If anyone visits hospitals and educational institutions operating in the public sector in Pakistan, highly depleted conditions establish two points: 1) paltry allocations for health and education confirm that the two sectors have remained on the lowest priority of the successive governments and 2) whatever dismal allocations are made, bulk of it is embezzled. The conditions of institutions operating under the federal and provincial administration are not different but worst are those operating in the low income urban areas and most of the rural areas. Almost all the MNAs and MPAs are allocated huge amounts for development but hardly any signs of utilization of these amounts are evident.
The most blatant fact is the presence of ‘ghost staff’. It is an open secret that those seeking employment in public sector healthcare and educational institutions ‘buy out’ the post by bribing the appointing authorities. Once they get an appointment, their first priority is to recover their ’investment’ though corruption and embezzlement. It is a common complaint that in the public sector healthcare units, spurious and expired medicines are bought. On top of that paramedics and administrative staff fleece money from ‘out patients’ as well as those hospitalized. Conditions of wards are pathetic/highly unhygienic. Food in the general wards is mostly distributed by the charitable organizations, not the hospital management.
A visit to OPDs of any public sector dispensary or hospital is enough to make a person of average wit jittery. There are long queues, highly inadequate sitting arrangements and at the best a few medicines are available. Patents are advised to buy medicines from a nearby pharmacy, which often sell spurious and expired medicines or sell the quality products at premium. The pathological labs are non-existent and patients are told to get the samples tested at ‘recommended’ ones. There are evidences that the labs in low income areas are run by non-qualified and untrained staff. Syringes are used repeatedly, exposing the patients to contentious diseases. There are few exceptions or ‘Islands of Excellence’, but these are not the product of any outstanding allocation of funds by the government, but huge contribution by the civil society.
Many reputable hospitals have been established by the private sector but a common complaint is that less than one percent of Pakistan’s population can afford the cost of these entities. Some of these are supported by communities but healthcare facilities are provided without any discrimination. It is worth noting that some specialized hospitals have been established for the treatment of cancer and thalassemia, which require huge amounts. It is heartening to note that individuals as well as corporates are making substantial contribution to these institutions but the common grudge is that political leaders go abroad in the name of medical treatment but little has been done by them for vote bank.
The areas which constitute India and Pakistan suffer from the worst cast and class systems. Those who belong to superior cast or higher class just don’t want the poor to get education. They still believe that imparting education will not provide them ‘bonded labor’. The situation remains pathetic because over 65 percent population of Pakistan lives in rural area, where the clan heads are elected Senators, MNAs, MPAs and even head of local governments.
In the past educational institutions were established and run by the communities but Zulifikar Ali Bhutto did the worst by nationalizing these institutions. When the process of liberalization, deregulation and privatization started in early nineties, many of the previous owners refused to take back these schools, colleges and universities. If one looks around, many chains of schools have been established that impart education, but their target market remains the elite. This is evident from the fees they charge and the curriculum they follow. Similarly, business schools and medical universities have been established in the private sector that charge fabulous fees. Parents are forced to send their children to these schools, colleges and university.
A disgruntled mother said, “we belong to the middle class and I and my husband has to work hard to pay the fees of my two sons, one doing his BBA from a private university and the other doing his ‘A’ level. Relatives and friends often ask the rationale for sending them to these institutions. The reason is simple; graduates from certain reputed institutions seeking employment are given preference by the corporates. Therefore, we have to pay fees from our nose and scarify many of our other wishes, i.e. living in a decent home and locality, owning a car”.
Many NGOs getting funds from outside, talk to the foreign media about child and bonded labor in Pakistan and also ask the importing countries to ban those goods, where such labor is used. It is true that these menaces prevail in Pakistan but refusing work to these children can push hundred and thousands to starvation. If any group is serious in improving the condition of marginalized people, it should work on facilitating for getting education along with working.
The time has come to educate girls for ‘empowering women financially’. Primary education must be made free and compulsory. The government and civil society should also establish vocational training centers. Schemes like Benazir Income Support Program (BISP), is good but it creates baggers. The government should follow the old saying, “Don’t give me the fish, tell me how to catch a fish”.