Viewpoint: Pakistan's social services are collapsing

Ahmed Rashid

New reports on Pakistan suggest the country still has a long way to go in tackling malnutrition, polio, lack of education, and terrorism. Guest columnist Ahmed Rashid says a tepid government response has only exacerbated such problems.

The government of Prime Minister Nawaz Sharif is facing a political and economic crisis and a spate of recent reports has highlighted the parlous state of the country's social services.

The government appears oblivious to chronic deficiencies in health, education and governance. If it addresses these issues, it is only to put out statements of denial about cause and effect and to clamp down on critics in the media.

A recent conference in Islamabad organised by the UN's World Food Program pointed out that 44% of Pakistan's population is facing malnutrition, 15% of whom suffer from acute malnutrition. As a result, some 11 million children under five will suffer from stunted growth. Other UN surveys that have been carried out and come to even more dire conclusions have so far not been published. According to some Western diplomats, this is because the government objects to them.

There is little recognition of the problem by Islamabad. Much of the cause for severe malnutrition is not the shortage of food, but its high cost which people can no longer afford.

Food riots have already occurred in Sindh and Balochistan provinces, and famine was declared last year in the Tharpaker desert area of Sindh, leading to an outpouring of support from civil society but few long-term plans for the region by the government. Such protests could spread to grain-rich Punjab province.

The water crisis across Pakistan is become more acute by the day, with vast areas of Sindh and Balochistan expected to be declared waterless in the next decade, while there is no management of excess water and floods during the monsoon season. The lack of water in Punjab's canal system built by the British Raj is already driving down food production in Punjab.

Polio crisis

Meanwhile Pakistan's campaign to prevent the spread of polio that afflicts young children has been termed ''a disaster'' by the Global Independent Monitoring Board for the eradication of polio.

In its latest report issued from Geneva on October 26, the Board says: "Pakistan's polio programme is a disaster. it continues to flounder hopelessly, as its virus flourishes.... Pakistan is now the major stumbling block to global polio eradication."

It calls the government's Emergency Operations Centre "a masterpiece of obscurity".

"It's frustrating, eradicating polio is not rocket science," Elias Durry of the World Health Organisation says.

Pakistan has had 217 polio cases this year, accounting for 85% of all instances around the world and the highest incidence in 14 years. Moreover, 64 vaccinators have been killed by the Pakistani Taliban who oppose the campaign, also a sign of inadequate protection by security forces. Nurses and support staff who carry out this dangerous work have not been paid for two months. Pakistan now faces the disgrace of having exported the virus to China, Syria, Egypt and Israel according to WHO, through carriers who went to these destinations.

WHO fears that if Pakistan refuses to act, more money will be spent on blockading Pakistan from other countries to prevent the spread of the virus than actually combating it.

However for more than a year the government has refused to acknowledge the scale of the disaster and kept facts hidden from parliament and the media.

The Foreign Office has issued disturbing and defensive statements accusing the international community of exaggerating the threat.

Only after the Board's recent report has Prime Minister Nawaz Sharif reacted. While addressing the chief ministers of the four provinces on 4 November, he said he would give the Committee on Polio Eradication six months to make Pakistan polio-free.However even that statement was withdrawn a day later.

Rise in violence

Meanwhile 25 million children still do not go to school - the largest number of any country in the world. A new report by Alif Ailaan, a leading education campaign organisation states that only one in four children who do enrol in school make it to grade 10.

Half the children drop out by the fifth grade while conditions in schools are deplorable as many lack running water, toilets or even classrooms. Despite large-scale spending on schools by the Punjab government, not much has improved over the past few years.

There has been an alarming rise in the level of violence against all minorities in Pakistan, highlighted on 4 November by the mob killing of a Christian couple and the burning of their bodies on account of alleged blasphemous statements they made, when a more prosaic version of events emerged: they owed their employer money and he was exacting revenge.

Many of the social campaigns such as anti-polio and population control are unsuccessful because they are threatened by terrorists. Yet how can any campaign be mounted against extremism when there appears to be no strategic policy of zero tolerance for terrorism or a central authority.

The National Internal Security Policy, announced as a clearing house and central command for the anti-terrorist campaign, has not been heard from since it was announced in February.

The lack of a clear political strategy by the government has led to an ever greater policy and implementation failure on social issues.