Wednesday, April 9, 2014

India's dynasty-dominated politics has no space for dissent

Siddhartha Deb
This technocratic India of growth and capitalism is at its most feudal when it comes to its elected representatives
It has become commonplace when speaking about the staggering accomplishment of parliamentary elections in India to suggest that it may just be the greatest show of democracy on earth. It certainly appears to be so in terms of the sheer numbers of the electorate and the high percentage of those who tend to vote, especially when one adds to this the incredible poverty of the vast majority, the social and ethnic diversity and the spread of geographical terrain.
But is that all that makes for democratic accomplishment? Certainly, the obsession of the Indian media with the contending leaders of the main political parties, and the people of the nation as a colourful backdrop, does not look too different from a 21st century version of the imperial Durbar. There too people took pride in the spectacle of apparently beloved strong leaders united, every now and then, with their colourful subjects.
In postcolonial, democratic India, the exercise of large-scale voting seems to have made no dent in the hardening of dynastic politics. Almost every party has taken on the practice of treating politics as a family business (the same, of course, is true for media, entertainment and business). The greatest attention is paid these days to the most egregious of the offenders, the Congress party, led in its current campaign by Rahul Gandhi, who can claim a political lineage going back four generations. But even the right-wing Bharatiya Janata party (BJP) – which touts as a contrast its leader, Narendra Modi, an apparently self-made man of humble origins (so much so that even whether he is married or not is subject, seemingly, to an unofficial secrets act) – has its own dynasts when it comes to other parliamentarians, while Modi's own success lies in pandering to the most hierarchical of instincts in the nation.
Patrick French has written about the fact that nearly 30% of the members of parliament in India are hereditary, connected directly by family to their political posts. Moreover, as French discovered, dynastic politics only increases as one goes down the age ladder, to the degree that all members of parliament under the age of 30 are the children of former politicians. It is the technocratic India of growth and capitalism that is the most traditional and feudal when it comes to its elected representatives. The concentration of power this involves is anything but democratic, especially when one considers that India's 543-member parliament, as Christophe Jaffrelot has pointed out, is the same size as the French National Assembly, but serves a population more than 17 times as large.
It is also a system that has no room for dissent, regardless of the party or group of parties in charge. This might have been most evident to the international media during the brutal crackdown upon the public protests in Delhi in December 2012 around the gang rape and murder of a young woman, but the long arm of the law has never been hesitant to choke off protests. Whether under the aegis of the Armed Forces (Special Powers) Act in disputed territories in the north-east and in Kashmir, or in more everyday guise against those protesting against the nuclear plants, dams and factories considered to be crucial to completing the task of modernising India, it has operated with impunity everywhere, assured throughout of the support of a craven domestic media in this stifling of oppositional voices.
None of this is likely to change, unless for the worse, if Congress is displaced by the BJP in the coming elections. Given that the identity of the BJP is built on virulent nationalism and religious sectarianism, it has no tolerance for even individual differences of opinion, let alone mass dissent. This is evident in the runup to the elections in everything from the proliferation of conspiracy websites that seem to find contaminating foreign influences behind every major political party but the BJP, to the recent forced withdrawal and pulping of Wendy Doniger's idiosyncratic but fascinating Hindus: An Alternative History by a pressure group connected to the BJP.
It may be that it is the withered nature of India's parliamentary politics that makes the inconsistency of the Aam Aadmi party (AAP) look like radicalism or dissent. The AAP was born out of an anti-corruption movement led by the rather conservative social reformer Anna Hazare, in which the AAP leader, Arvind Kejriwal, was a key figure. In this movement the focus was more on authoritarianism than dissent, especially in the demand to create the Jan Lokpal, a super tribunal that would have the power to investigate everyone. Kejriwal's resignation after serving for only 49 days as chief minister of Delhi and the fact that the current list of AAP candidates include the usual seekers of fortune as well as some thoughtful critics of the current system, indicate that its most characteristic feature might continue to be inconsistency rather than dissent.
This should not be surprising. In an India where more than 20 years of growth have left the vast majority badly off in so many ways, democracy is needed not just once every five years but every day.

Bahraini protesters hold anti-regime demos

Bahraini protesters have held anti-regime demonstrations across the country, despite an ongoing crackdown by Saudi-backed forces.
People in Daih, Sanabis, and Sitra took to streets in support of opposition leaders on Wednesday.
On Sunday, a Bahraini court handed down jail terms to seven anti-regime activists after convicting them of an attack that wounded a policeman during a protest in December 2012.
Since mid-February 2011, thousands of pro-democracy protesters have held numerous demonstrations in the streets of Bahrain, calling for the Al Khalifa royal family to relinquish power.
On March 14, 2011, troops from Saudi Arabia and the United Arab Emirates invaded the country to assist the Bahraini government in its crackdown on peaceful protesters.
According to local sources, scores of people have been killed and hundreds arrested.
Physicians for Human Rights says doctors and nurses have been detained, tortured, or disappeared because they have "evidence of atrocities committed by the authorities, security forces, and riot police" in the crackdown on anti-government protesters.

Exclusive: Heart docs seek curbs on kidney-zapping hypertension devices

Several leading U.S. and European heart doctors are calling for curbs, or even a moratorium, on using devices meant to lower blood pressure by zapping kidney arteries, following a surprising failure of the technology in a clinical trial.
The views highlight a significant new hurdle to wider approval and acceptance of the therapy, known as renal denervation, which had raised hopes in the medical community as a way to treat stubbornly high blood pressure for patients who don't gain enough benefit from drugs.
Wall Street analysts had estimated a potential market of $3 billion for the devices made by Medtronic Inc, Boston Scientific Corp and St Jude Medical Inc. But failure of the high-stakes clinical trial set off a heated debate between doctors who believe the approach is worth saving and those who say results show it provides no clear benefit.
Trial data presented at the American College of Cardiology (ACC) annual meeting last week showed that Medtronic's Symplicity renal denervation device failed to lower blood pressure any more than a fake procedure in a closely watched 364-patient study, calling into question the therapy approved in more than 80 countries.
The devices are not approved in the United States.
"I think sales should be suspended," said Dr. Steven Nissen, head of cardiology at the Cleveland Clinic, referring to the entire class of devices. "You (now) have a trial with no evidence it works," he told Reuters.
Dr. P.K. Shah, another prominent cardiologist from Cedars-Sinai Medical Center in Los Angeles and professor of medicine at UCLA, agreed that a suspension of sales might be prudent.
"European colleagues would be better off doing the right clinical trials and perhaps putting a short-term moratorium on making (them) available, except to participate in a clinical trial," Shah said.
The Symplicity trial was the first to subject one group of patients to a sham procedure - during which they were sedated and had a catheter threaded into their arteries but no actual treatment - to account for any potential placebo effect. Prior informal trials of the devices with no control group had shown average systolic blood pressure reductions of twice what was seen in the latest Symplicity trial.
Some cardiologists, including Dr. John Burnett of the Mayo Clinic in Rochester, Minnesota, and ACC President Dr. Patrick O'Gara, said a formal review of the products should be undertaken.
"A few patients seem to have derived benefit from this type of intervention. We need to convene a group of experts to weigh the positives and negatives of a moratorium," said O'Gara of Brigham and Women's Hospital in Boston.
The European Society of Hypertension recommended "further studies of high scientific caliber" on renal denervation's relative benefits. Many of the doctors interviewed by Reuters noted potential flaws in the Symplicity trial results, including questions over whether the trial procedures were done correctly.
Medtronic, in an emailed statement, said the trial did not prove renal denervation does not work. It will continue to sell the device where approved and study its effectiveness.
"Medtronic believes physicians should make clinical decisions based on the totality of evidence, including their own independent experience," it said.
THE KIDNEY CONNECTION
The renal denervation procedure involves inserting the device through the groin and threading it to the kidney via a catheter. It then applies radiofrequency pulses to the renal arteries to damage nerve endings in the vascular wall that doctors believe contribute to blood pressure elevation.
The therapy has been available for years in Europe, where medical devices must only prove their safety to the satisfaction of one of dozens of regulator bodies to gain approval. Effectiveness is determined through post-approval surveillance.
Many doctors are hopeful the therapy will ultimately succeed based on results of animal studies and previous trials. But Wall Street's predictions of multibillion-dollar sales within 10 years for the renal denervation market now seem unattainable, since they depended on U.S. approval.
"This certainly set the field back several years," Jefferies & Co analyst Raj Denhoy said of the failed study. "There are no prospects of a device getting approved in the United States anytime soon."
Medtronic expects sales of only about $20 million in 2014.
Dr. John Jarcho, deputy editor of the New England Journal of Medicine and assistant professor at Harvard Medical School, said European counterparts need to take the failed trial into account. "I don't think it can be business as usual," he said.
"If I were a patient, I would choose not to have the procedure."
European-based heart doctors who talked to Reuters at the meeting were not ready to pull the plug.
"We don't need a moratorium because safety is not the issue," said Dr. Steven Chamuleau of University Medical Center in Utrecht, Netherlands.
Dr. Francois Schiele, chief cardiologist at University Hospital of Besancon in France, said sales of the Medtronic product probably should be suspended, but he was unsure about rival products.
"We have to continue with ongoing trials," said Schiele, a member of the press committee of the European Society of Cardiology. "If another trial is negative, then we'll probably have to question whether we should stop."
Boston Scientific, in an emailed statement, said it believes that its Vessix denervation system "is a highly differentiated technology supported by compelling clinical evidence." It said it would work with the scientific community to determine the next steps in its clinical program.
St. Jude Medical said it would study the Symplicity data but still believes in the technique and its product.
Several doctors questioned whether the Medtronic device actually destroyed the nerve endings as intended. They suggested that some kind of diagnostic test to confirm actual denervation may be needed to advance the field. "When the dust clears, there will be evidence denervation works, and this will be one blip in the history of this technology," said Dr. Robert Siegel, professor of medicine at Cedars-Sinai.

U.S: Authorities on stabbing victims: "Everyone will survive"

The FBI will help investigate a stabbing at a Pennsylvania high school that injured 20 people.

Pakistan: Corps Commander Conference: Displeasure expressed over Defence Minister's statement

http://dunyanews.tv/
The participants of corps commander conference presided by Army Chief General Raheel Sharif on Wednesday expressed displeasure over statement made by Defence Minister Khawaja Asif. Others matters that came under discussion include; review of internal and external security, terrorist attack in Rawalpindi, and determination to strengthen democracy, Dunya News reported.
According to Dunya News sources, Army Chief will meet Prime Minister upon his return from China visit to discuss concerns. Khawaja Asif’s statements were seen with displeasure in the meeting.
The corps commander conference that took place at General Headquarters Rawalpindi reviewed internal and external security situations of the country, Pak Army’s operational preparations and professional skills of the forces. Sources said that the issue of fingers pointed towards army by some elements was also discussed.
The session also reviewed the ongoing Taliban negotiation process and its developments so far. According to sources, the participants also exchanged views over post-elections situation in Afghanistan. Khawaja Asif’s statement:
Earlier, Defence Minister Khawaja Asif had said that the Parliament is supreme institution and no institution should violate sanctity of other one.
Addressing during the session of the National Assembly on Tuesday, he said every institution protects its dignity and its personnel, but Parliament is the supreme institution of the country. The minister’s remarks came a day after army chief General Raheel Sharif’s statement in which he had said that army would resolutely preserve its institutional pride and dignity.
“While our country is faced with multiple internal and external challenges, Pakistan Army upholds the sanctity of all institutions and will resolutely preserve its own dignity and institutional pride,” the COAS said while responding to the concerns of soldiers on undue criticism of the institution in recent days, ISPR said on Monday. The army chief expressed these views while speaking to soldiers during his visit to Headquarters of Special Service Group (SSG) at Ghazi Base Tarbela, ISPR said in a statement.
The Army Chief paid glowing tributes to the sacrifices of the SSG soldiers and officers and acknowledged their tremendous success while fighting against terrorists.
He said, Pakistan Army takes pride in our brave and battle hardened Special Services Group who are ranked among the top elite forces of the world.
Given the specialized nature of their employment in the most sensitive, complex and challenging environment, COAS praised them for their outstanding professional skills.
Speaking to SSG officers and soldiers, General Raheel Sharif said that Pakistan Army never has and never will shy away from rendering any sacrifice in ensuring a formidable defense and security of the motherland.
Drawing its strength from national support, with its characteristic coherence and resilience, Pakistan Army has contributed immensely towards national security and nation building and will continue to deliver on its mission, the COAS added.

Pakistan: Bilawal Bhutto chides Taliban over Islamabad blast remarks

PPP Chairman Bilawal Zardari Bhutto on Wednesday scolded Taliban for their statement in the wake of a bomb attack at a fruit market in Islamabad, in which at least 24 people were killed.
In a media statement following the blast, Taliban spokesman Shahidullah Shah denounced the Islamabad bombing as un-Islamic. "The deaths of innocent people in attacks on public places are saddening. Such attacks are wrong and against Islamic law," Shaid said. The young PPP leader responded to Taliban’s statement. “I don't know whether to laugh or cry - "TTP Spox says attacks on public places and casualties deplorable, such acts are illegal and 'Haram'",” Bhutto wrote on twitter.

China urges stop of U.S. interference in HK internal affairs

China on Wednesday expressed strong dissatisfaction and firm opposition to U.S. interference in Hong Kong's internal affairs, urging the United States to respect China's concerns.
Chinese Foreign Ministry spokesman Hong Lei made the remarks in response to a question regarding a meeting between U.S. Vice President Joe Biden and two Hong Kong former legislators.
The White House said Biden talked to former Hong Kong Legislative Council member Lee Chu-ming and former Chief Secretary Chan Fang On-sang.
Biden underscored the United States' long-standing support for democracy in Hong Kong and for the city's high degree of autonomy under the "one country, two systems" framework, said the White House statement.
"The development of Hong Kong's political system is China's internal affairs," Hong said, adding that the country firmly opposes any foreign interference in its internal affairs.
Since Hong Kong's return 17 years ago, the region has seen remarkable achievements in implementing the "one country, two systems" framework, the spokesman said during a routine briefing.
Currently, the Hong Kong Special Administrative Region government is pushing forward related work, Hong said.
"What the United States has done was absolutely wrong," he added.
China urges the United States to respect China's position and concern and stop interfering in Hong Kong's internal affairs in any form, said the spokesman.

Russia can’t support Ukrainian economy forever- Putin

Russia can’t continue to prop up Ukraine’s faltering economy, and this responsibility should fall on the US and EU, which have recognized the authorities in Kiev but not yet given one dollar to support the economy, President Putin has said.
“The situation is - to put it kindly, strange. It’s known our partners in Europe have recognized the legitimacy of the government in Kiev, yet have done nothing to support Ukraine – not even one dollar or one euro,” Putin said at a meeting with government officials at his residence outside of Moscow.
The Russian Federation doesn’t recognize the legitimacy of the authorities in Kiev, but it keeps providing economic support and subsidizing the economy of Ukraine with hundreds of millions and billions of dollars. This situation can’t last indefinitely,” Putin said.
In December, Russia provided Ukraine with a $3 billion loan, which was a part of a bigger $15 billion aid package agreed the same month. Russia also offered a 33 percent gas price discount that would have saved more than $7.5 billion. The head of the International Monetary Fund Christine Lagarde said that Russia’s loan tranche last year was vital for the collapsing Ukraine economy. In the meantime, the West hasn’t yet effectively provided any money to Ukraine. The International Monetary Fund has agreed to provide Ukraine a bailout package of up to $18 billion, but the details are still being worked out. The US has also promised $1 billion in loan guarantees to help the collapsing Ukraine economy.
Gassing over gas
At the same meeting, Russia’s Ministry of Energy Alexander Novak said that Ukraine’s debt to state monopoly Gazprom stands at $2.238 billion. Ukraine has not paid for Russian gas since the beginning of 2013, and with all discounts withdrawn it is now charged $485 per 1,000 cubic meters of gas.
This is a price Ukraine says it will not pay, claiming it is much higher than most of the rest of Europe pays for Russian gas.
President Putin also asked Gazprom to refrain from asking advance payments from Ukraine, until further consultations are held.
“This certainly complies with the contract, but given the difficult situation in Ukraine and the incompleteness of our negotiations with the EU, I would ask the Government to hold off on such measures [advance payments - RT] that appear in the contract until additional consultations, if, of course, our partners agree to such consultations.”
“If they don’t agree, we’ll act according to the existing contract,” Putin added.
Ukraine’s reserves of natural gas have dwindled to 6.5 billion cubic meters which is not enough for the coming winter, Gazprom’s Deputy Chairman Vitaly Markelov said at the meeting. Kiev will need 11.5 billion cubic meters to keep the lights on, Markelov added.
Ukraine’s overall debt to Russia, including the bill for gas, now stands at $16.6 billion Prime Minister Dmitry Medvedev said.
"Three billion dollars is Ukraine's debt, the accumulated gas debt stands at $2.2 billion, and what we consider Russia's profit shortfall, at $11.4 billion, in total, $16.6 billion."
Moscow turned off gas transit through Ukraine to Europe in the winter of 2006 and 2009 after Kiev failed to pay its Gazprom bill, leaving parts of Europe without energy during the winter months. Moscow has accused Ukraine of siphoning off supplies intended for Europe during these periods, an accusation Kiev refutes.

American Doctors: : Data uncover nation’s top Medicare billers

By Peter Whoriskey, Dan Keating and Lena H. Sun
The Medicare program is the source of a small fortune for many U.S. doctors, according to a trove of government records that reveal unprecedented details about physician billing practices nationwide. The government insurance program for older people paid nearly 4,000 physicians in excess of $1 million each in 2012, according to the new data. Those figures do not include what the doctors billed private insurance firms. The release of the information gives the public access for the first time to the billing practices of individual doctors nationwide. Consumer groups and news outlets have pressured Medicare to release the data for years. And in doing so Wednesday, Medicare officials said they hope the data will expose fraud, inform consumers and lead to improvements in care. The American Medical Association and other physician groups have resisted the data release, arguing that the information violates doctor privacy and that the public may misconstrue details about individual doctors. Among the highest billers were: a cardiologist in Ocala, Fla., who took in $18.1 million, mainly putting in stents; a New Jersey pathologist who received $12.6 million performing tissue exams and other tests; and a Michigan vascular surgeon who got $10.1 million. Some of the highest billing totals may simply reflect a physician who is extremely efficient or who has an unusually large number of Medicare patients. The highest numbers also may reflect a physician who specializes in procedures that require costly overhead, and in those cases, a large portion of the money may wind up not with the doctor but with pharmaceutical companies or makers of medical devices. But in some instances, the extremely high billing totals could signal fraudulent doctor behavior, as government inspectors have previously found. Indeed, three of the top 10 earners already had drawn scrutiny from the federal government, and one of them is awaiting trial on federal fraud charges. The greatest tallies also may signal that the Medicare payments for some procedures are too high for the amount of work involved or that perverse incentives lead doctors to overuse a procedure. The specialties most common at the top ranks of the Medicare payments were ophthalmologists, oncologists and pathologists. This information gives the public “unprecedented access to information about the number and type of health-care services” doctors provided during the year, Jonathan Blum, principal deputy administrator of the Centers for Medicare and Medicaid Services, said in a blog post. The Medicare program is the nation’s largest medical insurer. By virtue of its breadth, the forthcoming billing data are expected to shed light on an array of questions that have arisen about health-care costs as the nation has confronted decades of rising medical bills. Overall, the data cover $77 billion in billing involving 880,000 practitioners in 2012. The AMA has warned that the data could contain errors, and in some cases, one doctor’s billing number may have been used by multiple support personnel for billing purposes. In addition, the billing figures reflect what a doctor receives in payment but does not show the actual profit after paying for equipment, support personnel and malpractice insurance. For some procedures, the overhead can reach three-quarters or more of the payment amount. Many of the highest billers, for example, were in fields with unusually high expenses, and that was likely to limit their personal share of the money. Using the assumptions that Medicare and the AMA make when setting payment rates, only 23 of the 4,000 biggest billers personally earned $1 million or more, according to a Washington Post analysis. Gerald Ho, 50, a rheumatologist who runs three offices in the Los Angeles area, said he had been “sort of dreading” the release of the Medicare payment data. Ho received nearly $5.4 million in reimbursements in 2012. Of that, he said, probably about $5 million covered the cost of genetically-engineered drugs to treat patients with rheumatoid arthritis. He also has to pay a staff of 40. “People are going to see these numbers and people aren’t going to understand,” he said. “I am not pocketing $5.3 million. To tell you the truth, I know there’s been lot of Medicare fraud, and I understand the government wants to provide a measure of transparency. But when they throw out numbers like this without any context, it’s going to be misconstrued by the public.” “The AMA is concerned that CMS’ broad approach to releasing physician payment data will mislead the public into making inappropriate and potentially harmful treatment decisions and will result in unwarranted bias against physicians that can destroy careers,” Ardis Dee Hoven, president of the AMA, said in a statement. “We have witnessed these inaccuracies in the past.” But consumer and public interest groups argued that the information will help consumers make better decisions. “This data is important because it will make it possible for consumers to identify physicians that will best meet their needs,” said Robert Krughoff, president of Consumers’ Checkbook, a group that began seeking the release of this information in 2005 and eventually sued for it. For example, it will allow consumers to know which doctors are most experienced in a given operation. Studies have shown that in several types of surgery, volume matters: Surgeries by doctors who have performed the procedure enough times are less likely to end with the patient’s death. As for the potential that the data might misrepresent a physician’s practice, Krughoff said, “The consumer organizations that have pushed for release of this information have a strong obligation to make sure that the information is used properly. But I believe in the marketplace of ideas.” Opting for expensive The doctor at the top of the list of largest Medicare billers is Salomon Melgen, an ophthalmologist in West Palm Beach, Fla., who took in $20 million from Medicare in 2012, according to the data released Wednesday. Most of Melgen’s take — about $11.8 million of it — came from injecting patients’ eyes with Lucentis, a drug used for macular degeneration, according to the data. For each shot, Medicare and the patient pay a doctor about $2,000, but the drug is very expensive and the doctor must then pay most of that money to the drug’s manufacturer, Genentech. What may be most interesting about Melgen’s practice, however, is that he could have used a much cheaper drug than Lucentis — one called Avastin that many ophthalmologists consider an equivalent. Had he used the cheaper alternative, his bill to Medicare for the shots would have dropped from $11.8 million to less than $500,000. But physicians have a financial incentive to use more expensive drugs. Medicare pays a doctor more for injecting the more expensive drug — the physician’s fee is based on the drug’s price — and Genentech offered doctors its own incentive to use the expensive drug: The firm gave discounts to those who use high volumes. Melgen’s name appeared in headlines in 2012 as result of his connection to Sen. Robert Menendez (D-N.J.), a friend who received campaign contributions from the ophthalmologist. Menendez has been accused of improperly raising concerns with federal health officials on his behalf. Melgen’s attorney issued a statement before the data release to try to put his client’s billing in perspective. “At all times, Dr. Melgen billed in conformity with Medicare rules,” Kirk Ogrosky said. “While the amounts in the CMS data release appear large, the vast majority reflects the cost of drugs. . . . Responsible analysis requires looking beyond the raw data to what was paid for pharmaceuticals and expenses.” The use of the more expensive eye drug helps explain why so many of Medicare’s top billers are ophthalmologists. Of the doctors who were paid at least $1 million by Medicare in 2012, 879 were ophthalmologists, who — like Melgen — relied on using the more expensive drug, Lucentis. Some physicians have suggested that using Lucentis is wasteful because a much cheaper alternative exists. “There is no advantage of using Lucentis over Avastin — as six randomized clinical trials have shown they’re equivalent,” said Philip Rosenfeld, a Miami ophthalmologist who has pioneered the use of the less-expensive drug. Top billers Melgen, like some other doctors among the top billers, already has drawn scrutiny from Medicare investigators. Indeed, government inspectors have noted that instances of billing disputes and potential fraud may occur more frequently among the highest Medicare billers. A December report from the Department of Health and Human Services, for example, analyzed the records of 303 physicians who were paid more than $3 million by Medicare in a year. It found that 13 were responsible for overpayments totaling $34 million, six faced payment reviews, three had their licenses suspended and two were indicted. In releasing the data, Medicare officials forbade news outlets to share any of the data until 12:01 a.m. Wednesday. This provision meant that reporters could not solicit responses from any doctors beforehand. The second-highest biller in 2012 was Asad U. Qamar, a cardiologist in Ocala. Qamar made headlines last year after a Reuters report detailed large donations the doctor had made to the Obama administration’s agenda and a detailed federal review of his billing practices. He told Reuters that he had seen “tremendous harassment of the physician community.” The seventh-highest biller is Farid Fata, a cancer doctor in the Detroit area. He received $10 million in Medicare payments in 2012. Fata was arrested in August and is awaiting trial in a Medicare fraud case, accused of intentionally misdiagnosing illnesses and ordering unnecessary treatments, including chemotherapy for patients who did not have cancer. Federal authorities say that Fata, who owned and operated two health-care companies, fraudulently billed Medicare from August 2007 to July 2013. He also is accused of conspiracy to pay and receive kickbacks to providers of home health services and hospice services in return for referring patients. He has denied any wrongdoing. Not all of the highest billers have faced such scrutiny, however. The fourth-highest biller on the list is a department chairman at the Mayo Clinic in Rochester, Minn. Doctors Respond Several physicians worried the data release would mislead the public. The database, for instance, lists Minh Nguyen, a hematologist-oncologist at Orange Coast Oncology in Newport Beach, Calif., as having received more than $9 million in reimbursements, ranking him as number 10 on the list of top billers of Medicare in 2012. Nyugen explained the high total was because all the chemotherapy drugs for his five-physician practice are billed under his name. “It looks like I’m getting paid $9 million. . . but it’s a pass through,” he said. “The majority of the billing goes to pay the drug companies.” Nguyen said the data could illuminate the challenge experienced by oncologists around the country who are struggling with rising drug costs. Typically, the practice must purchase drugs up front – at a cost of about $25,000 per treatment – and then wait weeks or months for Medicare or insurance companies to reimburse them. Jean Malouin, a family practitioner in Ann Arbor, Mich., said her perch at number 16 of top billers was because she was the medical director of an experimental University of Michigan initiative that sought to improve care and cost-efficiency at nearly 400 clinics across the state. Due to the project, Medicare paid out $7.6 million to her for work done with more than 200,000 patients. "I am most definitely not a high volume Medicare biller," she said. “I am one of the ‘good guys’ trying to save [Medicare] money.”
Answering questions
The data release is expected to answer a much broader array of questions than who billed the most. One of the persistent mysteries of U.S. health care, for example, is why some surgeries are performed much more frequently in some areas of the country than in others, as researchers at Dartmouth College noted. Why, for example, is the rate of bypass surgery more than five times as high around Hattiesburg , Miss., and Slidell, La., as it is in Grand Junction, Colo.? Why is the rate of heart-valve replacement in Paterson and Camden, N.J., more than twice that of New Orleans and Albuquerque? The data may allow researchers to take a closer look at individual doctors to find answers. Jonathan S. Skinner, a Dartmouth economist, acknowledged that some doctors “may feel that their privacy has been compromised” with the dissemination of their billing records. But, he said, “as earlier reporting has shown, there are people who are operating in the gray area of health care who are causing Medicare to spend enormous amounts on health care that may be harmful to their patients.”

Pakistan army chief stirs a hornet's nest

The army has contributed immensely towards national security and nation building and will continue to deliver on its mission, he said while addressing SSG officers and soldiers.
Much is being made of a statement by chief of army staff General Raheel Sharif when he visited the headquarters of Pakistan's Special Service Group (SSG) at Ghazi Base, Tarbela, on Monday.
"While our country is faced with multiple internal and external challenges, Pakistan Army upholds the sanctity of all institutions and will resolutely preserve its own dignity and institutional pride," the chief of army staff said while responding to the concerns of soldiers on undue criticism of the Institution in recent days, according to a statement from the Inter Services Public Relations(ISPR).
General Sharif also paid tributes to the sacrifices of the SSG soldiers and officers and acknowledged their tremendous success while fighting terrorists. He said Pakistan Army takes pride in its brave and battle hardened Special Services Group which is ranked among the top elite forces of the world.
Given the specialized nature of their employment in the most sensitive, complex and challenging environment, he praised them for their outstanding professional skills, ISPR said.
Addressing SSG officers and soldiers, General Sharif said the Pakistan Army never has and never will shy away from rendering any sacrifice in ensuring a formidable defence and security of the motherland. The Army has contributed immensely towards national security and nation building and will continue to deliver on its mission, he added.
The need to underscore the importance of the army especially on a visit to the SSG, to which former President Pervez Musharraf belonged, was not lost on anyone.
The government, which has been trying to assert its civilian authority though the prosecution of Musharraf for high treason, has been referring to the court of law which will deliver justice. There is frequent speculation about the government and the army having differences over Musharraf's fate and the prosecution itself.
On Tuesday, Defence Minister Khwaja Asif, in response to some members' allegations in the National Assembly on a different subject, took a strident note which many who were present felt was a riposte to the army chief's statement. He said all institutions protect themselves and when members vilify their own institutions, how will the others have any respect. He said everyone should be united and stand as one.
Lt General Talat Masood, chief coordinator of Pugwash told The Hindu that the chief of army staff wanted to clarify certain things and the army was overstressed as it was operating everywhere. He said the visit to the SSG was also to raise its morale and it was important as an army chief for him to do that.
However, his statements were overread by the civilian government and the media which created such an impression that today even the government had to clarify in a way.
He said the fact remains that there is a section of people who don't believe in the rule of law and for them narrow institutional interests are more important. However, Pakistan was a state in transition and there is an element of sensitivity because of the burden of history and the military coups. Both institutions tend to overreact, he said and added that the issue should hopefully die down.

Afghan Elections: FEFA records 11,000 instances of anomalies

The Free and Fair Election Foundation of Afghanistan (FEFA) on Wednesday said it had recorded 11,000 incidents of fraud, irregularities, militant threats and closure of polling stations during Saturday’s elections.
The watchdog released a report, saying it observers had noted 9,500 cases of electoral fraud, including 2,600 of a serious nature. It said people’s participation was beyond expectations, but there had been election law violations. FEFA chief Nader Naderi told reporters 141 ballot boxes had been stuffed in favour of a particular candidate and 997 cases were related to underage voting.
He added 323 cases were about militant threats to polling stations and 437 incidents about the closure of election sites owing to insecurity.
He said in some instances men used female voter cards and in others poor quality indelible ink was used. Observers were barred from monitoring the voting process at some polling centres, he said. He said some polling centres had run out of ballot papers until midday and others opened late.
FEFA chief executive Jandad Spinghar said men had used female voter cards at 507 polling sites in different areas.
He added 297 observers were not allowed to monitor the election process and 2,305 polling sites were opened late and 1,727 sites remained open beyond the official closing time. There were 209 cases of poor quality election ink. Spinghar said fraud and law violation cases in the April 5 election had been less compared to those occurred during the 2009 election.
All the cases had been referred to the Independent Election Commission (IEC) to decide, he concluded.

Analysis - Afghanistan's surprises

In a nation more associated with calamity than consensus, the initial results of Saturday's Afghan presidential election are startling.
Despite Taliban threats to attack polling stations nationwide, the same percentage of Afghans turned out to vote - roughly 58 percent - as did Americans in the 2012 U.S. presidential race. Instead of collapsing, Afghan security forces effectively secured the vote.
And a leading candidate to replace Hamid Karzai is Ashraf Ghani, a former World Bank technocrat who has a PhD in cultural anthropology from Columbia University, a Lebanese Christian wife, and an acclaimed book and TED talk entitled "Fixing Failed States."
"Relative to what we were expecting, it's very hard to not conclude that this was a real defeat for the Taliban," Andrew Wilder, an American expert on Afghanistan, said in a telephone interview from Kabul on Monday "And a very good day for the Afghan people."
Two forces that have long destabilized the country - its political elite and its neighbours - could easily squander the initial success. Evidence of large-scale fraud could could undermine the legitimacy of the election and exacerbate long-running ethnic divides. And outside powers could continue to fund and arm the Taliban and disgruntled Afghan warlords, as they have for decades.
"None of it means it's over, Afghanistan is a democracy and we've won,'" said Ronald Neumann, a former U.S. Ambassador to Afghanistan. "But I don't think you can look at this turnout - in the rain and against death threats - and say nothing much has been achieved, as critics like to say."
One of the biggest beneficiaries was the Afghan security forces. To the surprise of both Afghan and foreign observers, the Taliban failed to carry out a single large-scale assault in a major city. The group claimed to have carried out 1,000 attacks nationwide but security officials said that was a gross exaggeration. Election observers said the level of violence was unclear.
This year, there were about 90,000 fewer American and NATO troops in the country and those that remained were confined to bases and served as a reserve force. Instead, 350,000 Afghan police and soldiers fanned out across the country. Wilder said the Afghan government security effort in Kabul, where he observed the vote, was the most sweeping he has seen in thirty years of intermittently working in the country.
"It was a really phenomenal security operation," said Wilder. "I've never seen anything like it."
After the vote, Afghan police were a "sensation" on social media, garnering wide praise, according to Wilder. Their popularity also extended to the street: one election observer reported seeing a group of young Afghans buy scores of roses and distribute them to police officers the day after the vote.
Barnett Rubin, an expert on Afghanistan who served a senior adviser to the State Department from 2009 to 2013, cautioned that the Taliban will retaliate.
"There will be a test of strength this year and next year," Rubin said, referring to Taliban attacks. But "an election that goes well can only strengthen the morale of the security forces and reduce the morale of the Taliban."
The news media - as well as social media - played an unprecedented role as well. A series of presidential debates broadcast live on television were more sophisticated than in the past. And intensive Afghan news coverage - and social media commentary - on Taliban attacks before the vote may have driven up turnout.
In particular, the pre-election execution-style killing of popular Afghan journalist, Sardar Achmad, his wife, six-year-old daughter and four-year-old son as they ate a holiday dinner in a Kabul luxury hotel outraged many Afghans. A Facebook page that tracked the recovery of a two-year-old boy who was shot in the head -- the family's lone survivor -- generated vast online traffic and sympathy.
"The attacks really mobilized Afghans to come out and vote," said Wilder.
And in terms of candidates, it was Ghani, the technocrat turned effective campaigner, that most surprised observers. Despite wide praise for Ghani's 2002-2004 tenure as Afghanistan's finance minister, he was seen as lacking political skills or a large electoral base. Afghans who remained in the country during the 1980s Soviet occupation and 1990s civil seemed to resent Afghans who, like Ghani, had fled the country and flourished. In 2009, Ghani ran for president and won about four percent of the vote.
After his 2009 defeat, Ghani remained in Afghanistan, built a home and took a position overseeing the transition of security operations from foreign forces to Afghan units. Visiting every province in the nation, he developed a vast network of supporters. Criticized in the past for being too haughty, abrasive and Western, he donned local clothes and grew a short beard.
In a manoeuvre that surprised many, he forged an electoral alliance with Abdul Rashid Dostum, a former Uzbek warlord long accused of gross human rights violations. Having Dostum as an ally delivered a large block of votes to Ghani. In debates and on the campaign trail, Ghani vowed to end corruption and modernize Afghanistan.
"He has been exciting to young people," said Neumann, the former ambassador. "He is really the change candidate."
Numerous dangers lie ahead. Karzai can exert his sizeable influence on whoever wins. Warlords and others who have benefited from years of corruption may resist change. And the Taliban remain the largest wild card of all. After years of supporting the Afghan Taliban and undermining Karzai's government, Pakistan's army may decide to undermine Afghanistan's new leader as well. Rubin, the former State Department official, described a more alarming scenario. He argued that Pakistan's military has tried for years to influence the Afghan Taliban but their ability to do so has diminished in recent years.
"The fundamentals haven't changed that much," he said.
Wilder expressed caution as well but called Afghans' enthusiasm on Saturday "infectious." The question, he said, was whether a new group of Afghan leaders would respect it.
"Voters have done their part," he said. "Now, it's up to the candidates to behave responsibly."

Pakistan: Peshawar takes the lead in reported cases of extortion

The Express Tribune
It usually starts like an action thriller right out of Hollywood. A mysterious letter or phone call is made. A demand, deadline and place to drop off the money are set. If the instructions are not followed, then warnings are sent, usually in the form of a grenade attack or worse. Like militancy and kidnapping for ransom cases, Peshawar holds the top slot for highest number of reported extortion cases in the province in 2013.
According to police records, around 60 cases of extortion were reported in Khyber-Pakhtunkhwa last year out of which 22 were from Peshawar, nine from Lakki Marwat and seven from Charsadda. Swabi and DI Khan came in fourth with six reported cases, Bannu had four, Mardan had two cases of extortion while Chitral, Haripur, Nowshera and Swat had one each. The real number of extortion cases, however, is at least five times higher than the reported ones as in many cases the police does not file an FIR.
A high-ranking official told The Express Tribune last year 39 houses were damaged in low-intensity blasts carried out by extortionists while in the first three months of the current year there have already been 12 such attacks.
He said around eight FIRs had been registered in the city for extortion and earlier in March two extortionists had been arrested from Hayatabad for demanding money from a Hangu-based trader living in Danishabad, Pishtakhara. What is really worrying, he said, is the fact that small time criminals have mastered the art of making a bomb and are now busy extorting money from wealthy people.
Last year, the federal government issued a list of groups actively involved in extortion in the province. According to that list, 18 of the groups identified by intelligence agencies, operate in Peshawar and collect money from the city’s residents. The police, however, believe that the exact number of gangs cannot be determined. Fighting back
Last year in Charsadda when extortionists stole a businessman’s vehicle and attacked his house on several occasions, he was enterprising enough to build a protection tower. He mans it himself during the night and has hired a guard for the day.
Muhammad, a school owner, thought of a similar solution.
In an earlier news report he said while he would keep his resolve against such threats, he would be forced to take up arms for “self-defence” if the police failed to arrest the culprits.

Pakistan: Intelligence Sees TTP Lurking Behind New Terrorism Threats

shiapost.com
Secret agencies have alerted the police that militants opposed to the government-Tehrik-i-Taliban peace talks are planning terrorist activities in Islamabad, Peshawar and Quetta, according to police and interior ministry officials. They did not know when the malignant elements would strike, but the officials confided to Dawn that a new group, Ansarul Hind, would claim responsibility for the attacks.
Their intelligence sources, who raised the alert on April 3, said the TTP leadership had wished its informal affiliates to create the so far unheard of group.
Despite the possibility that the TTP sympathisers may be trying to pressurise the government by raising the threat of terrorist attacks in the three cities, the authorities took the threat seriously, police sources said. “Although peace talks are in progress, we are taking necessary measures to counter terrorism in the cities,” said one official. “Law enforcing agencies will be the main target of the terrorists, and in the case of their failure, any other official installation or public place.”
“TTP will choose the targets and the informal groups under its umbrella will provide support to the Ansarul Hind activists with weapons and other materials,” he added.
Security sources say the scenario looks similar to the terrorist attacks that quickly followed the announcement of a month-long ceasefire by the TTP last month. The most audacious of them was the bomb-and-gun attack on the district courts complex in Islamabad on March 3, which was claimed by Ahararul Hind group.
That group was heard of for the first time on February 9 when it sent emails to media outlets that it shared the ideology of the TTP but opposed it negotiating peace with the Pakistan government.
Its ownership of the March 3 attack gave rise to speculation that the Ahrarul Hind was affiliated with the Al Qaeda.

Former President Zardari condemns Islamabad blast

http://mediacellppp.wordpress.com/
Former President Asif Ali Zardari has strongly condemned as most barbaric and inhuman the bomb blast in Islamabad Fruit market reportedly resulting in the death of over twenty people and injuries to more than two dozen. In a statement Former President said this brutal and vicious attack on innocent citizens shows the distorted mindset of terrorists who want to disrupt and destroy daily life routine in Pakistan and impose their political and religious philosophy on Pakistani nation by use of force. He said that Pakistani nation’s resolve to fight these beasts to the finish will not be weakened by such cruel attacks. Former president prayed to Almighty Allah for grant of eternal peace to the departed souls and courage to the bereaved families to bear loss of their loved ones with equanimity. He also prayed for early recovery of injured.

PAKISTAN: Balochistan – rule of law or the maintenance of law and order?

http://www.humanrights.asia/
Baseer Naweed
The provincial Interior Minister of Balochistan has stated that a terrorist attack on a passenger train resulting in the death of 18 persons was an attempt to avenge the Frontier Corp (FC) Kalat operation by the militants and Baloch Liberation Army (BLA). The minister tried, as is the usual practice of the government, to place the blame for the deaths on some militant groups in an effort to hide the negligence and failure of the government to protect the people. If the statement of the provincial minister is accepted as correct then it means that the deaths were a result of retaliation by the terrorists against the FC operations and not as a direct result of their operations. This is a fairly blatant admission from the provincial minister that the government and military has no concept of how to tackle the sensitive issues of the people of a neglected province but rather try to solve the political issues with military force in the mere pretext of safeguarding the security of the province and the country.
The governments always try to deal with the situation arising out of continuous repression through law and order and not with the intention of providing justice. They have never considered that by providing justice to the people the issues could be settled under the concept of the rule of law. Providing justice to the Baloch has always been a last resort of the authorities; a last resort that they have never fallen back on.
The main problem of the state authorities and the so-called civilian governments is that they mix the rule of law with the maintenance of law and order. The law and order cannot be a substitute for the rule of law in any context.
The concept of law and order was introduced by the colonial powers for the purpose of allowing them to deal harshly with the people who resorted to different means of protest to achieve their rights. Whereas, the rule of law means that the laws should treat all the citizens equally and ensure justice without discrimination. It purports that institutions of law should be established in such a manner that the people can have easy access to them in order to obtain justice.
In the case of terrorism in Pakistan, either the state created and nurtured the terrorist groups in order to get involved in international conflicts and also for the purpose of obtaining huge amounts in grants by western forces, or state used repressing methods at the small nationalities by usurping their fundamental rights and natural resources and in doing so, forcing them to resort to armed struggle or terrorists activities, including bombings and other subversive actions.
In using these methods, the state always considered that the best option is to go for maintaining law and order by the use of force. The rule of law was thought to be the weakest option of running the country. This is the main cause why the institutions of justice were never developed but instead more funds were invested in strengthening the law enforcement authorities. This is the reason why the law enforcement authorities have never respected the legal and civil institutions and behave as if they are above the law.
In the case of Balochistan the rule of law has never been introduced to resolve the basic issues of the province but the maintenance of law and order was given priority since the creation of the country.
The founder of Pakistan, Mr. Jinnah, though he was a veteran lawyer, could not differentiate between the rule of law and rule by force. Within months of the creation of Pakistan he sent the armed forces to annex Balochistan, thereby making it part of Pakistan without realising the fundamental question of rule of law. The successive governments also thought that if the father of the nation could not differentiate between the rule of law based on justice and the use of force for usurping the rights of the people as the basic ideology of Pakistan then they could do the same. Since the creation of Pakistan five military operations have been conducted, and hundreds of Baloch were hanged and thousands disappeared and extrajudicially killed -- but the issue of Balochistan has remained as it was since the time of the creation of the country.
The irony of the political parties is that they come through the peoples’ votes and present themselves as the elected people of Pakistan but it is incomprehensible for them to understand the fundamental concept of the rule of the law and maintenance of the law and order. It is not a thin veil between the rule of law and the maintenance of law and order but rather a vast difference between the two. This is the reason why, on the one side the government is dealing with the poor and neglected people of Balochistan harshly and with all the facilities of the army and air force and at the same time, bowing down before the Muslim militant groups and the Taliban who have huge amounts of funding from both local sources and international Muslim countries and organisations and at the same time enjoy the very latest in modern military weaponry.
The struggle in Balochistan is for greater autonomy of their resources based on secular ideals; whereas, the Taliban movement is based on converting the country into a purely fundamentalist Shariah-based Islamic society and to destroy all forms of democracy. Being an Islamic country by means of its constitution it is easier for the state to deal with the Taliban rather than negotiate with secular and independent forces. Therefore, in the eyes of the state Islamic terrorism is the lesser of the evils because it will never insist on the rule of law and always be happy to maintain law and order by force.
The actions of the FC in the various districts of Balochistan were exactly what the state concept of law and order demands according to the wishes of the father of the nation. The Minister of the Interior of Balochistan was happy to say that in the Kalat operations the forces killed 30 to 40 persons while using helicopters for logistic purposes only because the nation would be pleased at the news of so many insurgents being killed. He cannot comprehend that these actions will wield a bloody response from the militant groups that never differentiate between the civilians and law enforcement personnel as they consider everyone to be their enemies.
Minister Mr. Bugti is famous in dealing with the province harshly with his illegal detention centers and torture cells in his home town of Dera Bugti and detaining young persons, in particular, who are generally unhappy with the provincial and Pakistan governments. When a man with such a mentality is appointed as the Interior Minister he will always think that the rule of law is a foolish thing and all issues can be dealt with by force.
Therefore, it is the FC and provincial government that are equally responsible for the attack on a passenger train in which 18 persons were killed and one family of eight persons were burned alive. The government must pay compensation to the families of the deceased and those affected by the attack because the deaths were caused by its actions.
This is the time for the government and the political parties to follow the rule of law rather than expending all their resources on maintaining law and order. The institutions of the rule of law must be strengthened and investments in law and order by force must be stopped. The law and order, which the government wants to maintain although it has not been benefiting the people-has been apparently a failed exercise when once looks into the Taliban and other militant groups who are taking their roots to the country. Without comprehending the essence and unavoidable necessity of immediately establishing the rule of law the entire nation or any it’s provincial governments are not approaching any form of solution of the existing problems that the people are plunge into.

Pakistan: Army’s warning

It seems that COAS General Raheel Sharif’s visit to the headquarters of the Special Services Group (SSG) at Ghazi Base in Tarbela proved uncomfortable in some respects and elicited a statement from him that has set the cat among the pigeons. General Sharif was subjected reportedly to the concerns and complaints of the officers and men at Ghazi Base about the criticism being heaped on the military by disparate quarters. In particular, since he belonged to the SSG, former commando and General (retd) Pervez Musharraf’s ‘humiliation’ was of particular concern, interpreted as eroding the dignity, respect and morale of the military. The statement by General Sharif released by ISPR spoke of the challenges facing the country, notwithstanding which the army would uphold the sanctity of all institutions while preserving its own dignity and institutional pride. Forensic analysis of the statement, its meaning and import aside, basically the well known concern of the military at the ‘treatment’ being meted out to their former COAS rankles more and more. This sensitivity in the ranks is something no commander can ignore. Therefore the statement of General Sharif can be taken as a message intended to boost the under pressure morale of the army and fire a warning shot across the bows of all its ‘critics’.
The unstated but perhaps equally important cause of not so hidden resentment on the part of the military as a whole is the controversial approach of the government to the Taliban. The military has acted with exemplary restraint in keeping a public posture of support to the government’s much touted peace-through-talks process. However, rumblings in the ranks are ‘visible’. Logically, two reasons suggest themselves why the current scenario troubles the military. One, the military has suffered deaths and casualties at the hands of the very people the government is treating with so much respect as to raise the Tehreek-e-Taliban Pakistan (TTP) almost to the position of an equal stakeholder in the state. This is obviously not going down well. Second, the issue of exchange of prisoners is so far a one-sided process, in which the government has released, and intends to release, Taliban prisoners in small batches after reviewing their cases. In fact the task is big, since reports speak of the TTP having submitted a list of around 800 prisoners they claim are non-combatants, including women, children and the elderly, who they claim are fit cases for release. The government has reportedly now decided to set up a committee to review all these cases in order to expedite the process. In return, despite demands, the TTP have yet to free a single hostage in their custody. While the general public and the Sindh Assembly through a resolution the other day are demanding the release of Shahbaz Taseer, Ali Gilani and Professor Ajmal, no one is talking about the military and security forces’ prisoners in the custody of the TTP and affiliated groups.
It should not be forgotten that 23 Frontier Constabulary hostages were mercilessly beheaded and their heads used as footballs, a grisly scene released on video, by the Taliban not so long ago. The rest of the hostages remain at risk until and unless the TTP shows some signs of willingness to release them. In return for the concession of release of their prisoners in batches, the TTP has yet to reciprocate the gesture. The military may have reservations about this one-sided bargain, particularly since the extension the TTP granted in the ceasefire runs out tomorrow (April 10). What will follow is therefore dogged by much uncertainty, as is the general outcome of the talks.
The military’s sensitivity on the criticism it says is being unduly heaped on it in recent days is on the agenda of the Corps Commanders meeting today. In a related development, two ministers of the government, Khwaja Saad Rafique and Khwaja Asif, both of whom have been in the forefront of severe criticism of Musharraf during his trial and incarceration, were at pains the other day to deny that their stance on Musharraf should be interpreted as criticism of the army as an institution. Given the delicate situation facing the country, in which the possibility of the talks failing and the need to take other measures looms overhead, the civilian and military leaderships should exercise greater restraint and care in their pronouncements to avoid unnecessary misunderstandings. After all, if terrorism is to be tackled, both wheels of the state need to be pointing in the same direction.

Pakistan: BDS defuse 13kg bomb near Karachi's Khalid Bin Waleed road

A bomb weighing 13 kilograms was defused near Khalid Bin Waleed road in Karachi’s PECHS area on Wednesday, DawnNews reported. On receiving a tip-off about the presence of a bomb near residential apartments on Khalid Bin Waleed Road, Bomb Disposal Squad (BDS) team personnel were dispatched. BDS personnel discovered the bomb in a fertilizer sack. The bomb was connected with a detonator device and contained two and a half kilograms of explosive material. Police took the explosive material into custody to conduct examination.

Pakistan: 21 killed, dozens injured in Islamabad blast

At least 21 people were killed and 116 injured, some critically, on Wednesday when an explosion occurred behind the Metro Shopping center in the Sabzi Mandi area of the capital city, DawnNews reported. Police and rescue teams rushed to the site of the incident after the explosion occurred. Initial reports suggest that the explosive material was planted inside a box containing fruits. Police said that a remote controlled bomb containing five kilograms of explosive material was used in the blast.
Police added that boxes containing fruits were brought to the market from the Punjab province. The blast occurred at a time when labourers and early morning shoppers were busy purchasing fruits. Police initiated a search operation and cordoned off the area. Police personnel claimed that the incident appeared to be an act of terrorism. Moreover, police arrested a 'suspicious' person from the location of the blast. Sabzi Mandi is situated in the sector I-11 of the capital city and a kachi abadi of Afghan nationals is also located in the same sector. Earlier, Pakistan Institute of Medical Sciences (PIMS) Vice Chancellor Prof. Javed Akram said that 31 injured in the blast were given medical treatment in the hospital and the death toll was likely to increase. Later, spokesperson Pims Dr. Ayesha said the earlier provided death toll was incorrect adding that 19 dead bodies and 73 wounded were brought to the hospital. Following the attack, emergency had been declared in the hospitals of Islamabad and Rawalpindi. Also, Pims hospital made an information desk which would provide information related to dead bodies and the wounded persons. The attack occurred just prior to the Corps Commanders’ Conference which was held today.
Intelligence warned of attacks
The attack came a day before the April 10 ceasefire by Tehrik-e-Taliban Pakistan (TTP) ends. Intelligence sources had first alerted the police and government officials on April 3, 2014 that possible terrorist attacks in Islamabad, Peshawar and Quetta were being planned by militants who oppose the peace talks between government and Tehrik-i-Taliban Pakistan (TTP). “Law enforcing agencies will be the main target of the terrorists, and in the case of their failure, any other official installation or public place,” one official said. “TTP will choose the targets and the informal groups under its umbrella will provide support to the Ansarul Hind activists with weapons and other materials,” he added. Security sources say the scenario looks similar to the terrorist attacks that quickly followed the announcement of a month-long ceasefire by the TTP last month. The most audacious of them was the bomb-and-gun attack on the district courts complex in Islamabad on March 3, which was claimed by Ahrarul Hind group.