SUNDAY
June 26, 2022
COVER STORY
Page 1
SBP did not have an understanding of
money laundering — APG report
I
n February of 2020, the president of the Financial
Action Task Force (FATF) gave Pakistan a stark warn-
ing: either enact laws in line with the body’s Anti-
Money Laundering (AML) and Combating Terrorism
Financing (CFT) standards along with bringing the
country’s regulatory framework in line with international
standards or be ready to face consequences.
And the consequences were grave – so much so that
they could have completely dried up the already low
levels of foreign direct investment estimated at hardly
$1.6 billion in this year. Had Pakistan not complied,
it would have had to deal with an increase in the cost
and time it takes to send foreign remittances back home
from abroad. Its banks would have struggled to carry out
international transactions, leading to an eventual slow-
down of the wheel of an economy already teetering on
the brink of being crippled.
But almost two and half years down the line – in
June 2022 – the FATF says that the initial determination
of Pakistan’s efforts to comply with two separate ac-
tion plans “warrants an on-site visit to verify that the
implementation of Pakistan’s AML/CFT reforms has
begun and is being sustained, and that the necessary
political commitment remains in place to sustain im-
plementation and improvement in the future”. Where
four years ago the country was fully or largely compli-
ant with hardly 10 out of the 40 universal FATF recom-
mendations, it now stands compliant with 35, placing
it among the top five nations that have AML and CFT
regimes compliant with FATF standards. The top three,
just for context, are the United Kingdom, the United
States and Italy.
“Pakistan is not being removed from the grey list to-
day. The country will be removed from the list if it suc-
cessfully passes the onsite visit,” FATF president Marcus
Pleyer said last week. The purpose of the onsite visit,
he said, is to verify the completion of reforms to check
whether they are sustainable and irreversible. In be-
tween these two timelines is the story of the use of law-
fare approach against Pakistan, efforts by Pakistani au-
thorities to put laws and regulatory frameworks in the
right shape to avoid blacklisting and reverse decades-old
policies and strategies that also allowed New Delhi to
change the constitutional and demographic status of In-
dian Illegally Occupied Jammu and Kashmir.
A stern warning
In February 2020, the FATF plenary had warned that “all
122
out of 190 countries is Pakistan’s rank in
medical tourism, according to WHO
It is also the responsibility of FATF
that its on-site mission remains
focused on strengthening of the
AML and CFT regimes rather than
on any specific individual or on the
behest of any member country
deadlines in the action plan have expired and should sig-
nificant and sustainable progress, especially in prosecuting
and penalizing terror financing, not be made by the next
plenary, the FATF will take action, which could include the
FATF calling on its members and urging all jurisdictions to
advise their investors to give special attention to business
relations and transactions with Pakistan.” It was a clear
warning to blacklist Pakistan. Exactly two years before, in
February 2018, the FATF had decided to place Pakistan on the
grey list with effect from June that year and handed it over a
list of 27 conditions that it needed to implement to exit the
grey list. For the first time, the IMF had also included exit
from the grey list part of its conditions set for the $6 billion
bailout programme for Pakistan.
The FATF is an inter-governmental body that enjoys
the backing of the United Nations. Its enforcement
arms are strengthened by FATF-styled regional bodies
and it also gets support from the International Mon-
etary Fund and the World Bank to enforce financial
punitive measures. The France-based FATF, founded
in 1989 on the initiative of the G-7, an organisation of
the world’s seven largest advanced countries, moni-
tors countries’ money flow and penalises those whose
financial systems are abused for money laundering and
terrorism activities.
The FATF had taken a decision without waiting for a
fresh Mutual Evaluation Report (MER) by the Asia Pacif-
ic Group (APG) – the FATF styled regional body in whose
jurisdiction Pakistan lies. The MER is usually a require-
ment to see whether the country’s AML and CFT related
laws, rules and risk frameworks are technically compli-
ant, the inter-agency coordination, judicial system for
prosecution and convection are effective and the nation
also cooperates with foreign jurisdictions to curb men-
ace of terrorism and money laundering.
ART, MEDIA
Page 7
Blind contour has fueled my work because
it’s intuitive — Sarah Mir
In 2018, Pakistan was compliant with only 10 of 40
FATF recommendations, prompting a stern and dire
warning. Four years on, it stands compliant with
35, placing it among the top 5 nations in terms of
FATF compliance. As the body now prepares an on-
ground mission to assess the progress, the need for
vigilance is higher than ever
A country can be put on the grey list for one of three
main factors: it is not a member of the FATF or a FATF
styled regional body, it performed poor on the MER or
any of FATF or regional body member may nominate a
country for being placed on the list due to deficiencies in
its AML and CFT regimes. In Pakistan’s case, there was
more than one reason to put it on the grey list.
Missed opportunities
In October 2019, the Asia Pacific Group – one of the nine FATF
styled regional bodies – released its comprehensive Mutual
Evaluation Report. The report had been based on Pakistan’s
performance against 40 recommendations of the FATF till
October 2018. The report showed that out of FATF’s 40 recom-
mendations on curbing money laundering and combating
the financing of terrorism, Pakistan was fully compliant only
on one. It was largely compliant on nine, partially compliant
on 26 and non-compliant on four recommendations. On the
level of effectiveness of Pakistan’s AML/CFT, Pakistan was
found moderately effective only on one benchmark while on
the remaining nine its effectiveness was declared as low as
of October 2018 cut-off date.
The APG 2019 report highlighted that Pakistan faced
significant risk of terror financing both from legitimate
and illegitimate sources as well as weak or no, regula-
tion and supervision of certain sectors such as hawala/
hundi, NPOs and DNFBPs (Designated Non-Financial
Businesses and Professions) and porous borders. The
implementation situation was so bad that the APG had
asked Pakistan in 2009 to have proper DNFBPs frame-
work, which we did not implement till 2020.
“The terror financing cases are identified by a number
of mechanisms but not via financial intelligence,” ac-
cording to the APG report. Here too, the APG had made
similar observations a decade ago about the country’s
risk assessment framework but no action was taken. At
the very least, it was a pathetic report for Pakistan that
also underscored that the country did not improve even
on areas that had been identified in 2009 by the APG.
The report also underlined that key Pakistani regula-
tors – the State Bank of Pakistan and Securities and Ex-
change Commission of Pakistan – had very limited un-
derstating of the money laundering and terror financing
regimes. “Pakistan should adequately identify, assess
and understand its money laundering/terror financ-
ing risks including transnational risks and risks associ-
ated with terrorist groups operating in Pakistan such as
Da’esh, AQ, JuD, FiF, LeT, JeM and HQN, and this should
HEALTH & FITNESS
Page 8
Being a native of Balochistan, this success [for
me] is like a dream come true — Dr Wasay
BY SHAHBAZ RANA
be used to implement a comprehensive and coordinated
risk-based approach to combating money laundering
and terror financing,” the report stated. “Also terror-
ist groups operating in Pakistan are reported to include
but not limited to, ISIS-Khorasan, Tehreek-e-Taliban
Pakistan, Quetta Shura Taliban, Haqqani Network and
Lashkar-e-Taiba (including its affiliates Jamaatud Dawa
and Falah-i-Insaniat Foundation), which raise funds
through a variety of means, including direct support,
public fundraising, abuse of NPOs, and though criminal
activities,” APG 2019 report added.
The report said that corruption, drug trafficking,
fraud, tax evasion, smuggling, human trafficking, and
organised crime were major predicate offences to money
laundering and areas of high risk. The APG advised that
Pakistan should significantly enhance the use of finan-
cial intelligence in money laundering, terror financing,
and predicate crime cases, particularly the use of finan-
cial intelligence to target terrorist groups and higher-
risk predicate crimes. It also sought improvement in
The situation was so bad that back
in 2018 Pakistani authorities had
very little understanding of the
country’s money laundering and
terror financing risks, and the
private sector also had a mixed
understanding of risks
asset confiscation that should commensurate with Paki-
stan’s money laundering and terror financing risks, in-
cluding cross-border currency.
The situation was so bad that back in 2018 Pakistani
authorities had very little understanding of the coun-
try’s money laundering and terror financing risks, and
the private sector also had a mixed understanding of
risks. While Pakistan established a multi-agency ap-
proach to implementing its AML/CFT regime, it was not
implementing a comprehensive and coordinated risk-
based approach to combating money laundering and
terror financing.
CONTINUED ON PAGE 2
 SCIENCE & TECHNOLOGY

THE RISE OF CYBERCRIME

A closer look at the Internet crime report 2021 reveals the alarming
rate at which cybercrime seems to be sweeping the world

By AYAZ HUSSAIN ABBASI
The Internet Crime Complaint Center
(IC3) is the FBI’s central depository
for collecting Internet crime com-
plaints. The Internet Crime Complaint
Center’s (IC3) objective is to offer the
public a reliable and simple reporting
mechanism for investigating Internet-
facilitated crimes to the Federal
Bureau of Investigation and to create
an effective alliance with industry
partners.
According to IC3 data, the top
three recorded crimes in 2021 were
phishing scams, non-payment or
non-delivery scams, and personal
data breaches, with business email
compromise scams, investment
fraud, and romance and confidence
schemes losing the most money
to victims. People in their 60s and
those who live in California were the
hardest hit. The IC3’s companion
2021 State Reports provide a more in-
depth look at data on cybercrime in
specific states.
Along with the statistics on cyber-
crime, the document gives advice on
how to protect yourself and prevent
future attacks. It also includes case
studies highlighting the FBI’s recent
efforts to combat online criminality.
In 2021, cyber-attacks and hostile
cyber activities in the United States
reached new heights. These cyber-
attacks harmed businesses across a
wide range of industries, as well as
the general population in the United
States. The FBI continues to use its
unique authorities and relationships
to impose risks and consequences on
our nation’s cyber adversaries as the
cyber threat changes and becomes
increasingly entangled with tradi-
tional foreign intelligence threats
and emerging technology. The FBI’s
Internet Crime Complaint Center
(IC3) allows members of the public
to report cybercrime directly to the
bureau.
This study examines and analyses
the reports in order to detect cyber-
criminal trends and dangers and
then share that information with
intelligence and law enforcement
partners.
The FBI understands the need to
share cyber activity information
with partners in order to better pre-
pare partners to address the cyber
threat using a whole-of-government
strategy. Public reporting to IC3 is
critical to that strategy, as it allows
IC3 to fill in the gaps with this crucial
information during the investiga-
tion. This reporting not only aids in
the prevention of future crimes but
also allows us to get valuable insight
into the ever-changing trends and
risks we face from malicious cyber
actors.
According to the FBI’s annual In-
ternet Crime Report, people lost
more than $6.9 billion to internet
crimes in 2021, an increase of more
than $2 billion from 2020. The re-
port, which was released on Tues-
day, provides “details regarding the
most common internet scams” as
reported to the FBI’s Internet Crime
Complaint Center. According to the
FBI, 847,376 internet crime reports
were reported in 2021, a 7% increase
from 2020 but a stunning 81 percent
increase over 2019. Phishing scams,
non-payment/non-delivery, and
personal data breaches were the top
three cybercrimes recorded last year.
Perhaps not surprisingly, much
of the rise in internet online crimes
over the past two years can be put on
the shoulders of the COVID-19 pan-
demic, which, as the FBI mentioned
in its report, led to a surge in work-
ing from home and virtual meet-
ings. In 2020, the FBI received more
than 28,500 complaints of criminal
internet activity specifically related
to COVID-19, though there appears
to be no tally of internet crimes re-
lated to COVID-19 detailed in the 2021
report.
While COVID-19 limits and man-
dates are being relaxed across most
of the country, criminal activities
on the internet, including phishing
and data breaches, which reached
an all-time high in 2021, may tend
to climb. Scams and support fraud,
which amounted to 32,400 incidents
in 2021, may become more com-
mon in the bitcoin realm. Romantic
scams, tech support fraud, and ran-
somware are all prevalent internet
crimes to be aware of. Here’s what to
do if you believe you’ve been the vic-
tim of an internet scam.
Cybercrime in the last five years
The report’s first section gives an out-
line of how cybercrime has evolved
over the last five years. According to
the report, the IC3 received an average
of 552,000 complaints every year dur-
ing that time period.
Business Email Compromise (BEC)
tops them all
When it comes to the most despite the
fact that ransomware dominated the
news in 2021, the analysis indicates
that BEC crimes had the most impact.
In 2021, the IC3 received 19,954
Business Email Compromise (BEC)
or Email Account Compromise (EAC)
accusations, totaling over $2.4 bil-
lion in losses.
It explains how BEC assaults have
evolved over time: “As fraudsters
have become more skilled and pre-
ventative measures have been imple-
mented, the BEC/EAC scheme has
evolved in kind.” Simple hacking or
spoofing of commercial and personal
email accounts, as well as a request
to transmit wire payments to bogus
bank accounts, have evolved into the
technique.
Ransomware in 2021
Ransomware numbers were substan-
tially lower than BEC schemes, accord-
ing to the IC3. Only 3,729 ransomware
reports were received, with total losses
of more than $49.2 million. These fig-
ures are startlingly low, but they are
also likely to be erroneous as many
ransomware occurrences go unde-
tected because executives often prefer
to keep this information under wraps.
Rise of Cyber Crimes in Pakistan
during 2021
With the widespread use of technol-
ogy and the proliferation of smart-
phones and gadgets, the number of
cybercrime complaints received by
the Cyber Crime Wing of the Federal
Investigation Agency from across the
country in 2021 surpassed 100,000.
The number of complaints received
by the FIA each month has doubled
in four years, from 4,031 in 2018 to
8,688 in 2021, indicating an alarming
surge in cybercrime in the country.
From January 1, 2021, to December
31, 2021, the FIA’s cybercrime division
received 102,356 complaints. “Face-
book was employed as a medium in
23% of the complaints.
Last year, 80,641 of the 102,356
complaints received were verified,
and 15,932 of them met the require-
ments for beginning inquiries. Over
1,300 people were arrested after
1,202 cases were filed under relevant
parts of the Prevention of Electronic
Crimes Act.
According to official data, students
reported 32 percent of complaints in
2021, with 25 percent of them involv-
ing financial offenses.
Financial fraud and forgery
topped the list, with 427 FIRs and
388 arrests, followed by extortion
and blackmailing, with 267 FIRs
and 185 arrests.
In the year, 205 cases were filed un-
der Section 20 (natural person’s dig-
nity), 199 instances under Section 21
(rape/modesty of natural person), 76
cases of cyberterrorism/hate speech,
and 49 cases of child pornography.
The number of complaints received
by the FIA each month has also
doubled in four years, from 4,031 in
2018 to 8,688 in 2021, indicating an
alarming surge in cybercrime in the
country.

CONTINUED FROM PAGE 1

For money laundering, there was
no clear understanding among com-
petent authorities, including LEAs.
“Competent authorities are focused
on predicate crimes and are un-
able to clearly differentiate money
laundering from predicate offences
which generate illicit proceeds,” the
APG pointed out. “For terrorism fi-
nancing, Pakistani authorities had
a mixed understanding of risk.
Federal Investigation Agency had
a low level of terror financing risk
understanding, while provincial
police, counter-terrorism depart-
ments (CTDs) have a better under-
standing of those risks within their
provinces.
“The State Bank of Pakistan did
not have a clear understanding of
the money laundering and terror
financing risks unique to the sec-
tors it supervises,” stated the APG
report. There was little evidence
that the SECP’s supervisory activ-
ity was improving AML/CFT be-
haviour. Pakistan Post, CDNS, and
DNFBPs were not supervised for
AML/CFT compliance. Also, Paki-
stan’s law enforcement efforts to
address money laundering were
not consistent with its risks.
Most banks and larger exchange
companies had an adequate under-
standing of their AML/CFT obliga-
tions but all other financial insti-
tutions had limited understanding
of their money laundering and
terror financing risks; they were
in a nascent stage of implement-
ing the risk-based approach and
internal controls; smaller entities
lacked proper systems to identify
Politically Exposed Persons (PEPs).
Pakistan had limited mitigating
measures for legal persons and
there was no supervisory oversight
for AML/CFT purposes.
The use of lawfare
Many countries, particularly the
United States and India, had long
been demanding through the FATF
forum that Pakistan should target
eight groups – the Afghan Taliban,
Jamaat-ud-Dawa (JuD), Haqqani
Network, Jaish-e-Mohammed
(JeM), Lashkar-e-Taiba (LeT),
Falah-e-Insaniyat Foundation, al-
Qaeda and Islamic State.
After the poor evaluation report,
Pakistan made its Director-Gener-
al of Military Operations (DGMO)
in-charge for the implementation
of FATF recommendations while
the then federal minister for eco-
This was a turning point when Pakistan
finally decided to take the FATF threat
seriously and started delivering on
conditions that it had long resisted
nomic affairs Hammad Azhar was
nominated for coordination from
the civilian side.
This was a turning point when
Pakistan finally decided to take
the FATF threat serious and start-
ed delivering on conditions that
it had resisted long. Pakistani
courts started handing over sen-
tences to JUD chief Hafiz Muham-
mad Saeed, with latest one given
in April this year when he was
awarded a combined sentence of 33
years imprisonment in two cases
of terror financing. It was un-
thinkable till few years ago.
Pakistan also amended 14 laws
to ensure technical compliance
with the FATF recommendations,
including few for the sake of
avoiding being blacklisted.
Still, the world powers were not
satisfied and they wanted effective
implementation of these laws.
The journey has not ended yet and
there is no time to relax. India
will not let the pressure off from
Pakistan.
In July last year, India’s Minister
for External Affairs S Jaishankar
said the Modi-led Bharatiya Janata
Party (BJP) government had en-
sured that Pakistan remained on
the FATF grey list. It had achieved
what Dehli otherwise could not
think even.
India and the US jointly pro-
posed on June 1, 2022 to list Paki-
stan based terrorist Abdul Rehm-
an Makki under the UN Security
Council’s Al-Qaeda (Dae’sh) and
ISIL Sanctions Committee, also
known as the UNSC 1267 Commit-
tee. Both India and the US have
already listed Makki as a terrorist
under their domestic laws. Ab-
dul Rehman Makki is the deputy
Amir/Chief and head of the Po-
litical Affairs of Lashkar-e-Tayy-
iba (LeT) /Jamat ud-Dawa (JuD),
which itself is a UN proscribed ter-
rorist entity.
Pakistan has in the past publicly
expressed its concerns about use of
the FATF for political purposes. In
an interview to Anadolu Agency
-a Turkish media outlet – last
year, Pakistan’s then law minister
Barrister Farogh Naseem had said
that “Even [though} the FATF
people are good people. I’m not
being critical against them…But
as long as these (FATF) standards
are universally applied, and not
applied to only Pakistan, and as
long as there is no international
politics, then we welcome FATF.
Let it be applied to everyone,” he
said, questioning why Pakistan
was still on the list. “There should
be no international politics, but
FATF is being used to arm twist.
Then what can we say?”
Need for compliance and vigilance
The FATF will soon send a mission
to Pakistan to kicking off the pro-
cess to remove Pakistan from the
grey list. Any of the FATF or APG
member countries can opt to be
part of the on-site mission team
and India may not like to lose the
opportunity. The mission will see
progress on the ground, the com-
mitment of the political leadership
to stay on course and importantly
to make sure that all the steps that
have already been taken are irre-
versible, including actions against
leadership of terror outfits.
All the Pakistani stakeholders
still need to prove to the FATF up-
coming mission that no serious
deficiency remains in its AML and
CFT regimes. The on-site inspec-
tion team will submit its report
to the FATF and on the basis of on-
site team report, the FATF will an-
nounce the decision of keeping or
removing Pakistan from the grey
list in the next plenary.
It is also the responsibility of the
FATF that its on-site mission re-
mains focused on strengthening of
the AML and CFT regimes, rather
on any specific individual on be-
hest of any member country.
Pakistani authorities need to
consolidate their efforts and make
sure that all actions taken in past
two years are irreversible, this
time for the sake of people and
prosperity. World now knows our
games.

HAFIZ SAEED – A TIMELINE OF CONVICTION AND ARREST

• Hafiz Saeed was sentenced to 33 years in jail on April 9, 2022. Crackdown on JuD
ATC had awarded combined sentence of 33 years imprison- leadership
ment in two cases from 2019 of terror financing registered by
the Counter Terrorism Department (CTD). • ATC sentenced Prof Malik Zafar
Iqbal, Hafiz Abdul Salam and Hafiz
• Hafiz Saeed was convicted in another terror financing case, Abdul Rehman Makki on August
sentenced to 5-and-a-half year in prison on November 19, 29, 2020. The court awarded
2020. ATC in Lahore had convicted Jamatud Dawa leader, who a collective imprisonment of
was already in jail serving two sentences of five-and-a-half- 16-and-a-half year to Iqbal and
years each, handed down to him in February 2020. Salam while one-and-a-half-year
jail term to Makki.
• Pakistan has arrested him several times since the 9/11 attacks
in the US, but it never charged him with specific offences and • Pakistan sentenced three top
always set him free in the end. JuD leaders, including deputy
JuD chief Abdul Rehman Makki,
• Hafiz Saeed was put under house arrest on a number of occasions, first when the Indian government blamed him for head of fundraising Zafar Iqbal
masterminding the December 2001 attack on its parliament, and then after the Mumbai train bombings of 2006. and media chief Yahya Mujahid,
for terror financing on December
• He was also put under house arrest several times between 2008 and 2009 following accusations that the LeT had car- 3 2020. Iqbal and Mujahid were
ried out the 2008 Mumbai attacks. given prison terms of 15 and a
half years each, while Makki was
• On each of these occasions, Pakistani government did not frame charges against him. Instead, it continued to file for sentenced to six months in prison.
extensions of his house arrest which the courts would ultimately refuse, setting him free.
• CTD had registered 23 FIRs
• Pakistan has done enough to satisfy FATF but will Pakistan be able to convince FATF teams when they come for against the leaders of the JuD in
physical inspection likely later this year. different cities of Punjab.
Asset freeze
• Pakistan freezes 964 assets of banned JuD, JeM in
September 2020. Senate was told that 907 of the frozen
properties belonged to JuD and 57 to JeM.
• A total of 611 properties of JuD were frozen in Punjab,
followed by 108 in Khyber-Pakhtunkhwa, 80 in Sindh, 61
in AJK, 30 in Balochistan and 17 in Islamabad.
• The frozen properties of the JuD include 76 schools, four
colleges, 330 mosques and seminaries, 186 dispensaries,
15 hospitals, 262 ambulances, a funeral bus, three disas-
ter management offices, 10 boats, 17 buildings, a plot, an
agricultural land and two motorcycles.
• Falah-e-Insaniat Foundation was a charity organization
established by Jamat-ud-Dawa amd it was banned in
2019.
• In August 2020, Pakistan banned 88 new terrorists,
in compliance with the new list issued by the United
Nations Security Council (UNSC). The banned terror-
ists include Hafiz Saeed, Masood Azhar and Dawood
Ibrahim.

Cover: Ibrahim Yahya

2 June 26, 2022

By JAVED CHAUDHRY
Raja Anwar runs a restaurant in
Valencia, a beautiful city in Spain.
After coming to Spain from Rawalpindi
around thirty-six years ago, he married
a local, and initiated his Pakistani cui-
sine business in the university area.
When we reached his restaurant called
‘Sher Khan’ on 29thMay, he began
dancing around us, overjoyed to see
Pakistani visitors – a first for him over
the past three decades. He believed it
was destiny that had made him initiate
his business to experience the fortunate
day a Pakistani tourist came to pay a
visit. I told him that even our group of
seventy select tourists would not have
made it to Spain, had the Ambassador
of Spain to Pakistan, Duran Gi Menez,
alongside Elena Gomez Aoiz, the
Deputy Head of Mission, and Ines
Mena Gomez De Merodio, the Head of
Visa/First Secretary not extended their
extraordinary help and support. These
friends of Pakistan earnestly believe in
warm and cordial relations between
the two countries. His Excellency,
Manuel Duran-Gimenez Rico, is highly
appreciated in Pakistan for his profes-
sionalism, charismatic personality,
exemplary diplomatic skills, and his
respectful consciousness of our culture.
Therefore, when I put forward the re-
quest for a group tour, he was very kind
and forthcoming.
Our group of seventy people spent
seventeen days in Spain, relishing
the spirit of the country. During this
period, we visited nine cities: Madrid,
Toledo, Segovia, Granada, Alicante,
Valencia and Barcelona.
Spanish people are different from
other Europeans, with their culture
bearing numerous resemblances to
that of our own. People in Spain are
SINDH’S SADH BELO
TEMPLE
The place, where today the Sadh Belo temple stands was
known as ‘Menak Parbat’; this name which is also mentioned
in Rig Veda, is one of the four holy texts of Hinduism
By SARFARAZ MEMON
“Har Har Maha Dev, Har Har Maha
Dev, Baba Bankhandi Maharaj ki Jai,
Jhullay Lal ki Jai,” The right bank of
the River Indus, opposite the Hindu
temple Sadh Belo, was buzzing with
these chants of devotees who had ar-
rived from different parts of Sindh to
attend the 159th death anniversary of
Baba Bankhandi Maharaj. Sadh Belo
is situated in a hilly area in the middle
of the River Indus near Sukkur. The
death anniversary events will continue
for three days, from June 14 to June 16.
Keerti Kumari, an 11-year-old
girl, was so excited to visit the holy
temple she tried to jump in a boat,
which was taking the devotees to the
temple. Unfortunately, she landed in
water, which was fortunately shal-
low, and was immediately rescued
by some people waiting for another
boat. Keerti, along with her parents
and siblings, had arrived from Ja-
cobabad to attend the death anniver-
sary events. When asked why she was
so excited she replied, “I love visiting
this temple because my mother often
visits it to pray for her wishes to come
true. When Keerti was asked what
her biggest wish was, she answered,
“Nothing special for me; I only want
my father to get rid of his ailment and
start earning more money to support
the family.”
Keerti’s father Bheman Das, in his
late fifties, is seriously emaciated be-
cause of his health issues. After intro-
ducing himself, he said that for the
last thirteen years, he was suffering
Threads of commonalities
friendly, alongside being against
social stratification, and racism. In
Spain, the rich and the poor, locals
and foreigners, all are treated at par.
Within offices and factories, the exec-
utives and the staff eat the same food
in joint cafeterias. At universities the
deans dance with the janitorial staff
during functions. The economy of
Spain thrives on tourism, and thus,
tourists are treated like special guests.
They, like us, also believe in social
networking. If a stranger asks for di-
rections, they guide him to his desti-
nation. Interestingly, Spanish people
are laid back. No matter what the sea-
son is, their daily siesta between 2 PM
and 5 PM remains imperative. In the
year 2000, there was a singular Paki-
stani restaurant in Barcelona, where-
as now, this number has swelled to
eighty restaurants. Around 80% of
their customers are Spanish, owing
to the fact that Spanish people tend to
prefer fine food and good hospitality
from a strange ailment. He added,
“Whenever I happen to visit Sadh
Belo, I feel new energy emerging from
within, and therefore, my wife and I
often visit the temple.”
Kishan Lal, a resident of Shikarpur,
had come with his friends to attend
the anniversary. He said, “I have been
visiting the temple with my parents
since I was just two or three years old,
and now I am thirty-five.” He says that
every success that he has achieved in
his life so far is due to the blessing of
Baba Bankhandi Maharaj.
Nand Lal, another devotee, looked
very happy and had brought two
cauldrons of cooked food to distrib-
ute among devotees. As soon as he
approached the boat along with
four men carrying the cauldrons, he
chanted, “Baba Bankhandi Maha-
raj ki Jai, Baba Bankhandi Maharaj
ki Jai”. Before embarking the boat,
Nand Lal, with a big smile on his face,
said to me, “With the kirpa (blessing)
of Baba Bankhandi Maharaj I have
earned much more than I expected
from my dry dates business, and that
is why I have brought two cauldrons
of food to distribute among the devo-
tees.” He told me that in his business
of dry dates, his earning doubled this
year due to, what he claims, the bless-
ing of Baba Bankhandi Maharaj.
While I was talking to Nand Lal,
I saw a group of women arrive at the
camp office to purchase two-way boat
tickets, Rs 20 for adults, Rs 10 for chil-
dren. Om Parkash, who was selling
tickets, told me, “Normally, there are
two motorized boats stationed at this
In Spain, the rich and the poor, locals and
foreigners, all are treated at par. Within
offices and factories, the executives
and the staff eat the same food in joint
cafeterias. At universities, the deans dance
with the janitorial staff during functions
over race and colour. They also believe
in trying new things, whether it be
new cuisines or new traditions. Like
us, they are also unhappy with their
lethargic bureaucratic system and in-
ordinate delays in legal judgments.
Spain has an agriculture-based econ-
omy. Therefore, the country is dotted
with fields, gardens and forests. In
Andalusia, olives are planted on mil-
lions of acres, as are date plants. Spain
place for pick and drop of the devotees.
Due to extraordinary attendance this
year, we have hired around twenty-
five motorized boats for pick-and-
drop purposes.” Prakash added that
devotees coming from other districts
often choose to stay for three days at
the temple where they are provided
with free food and water. According to
him, many well-off Hindus arrange
cooked food for the devotees during
the anniversary, and some people
provide sweetened milk and juices to
get blessings from Baba Bankhandi
Maharaj.
Talking about the security arrange-
ments, Prakash informed me that a
heavy contingent of police has been
deployed in and around the temple
and at the camp to avert any untoward
incident. Divers are also made avail-
able at the temple and near the camp
to handle any emergency. According
to him, only once an over-occupied
boat was overturned, resulting in the
death of two persons, while the re-
maining were rescued.
Om Parkash, going through the
history of Sadh Belo, said, “The place,
where today the Sadh Belo temple
stands was known as ‘Menak Parbat’;
this name is also mentioned in Rig
Veda, one of the four holy texts of Hin-
duism.” On the question that since
Baba Bankhandi Maharaj was not
married, why people visit his temple
with their prayers for marriage and
children, Prakash smiled, “Baba is a
Shaktimaan (powerful) and can grant
wishes to the people. Holy souls like
Baba Bankhandi Maharaj, with the
earns billions of dollars by exporting
olives. Orange orchards are spread
along the road emanating from Va-
lencia. Consequently, Spain is among
the top three countries exporting or-
ange juice and its bio-products.
Spain has deployed modern tech-
niques when it comes to farming.
Drip irrigation through local ponds is
extensively used. In terms of housing
and families, Spanish people live in
blessing of Eshwar upon them, can
bless people with their powers. I per-
sonally know many people in this
city who have been blessed by Baba,
and they visit the temple almost ev-
ery Friday to pay homage to him.
Once I contracted a strange ailment
and I thought I was about to die, but
I kept visiting the temple every Fri-
day, and very soon, I not only got rid
of the ailment, but became more en-
ergetic than before. Every visitor has a
story to tell about the power of of Baba
Bankhandi Maharaj’s blessings, and
that is why they regularly visit the
temple to keep in touch with Baba’s
spirituality.”
President of Hindu Panchayat
Mukhi Eshwar Lal narrated the his-
tory of the Sadh Belo temple to me.
It is located on an island that was
previously known as Menak Parbat.
According to him, Baba Bankhandi
Maharaj, who by birth hailed from
Nepal, came to the site in 1823 at the
age of fifteen. Baba Bankhandi Ma-
haraj belonged to the Udaseen school
of thought; personalities belonging
to that particular school of thought
never get married. Baba lived alone on
Menak Parbat and died at the age of
sixty. The construction of the temple
was initiated by Sant Harnam Das,
Maharaja’s eighth gaddi nasheen, in
1899.
TRAVEL
With numerous cultural
similarities, Spain tops every
Pakistani jetsetter’s list of
places to visit
farmhouses located in villages, with
the family system holding immense
significance. They abhor divorce, and
delay the separation process in antici-
pation of reconciliation. With a firm
belief in traditions, and their conser-
vative values, explicit public romance
is tremendously scarce.
The government haspro-business
policies. This is also evident through
the fact that when we invited the
Mayor of Granada to visit Pakistan,
he accepted the offer, despite his
busy schedule, on the condition that
his meetings be arranged with Paki-
stani businessmen and investors.
The Spanish Ambassador to Pakistan
was also of the same opinion: Spain is
open to investors, tourists, business-
men, technicians and skilled indi-
viduals of all kinds.
Owing to the excellent town plan-
ning, Barcelona is a properly planned
and modern city. If seen from above,
it appears to be laid out in square pat-
tern. The city is divided in blocks, and
every block has all the basic ameni-
ties. Therefore, people do not have to
travel from one block to another, just
to utilise educational, medicinal, rec-
reational, or occupational facilities.
This puts less pressure on traffic, and
less fuel is consumed. Spain is well
aware of the importance of tourism.
Therefore, it has made itself a tourist
hub.
Those interested in visiting cul-
Lal explained that after the death of
the tenth gaddi nasheen in Haridwar,
India, Swami Vish Darsh Jee Maharaj
has been elected as the new successor.
A very stringent process is followed to
elect the new gaddi nasheen; as he is
supposed to have nothing to do with
the mortal world, he must be honest,
dedicated and celibate (udaseen).
The Sadh Belo Parbandhak Commit-
tee is responsible for pilgrims’ lodg-
ing and food, which is a free service
provided during the three-day event.
More than thirty thousand pilgrims
can be accommodated in the temple.
Men and women are allotted sepa-
rate space under the open sky, but the
ones who wish to live with their fami-
lies are given a room. In all, there are
eighty rooms in the temple, which are
tural places that offer Islamic sites
can visit Cordoba, Granada, Toledo,
Murcia and Malaga, where Quranic
verses are engraved on buildings.
People fond of the sea can find more
than two hundred warm beaches.
Alicante has all the facilities es-
sential formarine tourists. Tourists
fond of modern life can visit Valen-
cia, Madrid and Barcelona. These
cities stand shoulder to shoulder
with Paris, London, New York and
other modern cities, and also cater
to those fond of gambling and club-
bing. People who seek thrill and
adventure can venture forth into
forests, oceans, and mountains. To
experience the richness of tradition,
one can observe the flamingo dance
in the caves of Granada. The annual
tomato festival and bull fights attract
millions of people.
Spain is a montage of tourism. We
share a similar climate, landscape,
and traditional values with Spain.
When it comes to tourism, we must
prefer Spain over the USA, UK, or
Germany. After all, we must further
strengthen our political and diplo-
matic relations with Spain, given that
the two countries have much to learn
from each other.
The writer is a renowned television host,
columnist, journalist and tourist. He also
supervises and runs the largest tourism
group in Pakistan, Ibex.
allotted to the devotees on first-come-
first-serve basis.
The temple is spread over nine acres,
houses separate places of worship for
men and women, a library with books
on religion and Hindu mythology,
segregated bhandars (dining rooms),
and a huge garden. The administra-
tion has also preserved the living quar-
ters of Maharaj and his disciples.
Talking about the visitors, Lal said
that devotees from all over Sindh, and
also India, converge at the temple dur-
ing the three-day anniversary. “Even
Muslims come to visit the temple, but
unlike Hindus, Muslims are required
to get themselves registered at the
camp, established at the right bank
of the Indus, to avoid any complica-
tions.”
June 26, 2022 3
 HEALTH & FITNESS

THE BECKONING OF HEALING HANDS

STORY BY : YUSRA SALIM DESIGN BY : IBRAHIM YAHYA

Despite receiving decades of criticism from locals for a lack of accessibility to medical treatments and
facilities, Pakistan has recently made a name for itself amidst expats who have been frequently travelling
back to their home country to get medical treatment

In a country that has its healthcare, in many
ways, in shambles, and its citizens do not rely on
public health care due to inadequate attention
from health care providers, what is the motiva-
tional aspect that is bringing back people who live
abroad to come to Pakistan and get their treat-
ments and surgeries done in Pakistan? In recent
times, a surge has been seen in people’s visits to
Pakistan for medical tourism.
Pakistan is ranked 122nd out of 190 countries in
the World Health Organisation performance re-
port. Pakistan ranks 154th among 195 countries
in terms of quality and accessibility of health-
care. And even then, if we see people believing
in our doctors for a quality treatment, it is noth-
ing less than a miracle.
Pakistanis living in the Gulf region or other de-
veloped countries, such as the USA and the UK,
sometimes travel back to their home country to
get medical treatments. Various reasons are fac-
tored in. One reason is that the waiting list in
their second country is very long, and sometimes
they have to wait for months, or even years, to
have their surgeries done. Secondly, in most of
the countries, health care is extremely expen-
sive. Another reason why many people come to
have their medical treatments done in Pakistan
is because they have their families here and can
get moral support from their parents, siblings,
or relatives. Most of these people only opt for the
private health care system, but in recent times,
we have also seen some surgeries performed in
public facilities. Such cases are not very com-
mon but not very rare either.
Bone marrow transplant
In 2019, when Rabia* got married to her first
cousin, she never thought that just after a year
she would be celebrating her anniversary in a hos-
pital isolation ward. “It’s been almost two and a
half years that we have been married but we have
not celebrated anything all this time, not the birth
of our son or our anniversaries.” Rabia shared that
their son, Syed Muhammad Qasim, was diag-
nosed with severe combined immunodeficiency
(SCID) at the time of his birth. SCID belongs to
a group of rare disorders caused by mutations
in different genes involved in the development
and function of infection-fighting immune cells.
Infants with this disease appear healthy at birth
but are highly susceptible to severe infections.
Qasim was diagnosed with the most severe and
rare form of SCID—reticular dysgenesis.
The couple live in Abu Dhabi due to Rabia’s
husband’s job requirements. Her pregnancy
went very smoothly, and she didn’t face any
complications. But in her thirty-seventh week,
her doctor suggested doing a caesarean opera-
tion because the baby was underweight; her
placenta was not providing proper food. “Just
because my son was underweight, he was put
in NICU and they ran some tests, which indi-
cated a lower number of white blood cells. As we
were alarmed, the doctors ran more tests, or we
would have never known that he had SCID,” she
shared how running some minor tests can help
save a life.
After realising the severity
of our child’s condition, we
instantly decided that we will
get the transplant done and,
as both my family and in-laws
were in Pakistan, it was the best
and the safest option for us
Despite being a mother for weeks, Rabia
couldn’t touch or even hold her baby Qasim be-
cause his white blood cells (WBC) were 0.06 per-
cent, very low for his age. “We kept shifting him
from one hospital to another for better facilities
for his case; many doctors suggested boosters of
WBC to help sustain him, but the biopsy report
after forty days of his birth made my son’s condi-
tion quite clear. We wanted a permanent solu-
tion, and after several opinions from different
doctors and through research, we found out that
only a bone marrow transplant was the solution
to Qasim’s problem,” Rabia explained.
The whole of Abu Dhabi didn’t have any bone
marrow transplant facility available at that
time. Now there is a centre, but it will still take
a few more years to have facilities for the trans-
plant that was needed for Qasim. Rabia and her
husband remember how they could only see
their firstborn wearing masks, gloves, and PPE,
as it was 2020 and the peak of COVID-19 restric-
tions. “After realising the severity of our child’s
condition, we instantly decided that we will get
the transplant done, and as both my family and
in-laws were in Pakistan, it was the best and
the safest option for us,” Rabia said. They had
two options—the Combined Military Hospital,
Rawalpindi, and the National Institute of Blood
Diseases, Karachi. “We sent all the reports to
Pakistan, my father consulted Dr Tahir Shamsi,
and we were told that as soon as we landed in
Pakistan, he would start the procedure of Qa-
sim’s treatment,” Rabia added.
Being a mother with a three-month-old child
it was difficult for Rabia to gather herself and
decide so many things, fully aware how in Paki-
stan everyone tries to intervene. “From the air-
port, we took Qasim straight to the hospital,
and within three-four hours, all his pre-surgery
blood tests were done. His father’s HLA typing
matched—he was his donor. NIBD handled ev-
erything very well,” she said with a satisfied
smile on her face.
Two of the main reasons why people come to
Pakistan for treatment is post-care and moral
support from family, and that was also the case
with Rabia. After the transplant, Rabia and Qa-
sim had to isolate for fifty days without any con-
tact with germs and life outside a room, extreme
precautionary measures. Rabia says, “It was
a very difficult time as my husband had to fly
back to Abu Dhabi; but my family and in-laws
stood by me like a rock during that time. That
was something I would not have had if I had not
been in Pakistan.”
Facilities that Pakistan offers in terms of
health care are phenomenal when it comes to
private hospitals, but the same cannot be said
for government-run hospitals. The trust people
have is for private facilities. “We were very scep-
tical about doctors in Pakistan, and personally,
we would have not come here if Abu Dhabi had
a transplant facility available. But as the best
option was Pakistan, and doctors here proved
me wrong, I am happy that we took that deci-
sion.” Rabia’s son is healthy now, and his regu-
lar check-ups are showing improvement in his
condition.
The entire transplant was estimated at PKR
4.5 million but was done in 3.5 million. “We had
to submit the full amount before the procedure
started, but after the treatment, the remaining
amount, around PKR 800,000, was returned to
us,” Rabia shared, adding that the CMH gave an
estimate of around PKR 5.4 million. It may seem
like a huge amount, but the treatment in Abu
Dhabi is even more expensive; a single injection
that is administered to Qasim every month costs
around AED 800, approximately PKR 45,000,
which her husband’s office covers in his family
medical insurance. Qasim’s monthly medicines
cost around AED 2,500. “Getting him treated in
Pakistan had its pros and cons, but yes, the doc-

Singapore has been a growing

medical tourism center in South East
Due to its close proximity to the U.S.,
Asia with 850,000 medical tourists
arriving in 2012. In January 2019
Mexico has become a top medical tourism
destination with 40,000 to 80,000 American
however, a report was released by RHB
seniors spending their retirement there
Research, the article quotes analyst
with a considerable number receiving
Juliana Cai saying “As healthcare costs
nursing home and health care. According
in neighbouring countries like Malaysia
After visitors number more than doubling in the to Politicohowever, the recent events with
and Thailand are much lower, they
last 5 years, Malaysia is also becoming a famous Donald Trump and the wall could damage the
have been attracting medical tourists
destination with 770,134 medical travelers in 2013. flow of medical tourism across the border.
from the region – thereby eating into
In 2016 Malaysia received numerous awards and Singapore’s market share.”
global recognition from International Medical
Travel Journal. Among the awards won by The
Malaysia Healthcare Travel Council (MHTC) were
‘Health & Medical Tourism: Destination of the Year’,
International Hospital of the Year, ‘International In Spain, the demand for medical
Cosmetic Surgery Clinic of the Year, ‘International The UK has recently announced the need for
tourism has skyrocketed, especially
Dental Clinic of the Year’, ‘International Fertility of improved quality standards for cross border
in the town of Marbella. Over 330
the Year’, and ‘Best Marketing Initiative of the Year’. care. There seems to be room for more private
million euros a year are generated
inbound medical tourism but there needs to be a
in the province. The Quirón business
change in the cap on numbers allowed currently.
group is the biggest medical supplier
in Spain and it treats up to 20,000
foreign patients a year, with most
of the patients coming from the UK,
Approximately 2.5 million Latin America, Netherlands and Finland.
foreign patients traveled particularly Costa Rica As fertility decreases in the MENA region
to hospitals in Thailand and Panama, are fast the demand for IVF and related services
in 2013. In Bangkok’s becoming tourist spots grows. In North Africa and the Middle East
prestigious Bumrungrad for medical travelers there is a $1 billion market, serviced by
International Hospital, with approximately Turkey but also increasingly by the United
over 520,000 international 40,000 foreign patients Arab Emirates and Saudi. India has become a medical
patients received treatment seeking healthcare in tourism hot spot, with 166,000
at the hospital. Costa Rica in 2011 international patients in 2012
coming to the country due to
the selection of highly skilled
doctors and improved medical
South Korea has now entered the top ten infrastructure. In 2016 the
countries in the world in terms of tourist volume. numbers kept rising, with
Medical Tourism Facts At the last available count in 2016, 390,000 people
travelled to Korea as a medical tourist compared to
over 170,000 medical visas
awarded. This represents only
the overall patient volume of 14 million. a fraction of the total medical
Why do people go abroad to get medical treatment? tourists entering the country

4 June 26, 2022

 HEALTH & FITNESS

Medical Tourism Index 2020-2021

Canada Singapore Japan
1 76 47
76.47 2 76 43
76.43 3 74 23
74.23

United Kingdom Dubai

4
Spain
5 71 92
71.92
6 71 85
71.85
72 93
72.93

Abu Dhabi
Costa Rica
7 8
Israel
9 70 26
70.26
71 73
71.73 70 78
70.78

India France Germany

10 69 80
69.80
11 69 61
69.61 12 69 29
69.29

Oman South Korea Czech Republic

13 14 68 81
68.81 15 68 32
68.32 Dentistry
69 03
69.03

tors were thorough professionals, and I had
my family by my side, which helped me so
much in my difficult time,” Rabia added.
Post care and waiting
Belief and fear attached to health care plays
a vital role when it comes to treatments.
People mostly travel to get surgeries done
eight-year-old and travelled to Pakistan and siblings by her side, it was easier for
from the UK for fifteen days just to get her her to recover soon.
surgery done. “In the UK, I was consulting
The idea was vague at first
my general physician, but he was unable to Government’s role
diagnose what exactly the problem was. He Expatriates or dual nationality holders com-
but, when I started online
kept giving me medicines, and I kept going ing to Pakistan to get their treatments done
Cosmetic
consultation, I didn’t take long
back to him with the same complaint. It is a positive image of the country but spend- surgery
went on for almost two years when I was ing taxpayers’ money and use of facilities for

Most Frequently Treated Conditions in Medical Tourism

because they think waiting might prove
fatal. Fabiha Zeeshan is the mother of an
to decide. The cost for a private
diagnosed with a fibroids issue,” Fabiha
says. Fibroids were causing several problems
facility in the UK would have
Cost differences in a few treatments between USA been much more than the cost
and India, and the cost of treatment in India as of coming to Pakistan
percentage of the USA treatment cost
in her daily life, but the doctor in the UK
USA Cost % India didn’t seem very serious about performing
a surgery.
For most people, getting second opinions
and asking family for help are the initial
Heart responses during an illness, and Fabiha
Bypass 8.8% did the same thing. “I was discussing the
issue and my frustration with my mother
when she suggested to me to consider
$113,000 $10,000 having my surgery done in Pakistan. The
idea was vague at first, but when I started
online consultation, I didn’t take long to
decide.” Rabia added that on the fifth day
after her flight, her surgery was conducted
Heart Valve in Saifee Hospital, Karachi, and after ten
Replace- 6.3% days, she flew back to the UK. “The cost
ment for a private facility in the UK would have
cost me much more than what it cost me to
$150,000 $9,500 come to Pakistan, get treated, and even see
my family.”
Ayesha*, another expatriate diagnosed
with fibroids, knew exactly what she had
to do. “I knew I would get my surgery done
Angioplasty 23.4% from Pakistan as I need my mother by my
side no matter what. The waiting list was
$47,000 $11,000 a factor, but more than that, post-care and
family is what mattered to me,” she told
me.
Ayesha, despite having a history of endo-
Hip metriosis and other related diseases, was
19.1% sure about the treatment she wanted and
Replacement
from where she would get it. The only fear-
$47,000 $9,000 ful thing was that she didn’t want to wait
long, as fibroids affect other organs, and
in many cases, intestines, and in some cas-
es, kidneys. Ayesha was clear in her mind
Knee 17.7% about coming to Pakistan and get her sur-
Replacement gery done at the earliest. She shared with
$48,000 $8,500 me how Dr Rubina Hussain operated on her
within a week, and as she had her mother
any patient who is treated in a public hospi-
tal cannot be sustained on a long-term basis.
“We are in talks with government; we plan
to regulate the system and set a minimal
amount for the treatment of patients visiting
from other countries. No one will be treated
free of cost,” Parliamentary Health Secretary
Qasim Soomro said. He was talking about a
woman who recently arrived from the USA
to have her transplant from the Gambat
Institute of Medical Sciences. After that case,
many questions were raised as to why and
Weight loss
how a US national was provided free treat-
ment while many Pakistani nationals are
on a waiting list. The reason cited was her
condition and promotion of medical tourism
in the country.
Soomro said, “We can’t spend taxpayers’
money like that; it is a high-end facility,
and we have to regulate it so that it can be
more effective for our people.” He added
that if numbers are taken into consider-
ation, government facilities do not have a
definite number for medical tourism. Keep- Cardiovascular
ing a track becomes a problem as it is hard
health
to prove whether the patient is a local or a
Pakistani residing in any other country.
Many instances have been reported
where people visiting from Europe, USA, or
the UK, for winter holidays or to see their
families in the interior parts of Sindh, get
their various medical procedures done from
the Gambat institute. After the belated
realisation of the importance of the insti-
tute’s high-end facilities, Sindh’s chief
minister has decided to declare it a medi-
cal city. “The plan is to extend the link to Kidney & Liver
Mohenjo Daro and Sukkur; if medical tour-
ism increases, government must increase transplants
facilities of travel and accommodation for
patients,” Soomro said. He added that a de-
tailed plan is expected to be out by August,
and initial work has already been started.
The reality is perplexing. People are visit-
ing Pakistan for treatment in private facili-
ties, but government is unable to maintain
a record as it is difficult to differentiate be-
tween a mere visitor or a patient arriving
for a surgery.

Dermatology

Potential Cost Savings

In Hungary, you can save from

40% to 50% of the cost in
dentistry and cosmetic surgeries In vitro
fertilization
Mexico is the favorite destination
In Thailand, the cost is
for Americans, offering from 25%
to 35% in medical services savings. 30% less
India provides health care
There are nine hospitals certified by services at a cost 20% lower
the Joint Commission International than in the United States

Medical services in Panama cost

between 40% and 70% less than
Singapore has 13 hospitals accredited by the
in the United States or Canada
Joint Commission International, with services Spinal
costing 35% less than in North America surgery

June 26, 2022 5

 BOOKS & LITERATURE

IN THE AGE OF
MISINFORMATION
Amongst a sea of political turmoil, The Liar’s Truth hits a little
too close to home with a tale of an ordinary man selected for an
extraordinary responsibility, riddled with drama and twists

By SAJEER SHAIKH
Mainstream media consumers are
on many occasions left part-amused,
part-horrified by the manner in
which debates, conversations, and
even news telecasts unfold. In addi-
tion to this frontier, with the advent
of digital media as a viable and im-
pactful communication platform, this
back-and-forth has, in many ways,
slid into an even messier downward
spiral of the deliberate spread of politi-
cal misinformation, and the doubling
down on relentless mud-slinging.
One often wonders where one can
turn to, in order to consume content
that is intelligent, and passed on in
a way that is well outside the fre-
quent boundaries of the mundane
and, quite frankly, embarrassing.
Haroon Khalid Akhtar constructs
The Liar’s Truth as that well-paced,
gripping medium of consumption,
making it an intellect-fueled, fasci-
nating read.
Before one manages to get their
hands on the book, one goes in with
a presumptive attitude. Perhaps, one
wonders, this is another book that
harps on about the common man be-
ing a vehicle of change, having been
given great responsibility; a second
coming-of-age, with stepping out
of the shadows of the ordinary and
propulsion into the remarkable as
a key theme. One may even mis-
takenly assume that the narrative
might be predictable, with a story-
line that doubles as a sermon or les-
son. Akhtar casts these assumptions
aside at the very beginning, and goes
on to prove one wrong at every turn,
concocting mind-boggling mayhem
that connects with the reader in a
fascinating way.
Akhtar’s delightfully built world
follows the tale of Arsalan - or Gup-
py, as he is affectionately referred to
- a common man with a thoroughly
fertile imagination, who has settled
into a routine that offers him little
to no solace. An unexpected break
in his life comes at a point where
he receives a mysterious (and ini-
tially, confusing) call that is set to
change the course of his life. Inun-
dated with rib-tickling metaphors
that make The Liar’s Truth a bravely
written read, it is the call that Arsa-
lan receives from Zeus (yes, the one
on Mount Olympus) that triggers a
transformative sequence of events.
To summarise the plot, without
giving much away, Arsalan - once
a layman - is selected to be the pre-
mier of his country, despite a com-
plete lack of know-how, and a crip-
pling lack of skills. Inexperienced,
naive Guppy has, as reinforcement,
an equally oblivious rag-tag team,
made up of a club singer, a stunning
model, a pimp, a scientist, an am-
bulance driver, and a matchmaker.
Amongst all this hullabaloo, a secret
plan is underway, being formulated
to hang Arsalan by making a case
for the fact that his love is a spy. All
this eventually leads him to the gal-
lows from where he pens this rich,
tongue-in-cheek memoir-cum-ex-
position laden with poignant liter-
ary gems.
Over the course of fourteen chap-
ters, Akhtar empowers Arsalan to
be an incredible storyteller - one
who keeps readers hooked with an
impeccable sense of humor. The
conversational unfolding of events
allows one to immerse themselves in
the universe of the text, becoming a
willing participant in all that takes
place. Satire, wit, and ingenious po-
litical commentary amalgamate to
contribute to the narrative, making
The Liar’s Truth an exceptional page-
turner that one cannot put down.
One can easily place Arsalan, Zeus,
and other recurring characters into
our universe. In fact, the countless
similarities that exist between Arsa-
lan’s world and ours open up a portal
of parallels, making the book all the
more interesting. Indeed, the lines
between fact and fiction are blurred
in The Liar’s Truth in the most spec-
tacular way. Semblances of the on-
going political circus, and its history
that has a tendency to repeat itself,
make an appearance in Arsalan’s
frenzy-driven life, and picking out
those instances, as a latent realiza-
tion clicks within the reader’s mind,
add to the overall experience of de-
vouring the novel as well.
There are many aspects of Akhtar’s
narrative that hit home, perhaps in
a manner that lies outside one’s zone
of comfort, invoking a sense of un-
ease and making one reflect on their
own helpless impotence and lack of
active action. For instance, early on
in the story, Arsalan talks, in pass-
ing, about generated chaos, and the
spread of successfully manufactured
hatred at an alarming rate.
While this brief mention is stated
rather casually, it juxtaposes, with
immense resonance, with the cur-
rent state of affairs within the na-
tion, where giants generate chaos
higher up on an ivory-tower hier-
archy, watching it trickle down for
their own benefit, manifesting as
seemingly unsolvable, yet crucial
differences between the common
man. In addition to this, Arsalan
also highlights the need for a scape-
goat, who bears the brunt of all that
transpires, and is, almost always,
the common man as well - a fact that
seems to be, in retrospect, a self-ful-
filling prophecy.
The repetition of history - the con-
stant, tired, rewriting of the same
chronicles with rotating characters
- is another significant part of the
novel. It is also an aspect that makes
one do a double take, switching back
and forth between the text within
the book, and the bombardment
of content on mainstream chan-
nels that have become akin to white
noise within a local context.
Furthermore, the entire conceptu-
alisation of an all-knowing, power-
ful, resourceful Greek god who keeps
tabs on Arsalan, alongside many
others, wishing to alter the state of
being of a developing nation from an
eagle-eyed perspective is, undoubt-
edly, a “heavenly” likening, and a
stroke of creative ingenuity. One
cannot help but grin, utterly be-
mused, by the presence of this self-
proclaimed kingmaker in Arsalan’s
life, and the impact of this detached
diety’s actions for what is passed off
as the greater good. In fact, one be-
gins to conjure up a very specific sug-
gestion for a vehicle that Zeus would
potentially lean towards possessing,
given that he chooses to utilize a very
modern, and very human mode of
interaction - a phone.
One particular takeaway that one
tends to ponder over once the novel
ends is the idea of a constructed nar-
rative - a drummed-up public rela-
tions message-cum-campaign on
steroids that spirals into positioning
itself as the absolute truth. As we are
made aware at the very beginning by
Arsalan, the book follows his version
of the truth - the way reality unfold-
ed before his eyes.
However, the contradictory truth
that exists is spread and believed
as well, opening up a conversation
on fabricated realities. One feels
deeply unsettled, fully taking into
account the fact that everything that
is peddled to us is one version of a
lie - for the absolute truth may have
never existed in the first place - and
it is the most convincing, most well-
marketed lie that sells for a certain
amount of time, till the next lie is
created. Undoubtedly, when one in-
fers this from the text, the avenues
of questioning data and informa-
tion around one crack open wide
into multiple directions, leading to
a spiral of further questions that are
- and may continue to remain - un-
answered.
In all of this, Arsalan’s innate hu-
manness makes him a wonderful
protagonist - one with whom we
forge a relationship in a strange way,
and one in whom we may even, at
times, catch glimpses of our own
selves. While Arsalan does not open-
ly masquerade as a microcosm for
most of us, there are certain hints of
commonalities that aid in develop-
ing the many emotions we feel for
the man narrating his own tale. On
the other hand, Akhtar also births
Arsalan in a way where the latter is a
quick-witted narrator, and we must
pay a great deal of attention to all
he states, for a lot of the exchange
between our hero and the reader is
laden with meaning and humor.
The author takes a tale, that is, on
the surface, one that follows the ebb
and flow of a political leader’s jour-
ney. However, Akhtar injects magic
into the very spinal cord of his book,
allowing readers to be swept under a
spellbinding wave that marries fact
and fiction. From the bigger punch-
lines to the subtle shots, Akhtar
outdoes himself at the flick of every
page, masterfully balancing the
message he wishes to convey with
varying tonalities.
When one touches upon the to-
nality of the book, it becomes im-
perative to highlight how skillfully
Akhtar utilizes Arsalan. At many
points, one finds themselves circling
back to the idea of absolute truths,
given that Arsalan, himself, at
many points throughout the story,
speaks in a manner that is befitting
of a politician.
From sounding delusional in
one instant, to employing grand
political rhetoric in the next, one
finds themselves wary of Arsalan at
times, further creating chaos on a
microcosmic level within the mind
of the reader. After all, is Arsalan
not a mere tool in a story, written by
the truths that exist within the au-
thor’s reality? One finds themselves
running in circles, trying to chase a
singular thread that could give way
to a narrative in which one can fully
place faith. Perhaps, that is the les-
son for readers, when all is said and
done. In the absolute circus that is
the sociopolitical sphere, one must
always be prepared for smoke and
mirrors.
The Liar’s Truth is Haroon Khalid
Akhtar’s second novel, and in this
nearly two-hundred page body of
work, one can spot instances where
Akhtar remains heavily influenced
by his father, the renowned writer,
Mohammad Khalid Akhtar. Indeed,
many of those who have consumed
Akhtar’s father’s work have been
able to notably shed light on the
pleasant similarities between the
wit and humor the father-son duo
have shared, while maintaining the
fact that individuality, and making
a piece of text one’s own, were key
parts of the process.
Summing up, one must hand it to
Haroon Khalid Akhtar for his cou-
rageous and revelatory plunge into
the deep, dark sea that is the socio-
political sphere of our nation. With-
out a shadow of a doubt, the novel
is a testament to Haroon Khalid
Akhtar’s artistic and creative lenses.
Touching upon, from time to time,
and borrowing from the reality in
which we reside makes The Liar’s
Truth a dangerously gratifying read,
as one grapples with the fragility of
all one knows to be true, whilst also
begrudgingly acknowledging the
fact that enjoying the novel far too
much might greatly become a cause
for displeasure for the all-seeing, all-
knowing, omniscient eye of Zeus.

T Magazine’s picks

Listen this week: Binge this week: Binge this week: Watch this week:
I Rather Kya Kahega Kazi She (Season 2) Bhool Bhulaiyaa 2
Music Podcast TV Show Movies

Singer-songwriter Zoha Zuberi made history
recently with ‘I Rather,’ Pakistan’s first origi-
nal in Dolby Atmos. The experimental track,
which was released on June 8th 2022, has
been produced by Ali Mustafa, and mixed and
mastered for Dolby Atmos by Sreejesh Nair
himself at Auo2 Studio Dubai. ‘I Rather’ is an
auditory treat, with a feel to the sound that
is quite different from what one may usually
listen to. The additional Dolby Atmos supple-
mentation allows one to place themselves
within the song, experiencing the ebb and
flow of the music, creating an overall immer-
sive and hypnotic experience.
Kazi Akber’s podcast is the go-to hub for all
things philosophical, explained and made easy
by the man himself, as he breaks down various
themes pertaining to the human condition
with a new guest on each episode discussing
the same. Many indie music artists have graced
the hot seat, alongside actors, poets, YouTubers
(Irfan Junejo is a recurring favorite) and influenc-
ers. Diversity is key to the podcast, as is the need
to conduct constructive dialogue, and thus, one
finds themselves intrigued by the guests seated
opposite Kazi, making casual conversation about
anything and everything - from the seemingly
mundane, to the evidently extraordinary.
When the first season of this Imtiaz Ali project
dropped on Netflix, many flocked to it, given
that the world had newly entered into a state of
contagious uncertainty. We devoured the first
season during the lockdown, and the series was
highly praised. Netflix just dropped its second
season, that carries forth the story of Bhumi,
a once-simple and naive Constable who finds
herself confronted by the world of darkness
and crime as she goes undercover, discovering
herself in the process. The second season is in-
triguing because it poses as an answer to many
questions that audiences had by the end of the
first season.
What happens when you take an iconic film, and
give it a renewed cast and some tweaks? You get
sequel called Bhool Bhulaiyaa 2 - a polarising second
part to the already successful first film. Based on a
chance meeting between Reet (Kiara Advani) and
Ruhaan (Kartik Aryan), this film follows their jour-
ney back to Reet’s childhood home - an abandoned
mansion haunted by the spirit of Manjulika. One
must call a spade a spade and state that this movie
does not hold a candle to its predecessor. Perhaps, it
is not meant to. However, if you want to experience a
hit of nostalgia, with hilariously placed call-backs an
undeniably suave title track, and a ton of promised
entertainment, Bhool Bhulaiyaa 2 is the way to go.

6 June 26, 2022

 ART, MEDIA & ENTERTAINMENT

THE MAGICAL
CONTOURS
OF ART
Many artists struggle learning to paint in the
beginning. The blind contour technique helps them
refine their observationary skills before they delve
deeper into the complexities of the art world
By NABIL TAHIR
How many of you remember art pe-
riod in school? Did you have enjoy the
class? Was it just an excuse to waste
away time with your friends or did
help you tap into a passion you didn’t
know you had? Were the results ever
so colossally bad that they made you
want to throw in the towel on your
future as an artist altogether? If this
was the case, there is one thing that
might have saved you from leaving or
might have developed an interest in
art: blind contour.
When someone thinks of becom-
ing an artist at an early age or at an
older age, one thing always comes
to mind, will I be able to draw a
good painting, or will others laugh
at my artistic skills. Well, blind
contour drawing is the thing that
he or she sees. The final drawing is
made up of one continuous line as
the pencil or pen is not lifted from
the surface so that the artist can
continue drawing without looking
down to see where he is.
The blind contour drawing pro-
cess was first used in the 1920s and
1930s, and the masses got to know
it from the art world in Kimon
Nicolaïdes 1941 book; The Natu-
ral Way to Draw: A Working Plan
for Art Study. The word contour
comes from the French contour,
which means outline or shape,
and is used to describe the lines
that make up the outside edge of
a drawing. Blind contour is when
you draw an outline of the subject
without looking at it.
It’s an excellent technique for
beginner artists to use when fo-
cusing on observational skills, and
it builds a perfect foundation for
more complex artistic adventures
Most creative minds quit painting as they
get demotivated after the first painting
they create. Students are not taught
about this technique and are rather
forced to focus on the perfection of the
drawing
ried out by beginners, but th
tthe
h be-
well-known developed artist
artists
ts
also use it to improve thei
their
ir
skills.
Professional artists and
d S har
blind contour drawing
An artist, Sarah Mir, hail-
il-
ing from Karachi, didn’t n’t
know that one day she he
would become an artist and
an art educator, but her passion for
trying new ways made her famous
during the last year of education,
and blind contour played an impor-
tant role.
“Being enrolled in the Fine Art
department of IVS, studying paint-
ing, sculpture and new media, I
had no intention of becoming an
artist. Admitting several times
that I had no courage or even the
confidence to stand beside a work
of art I’ve produced and explain it
to the viewers,” said Sarah, who
cause e
I ended
ende ed
with
wit h a ann ‘A’
A
grade
gra de later..
So hard w workork
k paysy
off,”
o
off ,”
” say Sarah,
sayss Sara
S arah,
h the fine ne
alumnus
artss alum
art alumnus Indus
nus of IIn Valley
dus Vallelley
School
S
Sch ool of A Artt and
Ar Architec-
d Arc chitec-
ture.
turre.
She
h co continued
conti
ntinue
nue ed ttoo admit
that blind d contour
onttour
o is on one
o e of the
essential things that has played
an important part in her success.
“Blind contour drawing plays a
huge role in my paintings. It’s a
practice that I thoroughly enjoy. I
draw the contours while observing
the visual reference,” she added.
“Making a ‘perfect’ visual is not
the point of my practice; therefore,
every other blind contour drawing
turns out to be a surprise for me as
well. For me, it’s unleashing the
silliness. That distorted visual is
then painted, mostly with acryl-
ic paints as my process is based borders of the drawing she does, creative minds quit painting as they
on several layers and often thick people can connect with the art- get demotivated from the first paint-
chunks of paint are applied one work that motivates her. She says ing they create. The students are
over the other.” that knowing that the viewers not taught about this technique and
In a struggle to make paintings can resonate with your artwork is rather are forced to focus on the per-
more accurate and perfect, the the most fantastic feeling in the fection of the drawing,” he said.
artists go towards the blind con-
tour drawing to improve the hand
world. “Even distorted or stylised,
they’re able to make connections
He explained that in most aca-
demics, the art classes are one of
and eye coordination, but Sarah
reintroduced the exercise of blind
to themselves and their lived expe-
riences,” she said.
the least interested ones for the
students at a younger age. “At
contour in her artwork. “Being an that time, they take art classes
How to make Blind Contour
art student at first and practicing
painting academically is a differ- To make a blind contour, you need
as a mandatory subject and not
something they are interested in.
ent chore altogether. Initially, I paper and a pencil. It is different from Finding engaging art lessons can
was a very controlled and care- the contour drawing, where you look be difficult in our current world of
ful painter and wanted to deviate at the subject and try to replicate it art education. If they are told about
from it. So instead of mechanically on the paper using the lines, usually the blind contour where they don’t
drawing or painting the subject without lifting the pencil. The blind have to worry about the result of
matter, I reestablished the exercise contour drawing rules are elemen- the painting and which tends to
of blind contour. It added as fuel as tary; focus on the area of your start- look silly, funny or goofy, the stu-
my work is very intuitive and spon- ing point, once your pencil or pen is dents will develop interest. That is
taneous,” said Sarah, who took touching your paper, you must not when you can identify the creative
her Master’s degree in Visual Arts lift it again until you’ve finished your minds and the ones with the profi-
from the National College of Arts, drawing, and you must not look down cient skills,” said Latif adding that
Lahore. at your paper at any point until your taking away your student’s abil-
The Textile Institute of picture is complete. ity to look at their drawing opens
Pakistan art teacher Sarah draws To complete the drawing, there up an entire world of challenges,
inspiration from shared histories, are two ways: to meet the edges of openness, and play.
memories and varied notions of the subject and then go into detail While explaining the activity,
home. She uses the blind contour or more information as they come. he said that a paper plate can be
in her artwork to create narratives Wherever the starting point is, placed on the top of the pencil
of belonging while illuminating remember that as soon as the pen so the students cannot peek into
lived pasts and shared present. “I or pencil touches the paper, it can’t what they are drawing. “Any of
create dynamic family portraits be lifted until the drawing is fin- the students or the teacher itself
employing unique aesthetic ished. Make sure to leave enough can become the model for the stu-
language taking religion- space to complete the drawing, so dents. Believe me, the students

The blind contour drawing exercise is a

fundamental tool that can help budding
artists create their first drawings,
and the experience allows artists to
become reacquainted with the power of
observation
you should start with since it is an
excellent activity to train the eye to
draw what it sees rather than what
the mind thinks.
The typical drawing is done from
short-term memory. You look at
the subject, then look down on the
paper to draw it, not from what
you see in front of you at the very
moment but from the short mem-
ory you have made of having just
looked at it.
The blind contour drawing ex-
ercise is a fundamental tool that
can help beginning artists create
their first drawings, and the ex-
perience allows artists to become
reacquainted with the power of ob-
servation. It is a form of art where
the artist, without looking at the
canvas or the paper, draws what
later on. Your final drawing is usu-
ally not very realistic and can look
a little messy, but that’s precisely
how it’s meant to be!
The idea is to do a drawing ex-
ercise without looking at the sur-
face until it’s done; it is practised
to refine observatory skills. The
process involves keenly observing
the subject in front while drawing
its contours. It also helps artists
to form hand-eye coordination. It
requires much attention, and the
artist must remain focused on the
subject without distractions.
The first drawing may look well
or funny. However, with practice,
the artist finds that they can ac-
curately record an image on paper
without looking at your hand as it
draws! This practice is not only car-
started painting in 2015. “It was
the opening of our thesis display
which turned out to be magical for
me. The whole thing was very sur-
real. Later it was open to the public
after the result was announced.
Passing with flying colours and
getting the acknowledgement
boosted my confidence. My show
was sold out! What else can a twen-
ty-three-year-old ask for?”
“I started painting in A’levels
while studying at Foundation Pub-
lic School, and I got a ‘D’ grade from
a very renowned teacher. So you
can imagine what my thoughts
would be on it. There’s no sob story
cultural constraints into account,
depicting notions of family life
and propriety by juxtaposing
family portraits with culturally
accepted images,” she said.
“The family members experience
a comical, exaggerated distortion
and, despite remaining repre-
sentational, may just manage to
escape the invasive supervision
implemented by societal norms.
Time, which is nostalgically pre-
served in family photographs,
comes in conflict with the playful
contemporary tone of the work,”
she added.
Despite the imperfection in the
starting in the middle or at one
edge and moving inwards on the
page, is a good technique.
While there’s no time limit for
you to work on your contour line
art, the artists usually set a timer if
they’re using it as a warm-up exer-
cise or if they are new to this tech-
nique. The eyes will likely feel tired,
and the artist loses concentration if
they work for much longer.
Not practised in schools
Another artist Asad Latif, who learned
the art around 20 years ago, says that
if this technique is taught in schools,
it can make many good artists. “Most
will certainly laugh upon revealing
their blind contour drawing. There
is something so silly, innocent,
and simple about a blind contour
line drawing that student’s love.”
For Latif, blind contour drawing
is an opportunity to be more fo-
cused and slow down the process
of drawing and looking. “I think
about the tip of the pencil as an
ant. It crawls around the contour
of someone’s shoulder, then falls
down to the table, and then up the
side of the saucer. Something mov-
ing that slowly and focused makes
your brain empty of everything
else.”

June 26, 2022 7

 HEALTH & FITNESS
BEATING HOPE FOR
BALOCHISTAN
The residents of Balochistan have continuously
struggled due to a lack of medical and educational
facilities. However, a team of trained specialists
have now made it possible for cardiac surgeries to
take place within the province, thus giving hope to
thousands of poverty-stricken heart patients
By SHAZIA MEHBOOB
In a rare development in the field
of medical science in Balochistan,
a team of doctors at Sandeman
Provincial Hospital (Civil Hospital)
Quetta have carried out two success-
ful open-heart surgeries. The pov-
erty-stricken people of Balochistan
term this welcome news for the least
well-off people to have this facility
within the provincial capital.
This milestone achievement is
not only a great success for the doc-
tors at the hospital, often working
in very trying circumstances with
inadequate facilities and paramedi-
cal staff but also a great relief for
hundreds of thousands of cardiac
patients in the province.
Hitherto, cardiac patients had to
travel to Karachi, Lahore and other
cities for heart bypass surgery cost-
ing millions of rupees over and
above other costs for traveling, ac-
commodation, and subsistence.
“We took our father to Rawalpin-
di, Karachi, Sukhur and other cit-
ies for cardiac treatment and spent
hundreds of thousands of rupees
in terms of travelling, accommoda-
tion and other related expenses but
yet the cardiac problem was getting
complicated,” said an under treat-
ment cardiac patient son from dis-
trict Noshki. “After bypass surgery,
I’m glad my father is recovering
now,” the son said.
Cardiac Surgeon Dr Asmatullah
Achakzai, a member of the first
team who operated open-heart sur-
gery, said, “The patients we operat-
ed here had travelled to many cities
for treatment purposes, spending
an estimated Rs350,000 each in
terms of travelling and accommo-
dations and other related charges.”
“Few days ago when one of the
two recovered patients visited the
hospital, his condition was com-
plicated and we recommended him
for a bypass surgery. When he came
to know that the hospital has a by-
pass facility, he wasn’t ready to go
home back, was insisting to admit
him and conduct surgery as soon
as possible,” Dr Achakzai recalled.
The patients had spent hundreds
of thousands of rupees on visiting
Karachi and Lahore and other cities
for treatment, the cardiac surgeon
informed.
This development has been a
milestone achievement in the
medical history of Balochistan at
the provincial level. In this regard,
Naseerullah Khan, a local resident,
said, “We are proud of the team of
doctors who made this possible for
the poverty-stricken people of the
province to get free of cost quality
treatment within their province.”
This development could be made
possible with the special interest
shown by a team of dedicated doc-
tors, hospital management, and
provincial health authorities, ac-
cording to the statement issued
by the hospital management after
conducting two successful open-
8 June 26, 2022
Earlier, we were short of trained staff,
anaesthesia doctors and surgeons.
Since returning after completing
specialisation, we have made a team of
dedicated doctors
heart surgeries.
The team of doctors, led by Dr Arif
ur Rehman Dr Syed Dawood Shah,
Dr Aftab Ahmed Khatri, Dr Asghar
Ahmed, cardiac surgeons Dr As-
mat Achakzai, Dr Abdul Wasay, Dr
Aqeel and others took part in the
operations.
Sandeman Provincial Hospital
MS Dr Amin Khan termed the de-
velopment a rightly described suc-
cess, adding that this achievement
is a result of joint effort by medical
and para-medical staff, pharma-
cists, perfumers and other relevant
personnel.
Dr Amin Khan further said the
sustainability of the cardiac facil-
ity depends on the availability of
resources now as we have acquired
a trained and trained doctors teams
at the hospital now, adding that
the hospital has a number of chal-
lenges including acute shortage of
nursing staff and other resources.
Dr Amin expressed fear that lack
of financial resources and short-
age of nursing staff can damage
this noble cause if not addressed in
time. He went on to explain that
the cost of disposables per patient
is estimated at Rs130,000 adding
that, “We need continuous assis-
tance from the government as well
as donors and administrative au-
tonomy.”
According to Cardiac Surgeon Dr
Abdul Wasay, “Our province was
lacking in the field of cardiac sur-
gery, when I was doing my house
job after MBBS we were sending
lots of patients to Karachi and other
cities for open heart surgeries, and
many of them died in our hands be-
cause they couldn’t afford to make
it possible. This gave me a push to
go and achieve specialisation and
excellence in this field to serve our
people back in my hometown.”
Dr Asmat Achakzai added, “A by-
pass package has different rates
ranging between Rs500,000 to
Rs800,000 in different hospitals.
We are here providing state-of-the-
art treatment free of cost in this
hospital.”
The cardiac surgeon said that the
disposables used during operations
are expensive and are to be afforded
by patients. “If we can have finan-
cial support and a regular supply
of disposables and other logistics
our 90 percent patients requiring
heart surgeries will be treated in
home town with best care and at
least equal to if not more than sister
provinces,” he said.
“We are hopeful that the govern-
ment will continue provision of
resources to continue this process
free of cost to the poverty-stricken
people of Balochistan,’’ Dr Wasay
expressed hope.
“Earlier, we were short of trained
staff, anaesthesia doctors and sur-
geons. Since we returned after com-
pleting specialisation, we made a
team of dedicated doctors, who took
them to NICVD Karachi for training
and after that such open-heart sur-
geries could be possible,” Dr Asmat
added. Initially, we were provided
resources for three patients’ surger-
ies, which we had done, he said.
Dr Abdul Wasay said, “We have a
well-trained team of doctors but it
would not be sufficient to provide
treatment to a large number of car-
diac patients in Balochistan. Thou-
sands of people are forced to travel
to Karachi, Lahore and other cities
for treatments.”
Currently, the hospital has a list
of 72 patients for open heart sur-
gery, who will be operated in the
coming days.
However, the hospital still needs
a mass level awareness campaign
to inform people about the state-of-
the-art facility as people who don’t
know about this facility are still
travelling to other cities for treat-
ment.
“For the initial start of the pro-
gram we have basic requirements to
continue open heart surgeries but
to entertain the large volume of pa-
tients that we have in our province
and to operate complicated opera-
tions we need much more support
from officials to make it possible
for the poor masses of Balochistan,”
added Dr Abdul Wasay.
Balochistan Secretary health Saleh
Muhammad Khan said the health
department will try its best to man-
age resources to continue the heart
operations in the hospital and in
this regard the department has not
only allocated special funds of Rs 30
million but is in talks with donors in
order to increase further resources.
Terming it a milestone achievement
in the history of Balochistan health
sector, he said the team of medical
staff will also be honoured as well as
cash prizes and this regard named
list has been dispatched.
He said so far seven open heart
surgeries have been conducted at
the Civil Hospital Quetta and the
process is continuous, adding that a
single case needs almost Rs400,000
investment and Rs200,000 are kept
in savings for any post-surgery
complications so that the patient’s
life could be ensured. Secretary
Saleh further said the government
has decided to allocate an estimated
Rs46 billion for the health sector
in terms of development and non-
development budget, out of which
Rs30 million will be allocated for
Civil Hospital’s cardiac units.
Regarding the initiative, he said
that a group of qualified doctors who
have completed their specialisation
from NIVD Karachi arrived in his
office and asked for finance to start
open-heart surgery and shared de-
tails of an estimated amount and re-
quirements for surgery, which was
provided to them within a few days.
No One Should Die of Heart
Diseases
“Being a native of Balochistan, this
success [for me] is like a dream comes
true,” said Dr Abdul Wasay, adding
that “some five years ago we travelled
to NCIVD Karachi with the mission
to give back to the native people
after completion of this specialisa-
tion. And our mission was to ensure
quality cardiac services to patients
at initial stage and later to bring the
hospital at par of hospitals of devel-
oped cities of the country,” Dr Wasey
informed.
“After a long journey when I com-
pleted my qualification, I worked to
learn how to establish a new setup
in an area where people are com-
pletely unaware of this specialty;
I took guidance from our mentors,
many founders of institutions there
in Karachi and also in Quetta, and
Our mission was to ensure quality cardiac
services to patients at the initial stage and
later to bring the hospital on a par with
those in developed cities of the country
started contacting concerned gov-
ernment officials and put my cause
before them,” Dr Wasay recalled his
years long efforts to achieve this
milestone.
“Initially it was considered an im-
possible project by all of us, but due
to our continued efforts finally we got
to have some support (in terms of lo-
gistics and human resource and their
training in NICVD Karachi which is
a renown and an established insti-
tute in the field) from hospital man-
agement and health department
to prove ourselves if we could really
make it happen,” he said.
“We had to work in bare minimal
circumstances but to prove that
it can happen so that we can have
their full support for the cause,” Dr
Wasay maintained.
“Today we are so happy for the
dream to come true,” Dr Wasy said
proudly, adding “We have per-
formed at least six to seven bypass
operations so far and they are do-
ing well and having smooth recov-
ery. We have our initial team very
strong, dedicated and capable of do-
ing every kind of heart surgeries, we
have to extend the program and our
wish and vision for the future is to
extend the program to other cities of
the province, and the slogan is ‘No
One Should Die of Heart Diseases’.
The 83-year journey of struggles
The Sandeman (Provincial) Hospital,
Quetta was established in1939 after
the earthquake of 1935 on Jinnah
Road, Quetta for a population of
50,000 with bed strength of 50 com-
prising 7.38 acres of land with a cov-
ered area of 268134 Sq. feet.
In 1973, Sandeman Provincial Hos-
pital, Quetta affiliated with Bolan
Medical College Quetta as Teaching
Hospital. In 2001, after the comple-
tion of Bolan Medical Complex
Hospital, all the Department units
of Sandeman (Provincial) Hospital
were shifted to Bolan Medical Com-
plex Hospital.
Soon after shifting, it was realised
that Bolan Medical Complex Hospital
alone cannot fulfill the requirements
of patients from all over Balochistan.
After that 50 per cent of each major
unit of every specialty and some mi-
nor specialties along with teaching
staff were shifted back to Sandeman
Provincial Hospital.
Currently, the government is also
planning to shift the cardiac unit of
the hospital to another place. The
hospital managements and doctors
are feared that shifting an opera-
tional unit to another place would
not only damage this noble cause
but also increased shortage of medi-
cal and para-medical staff in the hos-
pital. Being centrally located in the
city, the hospital is easily approach-
able to the common people. Post
Graduate Medical Institute Quetta
was established in 2003 for various
medical diploma courses affiliated
with Sandeman Provincial Hospital,
Quetta. The Clinical Section of Den-
tal College is also established in San-
deman Provincial Hospital, Quetta.
The hospital provides treatment fa-
cilities in 18 areas and it is 850 bed-
ded hospitals.
Non-Availability of Cardiac
Patients Data
When this correspondent asked for
statistics of heart patients from the
hospital management and the pro-
vincial health department, they said
thousands of patients visit hospitals
both in government-run and private
hospitals in the province. However,
neither the health department nor
the hospital management have es-
tablished database to maintain record
of the patients. The provincial health
secretary said there is no database
system to have exact statistics; how-
ever, he said heart diseases take thou-
sands of lives in Balochistan every
year. According the hospital to the
latest WHO data, published in 2019,
251,220 deaths occur per year due to
coronary artery disease that is 20.28%
of all cause deaths. And also Pakistan
is ranked 3rd in the world for rheu-
matic valvular heart disease and rural
and poor areas such as Baluchistan are
more prone to succumb to this disor-
der as compared to other provinces.
And every patient needed open heart
surgery had to be reoffered to other
provinces due to lack of a functional
department. The age-adjusted death
rate is 193.56 per 100,000 population
ranks Pakistan 30 in the world.