Tag Archives: Karachi

Smiles in Cracked Ice – Dedicated to Parveen Rehman (architect, selfless humanitarian and social scientist who lost her life in a brutal target killing on 13/03/2013 in Karachi, Pakistan)


(The brutal and cold blooded murder of architect Parveen Rehman today has most of us in a state of shock. That smiling face and graceful aura is gone forever and in what a way! From earliest days as a child listening to her discussion of her work with my father to later days seeing her as a spirited, animated individual exuding her usual warmth and smilng demeanour… she was… undoubtedly a model of selfless determination. Death is inevitable but when it is the result of violence it hits emotionally and it hits hard. I feel completely stunned and angry at the murder of a lady who gave her whole life quite literally for the welfare of the poor, the needy and the helpless. Today we look on – each of us as helpless and as poor as the ones she worked for – as we watch yet another humane soul succumb to the madness that surrounds this once peaceful city of Karachi. May Allah raise her to her heavenly abode where she truly belongs and bring her killers to justice. Parveen aunty, you stood up for what you believed in and brought light to the lives of several who were a part of the Orangi Pilot Project. I can hardly bring myself to believe that such efforts, tremendous as they are, go in vain in the end – the light, hope and courage along with selfless determination must and shall live on in other forms come what may. You will truly be missed. Inna lillah e wa inna ilaehe raajeoon.)

 

Blood buckets to wash the road

the earth to sketch the sky

eyes that tearless stare

and bullets endless supply.

 

It was another city in that lifeless book

where roses blooming grew

now the red velvet drapes luscious dew

on selfless souls. The look

still haunts – that glassy stare

of wide eyed wonder evermore

and destiny weaves its untold plot

 while we all count the score.

One, two, a thousand pleading eyes

beseech through tomorrow’s door

but drool frames what it loves the best,

Greed’s open corridor.

 

Love to mask the hate

soft voices to dim the noise

irony moves the cattle herd

and idiocy rules the wise.

 

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Elegy for the Victims of Bhoja Air Plane Crash


What tree, what lightning, what bloody ground,

all on board are dead.

What lament for the bloody crown,

for all on board are dead.

 

Fantasies may take wings and fly,

Wright brothers did not just dream,

Icarus was no Peter Pan,

Fate’s cards cannot be read.

 

Pine tree in Margalla’s ground,

you saw the bashful couple stroll

in shroud of white, then light, then shade

then fade… as all on board are dead.

 

An arm, a limb, torn from silken skin,

does it matter now what its colour was?

The hues of sunset mirror the loamy soil,

each tone a shade of red.

 

Grieve, the forlorn souls of yesterday,

tomorrow and then day after will come,

but never the smile, the pat, the hug,

now all on board are dead.

Should Karachi Zoo be shut down?


To cage or not to cage?

Browsing through an array of notifications that hits my screen every few minutes or so, I was recently stirred by an ongoing debate on one forum. The topic in question was about the efficacy of the Karachi zoo and whether it should even exist or not. Keeping for and against points towards one side, quite a case can be made for both aspects.

Perhaps one of the things that struck me the most was how many people there were right! If I existed in my bubble I would undoubtedly say that having a zoo in Karachi is a useless venture and be done with it. Yet, my bubble was broken long ago. Agreed, that in the case of the zoo it is quite painful to see the animals slumbering in smelly cages, especially the ever sleeping lion, yet it could be taken as a personal opinion. I am completely against the concept of keeping any wild or pet creature in a cage. It is against nature, demeans God’s creations and is tantamount to cruelty which no religion or civil society teaches. Reminds me of St Mary’s asylum in Bethlehem and the commotion it caused in history because there humans were being treated in the same way as animals. Think for a minute of our own selves in those cages and it is enough to make one shudder.

At the same time, I’ve come to realize that change cannot be pushed forward impulsively. One needs to remove a brick and place another in its place so the infrastructure doesn’t collapse. The zoo wasn’t made in a day and the jobs even though being understaffed are provided for and cater to several families. At the same time, there is a case for using the zoo as a ready made lab for the creation of a healthy genetic pool for endangered species.

On the other hand, conservationists feel that the main reason the zoo has survived so far as an open place in the heart of the city is because we have a valid excuse ‘there are animals in it and it’s a recreational space’. Without that excuse there is little between a bullet and a bullet to stop land grabbers. And we do need that open space as a breathing space in the middle of the city. Further while we of the car and facebook world bubble have our dens and haunts, many women living in the locality look forward to the day when it’s a ladies only day and they can easily spend their time there. On special occasions, ladies are not allowed inside and yes, there may be several pickpockets. I was once told that on such days men rule the place and sadly consider it great fun to poke animals to make them react. Brutal and callous yes, but the more we shut down and avoid such instances instead of re-educating, we are not giving anything to society. The concepts will not change.

The need of the day is to plan carefully and listen to different views as well along the way. There may be more than just animals at stake here. Food for thought… There should be adequate provision of open places for entertainment for masses rather than the elitist population only.

One of my earliest memories is of seeing finally all those wonderful animals that I had before then seen only in books as a five year old child. The wonderment and pleasure at the size and beauty of it all in that bright afternoon is a happy memory. So it is with others, photographers and nature lovers alike who go and spend time at the zoo on cloudy days and enjoy the open space. On good days it is still a great place to be. Long winding walks, greenery and the vast expanse of land make it an ideal picnic spot as well, especially for those who do not have the means to bear with the expense of carting their offspring to the beach and buying goodies for them there from the shops dotting the area. The convenience of the location as well as the economy of biying sweets and affordable snacks from vendors near the zoo cannot be undermined.

One suggestion of dealing with the knotty issue at hand is of converting the current facility into a focus on a petting zoo with pet animals in open spaces and trained staff to guide children how to handle such animals. Baby animals and pets may be better able to elicit responses of warmth than of poking and ridicule and change the concept of the zoo as many have it at present.

The problem with most petitions is that they communicate aggressive action and impulsivity – they denounce something and do not provide suitable alternatives. As a result many noteworthy causes fall flat as those in the Government feel they will face additional protests from a variety of people especially the employees if they listen to the voices of concern from civilian bodies. A shelter or petting zoo is a good alternative that would keep the space and the jobs intact, while getting rid of the abhorrent and expensive to maintain wildlife in cages concept with an always sleeping lion to go with it. He definitely needs to be out in the jungle where he belongs.

As for shutting down the zoo? Definitely NOT an option.

For a view of the improvements made in the zoo since its inception and to know more about the history, I recommend reading:

http://www.groupin.pk/blog/karachi-zoo-garden-animals-timings-pictures-attractions-for-kids/

 Photos courtesy:

http://www.care2.com/news/member/285806679/540773 , http://www.ysapak.com/YSAforum/index.php?topic=4059.42 , http://www.groupin.pk/blog/karachi-zoo-garden-animals-timings-pictures-attractions-for-kids/

Karachi Rain – Lessons to Gain


storm clouds...

Good old rainy ‘moonsoon’ or ‘MANsoon’ season courtesy the creative tongues of our media wallahs, is here again in Karachi. After a dry spell of several years and the last memorable drown-the-roads rain in 1992, we seem to be getting it all back again. While no animals or male species can be seen pouring from the heavens, the ones on the street are a sorry sight. Stranded on the roads, stuck in jams of their own making, the people of Karachi face their biggest friend turned enemy – water. The city infrastructure just can’t digest any more rain and there may just be a guttery Venice in the making.

Grumble or rumble, this is the Karachi of my childhood, the roads where I have steered that ‘kaghaz ki kishti’ (paper boat), splashed in puddles, got drenched in the rain and smelt the earth together with crispy fried goodies, heard the buzz in the air of happy sounds of laughter, shrieks of joy on spotting a rainbow in the sky and got stuck in HUGE adventures being stuck in the middle of water with open manholes dotting the way; not knowing which step would take me down under and these are the lessons I’ve learnt:

1. When it rains it pours, see one drop and run.

2. Necessity is the mother of all, if you don’t have a raincoat, wear a ‘shaaper’ (shopping bag) on your head.

3. All that is water, may not be water – watch your step!

4. Make hay while the sun shines, have a bath while it rains.

5. If someone splashes you from one side, splash him on the other.

6. When life gives you lemons make lemonade, when it gives you rain in Karachi, make pakoras, mosquito repellents and generators.

7. It doesn’t matter if you’re revealingly wet all over, all your ‘izzat’ (dignity) happens to be atop your head, which MUST be covered on a priority basis.

8. Look before you leap, you may just find an open manhole hidden beneath.

9. Every cloud has a silver lining, make sure your clothes do too!

10. Every dancer has her days, and sometimes they lead to rain.

11. Avoid air and water like the dengue, wear a tent!

12. There is water at the end of every tunnel, learn to swim!

Pakistan Zindabad!


Torrential downpour in the country, emergency situation due to floods in Badin, earthquake of 5.7 magnitude in Karachi and Balochistan and the Anthem record of 5000 plus enthusiastic people braving the lashing rain and wind in a stadium in Defence, Karachi – we finally usher in Pakistan’s 64th anniversary celebrations.

image courtesy Google.com

The land of green and the sea of blue,

The Quaid had thought it a dream come true,

Freedom from injustice and every kind of harm,

It would provide the muslims with a much needed balm…

A much younger version Kiran had written these lines on the occasion of Pakistan’s 50th anniversary. 14 years later, the idea of ‘freedom from injustice and every kind of harm’ rings in my ears. Negative portrayals have far overtaken the positive aspects in media reports.

Think positive we are told, and then the buzz dies down after 14th August as the days pass. There are those silent workers who continue their work… the Edhis of the age who never even solicit limelight while their worldly counterparts aka politicians light up million dollar smiles while doling out ration and supplies to the poor.

Google doodles have finally given in to repeated demands and come up with a suitable portrayal of the 23rd March monument of the famous Pakistan resolution monument and the crescent and star symbol replete with green and white colour.

Green for the muslim masses and white for the minorities – or the sum total for the ideals of purity. A secular state? Iqbal’s dream or Quaid e Azams? Changing of the guards ceremony at the mazaar – the Navy taking over as guards in the wake of the PNS Mehran incident; are they worthy or not? The debatable issues are endless, but is it even worthwhile getting into these debates?

The ones who want to work do not need to have every little detail cited and clarified, before starting their work. While the time for action bit may be a cliche’ , it stands before us clearer than ever today.

64 years have passed since Pakistan’s freedom. What freedom you ask? The freedom of choice.

In our lives each one of us has boundaries. In the true sense, none of us is ever or ever can ever be completely ‘free’. The bonds of religion may restrict one, the bonds of family may restrict another and so on.

Freedom of choice is the only idea that allows us to move in the little squares we step on in our daily lives. Today, if you decide to use this freedom of choice to do a good deed, howsoever small it may seem, who can stop you? And if we all decide to use our time and endeavour to do something good, the ripple effects will surely grow.

So, go and give someone the gift of your time; talk to a person who is ill, handicapped, facing life’s troubles and heal the pain. Go and give someone the gift of hope. Show someone that you care, be it human, animal or plant life. Live within that square you have been boxed into… Its the message in the lights of those mobiles that came on at the National Anthem record when there was no light…

Where there is a will, there is a way and today will be a new day if you make it different in some way… Will you?

Plans in Pink


Ahmad, K.B. (2007). Plans in Pink published in Neither Night Nor Day, 13 stories by women writers from Pakistan. HarperCollins Publishers, New Delhi, India.

(I am posting this story here at the insistence of my friends who will just not stir themselves to buy the book and yet keep asking me about when it will be available online. Finally, I’ve given in.) Plans in Pink is the story that was revised and rerevised to suit the ideals of a few Pakistani editors and publishers and even then did not get published. After multiple rejections on this side of the border, I decided to leave it almost to its second draft format – stubbornness of a mother denying the flaws of a newborn child. Providing it space, I call it now and have never had reason to regret it. It was in this ‘almost 2nd draft’ form that it was discovered first by an Indian website hosting prominent writers from the subcontinent

https://kiranba.files.wordpress.com/2011/07/kiranba-gallery0001.jpg

and then later was picked up by Rakhshanda Jalil for publication in a book edited by her. I consider this story to be one of the major landmarks in my writing life as far as learning the ropes of the writing business is concerned. I hope you enjoy the delicate web as much as I enjoyed spinning it.

Do leave your comments,

Kiran Bashir Ahmad

Heaven apartments were pink in colour. Perhaps the builder had the pale tints of sunrise in mind when he built it, but no matter what rationale one chose to give it, the fact remained there that standing tall, stark and solid through three years of the glaring sun, the lashing rain, the smoking vehicles of one of Karachi’s major arteries and numerous leaking bathrooms of their own design – they were now a bright, gaudy pink in colour rather closely resembling the hues of a tomboyish girl’s kameez which had remained unwashed for over a week. The girl – she had a definite role or rather would have a definite role but for now – the colour…

On a more positive note, the colour did distinguish the long line of apartments from the other grey, brown or white structures in the vicinity, which was exactly what Samina had in mind while explaining the address somewhat hurriedly to her daughter’s tutoress. What could a workingwoman do when literally everything had to be done on a Sunday, cooking for the week, doing the previous week’s laundry and the list went on…

“Its pink!” she had been forced to scream into the receiver through the increasing noise of the static.

“What stink?” came through the rather confused voice of Valerie.

The message had finally got through after a moment of sheepish embarrassment on either ends of the line and now Valerie was putting down the receiver, chewing on her stub of pencil like a meditative calf as her eyes took in the litter of the once neat and tidy room where numerous students had diligently learnt their ‘oh so difficult English lessons’. She could almost picture Ali and Mishal, or Al and Mish as her mother had liked to call the twins, sitting together on the cushy sofa below the window and reciting Wordsworth’s “Daffodils”. It was a poem usually reserved for the 10th graders at which level it was taught in their school but Valerie chose to make an exception in this case, as the twins proved to be an exceptionally bright pair, who, at their twelve years of age understood the various nuances of rhyme as well, if not better than the dull 9th and 10th grader lot she usually tutored.

It was their mother Mrs Samina Tariq she had been talking to. A good natured, helpful and inordinately stupid woman was Valerie’s first impression of her and now as she again surveyed her flight schedule, she smiled and hummed to herself happy that her guess had been correct. Though how on earth her mother would manage to stay on in Samina’s house for a whole year was a mystery Valerie chose not to dwell on. It was causing her a headache and plus the thought – the very thought of finally being independent was overwhelming. “Yes, better not think about it.” She chose instead to think of Sam…Sam – Samina, back to Samina… Valerie could remember the look on Samina’s face when her mother had tried to call Samina ‘Sam’. She laughed to herself. Apart from that first blunder things had gone on smoothly.

Samina had been a gem. “Of course!” she had gushed, “I can understand how difficult it is for you now that you are going to Australia. Don’t you worry. She can stay with me till she sets things in order here and joins you.”

“It’ll only take around two or three weeks I’m sure,” Valerie had beamed at her.

“Oh she’s more than welcome! I will look after your mother like my own. The children can sleep with me…so much the better since Tariq isn’t here…” but that was all that Valerie had heard or had needed to hear, she was already far away, blissful in her thoughts of Australia where somewhere sunnysam, as his nickname on the net proclaimed, was waiting for her as he himself put it, “as breathlessly as if on the edge of a diving board.” Valerie could almost picture his muscular and fully toned body in the pair of swimming trunks along with a few other toiletries she had sent him a month after their online relationship had commenced, thanks to one of the more popular Christian dating websites, and a week after he had told her he was serious in his intentions and wanted to marry her. She had sent him the trunks and had in return received a box of twelve long stemmed roses; white with a blush of crimson at the edges. Mrs D’ Souza had been unexpectedly encouraging. Valerie again looked at the ticket – Valerie D’ Souza was printed neatly at the top – a one-way ticket to the land down under…and with luck she would never have to bear with her mother’s foibles again, not for a year at least till when she would have to arrange for her to come to Australia…that was her mother’s plan, but in the meantime Valerie hoped she would be able to locate a comfortable old people’s home…

I was looking into the strip of mirror embedded on my cupboard and only Valerie’s sheet of shiny black hair was visible to me, yet I knew she was thinking about the future. The future – the word came fully loaded – expectations, responsibilities and desires, but above all, uncertainty. I wondered whether I had done the right thing in allowing her to dream, then shrugged the troubling thought out of my mind. Had I ever been wrong? And Valerie after all was my daughter. She could take care of herself. I was sure of that. Hadn’t she twisted Samina round her little finger? Granted, that I had guided her but she had managed the last part quite well. I was sure that she would be able to do the same with Sam. Once she had the nationality, there would be no need of him. There was one problem though. She said she loved him. Love over what? A computer? I was sure, as I pinned up my grey hair in the pink butterfly clip I reserved for that purpose, that all the love would go right out the swimming pool once Valerie had a chance to compare a Pakistani-Australian banker’s lifestyle with that of her beloved swimmer. That the said banker, James, was also from our community made the package more attractive.

One part of my plan was complete. The house was sold, I had a place to stay and Valerie had her ticket. Now I only had to see off Valerie and then land up two weeks later in Australia myself, unknown to any but James and of course Samina. “Come to think of it, the only one, who did not know that my so-called lie to Samina was actually the truth, was Valerie!” She would thank me later. Plus I could always say that I meant it to be a surprise. Did she think I was actually going to stay on here like the rest of them – the greying old wives of greying old remnants of the 60’s? An unsightly lot I found them, ambling forward wearily like turtles, poking their sticks here and there nervously like mice scuttling the ground as they walked up the drive of the Grand Club periodically to play the same old Mah-jong or chess or bridge – oh they were all alike! Dull people with dull lives. The Lord alone knew how long I would live and as long as I did I wanted to see the world and secure my youngest daughter a good future as I had done with Melanie. Wasn’t Melanie now living securely in Canada where her husband – also one of my findings in the community – worked in the oil fields? The thought was intensely comforting; like a woolly blanket on this cold December night. She had also considered herself to be smitten by that fellow…what-was-his-name-now…It would be history repeating itself, nothing more.

 * * *

The scrawny ginger and black speckled cat arched its back and tried to dive in deeper into the rotting rubbish pile beside a wall from which the pink paint was slowly peeling away. Its tail lashed out against the brutality of this cold December day. That its nameless and homeless existence would soon be changed by the arrival of a burly middle-aged female dressed also in a similarly shaded pink dress, was a matter far beyond its comprehension – for the moment at least.

 

Peering out the window of her third floor apartment in anticipation of her guest, Samina had a much better idea, that’s what she thought in any case, of the road on which things were to proceed. She had met Valerie’s mother – Mrs D’ Souza …come to think of it, she did not even know her first name – on two occasions only and had summed her up as a sweet old thing. A bit batty surely, but no harm in her. Her arrival would create quite a stir in the neighbourhood, but for her own purposes Mrs D’ Souza was the ideal person. After all, where else could she find someone who could manage her children in these winter vacations while she went out to work? She was sure that Valerie’s mother would prove to be an excellent housekeeper as well. Her first aim surely was to make her delay her flight and if that failed then a delay could always be caused…

 

The group of rag pickers stood staring at the gate – looks of mingled shock and awe writ large on their grimy faces. They stood staring for a minute and then as if on cue started sniggering at the sight of an old woman wearing… Could it be? A dress! They moved over gingerly to the boundary wall of the rubbish dump outlining the apartment blocks for a closer look.

“She’s a Mem Sahib!” said one in an awe struck tone, slipping over the stinking mound barefooted in his hurry to see a glimpse of her legs.

“You’re an idiot!” said one of the older boys cuffing him on the head with the younger one’s rubber slipper, which had fallen at his feet. He pulled him up. “Look at her face!” he said knowingly. “She can’t be one. Get back to work now.” The younger one was silenced and an assortment of cuffs and blows was enough to persuade the rest to resume their work. It would be much later in the evening when they would all be sitting on their haunches in front of Qalandar’s restaurant waiting for someone to donate food, that he would find out from the cart pushers of the area that she indeed was a foreigner by heritage and a non Muslim too!

For the time being he stole fervent side-glances at this new finding as the group rummaged in the dump for paper, broken shards of glass and even edible titbits for a change of taste.

“Meow!” the speckled cat was sniffing expectantly at his gunny bag.

He threw a stone at it, which caught it on the leg, and it meowed loudly and piteously.

It was this movement and then the meow that followed it, which drew my attention to the park beside the gate. Before this, I had been surveying the line of apartments in front of me while the taxi driver removed my luggage.

“Yes, they are pink,” I was thinking, “and yes, there is a stink too!” The pink heaven was standing tall before me, made more colourful by the washing that billowed gently from almost all the balconies.

Heaven apartments indeed! The rotting rubbish in front of it, the ragged little boys playing cricket on the rest of the land, the rag pickers sifting through the dump and the peeling paint outlined by yellowing pipes, made it look more like something out of a ‘Reality Bites’ TV Show! I nostalgically thought of my own comfortable flat, which had been sold off by now, and of Valerie’s tears when I had stopped her from going up the lift to see it one more time. That girl did have a tendency to get emotional. Just like her father, God bless him.

“Let bygones be bygones,” I had told her as I held her back. “Look towards the future!”

I had led her to the radio cab and we said our goodbyes at the airport – Valerie’s teary and mine, calm. Couldn’t really blame her for that of course. She had no idea that she would be seeing me sooner than she expected to.

I had spent the last few days in packing my stuff and the morning in handing over the keys of the apartment to the new owners. Now I smiled at my own joke as I stood outside my temporary ‘heaven-cum-haven’. This would be the final goodbye to my numbered days in Karachi.

All this and more was in my mind as my legs carried me easily across the ground to past the little urchins staring at me quite openly to where the rag pickers stood with their sacks over their shoulder also staring unabashedly. Nothing new for me, I knew they had little chances of seeing a woman’s legs and here I was, providing them with every opportunity to do so. The uncouth little brats! I admonished the one before me for hitting the cat and picked up the limping cat using the same handkerchief, which till then I had been holding to my nose. I have always loved animals. At one time I had eight cats and two children all in one flat. Now to see one in pain and move on would have been an anomaly. I carried it away still feeling their eyes at my back.

“No use,” I told myself, “some people never learn.”

 

Samina was watching the entire scene from above with no uncertain amount of trepidation in her heart. She hadn’t bargained on a cat entering the fray! This would have to be dealt with was her foremost thought as she left the window and headed for the door.

 

Flat number 20-C was the second apartment. I gave the rest a cursory look and signalled the driver to bring my luggage. Samina met me at the foot of the stairs. I had been framing the right words for a greeting when her shriek startled me. Her eyes were resting on the cat cradled in my arms. I held out my hand in greeting and she started sneezing and gesturing at the cat, which now showed an inclination to run away. I started to explain but there was a clatter above us and Mish’s braided hair bobbed into view. A moment later she had hugged me, kissed me and taken the cat from me with many ohs and ahs of concern. I smiled at her and felt the tension disappear from the corners of my lips.

“See you and me…same, same Pinky auntie!” she said tugging at her kameez and then my dress and indicating the colour.

Samina had stopped sneezing. I don’t know how else to describe it but when I looked into her eyes, which had a relenting look now, I had the uncanny feeling that I was being judged.

 

It was on the third day of my stay with the family that Samina asked me how long I planned to stay with them. I was surprised at the question but didn’t show it.

“I told you my ticket is booked for the 21st of December. I want to be there with Valerie on Christmas,” I told her.

She looked disappointed. “I’m quite delighted to have you here you know and so are the children and you did say that Valerie is going to meet her fiancé. Don’t you think she could do with a little more time on her own?”

“Good Lord!” I thought to myself, “does she really mean to saddle me with her children and the house while she goes out to work?” This was going beyond anything! My definite refusal was taken quite calmly. A bit too calmly I felt. Samina nodded, pressed my hand gently and expressed her regret.

 My flight was on the 21st of December. A day earlier I had my luggage ready and it was night when I proceeded to check on the time of departure for my flight in order to cal the radio cab for the airport. That’s when I found that the ticket had simply disappeared. The 21st of December – the day I was supposed to leave in a radio cab, I left in an ambulance. I had just had a heart attack.

* * *

Gloria Park. The plaque still adorns the gate of a certain pink boundary wall and the children playing inside, if you bother to ask them about the unusual foreign name in a very close knit and obviously conservative Muslim mohalla, will tell you quite boastfully that it was one of their Pinky auntie’s influential friends who got the rubbish dump converted into a park for the sole purpose of allowing her young and inexperienced teenage attendant to guide her wheelchair in the open for much needed fresh air in the evenings and that Gloria was Pinky auntie’s first name which he put on the plaque as a tribute to her love for gardening. If you ask where you can meet her they will point upwards and say in heaven.

Pinky auntie must have been quite a favourite you will observe, for the children look both eager and bashful when questioned about her. Further questioning will reveal she used to sit with them at night and tell them all stories of Princes and Princesses and far away lands. The flat in which she lived was filled with uncles and aunties all the time and they would have taken her away if Mish baji, as the children call her in respect, had not become so upset at the thought of losing her friend. You will learn that she did lose her ultimately, as Pinky auntie passed away a month after her heart attack.

 

There is a ginger and black speckled cat watching you as you are listening to all this. At night when the children have ceased playing, it goes and looks for scraps under the benches lining the boundary wall. Sometimes it finds something and sometimes it doesn’t, but it simply curls up in either case near the place where the rubbish dump used to be and waits for pink lines to outline the edge of the night – a time when a girl with long plaits swinging behind her as she comes running to the edge of the park, will bring a portion of leftovers and hurriedly run away again with a swift pat to its head. Far away in another land across the oceans, another well fed and similarly speckled cat is sleeping peacefully on a rug as a brown hand strokes it gently and thinks of her mother who loved cats so much.

Psychosocial Dynamics of the Khorwah Medical Camp – an Overview


paddy fields near Khorwah

There are instances when theory doesn’t exactly translate into practice – rather as I call it, it undergoes a transduction process. Each fragmented element, becoming whole through subjective perception. Let’s just say that the Khorwah medical camp held on 31st July 2011, barely a day before Ramadan, was another of such instances. A brainchild of the 4×4 Offroaders Club, this was my first experience with this group in their medical camp and their dedication to the cause is appreciable.

Khorwah, is located in the north east of Karachi and it took us almost 4 hours to reach there by bus. The land may be fertile for paddy fields but it is a hard life for the locals who have a hand-to-mouth living at best. The main profession in the area is hiring oneself out as farm labourers and its secondary adjunct is grazing cattle. A few luckier ones, according to the local definition of ‘luck’, are ironsmiths or carpet weavers, basket weavers and tradesmen who do not have to undergo the hardship of toiling in the hot climate.

While a quick online search shows that there are apparently two schools in the vicinity for boys and girls, not one of the children we came across has ever attended a school there and several of the elders shook their heads when asked about the existence of a school. Another ‘ghost school’ perhaps? From a psychological perspective the absence of a school makes the task of psychologists harder for the assessment of children. How does one gather data for any child’s achievement level when there is no available baseline? Simon – Binet and Wechsler, the fathers of intellectual testing, take the backseat in the face of pastoral and cultural dynamics. For my part, I found that I could easily add in a number of intelligences to Gardener’s Theory of Multiple Intelligence while assessing intellectual ability based on performance in Khorwah.

Towards Sujawal and beyond

The harsh climate, the financial hardships, the lack of knowledge, the focus on medicine only as the cure-all, and the disinterest in prevention over symptomatic treatment are definite barriers to creating awareness of diseases and disorders. There is also a tendency to label all mental issues as ‘pagalpan’ or madness – no matter what the age of the person under speculation. The language and dialect barrier is also hard to overcome. A slightly different inflection of the voice even if close to the original Sindhi word, was very difficult for the people, especially the womenfolk to understand. However, all is not as bleak as it looks. There is a definite interest in learning new ways and in the fact that for once there is a ‘different kind of doctor’ – someone who cares, wants to help and is ready to listen and, with no disrespect on my part, is not ‘just a journalist who will listen, go back and write or publish photos and not offer any concrete suggestions for our ailments’. Children with behavioural, intellectual and emotional issues were curious, and eager to try out new exercises yet too afraid of the doctor label to be able to open up and relax.

Most of the prevalent diseases are a result of poor health awareness and future programmes can be chalked out to include large scale group therapy with at least one translator available per group. This time we initiated a focus group venture but it did not succeed too well due to the low voice of the translator and addressing partial groups in the audience, neglecting those seated at a distance. It also didn’t help that the translator had her own views regarding what would help the women and what would not and most of the sentences spoken had to undergo negotiation before they were translated. Some of the women who had partially understood the sentence followed the negotiation ball as in a tennis match with frustration writ large on their faces.

A group of local women with the volunteer doctors

Among the common issues faced by the villagers that would require preventive awareness programmes, skin diseases are almost at the top of the list, and poor hygiene conditions make it very difficult to say that these will be eradicated anytime soon. The villagers walk barefoot in the fields in all weather and deformed calluses caused by incessant scratching and its resultant sores that may get infected, are very common. Again the issue is greater in women than in the men, who being seen as the main breadwinners, are less likely to go barefoot. Hand washing is a luxury and whether scratching sores, or tending to cattle or cleaning up their own or their children’s faecal matter with stones and leaves or hands, just a quick sieving of the fingers through sand or a nearby muddy pond is considered enough to cleanse the hands. The same hands then return to their own body, to the food they cook and the utensils in which they eat and drink. Clothes are not washed more than once in two weeks if there is time left over from working in the fields. Cotton cloth is tied round, washed after a day and reused in times of menstruation. Several women believe that having a bath during menstruation is bad for health and here the case was no different. I witnessed many garments soiled and stained with blood that are not washed at all and are kept aside only to be worn during the time of menstruation on a monthly basis. There is dire need of awareness and presentation of cost effective, easy alternatives to deal with the hygienic aspects of preventive health care in the region. Abdominal aches due to intestinal worms and other genitourinary problems

Another issue is of oral and dental health care. Many women are addicted to various substances used by their husbands and chewing hard betel nuts coupled with calcium deficiency along with other forms of nutritional deficits, leads to brittle teeth, swollen gums and cavities.  There is hardly any concept of brushing or even the traditional ‘miswak’ or ‘tooth stick’ use and dry twigs are used if anything gets stuck in between the teeth. The use of salt as a cleansing agent was advocated in front of quite a few women as a cheaper alternative to fill Dentonic bottles once they would get empty. Children were especially eager to show off shiny teeth and this factor can always be used to motivate them on future occasions.

PNS Shifa hospital affords us psychologists at the Institute of Professional Psychology, a cushioned existence. It has taken us a while to build up our reputation and most doctors here at PNS Shifa now know what we do, we have interlinks and they many refer cases easily.  With the medical camp we went back to basics. I was all the while strongly reminded of the words of our colleagues working in remote areas and in other parts of interior Sindh. It took awhile to tell people at the camp a number of things. Firstly that psychologists do take a long while to diagnose and treat but depending on the type of test or clinical interview, diagnosis can be a quicker deal especially in cases of psychosis and neurological issues, secondly the fact that therapy and counselling does take a number of sessions but there are a number of techniques that can be taught in a shorter time and thirdly the idea for the patients that psychologists are not journalists and they ask questions to diagnose, not write only and that medicines are not a cure-all, there are times when medicines are just not needed.  In this entire process I hope we have re-educated more than just the visitors.  It was heartening to see many men come forward to discuss their wives genitourinary issues after they had been silently observing us from a distance and felt that they could get some assistance from this ‘different’ method of treatment and develop some understanding about how to deal with such issues. I was extremely glad to see one patient in particular who approached us on his own after watching us from a distance. He was worried about his wife’s growing weakness and low mood and a complete clinical interview revealed that she had been suffering from post partum depression since the past one year. He went back encouraged to know the dynamics of the disorder and a few pointers to help her deal with this period of stress.

The Medical Camp site sans tables and chairs that were earlier lined up with numbers assigned for each doctor's table. Beautifully organized.

In a hospital setting such as the one in which we are based, we take it for granted that in case of any illness – terminal or otherwise, the caregivers will need to be counselled about the mode of care, their issues of anger or treatment follow up and prevention but in Khorwah, out in the open it hit us hard that there are people out there who need to understand that still. Similarly, many patients with chronic chest conditions were referred to us directly and we asked them to first see the general practitioner and then approach us on their way out.

Clinical Psychologists who are interested in the types of psychological issues faced at this remote area and the interventions we used for them would find it interesting that we went far off the beaten track with generally good results. Neurological problems were at the forefront of most cases seen and neurological screeners were applied for evaluation along with intakes. The rush at the camp made many children nervous, cranky and prone to tantrums which made this test very difficult and reinforcement in the form of biscuits generally helped in soothing more than one terrified child. Children also kept thinking that they were going to receive an injection as soon as they closed their eyes for a few subtests and refused outright to close their eyes even for a few seconds. It would be idealistic and demanding to expect a secluded spot for such testing in a medical camp but we improvised by taking a few patients slightly away from the camp for relaxation and guided imagery in the case of anxiety disorders as well as the motor subtests of the neurological screeners. Some patients were referred to hospitals in Karachi for further medical treatment. They were also provided with guidance about occupational therapy and its correlates and demonstrations were given to each patient individually about the simple exercises they could do at home to help improve the gait or eye-hand coordination.

another view of the Medical Camp site

Complete diagnosis and treatment for many patients with psychotic features could not be initiated at the camp but initial diagnoses revealed Schizophrenia with prominent visual and auditory hallucinations and they were again given detailed directions for seeking psychiatric help in Karachi. Most of the patients earlier had no idea what to do about this condition of madness and had been at the mercy of faith healers who were fleecing them. Their caregivers were guided about their conditions, expectations, possible prognosis and types of treatment along with modes of care, and do’s and don’ts.

Suicidal ideation, suicidal attempts, self mutilating behaviour and depressive features with melancholic states were observed in a number of women. Considering the financial state and the early marriages, childbirth issues, and other problems these women face this does not come as a surprise. A number of Conversion disorder and Somatisation cases that had been labelled as various pain issues gradually floated over to the Psychologists’ table after getting a negative from other doctors present. Far more had been noticed when conversing with the women during the group therapy initiative. Contrary to what some doctors feel, it is important to state here that Conversion and Somatisation are distinct from Malingering and just because there is no physical evidence for the patient’s condition, it does not always mean that he is indulging in attention seeking behaviour or wishes to gain some material benefits. The managers of the estates will as a rule complain about the labourers not working properly and defining a patient as alright and having no pain just because nothing comes up during the course of the physical examination does not mean that from now on the patient will be fine. Conversion symptoms are like the flow of a river. You can barricade the pressure, but temporarily. Eventually, the course may change, the walls of the patient’s self may tumble down or he may experience other similar symptoms incorrectly labelled by many novices as Hypochondriasis. A better alternative is to refer such a case to a psychologist who can then deal with the entire etiological presentation of the case.

While there are successes, there are stark facts of unforgiving and harsh circumstances in many cases. A few really saddened us and I still think of the old man who was caught in a catch-22 situation. An ironsmith by profession, he showed initial signs of Parkinsonism, was well aware of the changes in his body and yet he had been abandoned to his current state by his six sons who considered this trade a demeaning one, did not help him financially and he was still looking after his two daughters. Only one son helped him from time to time and he too rebuked him and had been distancing himself from his father. In another case, a man who was the sole breadwinner suffered from severe congestion and asthmatic symptoms each time he was involved in threshing procedures. He had no idea about safety procedures and used no form of protection whatsoever. He was counselled briefly regarding safety procedures and provided with suitable alternatives.

The entire initiative on the part of the 4×4 Offroaders was well executed and very well organized in terms of crowd control from start to finish and I’m sure it is not the last one! The whole team deserves to be congratulated and I’ll refrain from taking any one person’s name in particular as each and every member was immensely dedicated. There is always room for improvement and I’m looking forward to the next trip already. Let’s see how many suggestions can be utilized and how far it is possible to correctly identify patients at source or educate each other about our respective roles so that maximum benefits can be derived from everyone’s contributions.

 N.B. All the photos were taken by me after the camp was almost over and during the camp there was no time to take photographs. Hence there are no photographs of the doctors or the patients undergoing treatment. A safe estimate, however is that nearly 800 – 1000 patients visited the camp that day and were given free medicines, free treatment and physical and mental examinations.

 

In -Tolerance


If weather was an indicator of how things are on ground, the skies would rain ash. Its ironically lovely outside right now with just a hint of softness in the cool breeze while countless tyres burn on Karachi’s main artery, twitter is abuzz with MQM, PPP and ANP political parties’ love-hate triangleship and the vast majority of the citizens cower at home for fear of losing an arm, leg or precious neck.

See no evil, hear no evil and speak no evil needs a revision. The newer version could read “see everything, don’t hear, don’t speak’. For we all know what happens to those who do. Swan songs aplenty in the journalist world to remind us of consequences.

And what about tolerance? Bookish knowledge some say. Time for action, say others. The result? Mobs going wild and the scars of the 90’s in Karachi scratched and bleeding once again.

Extremism has no religion. A resident of Balfour's Siyabuswa township runs for cover as service delivery protests turned violent.

Extremism is a word, not a religion. Cross border dialogues turn into hate tirades and finger pointing but at the end of it all is an individual. In my short period of analysing extremist culture over time in different people from around the globe and more so in Pakistan, the picture has been multidimensional. There are those who feel angry and frustrated by events at a local or international level or those who grow up in the unjust world of lanes where might is right and in order to survive, one must hit hard. Many turn to religion using basic belief systems sans any analysis or psychosocially appropriate zeitgeist and use dogmas to establish an easy basis for intolerance. In order for me to be right (and obviously I am right), you must be wrong.

Many others use an extremist identity to resolve their own inner conflicts – a sense of belonging, a sense of support that makes them go on in life, provides them with purpose and eventual fulfilment. Life satisfaction as a double edged sword one may say. It would be a happy ending for all concerned if that ideology would stay contained. Yet, as the followers grow, it spirals into a movement instead and group-think being the time-ticking-bomb it is, it is bound to create a sense of fulfilment now in group ideals. Hence aggression and all its associated features come into play.

Karachi has been a bloody playground for party people since ages. Partition and a hunky dory time period passed in a dream and then we had individuals who spoke – the young student leaders who later banded, disbanded and created group-think. Now, its not even group-think, its instinct-think and the law of the jungle integrated. The one with the loudest voice – literal or metallic, gets heard and then there is an even louder silence.

MQM behind my removal as home minister: Zulfiqar Mirza.

Now we have Zulfiqar Mirza with his anti-MQM statements and the people’s voiceless but action filled rebuttal? Among the nameless faces of pyromania there are quite a few having a party and the venue happens to be the road outside. While Federal Interior minister Rehman Malik apologized on behalf of Mirza to appease the offended, dogs, a donkey, several public transport vehicles and private cars have borne the brunt of most of the anger. Goodbye ozone layer. Hopefully we won’t need you. Goodbye effigies and goodbye outbursts, the people need something more substantial that cringes and whines.  Such is the mindset of a tough minded audience while peace lovers look on in shock and disgust. Hundreds gather near Zulfiqar Mirza’s home in Karachi, children chant slogans like a mantra and the onlookers far outnumber the activists.  There are videos of people clapping and dancing in rallies in Badin, Hyderabad and other parts of Pakistan. If it were not for the burning tyres, the whole thing would look like a festival. Bonfire anyone?

Understood, no one likes to be called ‘hungry and naked’ and be reminded insolently that they were provided shelter; much in the manner of a landlord lording over his bonded labourers, yet is Zulfiqar Mirza’s speech incentive enough for anger? Were offended Karachiites hot headed enough to leap to action at the whip of a tongue of flame? A tongue is a tongue, not a gun and while an apology has been made to the hurt sentiments of the migrant populace, the unwittingly blown speech bubble includes names, and party politics along with an entire community. It will not be an easy task to smooth out everything in 48 hours by issuing ultimatums to those with a tongue to leave the city while the city dwellers vent their feelings conveniently by smashing their own utensils. Truly the angry mind doesn’t think. By the same formula, heaping all Urdu speakers into a pile and associating all of them with the name of MQM doesn’t work either.

TV channels are having a field day replaying the video taped speech over and over again. Much like a cricket ball by ball commentary we have shots of the background revealing who shook his head, who didn’t, who smiled, who tapped who on the shoulder and when. Welcome to the world of masala mix.

Time to make a third amendment for in-tolerance: See nothing, hear nothing and most definitely SPEAK NOTHING. And ofcourse those who are blind, deaf and dumb will do nothing.

Yet among all the gore, there are glimmers of light – the population that can differentiate between the right to speak and the right to vent was till yesterday sending sympathetic messages for the unfortunate  blasts in Mumbai and receiving equally thankful and understanding responses from the other side. Flip side of the coin, Pakistan and Afghanistan again gained an infamous image for exporting terror. Export? Both are busy battling the weeds in their own gardens.

And where there are gardens, weeds will grow.

In… tolerance.

Featured images courtesy

 http://whatisyourrrintelligence.blogspot.com/2010/02/balfour-culture-of-entitlement.html

http://www.nation.com.pk/pakistan-news-newspaper-daily-english-online/Politics/08-Apr-2011/MQM-was-behind-my-removal-as-home-minister-Zulfiqar-Mirza

Of Inattention and Hyperactivity


 Seven years old Ali* was rushing around the school playground pretending to be a rocket. The harassed looking teacher tried to explain to his mother how he never seemed to concentrate in class or sit still, always fidgeting and distracting others. His mother seemed equally helpless and soon after giving Ali a box on the ear, dragged him away, scolding him harshly.

Four years old Shafia* was known to her parents as a stubborn child. They had started despairing of ever getting her into a reputable school. She could not focus on one thing at a time and appeared to get bored of her toys, alphabets, letters and other educational and play material in less than a few seconds. While her mother tried to coach her in remembering colors and letters, she found she could not do so without hitting her daughter after every few minutes. Ultimately she decided to send her to a preparatory centre for getting admission later in the most elite school in Karachi. The headmistress on the first day said that they had special methods for such stubborn kids but they would have to agree for corporal punishment for their child so the centre could ‘mould’ her properly. Soon enough, the centre also gave up as their methods had only succeeded in developing a fear of studies in the little girl who now quaked at the sight of a pencil and a copy, refusing to touch it at all.

IPP. PN Shifa

Quite often many such cases pass by undiagnosed, where inattention or hyperactivity and impulsivity are the main symptoms. More often than not, they are dismissed as being just kids, or labeled as naughty and punished accordingly. Parents blame teachers for not making the subjects interesting and teachers blame parents for not handling their offspring in a better manner. At the end of it all, it is the child who suffers.

 ADHD or attention deficit hyperactivity disorder is a disorder characterized by a combination of lack of attention with features of hyperactivity and impulsivity. Psychologists use criteria provided in the Diagnostic and Statistical Manual for Mental Disorders (DSM IV TR) to see if a patient fulfils the minimum six symptoms requirement of either inattention or hyperactivity and impulsivity or both. In case the latter is missing, the diagnosis may be of ADD or attention deficit disorder only where a child is able to sit in one place for more than a few minutes but is not able to focus on his work continuously, loses necessary work items frequently, fails to carry out instructions and even fails to listen when spoken to directly. The diagnosis of hyperactivity/impulsivity disorder seems imminent when a child is always on the go, fidgets a lot, is unable to sit when situations demand it and interrupts or intrudes or has difficulty awaiting his turn.

 The ‘cure’ for a child with ADHD does not lie in harsh parenting. Correct diagnosis is the key to more than half the problem. Detailed clinical interviews along with certain pen and paper tests taken from the child and the parents help in diagnosis. Psychologists and remedial teachers alike can provide help through structured programs for parents and children. Exercises and games are conducted with children in individual settings that help them in focusing, reducing impulsivity and gaining a greater degree of control on their actions. Psychiatric help is necessary in establishing a correct dosage of methylphenidate (Ritalin) as the growing child requires medical support to help him focus. Controversy surrounds the idea of drug administration to children yet researches suggest that the benefits far outweigh parental concerns of dependency.

 Psychological help can also be provided in cases of ADHD. In fact many psychologists stress on reducing dependency on drugs and on utilizing a behavior based approach to reduce problem behaviors. In Pakistan, Applied Behavior Analysis or ABA is a relatively new phenomenon. This approach involves utilization of behavior principles such as rewards and different types of plans for focusing on different problems. For e.g. with a child who has a mild level of inattention during class, one of the ABA approaches may be to establish a baseline for the number of times he looks up during his work and then applying a reward system for the swiftness with which he manages to complete his work and then allowing him an early break. Eventually, the premise is that he will be able to develop inner controls and a post intervention analysis will reveal a change in behavior when compared to the baseline.

Institutes such as the Institute of Professional Psychology at Bahria University, Karachi, have initiated the teaching of ABA as a subject in Pakistan. The theses and projects produced by the students here show a strong link between the control of symptoms of ADHD and the application of ABA principles. Young patients are treated at the Institute’s PN Shifa outpatient department using behavior principles and parental guidance sessions are carried alongside to ensure the usage of these at home.

Child's play haven at IPP, PN Shifa, Karachi.

*Names and symptoms have been completely changed and adapted to suit the article. Yet, they are based on true accounts and observations of patients at my workplace.

IPP: Contacts: +92-21-99204889 , +92-21-99205065

Karachi – Our Mega-Village.


DHA Karachi by twilight

I wrote a short poem titled ‘Our mega-village’ way back in 1998. I had recently found out back then that Karachi is actually technically known as a mega city in line with others like Mumbai, London, Paris and New York etc. 14 million people approximately in 1998 = mega city. It is 2011 now. Irony: My words written back then ring true more than ever today.

Case in point: My area in Karachi has been without electricity for the past 36 hours and counting… KESC (Karachi Electric Supply Corporation) workers who are happily on a strike have ‘unofficially’agreed to fix the ‘tranformers’ ‘PMTs” for Rs 200 per house. DHA (Defence Housing Authority/Society) area is the worst struck. Known as one of the ‘poshest’ areas of the city, it calls for greater attention ‘ofcourse’ as the revenue through bribery is expected to be higher than any of the others. Hence while other areas of the city function as normal – with occasional loadshedding thrown in to remind residents of the power (all pun intended), DHA residents boil in the heat. No electricity or lack of generators equals lack of water in tanks. In some areas the rates are Rs 1000 per house and Rs 20,000 per lane. Even after payment the power supply has not been resumed. Hence we have a bleary eyed me posting this page from the past of 1998 coupled with regret and a resounding echo in 2011…

In a bygone era it was a novelty,

for people who went to stay in villages,

without water, gas or electricity.

But now we can enjoy that very same state

just by living in this mega-city!

23/06/2011 Update: 52 hours and counting and no sign of electricity supply as yet. Freezer items have perished yet surprisingly enough, Man’s resilience shines through. We have learnt to co-exist. The cool sea breeze is helping as well after days and days of blistering heat as Nature seems to be taking sides here.

A colleague reported that Rs 20,000 was the price for getting the PMT in her area fixed. Even then, power supply was restored after 48 hours. Another friend reported interesting scenes outside the KESC office where all bearded and cloth-above- the-ankle workers were seen lined up for a hunger strike with another line of lemonade (nimbu pani) and rooh afza (local sherbet) selling pushcarts right beside them. If beards are an emblem of humility and God fearing attributes, I wonder why we are being told that police protection is necessary for those who want to help and fix PMT (transformers) in the vicinity?

I hear menial workers making fun of the educated, sophisticated sufferers for their stupidity in not being daring enough to step out of their homes, bash up KESC workers and set fire to tyres on main roads. If that defines ‘daring’ in this country now, I wonder what will become of the word ‘tolerance’… ?

 

Update at 23/06/2011 (10:30 pm) from the dark. A kescwala affirms that other ousted kesc workers attack those who come to fix things.

A friend from PECHS congratulates me on suffering only for 4 days now as she got electricity back after 5 days… I’m actually lucky for once. Wow!

Meanwhile things look bleak in DHA especially in Phase VII where despite repeated promises, KESC or the Darakhshan police have always managed to miss each others’ timings. Residents in the meanwhile have turned it into a war situation leaving the menfolk in some houses at the forefront and the women and children being shunted off to the cooler climes of other relatives with light. Meatless days… lightless days. All in the same boat.

Pakistan Navy / Airforce Under Attack?


A few minutes ago courtesy the twitter brigade and a few who live near the PAF base, I have just been informed of the fifth blast for today inside PNS Mehran on Shahrah e Faisal, one of the major arteries of Karachi city and still the drama continues. (23/05/2011 at 12.30am) . Read on to get a round up of the events till now.

If reports are to be believed, the base was being used to build certain P 3 Orion planes using US army help.  These are highly sensitive and expensive planes that help detect fully submerged submarines at great depths and distances. These reports also state that parts of these planes had been brought in around 18 months ago and the area was known to be quite secure. One fully built plane was destroyed in the attack and tentative estimates reveal, that this has also left at least 5 people dead and  numerous injured. Around 15 terrorists reportedly entered the area and so far 6 have been killed.

Televised images have been horrific indicating a state of siege with ambulances piling up in front of the gates within minutes of the first blast and being kept there due to the continuous firing going on inside. Hats off to the commandos who were sent in to fight amidst pitch darkness as the entire area has been cordoned off by police and rangers to limit the escape routes towards Dalmia cement factory aka Dalmia road and the link route via Karsaz road.

While the controversy theories abound it is interesting to note that most of the world has been interested in how the terrorists got in, in the first place and very few comment on what has been happening in there between the first group of blasts and the second. There was silence in between and then suddenly the firing restarted with people reporting yet another blast, making it the fifth in a series.  The fact is that PNS Mehran covers a huge area and there are several dark spots where people could have gone right over the wall with none being any wiser.  The bhains ka paara (cow and buffalo pen) and pipline / gutter / manholes theories are also coming in focus with a couple of ladders conveniently placed for the world to see. Why such a major operative did not remove the ladders immediately after, is anybody’s guess. Another theory suggests the guise of security personnel for the terrorists who just calmly walked in. Thats something indigestible. In a place where everyone knows the other – especially guards on duty, it is quite difficult to suppose someone just casually walking by unless the identity is not only known but the venture was a joint and collaborative one. Again, we can not possibly blame all and sundry fo this security lapse. Nothing in the world is foolproof, least of all security. Loyalties can be bought, places exchanged and tongues sealed.

As for the manner in which they reached the said area undetected and were not apprehended till the first rocket was fired, the clothes of the men, the tme of night and the fact that they were on foot is self explanatory when put together and highly believable. I have been in the vicinity several times and been stopped for security checks but then I was always in a car, whether day or night. The area is not a flat and barren land but has bushes and adequate vegetation to act as suitable hiding places. Reason suggests that this was not a one time operation but that  a recce of the place had been conducted earlier to make this a possibility by outlining all the ways of getting to their target. Once over the wall, or through the pipeline etc, the gray / black clothing of the men in the dead of night in even a highly patrolled area could have easily gone undetected.

Media coverage lacks incisive and indepth analysis at this time which is not surprising given the current state of affairs and the number of breaking news reports over the past few hours. The International media picked up the thread one hour later than the Indian media which was quite an eyebrow raiser.

While speculations abound on every side, one can not help but feel for the people inside who are dealing with the mayhem on the ground. The bravado of ambulance drivers and volunteers also deserves a mention for being there for their duty at such a time while others sit in their cosy nooks and tweet about how Pakistan is a failed state, how Pakistan deserves all this and worse still how the Navy, Airforce and all armed forces had this coming to them. There is yet another bunch rejoicing that tommorow will be a holiday for educational institutes in the vicinity. Whither humanity?

This is the third incident in a month where the Pakistan Navy has been attacked. The firs two involved Naval buses and led to the deaths of innocent doctors. Healers became the victims and were treated at the same hospitals where they worked. Calling it irony would be an understatement.

The scene is of a battlefield and all the questioning in the world isnt helping
navy personnel at this moment. People are anxious to know exactly how, why ,
when this happened and when it will end. The answer to that can not be given
immediately. This is hardly a cricket match with all the details known. My
friend reports firing at the premises even now after 14 hours have passed since the first rocket was fired before 11 pm on 22 May 2011. Its an area with human lives who are and can be used as shields. The ones who have gone in with the terrorist  agenda have taken in food and water to last them for 3 days. Only 14 hours have passed as yet. It will be a miracle if they can gas and get them out of there for who knows if they have also had the forethought of taking in gas masks. If they had rocket launchers to destroy the P 3 Orion planes then they could well have anything else as well.

As I write this, a part of Karachi is burning. Sirens are blaring and newscasters are struggling to keep up with the onslaught of news coming their way. Its enough to drive an action movie enthusiast mad, thinking movies have come alive. And this is real life.

Summer Getaways from Karachi


Pakistan has a rich biodiversity whose full potential is yet to be exploited fully for recreational benefit of the public. Nowhere is this state of affairs more apparent than in Sindh. The people of Sindh, especially Karachi are often found complaining of a lack of recreational places and comparisons with the northern parts of the country abound. People living in Islamabad and Lahore have the luxury of zooming off to cooler climes like Murree, Nathiagali and Bhurban anytime they choose. Lahore itself is culturally rich and has something to offer every palate.

towards Murree and the northern areas

Karachi has discovered and rediscovered malls in all shapes, sizes and manner of pocket-emptying slickness and plain gaudiness. Shopping along with eating remain the main trends here. The beaches and beautiful islands are there but more development is needed to bring these into public eye. A look out of the city towards the surrounding areas reveals a vast desert. Hyderabad, the closest major  city from Karachi is rarely seen as a recreational spot. The lure of Hyderabadi bangles from the choori gali (bangle market/lane) and the glazed icing cakes of the Bombay bakery in Hyderabad and even the shrines are not bait enough for most Karachiites. Perhaps a visit once in a few years can bring back old memories without dwindling into boredom. Debal- the reported landing place of Mohammad bin Qasim, Chaukhandi tombs or the largest necropolis of Makli are good spots for the archaelogically inclined or artistically inclined like myself, but hardly good  picnic spots for a family outing.

towards Hyderabad

In reality, Sindh isn’t far behind when it comes to natural beauty in which elders and minors both can benefit and find a different experience away from the madness of the traffic and noise of the city. So, if you are looking forward to spending a quiet day in a serene environment with your family on a lower budget, with the feeling of being ‘out of the city’ then you can go off to the lakes. Apart from its several man made reservoirs, Sindh contains a majority of freshwater lakes – offshoots of the mighty river Indus, which continues its meandering course down into the Arabian sea. Here are the main lakes, which hold promise as weekend getaways:

–       Manchhar lake is the largest with an expanse of around 200 square miles. Located at a distance of 16 kilometres from Sehwan Sharif in Dadu district this lake is facing rapid environmental degradation. Still, the Mohanas or fisher folk in their floating homes and the surrounding tall grasses with meadows of lotus lend the lake its particular charm. It attracts flocks of migratory birds during the winter season and is popular as a hunting spot. However recently their numbers have dwindled. The dense forest surrounding the dense forest surrounding the lake is home to many mammals and small game. Be sure to take adequate food, water and c gear with you as facilities provided there can hardly be called adequate.

–       Kalri – Kinjhar lake situated near Thatta has an attractive rest house, boating facilities and during winter it becomes an ideal spot for fishing and duck shooting. The rest house is quite comfortable and according to the keeper, people who desire to spend a few hours and are willing to pay for the expenses hardly need book their rooms in advance. This lake is famous for its extensive reed beds and is an internationally important area for the breeding of wintering water birds. However, if you plan to go in for boating and have minors in charge, it is advisable to make sure you have life saving equipment handy and inflatable life jackets of your own and that not more than 4 people are accomodated in one boat. There are numerous stories of accidents and fatal ones at that, happening to people who have not paid heed to this warning. There is a plan to set up a resort and a water park near by in future, which may serve to make the spot more attractive.

–       Haleji lake is located within an easy driving distance of 88 kilometres from Karachi. Enroute to Haleji are its numerous lagoons located at an easy distance from Hudero lake, which thus
forms an ideal home for waterfowl from mallards to flamingos and birdwatchers. Approximately 200 different species of birds have been seen here especially on the outcrops of the pelican island and the cormorant island. Take your binoculars along and enjoy the view in the summer months but do not stay here after dusk, or even for more than a few hours at a time, as the area is also reported to be frequented by dacoits.

According to an estimate several thousand visitors visit these lakes every week and make the most of a picturesque and peaceful outing. Whether you are interested in hunting, fishing, bird watching, boating or simply travelling, the lakes of interior Sindh may provide a very different experience for you and your family.

Rehabilitative mental health care in Karachi – A case study of a single psychiatric set up.


It is 9:00 A.M. The wide green lawn ensconsed in the quadrangle of the double storey building  is bathed in mellow hues. Soon enough, they start emerging from their rooms, wearing fresh clothes after their morning showers. Single file, they are guided downstairs to begin the daily morning excercise session. A variety of expressions meets the eyes. Some look bored, a few seem indifferent, while others are quite enthusiastic – smiles lighting up their features. No, these are not children from a boarding school. They are mentally ill patients and residents of Karwan-e-Hayat PCRC (Psychiatric Care and Rehabilitation Centre) located in Keamari, in Karachi, Pakistan.

People have varied and often gross misperceptions about mental health institutions and their resident patients. A rehabilitation centre is often thought to be at par with an assylum with violent, drooling, dishevelled and possibly jumpy patients sitting in dark, narrow cells restrained by chains and administered electric shocks daily. These impressions belie the image of a rehabilitation centre like Karwan-e-Hayat PCRC. Though the entrance hall is flanked by burly security guards and has strong grills in order to prevent the patients from escaping, the rest of the Centre is bright, airy, clean and built on the model of Western rehabilitation centres. There are separate dining halls, activity rooms that are lined with the patient’s own creations and indoor game rooms for male and female patients. Two buildings adjacent to each other within the same compound house the male and female residential wards, semi private rooms and airconditioned private rooms. Presently it has 65 beds but in future there are plans to increase the number to 100 beds which is the Centre’s actual capacity. In short, it epitomizes the modern residential and Day Care facility for the mentally ill.

Karwan-e-Hayat started out as an NGO in 1983 committed to caring for the underprivileged  mentally ill patients. It got off to a good start with names such as Begum Ra’ana Liaquat Ali Khan, Cardinal Joseph Cordeiro, Ms. Anita Ghulam Ali, Prof. Dr. Zaki Hasan, and Dr Zafar Quraishi, who is currently the President of the NGO, as its founding members. In a city like Karachi where mental illness had a great deal of stigma associated with it they made the correct move – that of  organizing awareness camps. The target? Again, smartly enough – katchi abadi and slum dwellers who stood in utmost danger of being fleeced by miracle workers and fake pirs. In a simultaneous move, seminars were arranged in high profile schools like St. Joseph’s Convent and Karachi Grammar School. Since then, the NGO has come a long way. The Consultant Psychiatrist of Karwan-e-Hayat PCRC, Dr S. Ajmal Kazmi, met with Dr. Zafar Qureshi in 1995, then the Director of Karwan-e-Hayat. This interaction led to the concept of a rehabilitation centre in Karachi. The next few months brought on a search for a suitable location. KPT (Karachi Port Trust) were the owners of this premises in Keamari and after spending around Rs. 80 lacs for renovation, it became fully functional in 2004. As it is primarily a charity organization, 90% of the patients are treated free of cost thanks to various donors like Rotary Club Karachi and Infaq Foundation.

Theoretically, Karwan-e-Hayat combines two concepts – a rehabilitation program and a crisis  house. As such it provides services like medical examination and assistance, rehabilitation counselling and occupational training opportunities found in rehabilitation programs. As a crisis house in a community setting it is based on the model of rehabilitation and accordingly is staffed by mental health care professionals. The relatively little research that exists on such centres has not only found that they are very acceptable to their residents, but also suggests that they may be able to offer an alternative to inpatient care for about a quarter of the patients admitted to hospital, and that they may be more cost-effective in the long run than inpatient care since most patients are eventually assimilated back into society!

Karwan e Hayat follows a  multidimensional approach for treatment of adult patients between the ages of 18 years to 65 years. Drug addicts were earlier not treated here due to the vast differences in treatment methodology and other complexities. However, drug addicts suffering from psychoses are now admitted and treated.

Occupational therapy activities

Generally, firstly an RMO (Resident Medical Officer) medically examines the patient in the OPD and takes his history. Next he is sent to a Psychiatrist for consultation where, if needed, he is prescribed medication or admitted as an inpatient. The Centre offers admission to some patients who need inpatient care because of acute and severe mental health conditions like Schizophrenia, Bipolar Disorder etc. The patient may also be referred to the Clinical Psychologists for psychological testing and psychotherapy to resolve his inner conflicts. Inpatients are divided into three main categories for individual psychotherapy which takes place twice a week: 1. Obsessive Compulsive Disorder and Depression, 2. Schizophrenia, and 3. Personality disorders. Testing material worth Rs. 3.5 lacs has been acquired by the Centre to facilitate psychological diagnosis. Occupational Therapists attend to the patient in the Centre’s Day Care. They give the patient something  purposeful to do in the Activity Rooms with the intention of improving his general sense of self. Sessions for improving the patients’ awareness about their illness are also conducted frequently with a view towards helping them manage their self care. Various organizations such as the Institute of Professional Psychology and the Aga Khan Hospital send their students to the centre for internships and community service.

All these professionals work together to firstly diagnose and then help a chronically ill patient ease into society or at the very least sustain daily functioning ability. There are plans to include a Social Worker in the team this year as in other Western countries, but Dr Kazmi laments that the training provided in Pakistan at Masters level in Sociology or Social Work is far off the mark.

Karwan e Hayat ward

A typical day at the Centre starts with the ward boy waking up those in the Inpatient facility and encouraging them to wash themselves and take a shower. Some of the long term stable patients are encouraged to lead the morning Excercise Session. The patients then return to their wards or rooms for the morning round by the mental health professionals. Any decisions taken during this round are noted and the team then divides in two groups for better management of the not so stable inpatients and the Day Care activities. The Day Care group session includes both male and female patients who are stable enough to take part in discussions on basic topics such as “The importance of cleanliness”, “Ways to control anger” or “Hobbies”. The objective of such discussions is to draw the patients out of their fantasy world towards practical life and develop their interests.

All other activities apart from the group session are carried out in a segregated environment under supervision. During occupational therapy the patients are encouraged to make arts and craft items as per their interest. Many simply colour in drawing books and often the colours they pick or their manner of colouring is quite suggestive of their inner emotional states. Computers in the activity room are a relatively recent acquisition and selected patients are even taught programs like Microsoft Word by others. Evenings bring with them time for indoor games like table tennis, cards, carrom board and sometimes cricket. While it is encouraging to see the careful supervision of various activities, it is surprising that the patients are exposed to several cable channels and can watch movies – blood, gore and dances included, without a bat of an eyelid by the supervisors, in the activity room. Major activities at the Centre culminate with the Day Care closing at around 4:00 P.M. There is a skeleton staff for night duty to prevent possible mishaps.

Overall, it is creditable that Karwan-e-Hayat has not only managed to live up to its mission objectives by establishing centres such as its outpatient clinic on Khayaban e Jami and PCRC at Keamari during the past 24 years, but has fostered healthy links between psychiatrists, psychologists and occupational therapists – bringing them all under one roof at PCRC. Job satisfaction appears to be moderate amongst the staff members which is saying something, since the Centre is located at quite a distance from their homes. Yet many psychologists are sceptical about the level of therapeutic care being provided at the Centre as psychiatrists take centre stage in the proceedings.

There are several other rehabilitation centres – for drug addicts or psychotic patients etc located in the city but an impromptu survey taken from mental health professionals and patients revealed that most are not as spacious or as well organized. Moreover, there were complaints regarding the quality of meals provided elsewhere and the level of hygience maintained in the kitchens. Similar complaints of boredom, lack of good and comfort come from patients at this centre as well but they seem to be fewer in comparison.

The seemingly eternal rivalry between psychiatrists and psychologists has also proved to be a bone of contention in many cases with each faction wanting to show their supremacy over the other in terms of treatment efficacy. Dr. Kazmi’s rejoinder is interesting to note: ” Team work should always be there. If you work alone you can never do as well.  I’m lucky to be working with an honest and hardworking team. If someone is at the forefront, it is because there are several unnamed people at his back.”

Mental Health Professionals and policy makers would do well to take a leaf out of Karwan-e-Hayat’s book. With Schizophrenia at 11% and Depression at 15% world over, the demand for mental health facilities is bound to increase with the rise in population. Already, a figure of 1.5 million mentally ill people is estimated for Karachi. Karwan-e-Hayat’s PCRC is but a drop in the ocean. True, it is one of the few fairly good centres and is providing free treatment to poor patients but it is definitely too far from the city and has a limited capacity. There is dire need for many more centres, not only in Karachi but in the whole country.

N.B. This article was published in 2009 in Expose’ magazine, Karachi.

Photos courtesy: Karwan e Hayat website

Offshore Retreats of Karachi


heading towards the mangrove region

Karachi, the city by the sea, has a natural harbour. The shoreline curves from Manora, which is the breakwater to Cape Monz, which is the other lighthouse. It can also boast of quite a few offshore retreats surrounded by mangroves that serve as nesting places for the sea life and maintain ecological balance. Sadly, mangrove destruction by the locals when they utilize it as firewood and recent dredging is endangering these areas. Nevertheless, the islands and rocky mounds in the estuary region are worth visiting if you are a sea enthusiast.

Here’s a general look at these sea havens:

–           Bhit Shah island:

It is located 7 kilometres from Karachi and has around 12,000 katchi abadi residents whose livelihood is fishing.

–           Bhundhar (Bundal island) and Dingi (Buddo island)

These twin islands belong to Port Qasim Authority. Bhundhar is the largest. They are located about 1.5 kilometres from Defence Phase 8, between Phitti and Korangi creeks. During the fishing season fisher folk swarm the area to clean their nets and dry their fish. There are
plans to build two island resorts and a bridge to link Phase 8 with the islands. The islands will be renamed Diamond Bar City. A Dubai based construction company

serene sands near Mubarak village

is working on the estimated 12,000 acres through reclamation of the mangrove forests, which connect the two islands. Construction is currently being carried out on Bhundhar Island. 15,000 houses
will be sold to the public in the first stage.

–           Oyster rocks:

A clear view can be obtained of these picturesque rocks from Clifton. They can be reached via KPT boats from Keamari. An underwater cave into which boats can sail is reachable during low tide. Once inside, the visitor is treated to a display of crystallized rocks that twinkle in torchlight.  These rocks are now the home of one of the worlds tallest man made fountains.

–           Churna Rock:

It is one of the biggest and frequent fishing spots for fishing enthusiasts and fishermen alike in their powerboats from Karachi’s boating clubs. Many people drive to nearby villages such as the beautiful Mubarak village and hire boats from there. Divers of all levels get a chance to hone their diving skills here as diving activities are also undertaken at 0 – 30 feet depth. It is a good idea to check the condition of the sea and inquire at local fishing villages before your sojourn here as the waters can get pretty rough and you may just find yourself leaning out of the boat throughout the ride if you head into a stormy sea – an experience I have had the misfortune to face.

–           Chota Churna:

This smaller island is directly opposite Gaddani and has been named thus by the fishermen.

–           Baba island:

Inhabited by fishermen, it is situated 1 kilometre from Keamari. Recent inauguration of a 12-bed dispensary, 24-hour emergency and maternity health facilities from a multinational concern make it the first island to have modern health amenities. Facilitation of fresh water
supply is also in the pipeline.

–           Manora island:

The island of yore has now become connected to the mainland via the 12 kilometres long causeway of Sandspit beach. Technically it is now a peninsula and has a population of approximately 10,000 people. It can be reached easily by boat from Keamari. Tourist attractions include the 91 feet high Manora lighthouse with its colourful and traditional tiled flooring, a dilapidated but still exotic mandir with the smell of incense inside, colonial style churches, and a thin strip of the Manora beach replete with camel rides.