Ag vs. HSUS: The Rural Battlefield | Daily Yonder | Keep It Rural

Ag vs. HSUS: The Rural Battlefield Daily Yonder Keep It Rural

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)

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.

What's Missing for Rural Schools in Obama's Blueprint | Daily Yonder | Keep It Rural

What's Missing for Rural Schools in Obama's Blueprint Daily Yonder Keep It Rural

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???/

Sign The Petition..Join The Fight Against Corruption.

G20 Transparency Petition


Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services…



--Article 25 of the Universal Declaration of Human Rights



Research shows that developing countries are losing $1 trillion every year due to crime, government corruption, and tax evasion. These illicit monetary outflows are roughly ten times the amount of aid money going into developing countries for poverty alleviation and economic development.



The loss of money from poor economies that would otherwise go to provide health services, infrastructure, and other critical needs exacerbates poverty and leads to the deaths of millions of people. The annual loss of hundreds of billions of dollars from the world’s poorest and most vulnerable economies constitutes one of the most pressing human rights issues of the new decade.



The key to tackling this problem is transparency in the global financial system. After these stolen or otherwise ill-gotten gains exit their country of origin they vanish into an opaque financial system comprised of tax havens and secrecy jurisdictions. The most effective deterrent to criminals, corrupt officials, and tax evaders is to create a global financial system where illicit money cannot hide.



When the world’s 20 largest economies – the G20 – meet in Toronto on June 26-27, 2010 they will have an unprecedented opportunity to institute changes to create a transparent global financial system that is open, accountable, fair and beneficial for all.



Toward that end, we call on the G20 leaders to:



• Recognize the link between illicit outflows of capital from developing countries, absorption of those resources by tax havens and secrecy jurisdictions, and the adverse impact those flows have on poverty alleviation and economic development.

• Call on the Financial Action Task Force to amend its recommendations 33, 34, and VIII to provide that the beneficial ownership of all companies, trusts, foundations and charities be made a matter of public record.

• Instruct the International Accounting Standards Board to recommend that all multinational corporations report their income and taxes paid on a country by country basis.”

We the undersigned call upon the leadership of the G20 nations to take action on the problem of illicit capital loss in developing countries and increase transparency and accountability in the global financial system.



-Your Name Here

Pakistan: Negotiating With Taleban, Should It Be A Taboo?

Pakistan :  Negotiating With Taliban, Should It Be  A Taboo?

While talking to a knowledgeable intellectual who has authored books and articles on reforms, development and governance also, I  learned many important points in order to reach a more peaceful environment in Pakistan today. Post war on terror and Swat operation, it seems that although the Pakistan army has managed to clear many strongholds of the Tehrike Taliban Pakistan, many co-existent militant networks remain. These are based in Punjab, loosely in some parts of Sindh and are as such are not easily categorized or traceable. The recent Lahore bombings are a clear evidence of their swift reach and access to urban Punjab and their ferocity and ability to inflict wounds on the state and its ordinary citizens. Though , the recent blurts of the Punjab chief minister speak volumes about his parochial and somewhat confusing stand on the Taliban issue, there is an undercurrent of reaching out to the militant forces that are inflicting unbearable damage on innocent people of Pakistan. The doors of talks and negotiation should never be closed. Take the example of the Sein Fien, Irish Republican army. Despite the almost impossible scenario of reaching a peaceful solution, in the long conflict ridden, bombed out, murder ridden streets, a final peaceful solution was found and Ireland limped back to a normalcy. The conflict was so bad that the children across a street were divided and a very dangerous and death ridden political scene was the norm. Thank God, in Pakistan no such scene is there at least in larger towns. The Green Chowk murder scenes are also taken care of post Swat operation by the Pakistan army.

All violent conflicts, especially in the modern era have been solved only by negotiations and talks. Pakistan also needs a very well negotiated and widely inclusive peace talks .Only one example of that of Bader Meinholf operation by the German army , police and intelligence is not possible for Pakistan due to its various constraints and deficiencies.

There are a very large number of people who are of banned outfits and banned organizations, which freely access and are part of the community of politicians and parliamentarians in the Punjab. Recent news and television reports of the incumbent Punjab interior minister is a case in point. Pakistani society is very intertwined, complex with close linkages between families, biradaris and villages. This is very apparent in the Punjab province. These groups if militant also, are still operative and are not really bound in a very rigid way. Simply wishing them away will also not solve the problem.

  The Taliban are also a militant force, though they may not pretend to be an army and basically put a face as only implementers of the Islamic Shariat in order to gain legitimacy of the existence and gain favor from the ordinary masses. Post Bajaur, Waziristan and other area operations, some success has been achieved in inflicting some damage and containing some strike capability of the militants in NWFP, but a large population still remains un- convinced and with the Taliban ideology, which again appears confused and abstract. They were really not anti –Pakistan initially and as reflected by Sufi Muhammad’s post Nizam e Adl show of force, appeared totally limited in a regional context to Swat and Malakand. These other areas in NWFP also seem to be populated and led in a similar way. As a large number of women and children were displaced in the Bajaur operation. There is now a dire need for prevention of further displacement and difficulties for these vulnerable groups. The purpose of the military operation was to secure peaceful environment in these areas where the larger population is not militant but becomes hostage to militants and their ideology (no matter how vague or misplaced) over a period of time. As the displaced population has to go back and be rehabilitated safely in their areas, a negotiation with militant groups, in this case, the Taliban becomes relevant. No wars are really won or lost. All are resolved through negotiated settlements. As the Taliban were initially created by us, the time has come to negotiate a peace deal with them and resolve the conflict so that the displaced people are rehabilitated.

If suicide attacks are an indicator, the recent spate reflects the need and justification to open a dialogue. The beauty of democracy and politically diverse groups’ plurality is in dialogue and negotiated settlements. The militant and violent groups that were are our very own creation in a fascist way, will gradually be finished and dissolved only if we open a window of getting back to normal polity for them. How can they give up their desperate violent acts if we do not offer any window of dialogue for them? I am sure there are many among them who are sick and tired and just simply want to get back to normal life of being a Pakistani .citizen. ( I personally know one such family who has seen death and destruction by joining the militant Taliban. Their pain agony and loss has destroyed their and the children’s lives).

By this appeal I am not asking the military to stop their operations without achieving their objectives and begging the Taleban to spare us. I simply mean that a dialogue should be started so that the path to peace becomes defined and clarified and the poor population of Pakistan areas that are directly affected and also the areas that are under threat of suicide bombings are able to start their lives again.

Only today, while shopping at a shopping mall in Karachi, Clifton area I came across three boys of Pathan origin, residing in Tapu, near Shireen Jinnah Colony, trying to clean my car. They were from ages 14 to 16, innocent and young, so poor, with no future, no education. I gave them some petty cash and was wondering as to why should they not become suicide bombers? They would at least have some ideology, paradise for a future abode, some cash 10-20 lakh rupees for their families? Some justification for being born even. I may sound terrible, but the dust ridden clothes, their innocent beautiful faces, the hopelessness in their eyes, while other people with blackened windows in cars with dubious number plates shopped around in luxury malls, made me feel so guilty, helpless and wanting to do something for the poor people of Bajaur, Waziristan and other such areas. As these boys and I have seen even smaller, begging here in Karachi, cannot even speak Urdu, shows that they have come down to Karachi recently. What future awaits them here in these slums, shanties? Should not these people be able to go back to their areas and given some decent schools or a living? If we do not think of peace and negotiations this problem of militancy and these violent groups solvency will remain and we will never be able to contain violence.

The people of Pakistan are very brave and resilient. They have great courage and ability to rise from the ashes and be able to make something for themselves. Given the chance again, the people especially of the NWFP will again contribute to Pakistan. Only this time we have to really extend the political parties and democratic system to all closed tribal areas and use development as the tool mall over NWFP. Only political voice and amalgation with the rest of the frontier province will curtail the tendency of the people to join non-state or anti-state forces. Providing education and developing infrastructure for economic activity will change their mafia, cartels, smuggler groups and recently militant activities. Only if healthy choice is given for jobs and lifestyle will this impoverished and violence ridden area be rehabilitated. This also stands true of the Punjab. Here also the education and economic opportunity aspect has to be addresses on a priority basis. The power groups which post Afghan jihad have taken a religious façade, have to be deflated only through education and employment. Southern Punjab has to be rehabilitated by bringing in land reforms or providing some mechanism of absorbing the masses in economic activity that is not cartelized by the big landlords. The political economy of Southern Punjab has to be recognized and given a new dimension. Maybe Cooperatives as Akhtar Ali writes in his forthcoming book.