Pakistan In 2021: A Conscientious Doctor Speaks And We Should Listen

Pakistan In 2021: A Conscientious Doctor Speaks And We Should Listen
I have been a citizen of Pakistan for nearly six decades and have remained figuratively faithful to the National flag, despite an offer to take up a Middle Eastern monarchy's 'subjecthood' and an opportunity of 'naturalization' within the largest Western democracy.

I had my early schooling in East Pakistan, now Bangladesh, before the tragic breakup I was traumatised by. I got educated in a leading missionary school of Karachi, went to the premier pre-Medical college of Karachi and graduated as a Doctor from a leading medical college of the country with huge governmental subsidies.

I had access to sound and often cutting edge tech. After Fellowship in USA, I served briefly as Assistant Professor and before embedding in the system, I voluntarily shunned US Nationality because of personal and family convictions. I made a detour to Pakistan via Saudi Arabia, where I spent nearly 12 years in the finest academic institutes, inclusive of a prestigious Chairman Medicine position.

I voluntarily returned to Pakistan; for the country, for my family, and to help set up institutions in my homeland. I had the opportunity, over a decade plus, to help setup in ways small and not so small, the finest quaternary care academic institution of Pakistan. Subsequently I helped put together the 15 year academic and research vision for a National Medical University of Pakistan as its inaugural Dean.

Now I am back in active patient care but have been spending a considerable time in research capacity building for 15 years in postgraduate research.

I pay my taxes, have my limited assets here in totality, invest in the country entirely and vote in National elections.

So, I wonder, do I count in this country and have any stake and voice in its future?

I believe, I have gone through pains to establish my credibility above and thus do count and through my reflections and writings, I will document my ideas for posterity.

So briefly, what ails Pakistan from an 'academic perspective' and the proposed 'academic' solutions?

Governance: A failure of the political system was destined because of absence of true proportional representation and sham democracy run by 'unelectable' powers of the country. An institution of political mentorship marked by academic discourse, debates and critically appraised policy formulation is entirely in order with restoration of political activities in professional colleges as a Nursery for development of political acumen, sans the violence of yester years. A grass root democracy through mayorship, municipal elections and local bodies should breed genuine leadership. All institutions of the state need to reconcile with this critical need through a fresh constitutional framework.

Education: Restoration of education as a means for transfer of values, with rote learning replaced by problem solving and critical thinking. Vocational training and civic sense to own national responsibilities should be part of the portfolio of co-curricular activities. Subsequently, it will develop responsible citizenry. Equitable access to education and removal of gross disparities is paramount in all corners of the country.

Healthcare: Health security should become a national priority and emergency; falling closely on the heals of the covid 19 thoroughly exposed major gaps in health governance, infrastructure, quality/patient safety and translational research with lack of evidence informed policy formulation. Healthcare disparities and the multiple systems need to be replaced by a commitment to a National health service in Pakistan.

Economy: No country can survive without a documented economy and shared responsibility through proportionate taxation. This should be emphasized through the media, academia and via strict enforcement of tax regulations and violators should be imprisoned for white collar crime. Import substitution through indigenization and adoption of the triple helix model of academia, industry and government partnerships is imperative.

Judiciary: The legal fraternity needs to come up with a pyramidal structure and competency framework for sending the finest to the local, high courts and apex courts. A mentorship program with longitudinal milestones is in order with the essence of formulation of 'just' laws and timely dispensation of justice.

Armed forces: A complete rethink in the philosophical approach to defending the country's political and ideological borders needs to be embedded within a framework, committed to the democratic dispensation within the country. A process of institutional back-transfer of national and international policy decision making, after due discussion and debate, needs to be mechanized and operationalized through an institute of public policy to the representatives of the public within the parliament and senate. The dignity and integrity of the armed forces, having the unbridled trust, love and support of the nation is vitally important and there can be no two opinions on that.

To conclude, I would say that for too long, we the citizens have watched the unravelling of the political and public order within the country, silently. Perhaps as a humbling experience from 2020, we can individually and collectively come together in 2021, for rebuilding our nation. The opportunity missed shall peg us decades back, in the comity of nations.

My opinion should matter and I hope Pakistan is listening!

Prof. Mujtaba Quadri is Head of Nephrology at Maroof international Hospital, Islamabad.