Looking back at COVID-19

(A few additional comments added on 02/21/21)

COVID-19 is still a menace that is affecting thousands of people every day across the globe. However, vaccination and palliative therapies indicate that there is less of it ahead of us than behind us. I am training in pathology at a hospital in Texas and do not have the required qualifications to talk about the nitty gritty of COVID virus and its structure. However, I was involved in management of patients with COVID who were in intensive care and before that, in procuring convalescent plasma for COVID patients. I want to write about the policy and public health side of managing COVID and not the clinical perspective, which is not my primary specialty. This piece was inspired by two articles in the New Yorker, the first is a long-read from Lawrence Wright (here) and the second is from Charles Duhigg (here).

When news about COVID started trickling at the end of December 2019, I was not alarmed. I thought of SARS, Swine flu, Ebola and MERS, which were mostly containable viral diseases and their human impact was not global. I was at a conference in Dallas at the end of January, where a presentation was on memories of dealing with the first Ebola case in the US. I remember sitting in the back row of the auditorium and listening to the lengths that a particular hospital in Dallas went, to quarantine the said Ebola patient. By February, there was news of how Chinese state was hiding things about the mysterious viral infection and whistleblowers were shedding more light on the disease. It was in late January-early February that first cases of the mystery virus were discovered in Seattle suburbs and suppression of data/news about COVID started in the US (the Trump administration). I was at another conference in Los Angeles at the end of February and saw the news that cases of COVID had been diagnosed near San Francisco.

Upon my return to work in the first week of March, I was required by the hospital to report travel to the employee health clinic, which I did. Prior to arrival of COVID, I was going to travel to Ohio for an elective rotation and to New York to present at a conference. With COVID, all plans had to be cancelled. Since March of last year, COVID has affected millions of people across the globe and disrupted life as it used to be. One of my friends refers to any year before 2020 as “X years B.C.” (before COVID).  Moving from my personal story to a bird’s eye view, what can we learn from COVID moving forward? I have tried to distill my thoughts about the pandemic, pandemic response and best practices.

Based on what we know now, here are a few things about COVID response, with relevant exceptions:

1. Island nations have generally done better, with exception of Britain and to an extent, Vietnam. At the start of the pandemic, there were fears that autocratic governments will prevail better because dictators don’t have to worry about human rights, laws or courts. That fear has not come true, generally. Australia, New Zealand, Taiwan, Sri Lanka or Vietnam are mostly democratic nations.

2. Things have been better when scientists and public health officials have been allowed to be at the forefront, except in the case of Sweden, where the top epidemiologist wanted to test his “herd immunity” theory.  The New Yorker story from Charles Duhigg that I mention above, refers to a significant difference in COVID cases and deaths between New York, where politicians were at the forefront of COVID response, versus Washington state, where public health officials made the rules.

3. African nations have done better at managing COVID than most ‘first-world’ countries, in my opinion, due to their experience in dealing with Ebola, MERS and similar viral illnesses. There has been a recent second wave and a South-African variant that is more resistance to the mRNA vaccines than the OG COVID-19 or the UK variant. There was a recent story in the BBC about the second wave (here) and earlier, about the low rates of infection and mortality in the African continent (here).

4. It is incredibly hard to restrict what constitutes “daily life” even in the face of a deadly pandemic. Human beings are social animals and severing that connection from others, whether in form of closing offices or bars and restaurants, cannot be reliably depended on for long periods. Travel has become another necessity in this day and age, for business or pleasure. Airlines and the hospitality industry as a whole will be running losses for years to come. I traveled three times during the last year, twice domestically and once on an international route. I tried to be cautious and got tested before/after each of these journeys, which, admittedly is not a perfect way of being safe from COVID. There were multiple studies about spread of COVID on airplanes and I was constantly in fear of contracting it while flying, despite all precautionary measures.

I do not frequent bars/clubs in general so i didn’t miss them much. However, I did miss spending time at the library and our nearby Barnes and Noble.  If one were to look at the graphs of cases and deaths in the US, there are peaks around memorial day, 4th of July, Labor day, Halloween, Thanksgiving, Christmas and New Year. Around Christmas, close to a million people were flying every day in the U.S. Graphics from the Washington Post tracker.

5. China, not completely culpable but deserves blame for its early missteps and obfuscation (a la Great leap forward) when it comes to COVID. We still don’t know if COVID transmission started at a wet market or somewhere else. Wuhan is back to pre-COVID times while the rest of world keeps suffering. Chinese authorities have tried to strong arm the WHO and any outside effort to investigate the origin of transmission of COVID. I do not subscribe to the conspiracy theory that COVID is a “China virus” or that it was manufactured in a Chinese laboratory.

6. Vaccines. I consider the development of COVID vaccines a modern day miracle. The fastest that a vaccine had been previously prepared was close to three years. The severity of disease, mounting death rate and irresponsible behavior by the general public, made the timeline for introduction of a vaccine shorter than ever. Fortunately, the mRNA type platform vaccines had been in development for years and this was the right moment for them. The journey started in January 2020, when COVID genome was first shared by Chinese scientists and culminated in November/December 2020, when two major candidate vaccines was ready to be administered. Since mid-December, more than 73 million doses of either of these vaccines has been distributed in the US. This is a graphic from the Washington Post tracking vaccine distribution in the US:

I got vaccinated in January and feel fortunate to have that immunity. However,  the mRNA vaccines have a 66% response to the South-African variant (versus 90-95% against the OG COVID).  The AstraZeneca vaccine has a 23% immune response to the South African variant. There is very little good data on vaccines developed by Russia, China and India. From what we know about their mechanisms of action, Russian vaccine is similar in mechanism to the AstraZeneca vaccine (uses inactivated Adenovirus), while the Chinese vaccine is based on inactivated virus and the Indian (serum institute version) uses live attenuated virus. Graphic from NEJM.

7.  Viruses don’t care about state or national boundaries. The Sturgis motorcycle rally in South Dakota in August led to increased cases in neighboring Minnesota (here). A single conference in Boston in Feb 2020 lead to almost 300,000 cases (here). COVID has reached Antarctica, the last bastion of human presence without infection (here).

8. Disinformation spreads faster than the truth. The famous line that “A lie can travel halfway around the world before the truth can get its boots on” was truer during the COVID pandemic than any other modern peacetime event. Since I have a medical degree and had some exposure to COVID response, I was asked by many family members and friends from across the globe about various conspiracy theories circulating regarding COVID. The top hits included COVID vaccine altering your DNA, different cocktails for treating COVID (the whole hydroxychloroquine debacle), herd immunity, exaggerated vaccine side effects, masks, Vitamin D, COVID vs Flu, PCR vs rapid testing and their predictive values, various miracle cures etc. Many of these lies and misinformed views were spearheaded by medical personnel (doctors, nurses, nurse practitioners etc) which made it incredibly hard for a layperson to know what was the truth and what was just a fanciful conspiracy theory. To top it all off, many people initially (and still) refuse to believe that COVID is real.

9. Masks work but not all masks are the same. This is related to point 4 from earlier (human nature cannot be suppressed for long). It is hard to wear a mask all the time. I work at the hospital and that being a high-risk area, everyone has to be masked almost all the time. But, due to strict masking requirement, infection rate of workers (both medical and non-medical) at our hospital stayed less than 1% even when the infection rate was close to 10% in the community that we serve. N95s which should be worn by individuals who are at the highest risk of getting COVID provide better protection than a regular surgical mask (efficacy close to 65%), which is better than a regular cloth mask (efficacy less than 50% and needs to be washed regularly). I have seen innumerable number of people wearing their masks incorrectly (i.e. nose not covered) but I think that at least they are wearing a mask. One reason that east asian nations did better at controlling the pandemic is because mask-wearing is normalized at a larger societal level, compared to “freedom from tyranny” type attitudes seen in the US. According to estimates, if 90% people in the US had worn masks at the beginning of COVID, we could have averted millions of cases and thousands of deaths.

In Arizona, there were dramatic improvements in case numbers once mask mandates were enforced. (paper from CDC here).

10. The curious case of Pakistan and India. Early in the pandemic, while COVID was running rampant through most of Europe, North America and South America, India and Pakistan had very few cases compared to their populations. While India has caught up with the rest of the world lately, Pakistan is still reporting less cases than any major city in the US per day. What is causing this divergence? There are many theories and until it is studied methodically, I don’t have a clear answer. Even people who got COVID in Pakistan, got a mild disease. Many people pointed to BCG vaccination as being semi-protective against COVID. Some commentators proposed immunity due to earlier sub-clinical viral infections. Are there genetic factors causing this? My hypothesis is that Pakistan is not as exposed to the outside world as lets say the United States is. Secondly, testing in Pakistan is at a much lower level than anywhere else. At one point last year, the state of Punjab, with a population larger than Germany, was doing close to 15,000 COVID tests a day. If you don’t test, you can’t diagnose. Cases in Pakistan and India, graphs from the Johns Hopkins dashboard.

11.Personal Responsibility. The mantra of personal responsibility has been used throughout the pandemic by mostly right-wing politicians, trying to avert blame from themselves, resulting in a terrible failure. Anyone who has ever worked in customer relations can tell you that most people don’t really care about other people (knowingly or unknowingly). Public health does not work that way. One can argue that even economics doesn’t work that way either, but that is a separate debate.

12. One heard the phrase “how many lives can you save by closing the economy” or variations of it since the early days of the pandemic. The lives versus economy rubric was debated over and over, without much evidence. Countries in the EU and Australia/NZ paid people to stay home. That approach is paying them off in the long run. In a paper titled “COVID-19 and global income equality” (here), Angus Deaton showed that saving lives has a positive impact on long-term economic outlook of a country.

13. Is the “office space” dead? Are we going to have a different economy after the pandemic? Would there be mass migration from major cities towards smaller towns and suburbs? I don’t have these answers as I am not an economist or a public planner. But these questions interest me and I am always trying to read about them.

14. Lastly, I cannot predict what is going to happen with COVID. When the pandemic started, my hope was that it would die down within six months. With a sharp decline in case numbers and increase in vaccinated individuals, I have hope that COVID would be under control by the end of the year. Would new variants disrupt this timeline and everyone will have to get a booster vaccine at some point in time? It is quite likely.

Comments and suggestions welcome!

 

 

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Rise of the millennial grifter: Book Review

“A good story is a problem. It makes your mind shut down, and you ignore everything else”.

ATF agent in Manhunt: Deadly Games 

I have recently been reading ‘Billion Dollar Loser’ by Reeves Wiedem, about WeWork and its founder Adam Neumann. It reminded me of an NYT article from Amanda Hess last year titled “Fyre Festival, Theranos and our never-ending ‘scam season'” about the rise of grifting among Millenials. She pointed to Billy McFarland (Fyre Festival), Elizabeth Holmes (Theranos), and Anna Delvey (SoHo grifter) as examples of American Millenials who have become infamous in the last few years for overselling bad products/personalities and underperforming or outright lying people out of enormous amounts of money. Jia Tolentino wrote in 2018 that “At some point between the Great Recession, which began in 2008, and the terrible election of 2016, scamming seems to have become the dominant logic of American life.” She further expounded on this phenomenon as “Grifter season comes irregularly, but it often comes in America, which is built around mythologies of profit and reinvention and spectacular ascent. The shady, audacious figures at its center exist on a spectrum, from folk hero to disgrace. The season begins when the public catches on to a series of scammers of a particularly appealing sort—the kind who provoke both Schadenfreude and admiration.”

Adam Neumann, the co-founder of WeWork, is another addition to this list. Some on Twitter would argue that Elon Musk, and to a certain extent, Travis Kalanick, should be mentioned in the same breath as these grifters, but he is not a millennial and at least has something to show for all the hype. There are many similarities among this lot, including the worship of Steve Jobs (Neumann in passing, Holmes to the extreme), megalomania (Neumann telling a rabbi, “I am WeWork”), abusive behavior with employees (Neumann hired people for office jobs and forced them to do hard labor, Holmes was frequently threatening, McFarland did not pay local workers in Exuma), no or little experience in the industries they wanted to disrupt (Neumann had been a landlord for one floor of a building before starting WeWork, Holmes came with a background in chemical engineering undergrad training which she never finished, McFarland had never organized a musical festival before), middle class upbringing (Neumann’s parents were doctors, Holmes’s worked in the government, McFarland’s were real estate developers), using family and friends for early funding (Neumann through his wife Rebekah Paltrow and the connections he made at the Kabbalah center, Holmes through her family friends such as Tim Draper and Victor Palmieri), nepotism (Neumann employed his wife, sister and brother in law, Holmes installed her brother and his fraternity brothers at Theranos), and lots of charisma. There was even overlap between Neumann and Billy McFarland. McFarland had started his first company out of a WeWork office.

There were a lot of dissimilarities too. Neumann fudged numbers, but Holmes outright lied to people about her technology and what it could achieve, possibly harming cancer patients. Neumann had a major benefactor, Masayoshi Son, who invested billions in WeWork, an opportunity that Holmes did not get but more on Holmes later.

Neumann wanted to disrupt an industry that he did not understand well and which may or may not need to be “disrupted.” WeWork was a lousy landlord that provided small spaces for high prices with the promise of ‘community building’ in the form of common areas, beer on tap, and fancy coffee. Neumann tried to frame it as a tech company even though there was little to no technology involved in this operation. He wanted to ride the wave of success that tech companies were on. Unfortunately for him, he believed in his own bullshit. At its height, WeWork was opening up a new co-working location every day. By the summer of 2019, WeWork had 528 in 29 countries. The company had raised $12.8 billion but was losing $219,000 an hour.

The person who I find the most similar to Adam Neumann is, ironically, Donald Trump. They share many traits such as megalomania, exploiting their employees, hypocrisy (implementing vegetarianism at WeWork while having Lamb dinners), nepotism, fondness for opulence (Private jets, fancy cars), self-dealing (Neumann buying buildings and renting them to WeWork), showmanship, wanting absolute power, and expanding their brand outside their areas of expertise. The final days of Neumann at WeWork are reminiscent of the final days of the Trump presidency: everyone around Neumann knew that the jig was up, but they were too afraid to say anything. There is still litigation going on about his exit.

The tale of WeWork’s rise and fall is also the story of how venture capitalists (V.C.s) have taken over the startup world. In a NewYorker story titled “How Venture Capitalists are deforming capitalism“, Charles Duhigg wrote that ‘Whereas venture capitalists like Tom Perkins once prided themselves on installing good governance and closely monitoring companies, V.C.s today are more likely to encourage entrepreneurs’ undisciplined eccentricities.’ He writes at length about what happened at WeWork once the leash was off:

“WeWork had a number of internal problems that should have concerned Dunlevie and the other board members. In the spring of 2018, the board learned that a senior vice-president had prepared a lawsuit accusing a colleague of giving her a date-rape drug. She also alleged that executives often referred to female co-workers with such epithets as ‘bitch,’ ‘slut,’ and ‘whore.’ (The senior vice-president received a settlement, and the suit was not filed; Dunlevie told me that he has no recollection of the complaint.) There were reports, too, of top executives using cocaine at events, dating subordinates, and sending texts like ‘I think I should sleep with a WeWork employee.’ Some board members knew that Neumann used drugs, that he had once punched his personal trainer during a workout session in his office, and that a raucous party in Neumann’s office had ended with a glass wall shattered by a tequila bottle.

The board had also allowed Neumann, a passionate surfer, to take thirteen million dollars in WeWork funds and invest them in a company that made artificial-wave pools, even though surfing had nothing to do with WeWork’s business. Neumann spent millions more to finance an idea from Laird Hamilton, a professional surfer, to manufacture ‘performance mushrooms.’ The board knew that WeWork had spent sixty million dollars on a corporate jet, which Neumann and his family took to various surf spots. It had stood by as WeWork’s name was changed to the We Company; not long afterward, the company paid Neumann $5.9 million in stock because he had trademarked the word ‘We.’ (The payment was later returned.)”

For decades, venture capitalists have succeeded in defining themselves as judicious meritocrats who direct money to those who will use it best. But examples like WeWork make it harder to believe that V.C.s help balance greedy impulses with enlightened innovation. Rather, V.C.s seem to embody the cynical shape of modern capitalism, which too often rewards crafty middlemen and bombastic charlatans rather than hardworking employees and creative businesspeople.

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“I tend to be wary of charismatic people. My father always reminded me that Ted Bundy was also very charismatic”. A former WeWork employee on the podcast WeCrushed.

 

There is an alphabet soup of regulators and regulations that governs laboratory medicine in the United States, including but not limited to FDA, CMS, CAP, AABB, Joint Commission, CLIA, and so on. Devices in a laboratory are regulated by the FDA. Any new device that one brings on or any new testing methodology that one wants to start requires permission from the FDA. Recently, many labs have applied for or received emergency use authorizations (EUA) from the FDA for their lab-developed tests (LDTs). Getting a full authorization for an LDT is a painstaking and tedious process involving loads of paperwork, which hindered the early rollout of COVID testing in the U.S. Center for Medicare and Medicaid Services (CMS) is responsible for regulating lab personnel and effective running of testing. They have approved some organizations such as The Joint Commission (TJC), CAP, or AABB to do inspections on their behalf. A lab director (M.D. or Ph.D.) has to get licensed to work as the lab director, and the buck stops with them. College of American Pathologists (CAP) is one of the leading organizations in the U.S. that inspects and provides guidelines to pathology labs. CAP is mentioned in the book ‘Bad blood’ by John Carreyrou inaccurately as the “medical association representing laboratory scientists”. CAP is an association of board-certified pathologists who are distinct from medical lab scientists (MLS).

Theranos considered itself above all these regulations. They constantly lied and manipulated data to satisfy the minimum requirements for getting their lab registered. They showed a running loop of pre-recorded videos to Novartis that showed blood flowing their cartridge and getting tests done for their Theranos 1.0 machine, in order to sell their product. Holmes was not trained in pathology, not even biology. She came with an unfinished bachelors degree in chemical engineering. Holmes’s mind veered from idea to idea until something stuck. She started Theranos initially to develop a wrist-worn device that analyzed a person’s blood, then switched to using small amounts of blood for lab testing and wanted to deploy it to help cancer patients, then to use the same technology to detect swine flu, to use the same technology to assist the US military in Afghanistan and Iraq, and to have her machines in Safeway and Walgreens.

Holmes was a control freak. She would ask anyone visiting the Theranos offices to sign an NDA first, this included all employees as well. She would pit one team of engineers against another for similar tasks. She appointed people to keep an eye on when employees came to work and left. In a tactic also used by WeWork, Holmes would order dinner frequently that arrived at eight o clock at night, ensuring that employees stayed late. Anyone who dared dissent was purged from the company without explanation. There was a lot of staff turnover at Theranos during its existence. There was a lot of hype created by Elizabeth, using her idea as revolutionary and selling it to gain reputation and money while actually delivering nothing. Along the way, she fooled V.Cs, CEOs of Pfizer/Safeway/Walgreens, General Mattis, Herny Kissinger, Rupert Murdoch, Larry Ellison, and David Boies.

These two stories illustrate two ambitious millennials who wanted to change the world, fooled enough people, spent billions of dollars to achieve their dreams but ended up as cautionary tales. As old Abe Lincoln would say, “You can fool all the people some of the time and some of the people all the time, but you cannot fool all the people all the time”.Good riddance Elizabeth Holmes and Adam Neumann.

Books and podcasts that I accessed while reading this piece, 1) Billion dollar loser by Reeves Wiedeman 2) Bad Blood by John Carreyrou 3) WeCrashed podcast 4) The Drop Out, podcast.

An article comparing WeWork and Theranos that complements this piece is from Bussiness Insider: https://www.businessinsider.com/with-wework-theranos-line-between-charm-and-fraud-doesnt-exist-2019-9

P.S I think Adam Driver should play Adam Neumann in the movie version of WeWork. Both of them have a military background, are very tall, and of course, charismatic.

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Ammar Rashid and the frailty of Pakistan’s state narrative

ImageI don’t personally know Ammar Rashid, but I know many people like him and many people who either went to school with him or moved in the same circles. Unlike many (most?) Pakistani students who study abroad and develop a deep understanding of the mess that is Pakistan, Ammar Rashid chose to return to his country. He lives his life according to what he believes in (no matter how unpopular those beliefs and ideas may be), and not a lot of people in Pakistan can say that. I heard him singing Faiz Ahmad Faiz’s Intesaab (Acknowledgement) many years ago, and that is my favorite version of that verse ever sung. I do not agree with everything that Ammar believes in (Listen to him eloquently explain his positions here: soundcloud.com/howtopakistan/episode-14-awami-workers-party-the-pakistani-left), he is an officeholder for the Awami Workers Party (AWP), an artist, writer, and a teacher. He participated in the 2018 national elections for a National Assembly seat. He was one of the leaders of the movement to preserve katchi-bastis (slums) in the I-11 sector, Islamabad.

Why was he arrested?

He was protesting alongside his comrades against the arrest of PTM leader, Manzoor Pashteen. Pashteen galvanized the youth and adult population in former federally administered tribal areas (FATA) that border Afghanistan. The presence of PTM threatens the ‘national narrative’ put forth by Pakistani establishment that they ‘cleared’ FATA of all militants during the Zarb-e-Azab operation (2014-2017). PTM contends that during and after the operation, military demolished homes and business places of non-militants living there and killed (or facilitated the killing of) many tribesmen who were actually anti-militant (Pashteen wrote about this for the NYT, read here. )

Following Ammar’s arrest, there were more protests in different cities in Pakistan. In Faisalabad, many protestors were picked up by the police today for protesting against the arrest of Ammar, who was protesting the arrest of Manzoor Pashteen.   This suppression of dissent is reminiscent of fascist regimes around the world. There are not a lot of people as well-read and politically conscious as Ammar and his fellow protestors and muzzling their voices by force merely exposes the fragility of the military’s narrative. The number of people who think like Ammar in Pakistan is probably less than five hundred. Compare that to the numerical strength of Army proper: half a million (and millions of admirers). Since January 2017, when bloggers were abducted by agencies (and later released), there has been an uptick in ‘disappearances’ of progressive activists and students. Due to the abovementioned numerical mismatch, these abductions don’t always get the media coverage they deserve, and mainstream political parties almost never defend these dissenters. In such dark times, just a safe release of these protestors would be a welcome step.

P.S A twitter thread of tributes to Ammar by creative comrades: https://twitter.com/tooba_sd/status/1224025720873275394?s=21

 

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Junaid Hafeez and Teaching in Pakistan

I could have been in Junaid Hafeez’s place. He was born in a small town in Punjab and was ‘foolish’ enough to leave a career in medicine to pursue the arts. He got a Fulbright scholarship and studied literature, photography, and theatre at Jackson State University in Mississipi before returning to Pakistan and working as a guest lecturer at Multan’s Bahauddin Zakariya University. In 2013, he was arrested on charges of blasphemy. In 2014, his lawyer, Rashid Rahman, was killed in broad daylight, and some lawyers in Multan celebrated that killing. According to witnesses, when Rahman’s body was being bathed before being buried, someone was beating the dhol (signifying happiness) outside their house.  This month, Junaid Hafeez was sentenced to death (link from BBC). He has been kept in solitary confinement for years, for his own protection. What was Junaid Hafeez’s fault?

He chose to say (or just think) things that are not supposed to be said or thunk in Pakistan. He could have chosen to return to the United States or to another country where his life was not in constant danger and where he would not be held in solitary confinement for his own sake. He also chose to teach younger generations and give back to the country, which is also a grave sin in the land of pure. (Read my friend Komail’s experience in his recent piece here).

Sometime during medical school, I myself got disillusioned with medicine and thought about alternative careers. It took me a few years to figure that out and in the meanwhile, I graduated from medical school and completed the necessary medical training. I also got a scholarship to visit the United States and was writing for blogs and newspapers during that interim period. I got sick and tired of sitting at home and applied to be an instrutor in Anatomy (never my favourite subject but that was the only job open at the time) at a private medical school in my hometown. I had never formally taught a class, much less a class of fresh faced medical students on their first day. I did my best effort to hide my nervousness (using my experience as an actor during med school) and hopefully succeeded. There is not a lot of ‘concept-based’ teaching in Anatomy which made my life hard and the fact that in Pakistan, most med schools spend an inordinate amount of time teaching anatomy that students will never use (2-3 months on upper limb!!). I tried to mix things in, just because i wanted them to pay attention. Some of my first lectures would include a mention of the theory of evolution and anatomic signs of that alongside the scientific method. I once started a presentation with a small biography of Karl Marx that I had written for an urdu newspaper, as the day was Marx’s birthday. I tried to not bring up religion or politics in class (other than that one Marx episode, and I wasn’t even a Marxist!) because i wasn’t teaching them social sciences and didn’t want to get into trouble. I was however once asked what an atheist is, to which i gave a very diplomatic answer. The place was run by a political family, who had bought the land for that med school when one of their members was a local nazim under in the Musharraf era. They ran the school like a traditional patriarchy. Female students were prohibited from openly mingling with their male classmates. They eventually started giving ‘tickets’ to such micreant girls and started calling their fathers when they were ‘found’ talking or sitting with a male. I taught at that place for about a year and then moved to Lahore to start my residency.

During residency, we were supposed to oversee students during their labs but there were very few opportunities to actually engage them in a conversation. I took a break from residency after ten months to study for USMLE exams and got a teaching job at another med school in Lahore. That place was the worst of my three experiences mostly because it was a diploma mill. It was also a hybrid campus, so med students would attend classes alongside pharmacy, physical therapy and social sciences students. The social sciences segment was a net-negative for the med school since there was a lot of reactionary views (Orya Maqbool was a frequent guest at their events) going on. One day, I was studying in the lab (the only reason I went to campus every day) when a media student came in and asked if he could do a mock interview for his project to which I agreed. He wanted to ask generic questions so I fed him generic answers without delving too much into specifics. Otherwise, that place was quite toxic. The lab staff (high school graduates and diploma holders) treated female teachers (all of them doctors) as their equivalent and misbehaved with them. One of the lab staff tried to sell the annual exam questions to the highest bidders and was caught on tape (thanks to WhatsApp). Before anything could be done against him, he had fled. I felt sorry for the students and their parents who spent millions of rupees on their offsprings’ education.

No wonder the best and the brightest (not including myself) don’t bother coming back to Pakistan.

 

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The role of Comedy in our age

I am an aspiring stand up comic (‘aspiring’ the operative word here). I was attracted to quick-witted, slapstick comedy while I was at an all-male boarding school in Pakistan. Since I was not physically strong enough to compete with the big boys, I had to use my tongue as an asset/weapon. I grew up watching mild-mannered comedies in Urdu on Pakistani television. It wasn’t until the late 2000s that I discovered ‘Seinfeld’ as a syndicated show on an Indian TV Channel. I had started watching ‘The Daily Show ‘ with Jon Stewart almost at the same time, through pirated websites (broadband internet was a late arrival in our household). There was no broader culture of stand up comedy in Pakistan, except a few souls with western education who were briefly on the scene in the early-to-mid 2000s (Sami Shah, Saad Haroon, etc.), mostly clustered in Karachi (which was as culturally far away for me as New York City). I used whatever avenues I could to write humor. I wrote parodies and mockeries in Urdu, first in boarding school, then in med school. Urdu has produced some great humorists (Ibne-Insha, Patras Bokhari, Khalid Akhtar, to name a few), but written humor is different than performative comedy. The only parallel I could find was in stage dramas that were mostly, if not entirely, produced in Punjab and consisted of varying degrees of ‘jugat baazi,’ which is pure slapstick comedy. It can consist of monologues or a back and forth between two men (and it is almost always men) who take turns to insult each other. While it is quite entertaining, it is most often misogynistic and hinges upon common tropes.
Image result for sami shahhttps://i0.wp.com/www.radioazad.us/wp-content/uploads/2016/05/sAAD-hAROOM.jpg?resize=506%2C760

The TV show ‘Hasb-e-Haal’ ushered in a new era of political comedy in Pakistan. Before that, there was ‘Hum Sab Umeed Se Hain’ (literal meaning: we are all hopeful; a double entendre since ‘umeed se hain’  can mean hopeful or pregnant), which consisted of parodies of major political figures. Hasb-e-Haal had regular news and humorous analysis of that news by Azizi, a character played by veteran stage actor, Suhail Ahmed. The show was competing against completely serious political shows and shot to popularity in the late 2000s/early 2010s. Soon after that, there was a deluge of TV shows offering political comedy, in varying degrees of success. There was no ‘Saturday Night Live’ analog that poked irreverent fun at every possible institution in the society. Noone could criticize the judiciary, the military (and its proxies), or the ‘Two-Nation Theory’ (TNT).  I remember watching a stage show that was quite popular in 2013-14, written by Anwar Maqsood (famous playwright), in Lahore. It was a miniature, middle-class, sanitized version of the nightly news shows. The state of humor in Pakistan was bleak, a nation taking itself too seriously and too afraid to laugh at ourselves. I actually wrote a parody show that was educational at the same time as it was humorous, in 2012, which was filmed by a friend but did not make it to the screen, partially because it was my first experience writing in that format.
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Recently, there have been some positive developments like Aurat Naak, an all-female comedy troupe, and satire sections in newspapers (dearly-departed/banned Khabaristan Times and The Dependant, both of which I contributed to). However, satire in English newspapers and blogs has its limitations: Very few people in Pakistan read English papers regularly. A few years ago, Nadeem Farooq Paracha (cultural critic for Dawn and one of my early heroes) wrote a blog for Dawn.com that portrayed Malala Yousafzai as a polish agent planted in Pakistan (there were enough hints in the piece for it being a satire column/blog). The article was soon shared by people who took is as gospel truth, and some local newspapers even published Urdu translation of that piece as evidence that it was proof of Malala being a fake (a common enough conspiracy theory in Pakistan). Dawn had to label the piece as Satire at the front and bottom of the page as a response. A year or two later, when I submitted a satire piece to Dawn, I was told to ‘tone it down a bit’ in light of the Malala story. In Pakistan, there is a very fine line between humor and absurd reality, and as a writer, I was often treading that line, veering from one side to another.

It is not as if Pakistan does not have people who are funny and can poke fun at the ‘holy cows.’ I know dozens of people who do that in private frequently but cannot, for their safety, say those things in public. There is no First Amendment guaranteeing free speech rights in Pakistan. ,’ 19 of the constitution explicitly identifies the holy cows (military, judiciary, TNT) and prohibits speech against that. Adding to this fuel is the firepower possessed by Pakistan’s right-wing media and loudspeaker power wielded by molvis who can commandeer people to form a mob against anyone at the drop of a hat. A few years ago, a fellow journalist and friend wrote an article about the ‘homosexual question’ in Islam on a popular Urdu website. A week later, Orya Maqbool Jan, former civil servant, and lifelong windbag dedicated a whole TV show to that one article and targetted that Urdu website. A case of hate speech was filed against him with Pakistan’s Electronic Media Regulatory Authority (PEMRA). For his hearing, Orya brought a bunch of goon (including lawyers, molvis and other members of a for-hire mob) and disrupted the hearing. Nothing ever came out of that hate speech case.

When I moved to the US in 2017, I had the opportunity to see stand up comedy myself. I went to a place in Miami that had bi-monthly comedy shows and to a place in Fort Lauderdale that had an open-mic. I wrote some material myself, which I performed in front of a group of friends but never on stage. In Houston, I went to an open-mic and was going to perform my set, but I was supposed to be on stage around 11 pm, which is way past my bed time, and I had friends in the audience who had to go to work the next day. In Washington DC, I went to a show titled ‘Black Side of the Moon’ in December 2016. It was a combination of monologues and sketch comedy by an all-black cast. The most memorable moment in the show was when a white volunteer who came on stage was given the ‘Full African American Experience’, including being sold at a slave market, denial of place in a sports team despite his qualifications, and being shot dead by a black policeman. It was probably my first exposure to live, politically conscious comedy. A Pakistani version would have Ahmadis or Baloch people mocking the majority Sunni population or Punjabi elite. That show is not going to happen any time soon.

Sadly, the only Pakistani import to the US in terms of stand up comedy (Kumail Nanjiani) is a good actor but a subpar stand up comic. His film ‘The Big Sick’ was an amalgamation of stereotypes and some mildly emotional scenes. He does quite well in the HBO TV show ‘Silicon Valley’ and was admittedly quite good in the movie ‘Stuber’. Many of his Karachi acquintances are on the record saying how he fabricated things about his life in Pakistan (you can google that). Do You Believe in Madness?

I was in Chicago recently and saw a show at the famed Second City theatre titled ‘Do you believe in Madness?’. It was a powerful sketch show with a diverse cast and ranging in topics from Abortion to Impeachment, global warming , Brexit and including a song with names of all the people who have left the current white house (sung to the tune of Billy Joel’s ‘We didn’t start the fire’). It was like watching SNL but better. This is my long-winded way to say that the satte of comedy in the US, is strong, and long may it continue!

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Book Review: The Battle for Pakistan by Shuja Nawaz

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In the post 9/11 years, a multitude of “Pakistan experts” emerged and the bookshelves were flooded with books containing the words ‘Pakistan’, ‘crisis’, ‘storm’ or ‘battle’. In my opinion, very few writers from outside Pakistan (and even inside) have explored the country, its politics and its regional dynamics pre- and post-9/11.  I consider Shuja Nawaz as one of the authors who, both as an insider and an outsider, written about Pakistan’s civil-military imbalance and foreign policy while maintaining balance and equanimity. I would like to disclose here that I have benefitted personally from Shuja Nawaz’s actions in the past. I was selected as one of the fifteen ‘Emerging Leaders of Pakistan’ (ELP) selected by Atlantic Council’s South Asia center (headed by Shuja) in 2012.

A little backstory: I was in a strange place in my life at the time. I had just finished medical school and had started my internship in internal medicine. My life was in flux. In the last year of medical school, I had drifted away from medicine and towards political science and history. Following Salmaan Taseer’s assassination in 2011, I had taken night classes at a makeshift school on political economy and history (more on ST’s assassination and my transformation here ). I had also started writing for my own blog and later for express tribune’s (ET) blogs and for Viewpointonline, a fledgling left-wing weekly. By the time I started my internship in May 2012, I had been published in ET, Pakistan Today and Dawn Blogs. During medical school, I had taken part in student politics and was aware of the brewing ‘Doctors Movement’ which was headquartered in the same dorms where I lived. In June-July 2012, there was a massive strike across Punjab and many of my classmates who were interns got arrested and were placed alongside death row inmates in Lahore. I wrote about this for ET and Dawn and engaged in twitter and Facebook wars with people who saw no benefit in our strike. A week after the strike was over, I received an email from Shuja that I had been selected for ELP and would be visiting the US in October-November 2012. I had earlier done an online interview and an in-person interview (after a typical 40-hour shift at the hospital) during the selection process. The other 14 people came from different backgrounds (Activists, NGO people, media people) and I was selected as a writer.  We met General Mattis at Shuja’s house in Virginia, Lt Gen Douglas Lute (Obama’s special rep for Af-Pak) in the West Wing of White House and Chuck Hagel at the Atlantic Council. We also visited the Pentagon and Hoover Institute in San Francisco where we met George Shultz. Most of these meetings came about due to personal connections and efforts by Shuja and his staff. One of the dominant themes of our conversations was the status of Pakistan post-2014 ‘withdrawal’ of the US from Afghanistan. We also got a two-hour masterclass in US-Pakistan history from Shuja while we were stranded at our hotel in NYC due to Hurricane Sandy (and had to cancel our meeting with then-Mayor of Newark, Cory Booker). I wrote a few blogs for the now-defunct website for the fellowship that can be accessed here, courtesy of way back machine.

Personally, that first visit to the US in 2012 changed a lot of things for me in the short and long run. The fact that I’m writing this while sitting in the United States with a pretty stable life owes a lot to that selection. I have met Shuja over the years both in the States and in Pakistan and have learned a lot from him. I rate his earlier book ‘Crossed Swords’ (which I have a signed and amended-by-the-author copy of) as one of the best books on Pakistan’s military-industrial complex and its impact on Pakistan’s history.

Moving on to the next book. Shuja has been close to many of the protagonists in the book on both the US and Pakistani side. He grew up in a military family and his brother Asif was Chief of Army Staff in the early 90s, before his sudden death. He has been called the ‘Pakistan army’s man in DC’ by some people in Pakistan over the years.  Having read books on Pakistan-US relations in the last decade (including but not limited to: Directorate S, The Dispensable Nation, War on Peace, India vs Pakistan, Sleepwalking to Surrender, The Wrong Enemy, The Way of the Knife), one gets a general outline of the ebb and flow of the relationship between the two countries. What Shuja’s book does is to add an insider’s narrative on the events and puts things in perspective. It starts off on the Pakistan side with the political reshuffling underway in 2006 when Musharraf wanted to sign an NRO with Benazir Bhutto (BB) and a few months before that Nawaz Sharif and BB had signed the Charter of Democracy. Musharraf wanted to share power with BB but on his own terms, as a dominant partner. BB was not interested in such a lopsided setup and was gathering allies in the US before her trip to Pakistan. Musharraf was fighting many fires in 2007, the chief one among them was ‘Lawyers Movement’, allegedly an internecine conflict involving different intelligence agencies. BB landed in Pakistan in October and faced a bomb blast in which she survived but more than 100 of her dedicated party workers perished. In December, BB was not so lucky and became the target of another assassination attempt. Musharraf had lost the plot. Fresh Elections were held and BB’s party took control of the Federal government. Musharraf tried to maneuver a role for himself in the democratic setup but had to resign in August 2008. It was a new era for Pakistan and the political class was in charge after 9 years of complete military rule. Shuja was a first-hand witness to BB’s deliberations in the US and provides an insight into her mindset and that of Zardari at the time.

There was a change of guard in the US as well. Obama was elected President on the promise of quitting the useless, forever wars in Iraq and Afghanistan. In the first Obama term, there was the morass known as ‘Af-Pak’ policy review with State Dept, CIA, Military on one side and Richard Holbrooke on the other. In the end, with all possible information, Obama chose to announce an exit timetable from Afghanistan alongside a surge of troops. That was a blunder, as has been acknowledged by people in the Obama Foreign Policy team. The details of this process have been documented by Steve Coll and Vali Nasr in their respective books but Shuja provides further insight gained from candid interviews with key stakeholders and policymakers including Bruce Reidel. One particular thing that caught my eye was the discussion on Haqqani Network. I have always wondered why Pakistan protected them with such rigor and passion. A ‘senior Pakistani army officer’ told Seymour Hirsch that Haqqanis had “facilitated the evacuation of ISI personnel and their friends from Kunduz” and that was why they were regarded highly. Shuja thinks its not the right answer and I tend to agree with that. I wrote about the infamous Kunduz airlift here (link) and wish more Pakistanis would know about that incident.

With the arrival of Obama, the Musharraf-Bush ‘bromance’ post-9/11 was also over. Pakistan had received generous US aid and support (Non-NATO ally status and more) as a result of that relationship. The year 2008 changed that. Things went from bad to worse in 2011 though. Shuja has reserved a major chunk of his book on what happened in that fateful year. It was the year of Raymond Davis, of the OBL operation (my first ever blog for Dawn was on the OBL raid and I remember writing about the incident in Urdu while sitting in a General surgery lecture during May 2011), Memogate and Salala. I remember being quite up to date with the news at the time but Shuja’s narrative on all of these events, particularly the Memogate and Salala has added to my understanding of how the events unfolded and divergent viewpoints of protagonists.

He devotes a chapter to the issue of Financial Aid from the United States to Pakistan. It is a complex topic that involved failures on both sides. I have talked to many friends in Pakistan about this who work in development/human rights organizations and they told me stories of how cumbersome the process of getting funds from USAID is and the need for publicity often has to be weighed against the image that the US has in Pakistan (which is overwhelmingly negative).  That is the reason why some of the leading human rights organizations (e.g HRCP, Shirkat Gah) in Pakistan don’t even apply for grants and funds from US sources. There was (still probably is) a whole industry of ‘grifters’ who arose from the post 9/11 largesse by the United States. In the mid-2000s till recently, using the words ‘combating religious extremism’ was a very good way to get international aid in Pakistan, a fact that has been criticized by actual human rights activists. Many religious figures also used this opportunity to get US visas and money in the guise of fighting religious fundamentalism. Shuja writes about the much-maligned Kerry-Luger bill (in 2009) that was supposed to prioritize civilian aid to Pakistan and was disparaged from early on by the military. In the Tierney Repot in 2008, prepared by the US House of Representatives Committee on Oversight and Reform, it was admitted that “US brand in Pakistan had become ‘toxic’ over time”.

The New York Times wrote an editorial in 2015 titled ‘Is Pakistan worth America’s Investment?’ which Shuja quotes (and I find very true):

“Since 9/11, the United States has provided Pakistan with billions of dollars, mostly in military aid, to help fight extremists. There are many reasons to have doubts about the investment. Still, it is in America’s interest to maintain assistance—at a declining level—at least for the time being. But much depends on what the money will be used for. One condition for new aid should be that Pakistan do more for itself—by cutting back on spending for nuclear weapons and requiring its elites to pay taxes.

Doubts about the aid center on Pakistan’s army, which has long played a double game, accepting America’s money while enabling some militant groups, including members of the Afghan Taliban who have been battling American and Afghan troops in Afghanistan”.

Military Aid and what Pakistan did with that is no different. The details about how the Navy claimed $445 per sailor from Coalition Support Funds (CSF) in June 2005 but $800 per sailor in December 2005 would be comical if not tragic. In contrast, Air Force charged $800 per person in 2004 and $400 in later years. The Army charged steadily at $200. Similarly, Navy charged $5700 per vehicle per month as opposed to Army’s less than $100 per vehicle per month.

For Pakistan-watchers and students of civ-mil imbalance in Pakistan, there are frequent nuggets of interesting information. For example, about the 2014 PTI Dharna, US Ambassador Olson told Shuja that “We received information that Zahir-ul-Islam [DG-ISI] was mobilizing for a coup in September of 2014. General Raheel Sharif blocked it by, in effect, removing Zaheer, by announcing his successor. Zahir was talking to the corps commanders and was talking to life-minded army officers. He was prepared to do it and had the chief been willing, even tacitly, it would have happened”. We also learn about the inroads made into military by Tablighi Jamaat (TJ) and the ‘Pir-Bhai’ system which distorts the discipline of army.

In my opinion, the book is recommended reading for people interested in Pakistan, its civil-military relations and how the US treats its relation with Pakistan.

 

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A letter to Gandhi

(In 2017-18, an Indian friend wanted to collect essays from Pakistanis on how they view MK Gandhi across the border. I wrote this short letter to Mr. Gandhi that I recently saw in my collection. Sharing it with the BP community. )

Mohandas Karamchand Gandhi
Birla House,
New Delhi.

Dear Mr. Gandhi,

My name is Abdul Majeed and I am writing to you from the city of Lahore, Pakistan. I have been asked to write about you by an Indian friend of mine and I accepted his proposition. I feel ambivalent writing about you since I have thought about you in myriad ways over the course of my life. I grew up in a conservative Muslim household in a small Punjabi town called Sialkot and first learned about you in the ‘Social Studies’ textbooks taught to schoolchildren. My first impression of you as a person was quite negative since the role assigned to you by virtue of ‘Two Nation Theory’ (or TNT, as I now call it) was that of a Hindu politician who opposed the formation of Pakistan and probably hated Muslims. Like many schoolboys of my age, I idolized Mr. Jinnah, your arch-nemesis and a founding father of Pakistan. For us, Jinnah was the David to your Goliath, a defender of minority rights against all odds, an impeccably dressed man who stood up to the might of Hindus and saved Muslims of India from a cultural annihilation. In our imagination, he was everything you were not. We used to make fun of your attire and your persona. I grew up in a society where violence was the channel through which you expressed your masculinity and thus we thought your non-violent methods were signs of cowardice. I learned that All India Congress, a party you led for many years, did not support the idea of an Independent Pakistan (or a divided India, depending on whom you ask) and refused to believe in Partition even after two separate countries had been established.

My outlook towards history and towards your personality changed when I went to boarding schools in the northern part of the country. While the basic ideological framework remained in place, facts added up through the years. At one point in time, I could recite the whole ‘Pakistan Studies’ book by heart in two hours, including names of the books written by Sir Syed Ahmad Khan, a Muslim educationist and reformer in Nineteenth-century, charter of demands presented by the Shimla deputation to Viceroy of India in 1905, consequences of Bengal’s partition in 1905, Minto-Marley reforms of 1909, Fourteen points of Mr. Jinnah (a proposal for constitutional reform in British India) and the Islamic clauses in Pakistan’s three constitutions. You might be astonished to know that history books in our schools start the story from the Nineteenth century as if nothing happened in this land before. The boarding schools I went to, were located near Mansehra (containing artifacts from two thousand years ago) and Taxila (where the oldest University in the world was once present) respectively, sites containing artifacts from a past I never had. I knew you as a wily politician who duped Muslims during the Khilafat Movement. The word ‘Mahatma’ was used as a prejudicial slur towards anyone ‘Indian’. I often got called by this name because I was a vegetarian.

Years later, I ended up seeing you in a different light. I was roaming the streets of New York City in the immediate aftermath of Hurricane Sandy when I chanced upon a statue of you in Greenwich village. A week after that, I saw another one of your statues at the MLK memorial in Atlanta. I learned about your influence on Martin Luther King Jr. and the strategy of non-violence resistance. It was around this time that I read Arundhati Roy’s foreword to ‘Annihilation of Caste’ and ‘The South African Gandhi: Stretcher-bearer of Empire’. As I grew up, I came around to the idea that human beings contain multitudes and having contradictions is partly what makes us human. On one hand, you paid lip service to the idea of caste in Indian society, on the other, you made public displays of spending time with the untouchable community. You accelerated the fusion of religion and politics in India during the late 1910s and the Khilafat movement and you also held fast when Pakistan was not paid money it was due after partition. You used elements of Hinduism in your political and social message and were eventually gunned down by a Hindu nationalist. You didn’t subscribe to the Two nation theory but the last century proved you wrong. India and Pakistan have grown and keep growing apart as a Sunni state and a Hindu state. Some of your ideas were as controversial then as they are now. You were in favor of treating Nazis with peace and non-violence and you lived to see how that turned out. In Pakistan during the 2000s, some people wanted to talk to the Pakistani Taliban (TTP) and that didn’t go as planned either. The question then is, how does one deal with groups whose founding ideology is based on violence? With this, I’ll leave you in peace in your forever abode.

Greetings from Lahore,

Abdul Majeed Abid

 

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Film Review: What Will People Say?

**Caution: Spoilers Ahead**

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I was watching the film ‘What will people say’ (courtesy, Kanopy), an official selection at the Toronto film festival in 2018. It is a story familiar to anyone who grew up in Pakistan or in a desi family abroad. A young, second-generation Pakistani teenage girl (Nisha) in Norway wants to live her life like any other teenager in her peer group but is restricted by her parents. Like most rebellious teenagers anywhere in the world, she finds ways to do what she wants to do (go out partying with a friend in the middle of the night) but stops just shy of having physical relations with one of her guy friends. One such day, she gets caught by her father who finds one of her male Norwegian friends in her room and starts beating him and then turns his fury on her. A neighbor calls the police and Nisha is escorted to a safe place by Norway’s version of the CPS.

After spending a night at CPS, Nisha’s mother calls her to tell her that everything will be okay and that her father will pick her up from CPS in a few minutes. Nisha, being a teenager, falls for this trap. She ends up on a flight to Pakistan with her father. Her father leaves her at his sister’s house and returns to Norway the next day. Nisha tries to contact someone in Norway but she has no access to international calling or internet. Her first night, she tries to run away in the streets but comes back to find her aunt at the door telling her that the nearest airports in 350 Kilometers away. At another instance, she tries to send a message to one of her Norwegian friends via facebook through a net cafe but is caught and her Norwegian passport is burned. She spends eight months at that place. While she is there, she falls for one of her male cousins living in the same house.

One night, they are caught kissing at night by local police who beat him mercilessly and ask her to strip at gunpoint. The police then ask the guy to fondle her in front of them, all while taking photos of them. The couple is then dragged to their house and police demand money in exchange for deleting those photos. Nisha’s father is summoned from Norway by the Pakistani relatives and she is sent back. While Nisha’s father is in Pakistan, he spits at her face and then takes her in a taxi to the top of a mountain and orders her to jump from there. She tries to plead with him while he throttles her and tries to push her. He is unable to, and they end up back in Norway.

There is a family meal and her mother tells her that they are giving her a final chance. The prospect of her becoming a doctor is brought up and that it would be one way in which the honor of family can be redeemed. Some of the dialogues used by her mother upon her return are,

People don’t even invite is to weddings anymore.
I wish you were stillborn”.

Within a few days of her return, she comes back from school to find that there is a ‘match’ ready to happen. The boy (Adnan) is a doctor in Canada and from a Pakistani family. Adnan’s aunt is visiting Nisha’s house and he is present via Skype.

Her father muses out loud that she can study and later work once she is in Canada. The boy’s aunt says ‘No, there is no need for studies or work. Adnan earns plenty of money. She’ll later be busy enough with children and the house”.

Nisha’s mother agrees with this statement.

After a brief chat, the ‘match’ is finalized and they are officially “engaged”. Sweets are consumed by everybody present (they are Pakistani, after all). The boy’s aunt then says, “Nisha, we are doing it only for your wellbeing”. The following night, Nisha, who had been rooming with her younger sister, decides to run away from the house again. It is snowing outside and before she leaves, her younger sister (who is about 6-9 years old) wakes up and sees her leave but doesn’t say a word. Once she has climbed down from her third story apartment, she walks towards the street outside their apartment complex and looks back. Her father is standing in the window, looking at her. Their eyes meet for a few moments and then Nisha takes off in the snow, running far away from the house. The End.

I thought the movie was generally well-made. There is some exoticization of Pakistan, as one expects in most films for a primarily western audience. The narrow streets, old houses, mountains in the background and a dilapidated bus, with Khawaja-siras (transgender people) selling boiled eggs to passengers, the old school vegetable and fruit market, classrooms without whiteboards and households without domestic servants. I read later that the story is loosely based on the life of its director, Iram Haq.

The premise, as I said earlier, is familiar to a Pakistani or a Pakistani-origin person. The rank hypocrisy of Pakistani society, the guilt-trapping (Pakistani parents’ favorite sport), violence in the name of honor and efforts to ‘save face’ in the community are daily realities of a desi household. While honor killings get splashed as headlines (deservedly), there is a lot of ‘micro-violence’ that happens every day in a middle-class Pakistani household with young girls (I’m talking about a representative sample). Some of the statements that I have bolded and put in quotation marks in the synopsis are familiar tropes of Pakistani parents, once they find out that the human being they created is not a robot that they can program. The situation, however, is much more dire for girls than it is for boys. Particularly when it happens abroad. One of my mentors used to say that Pakistanis in the diaspora tend to be normal people until their daughters start growing up. If it were up to Pakistani parents, they would bottle up puberty of their children and throw it away in the trash, instead of dealing with it like people everywhere else.

I write this not just as a commentator but as a witness. Both of my sisters, at different times in their lives, were ‘disciplined’ when they developed an interest in men that my parents had not chosen for them to marry. Sister number one was a teenager and had a crush on one of her teachers (which is the most teenager thing that I can think of). The guy in question used to visit our house for coaching (a normal occurrence for our household, to be clear) and he belonged to a lower-middle-class background. Once the ‘crush’ was discovered, he was banished from our house and my sister was warned never to mention his name again, or there would be dire consequences. She was 16 at the time. Around the time that she turned 17, she was engaged to a cousin who was studying abroad at the time. She got married at 18 and has lived abroad ever since. She has always been an obedient and slightly-passive child and has done okay in life, despite the obvious disadvantage.

Sister number 2 has always been a more outwardly emotional and strong character. Her first ‘issue’ arose during teenage years when she was found talking too many times with one of the male cousins. She would also ‘dress up’ (as much as one could in a provincial Punjabi town) when she went to coaching centers in the city during her high school years. Later, when she was in college, she needed some help with coursework and an acquaintance who worked in that profession was asked to help. The acquaintance deputed one of his juniors to help my sister. Fast forwards a few years and they were romantically involved. My parents were having none of that. They tried to ‘arrange’ her marriage at different places but she would stage some sort of stunt (act cold/be sarcastic/or just being rude) to get out of it. She tried to kill herself at least twice during this period. She was probably physically beaten more than once as well (I was at boarding school between 2000-2006 and in med school for 5 years after that so I only heard these things second-hand). I had met the dude in question and found him to be okay, nothing too spectacular or bad. As the firstborn male, I held a certain role in the family so I first cajoled my mother (who hated the guy partially because he was 10-12 years older than my sister and partially because he came from a lower-middle-class family and my sister has always had ‘high’ ambitions) and later my father (who felt guilty for having introduced the couple in the first place) and sister number 2 finally got married to him.

Were my parents monsters or merely representing the middle class, small-town, religious morality that they themselves grew up in? I don’t know the answer to that question. They are otherwise very decent, educated, ‘honorable’, pious people and a neutral observer meeting them for the first time won’t be able to see anything wrong outwardly. The pathos inflicting my parents is not restricted to them, it is shared by everyone around them, most of the society is rotten. And it’s not getting any better with time.

P.S A book that deals with issues of ‘honor’ in the Pakistani diaspora, particularly in Britain, is ‘Maps for lost lovers’ by Nadeem Aslam. One can also glean some knowledge about this from certain portions of the movie ‘Blinded by the Light’.

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The damage done to third world countries by Harvard and UChicago

I recently read an article in The Economist about Jair Bolsonaro and one of his prominenet supporters  (a UChicago economist) and it remineded me of the damage done by such ‘luminaries’ to other third world countries such as Pakistan.

“In July, at a convention of his small and inaptly named Social Liberal Party, Jair Bolsonaro unveiled his star hire. Paulo Guedes, a free-market economist from the University of Chicago, has done much to persuade Brazil’s business people that Mr Bolsonaro can be trusted with the country’s future, despite his insults to women, blacks and gays, his rhetorical fondness for dictatorship and the suddenness of his professed conversion to liberal economics. At the convention Mr Guedes praised Mr Bolsonaro as representing order and the preservation of life and property. His own entry into the campaign, he added, means “the union of order and progress”.”

Further in the article,we learn more about the adventure of ‘Chicago Boys’

“[Chile’s dictator from 1973-90, Augusto] Pinochet sensed, rightly, that corporatism would require him to share power with his military colleagues. Instead, he called on a group of civilian economists, dubbed the “Chicago boys” because several had studied at the University of Chicago, where the libertarian economics of Friedrich Hayek and Milton Friedman held sway.

The Chicago boys applied these principles in Chile, whose economy had been wrecked by the irresponsibility of Salvador Allende, a democratic socialist overthrown by Pinochet. Their programme would eventually lay the foundations for Chile to become Latin America’s most dynamic economy at the turn of the century. But it was akin to a major operation by trial and error and without anaesthetic. They slashed import tariffs and the fiscal deficit, which fell from 25% of GDP in 1973 to 1% in 1975. They privatised hundreds of companies, with no regard for competition or regulation. Worried that inflation was slow to fall, they established a fixed and overvalued exchange rate. The result of all this was that the economy came to be dominated by a few conglomerates, heavily indebted in dollars and centred on the private banks.

In 1982, after a rise in interest rates in the United States, Chile defaulted on its debts and the economy slumped. Poverty engulfed 45% of the population and the unemployment rate rose to 30%. Pinochet eventually dumped the Chicago boys and turned to more pragmatic economists, whose policies contributed to Chile’s post-dictatorship prosperity.”

Pakistan was one of the countries that was ‘advised’ by economists from Harvard during the 1950s and 60s.

M. Ziauddin, veteran Pakistani journalist, wrote about the influence of Harvard and UChicago on Pakistan’s economy in his piece titled: Way Out of Deepening Inequality.

Some critique of the Harvard Advisory Group’s (HAG) broader actions can be found in a paper (found here and without paywall here) by Nadeem ul Haque and Mahmood Hasan Khan (Haque obtained a PhD from UChicago and Khan from a Dutch University).

“The HAG vision was flawed in three respects and sowed the seeds of the distorted development of the economics profession in these three respects.

First, it did not attempt to develop an economics profession that was rooted in the country. They left the universities and colleges in a state of neglect attracting resources to these new non-academic, semi-bureaucratic institutions and attempted to give them the lead in the profession. Without the seed of the pure profession being nurtured and jealously guarded in academia, the profession was bound to have a distorted growth.

Second, the HAG trained economists were very different from the economists of the time. The HAG training was very development oriented and specific to Pakistan. They were not encouraged to do any theoretical or pioneering research. Third, given the importance of HAG and the new institutions and the symbiotic relationship between these institutions and the bureaucratic and political setup of the time, these HAG trained economists acquired a large and visible role in the economy. These visible economists not only played an important role in Pakistan’s history but also distorted the country’s perception of an economist, the economics profession and economic policy.

By design, the HAG group was interventionist, plan and budget allocation oriented. They mistrusted the market and had the arrogance of having more information than the market and the rest of society. Interestingly enough, the HAG training of development economics was collapsing on itself. Because these people had no behavioral relationships in mind and no faith in markets, they did not merely push policy levers and study response lags and dynamics. Instead, they developed lengthy plans or wish lists and used the bureaucratic structures to control the environment to make these plans happen. This control-oriented and market-mistrusting civil service loved this new intellectual force given to their view.

A second element in the thinking of the HAG economist was the concern with inequality. Haq and Baqai (1986), two important economists of the HAG era, note with concern that “early writing on economics in Pakistan surprisingly did not contain much reference to poverty related themes.” It is very interesting that most of the early econometric or behavioral research is done mainly by the HAG advisor, whereas the work on measuring poverty, productivity (the ratio calculation work) is done by the Pakistani economist. Before anything about the economy was understood, poverty indices, regional inequality indices, and declines in real wages (when hard wage data was hardly available) were the main areas of concern.

The manner in which these economists were trained itself created a certain perception of economists in the country which lasts till today. These economists were trained to be policy-oriented development economists. A sharp distinction was made between such economists and those who studied more theoretical and academic economics. The erroneous impression was unintendedly cultivated that the study of theory or more rigorous economics is of limited use to the country. Such a pursuit was considered a luxury that the country could ill-afford. This view has persisted and developed over time and reinforced the perception that to be a good economist for Pakistan a grounding in economic theory is not only not required but perhaps may even be a hindrance. The result is that there is a tremendous disrespect for academic and theoretical economics. The term “ivory tower” intellectual was used to describe anyone who attempted to read and keep abreast of academic economics. Instead, an amalgam of general knowledge and mild development verbiage has been established as sound Pakistani development economics.’ Fragmentation of the Profession”.

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Book Review: Flat Earth News by Nick Davies

One of the many things in life that fascinate me is the way something becomes news. In my previous life in Pakistan, I had the opportunity to explore this issue further. I interacted with plenty of journalists, both as a source of news and sometimes as a reporter. I was never involved in decisions that happened in the newsroom or any particular editorial decisions but I saw journalists working at close quarters. I was intrigued by many things and asked a lot of questions. One of my friends who used to work at BBC Urdu service once said that BBC’s way of reporting a story is to give everybody a chance to speak. If a bicycle is stolen from an apartment complex, BBC journalists would like to talk to the owner, the thief and if possible, even the bicycle. BBC’s standards are not widely followed in Pakistan (based on my limited view) and a lot of local reporting by correspondents of major newspapers and TV channels is cursory. I also became aware of this issue when I talked to people working at Punjab Lok Sujag, a non-gvovernmental organisation with local roots which had previously worked in making Punjab’s culture more popular (by staging plays in Punjabi, translating major works of fiction in Punjabi and holding an annual Punjabi mela [fair]).

I recently read a excellnt book that dealt with issues of all things ‘news’. It was published in 2007-8 by British journalist, Nick Davies. He spent most of his career working at the Guardian and The Observer in England but he did oversees stints in Australia and United States as well. The book starts off with an exploration of the ‘millenium bug’ story that gripped the attention of a lot of people at the turn of the twentieth century. I’ll let Mr. Davies do most of the talking here.

Where did the millenium bug story start?

“As far as I can tell, the story first hatched one Saturday morning in May 1993, in Toronto, Canada. Inside the city’s Financial Post, on page 37, there was a single paragraph. Under the headline, ‘TURN OF CENTURY POSES A COMPUTER PROBLEM’, the story recorded that a Canadian technology consultant called Peter de Jager was warning that many computer systems would fail at midnight at the start of the new century and that few companies had taken steps to head off the problem.

Rather like the B-movie egg which is laid by the alien in the dark corner of the peaceful suburb, this little story broke out of its shell and slowly started to distribute its offspring around the undefended planet. By 1995, it had spread out of North America into Europe and Australia and Japan. By 1997, bug stories were being sighted all over the globe. By 1998, they had multiplied tenfold, infiltrating media outlets of every kind, and they were still mutating and dividing, still penetrating more and more newspaper columns, more and more broadcast news bulletins until finally, as Millennium Eve approached, they achieved a global conquest of the media, tens of thousands of bug stories infesting almost every news outlet on the planet.”

The financial cost of the story

“Journalists reported that the British government had spent £396 million on Y2K protection. They also reported that it had spent £430 million. And that it had spent £788 million. The American government had spent far more, they said – $100 billion, or $200 billion, or $320 billion, or $600 billion, or $858 billion, depending on which journalist you were reading. Anyway, it was a lot. Beyond that, the private sector had spawned a mini-industry of companies selling millennium bug kits, while publishers turned out bug books and bug videos, and estate agents sold bug-resistant homes, and a few families sold their houses and fled to remote cabins in order to give themselves a chance to survive the coming bug-related chaos.”

How he defines ‘Flat Earth News’

“This [millenium bug story] is Flat Earth news. A story appears to be true. It is widely accepted as true. It becomes a heresy to suggest that it is not true – even if it is riddled with falsehood, distortion and propaganda”

An issue that befuddles ordinary consumers of news (like myself) is the difference between objectivity and neutrality. Should journalists be telling the truth (Objectivity) or just giving both sides of the story (Neutrality)?

“Neutrality requires the journalist to become invisible, to refrain deliberately (under threat of discipline) from expressing the judgments which are essential for journalism. Neutrality requires the packaging of conflicting claims, which is precisely the opposite of truth-telling. If two men go to mow a meadow and one comes back and says, “The job’s done”, and the other comes back and says ‘We never cut a single blade of grass’, neutrality requires the journalists to report a controversy surrounding the state of the meadow, to throw together both men’s claims and shove it out to the world with an implicit sign over the top declaring, ‘We don’t know whats happening-you decide’.

The damage goes further than merely abandoning the primary purpose of journalism. It actually transfers the truth-telling judgments out of newsrooms and into the hands of outsiders.”

Mr. Davies mentions that most of the news stories in major newspapers are lifted straight from news agencies, which could be local and global. Two global agencies that he talked about are Associated Press (AP) and Reuters.

“Just like PA (Press Association, England), their concern with accuracy is deliberately different from a newspaper’s concern with truth. One man who has spent many years as a senior executive from Reuters echoed Jonathan Grun from PA explaining to me that Reuters was not concerned about the truth. The agency would try to provide an accurate amount of an opposing point of view: ‘But it isn’t an agency’s job to start choosing between these voices and saying who is telling the truth’. All the great flat earth news stories have travelled via wire agencies into the unprotected global media.  It was AP and Reuters who told the world about the millenium bug and the weapons on mass destruction, who carried the myths about drugs and crime and radiation and education and all the other Huckers, big and small. All these stories were accurate, in that they faithfully recorded what somebody had said; none of them were true”.

The epilogue of the book starts with some golden words from The Simpsons: “Journalists used to question the reasons for war and expose abuse of power. Now, like toothless babies, they suckle on the sugary teat on misinformation and poop it into the diaper we call the six ‘o clock news”.

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