, as he explains to me the ins and outs of this world, using his splendid gift of repartee, I feel inspired, not just in thought but also action.

Hence, I propose Hararism – a philosophy or movement inspired by Harari; which I find to be reminiscent of other contemporary -isms that I have delved into over the past decade, namely Stoicism, Sufism and Taoism.

As with the other modern isms for the 21st century, I have picked up many practical and meaningful lessons from Hararism. Hence, my hope remains that I get to meet and chat with Harari over a cup of chai soon, with all Covid SOPs being maintained of course.

THE AUTHOR IS AN ER PHYSICIAN, RESEARCHER AND INNOVATOR-INTRAPRENEUR AT THE AGA KHAN UNIVERSITY, WHO WRITES ON TOPICS RANGING FROM HEALTHCARE, EDUCATION AND INNOVATION TO HUMOUR AND POPULAR CULTURE. HE CAN BE REACHED ON TWITTER @AMIAN74

Harari continues to critique all kinds of governance ranging from (confused) liberalism to (jingoistic) nationalism Photos: Creative Commons/Files

APRIL 11, 2021

7

LAW & JUSTICE

A HASNAAT MALIK ISLAMABAD

By the end of March this year, the backlog of cases in the Supreme Court of Pakistan hit a record of 48,594 cases. The pandemic is the main cause for this massive pendency in the apex court as providing justice has become a massive challenge during a time when social distance is the need of the hour.

More than six thousand cases were added to the total pendency during the last 15 months. In January last year, the total number of pending cases was around 42,000 , with a total of 6,594 added by the end of March.

Former Chief Justice of Pakistan Asif Saeed Khosa had previously focused on clearing criminal cases and he remained successful in his strategy. However, it has now been witnessed that the backlog of criminal cases is also increasing day by day. No special bench is working to decide jail petitions. A total of 2,436 jail petitions were pending until 31 March.

A state law officer who represents convicts in criminal cases and requested anonymity revealed that due to the non fixation of jail petitions or criminal appeals, relatives of prisoners have been contacting them to know status of their cases. “There is a dire need for a special bench to consistently work to clear the backlog of criminal cases in the apex court. Likewise, around 30,000 cases of civil nature are pending in the apex court,” he said.

In December last year, the Supreme Court of Pakistan allowed a senior lawyer to represent his client from home using a video-link There are many factors responsible for this huge pendency. The prime reason is that the court work has been badly affected due to the Covid-19 pandemic. On the other hand, it is a fact that Supreme Court could not expand the use of technology to ensure justice during this critical time. During the hearing of Justice Qazi Faez Isa application for live broadcast of his case, another Judge Justice Syed Mansoor Ali Shah rightly pointed out that science and technology should be welcomed as they hugely help improve and bring more transparency to the system of justice.

Although, having said that, it is important to note that the Supreme Court has taken some significant initiatives recently to use technology for speedy and inexpensive justice. In May 2019, for the first time in the judicial history of the country, the Supreme Court used the e-court system under which its registries in the provinces would be connected through latest technology to its principal seat in the federal capital.

The advocates in Karachi, Lahore, Peshawar and Quetta whose cases are fixed at the court’s principal seat in Islamabad may argue their cases from their cities through a video link. The system is benefiting the lawyers as well as the litigants and rendering the judicial system more responsive to the needs of the people approaching courts to redress their grievances. However, this option is only being used limitedly. The current infrastructure of the court system does not permit the use of technology in a majority of cases.

In view of the current situation of Covid-19, there is a need to expand this technology by allowing lawyers to argue from their home or their office.

In December last year, in view of the deadly coronavirus, the Supreme Court of Pakistan allowed a senior lawyer to represent his client from home using a video-link facility.

Similarly, the Islamabad High Court is already permitting counsels to plead their cases remotely. Situation is same in other superior courts wherein judges could not work with full efficiency. It is pertinent also to mention here that several of the high court judges were affected due to the coronavirus. Even the Chief Justice Peshawar High Court Waqar Ahmad Seth died due after contracting Covid-19. Thus since a majority of the lawyers are above the age of 60, virtual hearing are most certainly the need of the hour.

Justice Isa’s proposal In April last year, a division bench of the apex court led by Justice Qazi Faez Isa, in its order, as a solution, proposed a mechanism for hearing cases through a video link. The bench suggested that each courtroom or bench be provided with a WiFi-connected cell phone while the number of cellular devices to be mentioned in the cause list and on the website of the apex court.

Pendency problem

Over 6,000 cases were added to the Supreme Court’s backlog over the past 15 months The proposal also suggested that applications such as Skype, WhatsApp, Telegram or any other suitable video conferencing platform be installed in the said Supreme Court cell phone and the counsel should also be asked to install the same application in their devices.

After the identity of the counsel is verified, cases may be heard by the use of the said video-conferencing application. The proposal further suggested maintaining transparency and openness during the proceedings and that the screen of the court cell

8

APRIL 11, 2021

Technologies developed over time can allow remote hearings for counsel based in other cities Barrister Asad Rahim Khan judicating a question regarding live broadcast of case hearing. Interestingly, the federal government has opposed live broadcast of court proceedings.

Across the globe

As the backlog of cases in Pakistan builds up exponentially due to the pandemic, the need for courts to follow the lead of their global peers has never been stronger

In complex cases, I prefer in person hearing as one gets more attention from the judges Lawyer Haris Azmat phone may be mirrored on television sets which are already installed in every courtroom.

“The possibility of preserving the recording of the court proceedings (six months) be explored,” the proposal stated. The divisional bench also recommended that this task be assigned to the apex court’s information and technology department. However, before using the proposed system, the IT wing should ensure successful trial runs.

The Pakistan Bar Council (PBC) and Supreme Court Bar Association (SCBA), offices of Attorney General for Pakistan and advocate generals and prosecutor generals to be given a demonstration of the workability of the proposed system and consider their suggestion, stipulated the proposal.

The mechanism was subject to the approval of Chief Justice of Pakistan (CJP) Gulzar Ahmed.

ic, courts have rapidly adopted digital technologies.

Break up of digital hearing of cases done by the courts with Supreme Court hearing 7,800 cases, high courts hearing 1,750,000 cases and subordinate courts hearing 7,340,000 cases. Following the surge in Covid-19 cases, the Jammu and Kashmir High Court, along with lower courts, has again switched over to virtual hearing, he adds.

Lawyer Atira Ikram says that coronavirus changed the world in some ways for the worst and in others for the much better. “Virtual hearings are a long over due step in the positive use of technology to overhaul the legal system. It will help overcome the unnecessary delay in the administration of justice, provide convenience for lawyers and litigants alike and positively impact the environment as well,” she says.

A 10-judge larger bench of the apex court led by Justice Umar Ata Bandial has already reserved judgment on Justice Isa application for live broadcast of his review petition against the court June 19, 2020 order wherein matter related to undeclared prop-

All over the world, including India, lawyers are being allowed to plead cases from home due to the pandemic.

It has been reported that in February that the Indian judiciary achieved a record of conducting 6,685,000 case hearings through video conferencing during the lockdown. The Supreme Court, according to the law ministry, has become a global leader with 52,353 virtual hearings during this period.

The law ministry, in its performance audit of courts, has found that the district courts have heard 4,573,000 cases over video conferencing till December 2020, while the high courts have heard 2,060,000 cases. The Supreme Court heard 52,353 cases till January 31, making it a global leader in virtual hearings.

Similarly, United States of America Supreme Court is also hearing lawyers arguments through phone. Its also reported that several countries courts too, are likely to emerge from the tumult closer to modern times.

According to data published by the government, there were 550 hearings in the United Kingdom using audio or video technology on 23 March - the day Britain announced its social distancing lockdown. By 6 April, the last day of the study, that figure had surged to nearly 3,000, or 85 per cent of hearings. In Germany, where a judge in Berlin last month told a packed courtroom that one attendee with coronavirus could infect them all in 15 minutes, the shock of the pandemic may finally sink in enough to make some changes too.

Likewise, a lawyer who appeared before international legal forums confirmed that all international tribunals are conducting their proceedings through video link during pandemic. Its an undisputable fact that modern technology is useful for ensuring transparency and efficiency in the justice system. Virtual hearings are also going to be useful for the implementation of Article 37-d of the constitution which says that the state shall ensure inexpensive and expeditious justice.

India’s judiciary conducted a record 6.685 million hearings using video link during the lockdown

Lawyers opinion In support of virtual hearings, Barrister Asad Rahim Khan believes that this is very much required in view of how the third wave is exploding. “The technologies developed over this time can also assist the courts in enabling remote hearings for counsel based in other cities,” he said.

Another lawyer Haris Azmat says that virtual hearings are a great initiative. “It saves cost and time of both lawyers and litigants. It also reduces the cost of litigation. To reduce the work load of cases especially in the pendamic, virtual hearing should also be introduced in High Courts,” he said. “However, in complex and hotly contested cases I always prefer in person hearing as one gets more attention of the judges if one is present in court,” he adds.

Advocate Khurram Chughtai believes that almost all jurisdictions including small countries and countries with unrest like Iraq have introduced detained legal, administrative and digital framework for virtual hearings. “We in Pakistan have introduced it only in the Supreme Court and that too is actually from Supreme Court registries provincial capitals only,” he said.

Chughtai also said that restrictions to argue through video link at the registry won’t serve the real purpose of social distancing and remote working. He noted that there is no such arrangement in high courts and lower courts. “So, linking a restricted video link hearing from registry with Covid-19 pandemic is actually a flawed notion, the same was operation was there even before the pandemic,” he said.

He said that in India, during this Covid-19 pandem-

erties of his family members were referred to Federal Board of Revenue (FBR) for conducting inquiry.

The judgment will be significant as its case of first impression wherein the court is ad-

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