Monday, April 19, 2010

Pakistan Happenings...April2010.

The "historical" event and much acclaimed about political parties was the 18th amendment which finished off the 17th amendment , doing away with the all empowered presidential seat and the ban on third time prime ministerial seat, which hung around the neck of Nawaz Sharif.The controversial points which are bieng disliked by many are doing away with increased women's seat, intraparty elections and the change of name of NWFP to Khyber- Pakhtunkhuwa. There have been very bad kind of mob protests, mainly by non-political party groups whose name is little known suddenly, burning breaking public property, buses and halting all traffic and business. The over strong action by police, killing 10 people in Hazara has led to people asking questions about the intent of the administartion to use more force. The question here is what should the administration do as there are suicide bombings almost everyday in the province. The Hazara seperate province group has suddenly become very vocal.This is fanning the other seperate province moves also.
The other events that are creating havoc are almost daily suicide bombings, in the frontier province and Baluchistan. The Kohat bombing yesterday where twin suicide attacks killed at least 40 people, some of them poor IDPs who had lind up for food aid and in Quetta inside hospital, where a killed banker, son of  a Shia leader was bieng visited by an MNA and media, are are truely gruesome. As I write this post another bomb blast has occured in Peshawar. The frequency with which schools are bieng blown up and bombings occuring is so frequent that I am unable either to keep count or write in detail about them.
The UN commission on Benazir Bhutto's murder has also given a report. Some  like the PPP call it vindication and some question the authenticity, intent, and completeness of the investigation.The pointing of fingers at general (retired) Musharraf has him reacting prematurely and saying things like " he has  a shot left in his armour" has opened up a musical chairs game in pointing fingers and trying to find answers .The entire country wants to know the answer in black and white.If Baitullah Mehsud was the mastermind then he has succeeded in planting suspicious seeds and tightening the noose or almost around his enemy. meanwhile conspiracy theories, which the Pakistanis are so fond of due to any logical and illiterate approach to investigation, aboud, and circulate. For the Zardari haters it still remains a much parrotted "who gained most from her death' theory as if getting a presidential seat and the party Co-Chairmanship is maximum benefit. What about applying this logic to Pakistan's enemies like the militants and the terrorists. Do not they gain maximum by depriving Pakistan from an able and energetic leader who may have been able to take the country forward?
As I write about these thoughts I want to share a few startling things I discovered trying to make a list of young , promising Pakistani politicians on Twitter.There were only three , two of them women and one male . Out of the two women , one does not even describes herself as politician but an author, activist and a journalist. no mention of Dasti , the lying about his graduation parliamentarian, who the PPP is giving ticket to again. Out of the other dynastic progeny in political parties, none is on twitter or facebook, none cares what other people think or write or say. By the way the three on twitter also dont care for any interaction and their mmessaging is shut like masters or kings. Long live failing Pakistan. (This definition and explaination another time)

Saturday, April 17, 2010

NEJM: Physicians must 'take back' ownership of EHRs

NEJM: Physicians must 'take back' ownership of EHRs

I created an EMR based on clinical practice. Was too early for Pakistan? For the world? Back in 2002.

Wednesday, April 7, 2010

Why OSAMA BIN LADEN Is Right And We Are Not!

Gotcha! Ha! Listening? Looking?
Watch Now!


So the world watches ,listens and sees when its attention is caught. Othewise a NANO bieng like myself can write NICE article, NEW thing but BULLSHIT who sees , who listens. Well , this is not a depressed female rant. I am trying to write a new serious post about the new BUSINESS model for HEALTHCARE as envisaged by the HARVARD BUSINESS REVIEW and also where in the world WE (3.8 BILLION ASIANS) do we stand when the very modern strategy is applied and HITS US?
Asia is uneven. In terms of ECONOMY, PER CAPITA INCOME, and plain right means to address or RESTRUCTURE , where do we the ASIANS stand ?
Our Children OR midgets?


According to the HARVARD BUSINESS REVIEW, there will be ten new COMMANDMENTS according to which our health , well THEIR  health needs will be addressed .
Asia is uneven in terms of health ,  education, service delivery mechanisms and institutions in social sectors. CORRUPTION, Social sector budgeting. The Chinese model of growth will be not emulated by any other Asian economy as the BLUEPRINT is very different in India and others. However, the level of HEALTH DELIVERY and OUTCOMES will depend on the PRIORITY given to HEALTHCARE, the need to keep Millinium Development Goals as THE development/ political agenda, the warding away and prioritizing Budgetary allocations on Social sector and of course fighting or WEEDING OUT CORRUPTION.
The Asian picture arises as MALARIA, TUBERCULOSIS, OTHER ENDEMICS LIKE TYPHOID, INFLUENZA and their control, and providing health services in an even manner to SUCH Large populations such as INDIA(1.14 billion) and CHINA (1.325 billion). In case of infectious diseases which are likely to become pandemic the capacity of the HOST COUNTRIES  to PREVENT and CONTROL these monsters is again questonable.
According to this post (Megatrends in global healthcare by Karen Dillon and Steve Prokesch http://hbr.org/web/extras/insight-center/health-care/globaltrends/), the trends in typical diseases of the West will arise sharply in the East as the population and lifestyle changes in Asia. The needs and expenditure will also need to be addressed.
So the entire paradigm for HEALTH SERVICE PLANNING AND DELIVERY is VASTLY DIFFERENT in THE TWO WORLDS APART like the WEST and the EAST.

Planning or PLANING?


A question thus arises here what will be the impact on the Developed world if we fall short/ slip away/do not prioritize the HEALTH NEEDS of ASIA?.Look for answers  WHERE?
I think gone are the days of massive policy planning at GOVERNMENT level inputs. Now the whole approachshould be GRASSROOTS. How the health of a nation improves should START at the community level. Policy INPUTS also have to be from BOTTOMS UP

Dive or Delve?Prepared to face the Health Challenge in Asia?


 ,just like EVIDENCE BASED MEDICINE. And a the new trends arise in sophisticated health delivery systems like vending machines for BP, Cholesterol checks,remote reporting, these will definitely help the far off .
(See Innovations and demand soar in emerging economies, Innovations that will Transform Medicine by Gardiner Morse, http://hbr.org/web/extras/insight-center/healthcare/10innovations/ )
 The communities that do not have trained health personnel will also be helped as in the remote villages and mountaineous dwellers in Pakistan.
The only hurdle is the cost of providing the new technology for health care, but then the budgeting and funding needs to be Prioritized in terms of HEALTH OUTCOMES and IMPACT.(I am not even thinking about making mobile fones HEALTH SMART& they want their excitement thru IPAD only, right now!)

Food, Nutrition, Obesity, Diabetes, Ear Wax?///Health Impact and outcomes???Cost effective healthcare/health costs packages?

by now you must have read the links I attached and must have started thinking about the WIDE GAP between the two WORLDS of WEST(DEVELOPED) and EASTand I mean Asia (DEVELOPING AND UNDERDEVELOPED) all lumped into one countries and its socio-political and socio-economic impact.
Grey matter turning into Grey areas, eh?
Choices of Cost effective Strategies, health Insurance/ cost packages , priority areas for health intervention or ZOOM!!!!!!What health Markets???/