Health and peace in subcontinent (The News)

Imagine two countries almost at the bottom human development level, indulging irresponsibly in battling with each other at the world’s highest point. Yes, you guessed it right the two foolish countries are Pakistan and India. They are pitched against each other at an altitude of 21000 feet above sea level at the world’s second biggest non-polar glacier of the world — Siachen — for the last 26 years.

Now consider its human and financial cost. First the human cost: Almost every fourth day one Pakistani soldier dies and every second day one Indian soldier dies at Siachen. They are not killed by each other but by their biggest enemy – weather. We have a ceasefire on Siachen since 2003. On both sides many soldiers who serve at the Siachen have come back with impaired eyesight and serious health and psychological problems.

And look at the financial cost to the country. According to one researcher Pakistan spends around Rs 20 million a day for sustaining its troops on Siachen and India spends twice as much. Even excreta of Indian soldiers have to be airlifted and brought to base for disposal. In sharp contrast to the senseless expenditure on the Siachen adventure by the two governments to massage their inflated national ego, Pakistan was ranked 139 and India 132 on the global Human Development Index a year ago. Given the state of Pakistan’s economy, I would not be surprised if it would further slide down the HDI ladder.

The money that has been wasted on Siachen by the two countries can be saved if peace is given a chance and the troops are called down. Pakistan can afford to divert this money to say the cash-strapped health sector. It can build and maintain 365 Basic Health care units every year; India can build twice as much. I know these are crude assumptions and need to be worked out in detail. But the fact is that this will freeze the non-productive expenditure and save our soldiers from freezing to death.

Reports are that the solution is stalled because India which holds the post at a height wants to only come down after the marking of its territory. This position is not accepted by Pakistan which says Siachen is actually on its side of the LOC. Why can’t they get their forces down and save the horrendous financial cost and human lives and then decide the future of a glacier? The only answer is that nation states have feudal egos and civil and military bureaucracies are trained to think only in terms of geostrategic gains. Human life factors are way down on their check list.

Lt. General (Retd.) V.R. Raghavan, a former DGMO of India in an article on Siachen had talked about the strategic myth of Siachen. He said: “The theatre of conflict as is now widely accepted did not offer strategic advantage … It is clear that neither India nor Pakistan wished the Siachen conflict to assume its lasting and expensive dimensions.” But still it goes on adding to the millions of rupees expenditure every day at each side. Pathetic, isn’t it!

The idea of linking Siachen with the health sector peace initiative struck me while attending the Aman Ki Asha Health committee meeting a few days back. Senior doctors and public health specialists discussed the possibilities of cooperation with their counterparts in India and agreed that at present both the countries have similar challenges. And that if peace is given a chance this cooperation can be translated for the benefit of the people of the sub-continent.

They are right. Look at some of the basic health indicators of the two countries. In Pakistan 100 children die before they have their 5th birthday, 400 mothers out of 100,000 die during childbirth and almost 46% of the population is under-nourished. Pakistan’s spends about 2.4 percent of the GDP on public health (2003). India’s expenditure on health in that year was 4.8 percent. But this is the total health expenditure figure that includes the amount spent by the people on private health services. The public health expenditure is less than half of the total. Both countries, it seems, are far from their respective Millennium Development Goals (MDGs).

However, according to Feyza Bhatti and Shazra Murad, research fellows of Dr. Mahbub-ul-Haq Human Development Center, primary health indicators are improving in South Asia but “they are not equally distributed in the region and among the various groups. The poorest and most vulnerable segments of society in the region have benefitted least from improvement in the health sector.”

Leading Paediatrician Dr. Zulfikar Bhutta, who is a member of the Aman ki Asha Health committee made a valid observation at the meeting that while at present primary health issues are same in both the countries, they may not be so in times to come given the high growth rate trajectory of India. Prominent writer on public health issues, Dr. Sania Nishtar said that some of the leading Indian doctors she has met at various conferences were also for cooperation with Pakistan in various health related fields. But she said that this cooperation has to be institutionalized. Dr. Samad Shera, who is a well-know Diabetologist, hoped that the civil society would succeed in bringing the two countries closer, where the politicians have failed.

For Pakistan it is extremely important to divert its resources from non-productive defence expenditure to health and education. This is not only the question of providing basic facilities to every third person who live below the poverty line, it is also an economic issue. All economist and social scientists agree that a healthy and educated population is extremely important for economic prosperity. A healthier and educated nation has more time for productive activities and higher productivity at the workplace. (

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