There is a growing wave of urbanization in the developing world as the cities are drawing people away from subsistence farming to jobs in the industrial and service sectors. This rapid migration of people from rural to urban areas is causing massive increases in urban populations, creating more and larger urban slums, increasing the potential for environmental deterioration, and bringing tremendous pressures on city services already strained beyond limits. Take sanitation, for example, and it is no surprise that three major South Asian cities, Dhaka, Mumbai and New Delhi, show up on Mercer's list of the world's dirtiest cities. 
United Nations Habitat estimates that roughly 1 billion people -- or 33 percent of the world's urban population lives in slums. By 2030, according to the UN's human settlement program, that number is likely to double.
The slum dwellers struggle to survive with little clean water and sometimes no electricity around metropolises like Rio de Janeiro, Brazil; Mumbai, India; Lima, Peru; and Istanbul, Turkey. Their shantytowns are usually vast in expanse and dense in population. In Kibera, a slum near Nairobi, Kenya, for example, more than a million people live in an area about the size of New York's Central Park.
When visitors see a squatter city in India or Pakistan or Bangladesh, they observe overwhelming desperation: rickety shelters, little kids working or begging, absence of sanitation, filthy water and air. However, there are many benefits of rural to urban migration for migrants' lives, including reduction in abject poverty, empowerment of women, increased access to healthcare and education and other services. Historically, cities have been driving forces in economic and social development. As centers of industry and commerce, cities have long been centers of wealth and power. They also account for a disproportionate share of national income. The World Bank estimates that in the developing world, as much as 80 percent of future economic growth will occur in towns and cities. Nor are the benefits of urbanization solely economic. Urbanization is associated with higher incomes, improved health, higher literacy, and improved quality of life. Other benefits of urban life are less tangible but no less real: access to information, diversity, creativity, and innovation.
In a recent interview published by Wired Magazine, Stewart Brand, "the pioneering environmentalist, technology thinker", and founder of the Whole Earth Catalog focuses on the positive aspects of urban slums. Brand also makes a counterintuitive case that the booming slums and squatter cities in and around Mumbai, Nairobi, and Rio de Janeiro are net positives for poor people and the environment. Wired asked him to elaborate.
Wired: What makes squatter cities so important?
Stewart Brand: That's where vast numbers of humans—slum dwellers—are doing urban stuff in new and amazing ways. And hell's bells, there are a billion of them! People are trying desperately to get out of poverty, so there's a lot of creativity; they collaborate in ways that we've completely forgotten how to do in regular cities. And there's a transition: People come in from the countryside, enter the rickshaw economy, and work for almost nothing. But after a while, they move uptown, into the formal economy. The United Nations did extensive field research and flipped from seeing squatter cities as the world's great problem to realizing these slums are actually the world's great solution to poverty.
Wired: Why are they good for the environment?
Brand: Cities draw people away from subsistence farming, which is ecologically devastating, and they defuse the population bomb. In the villages, women spend their time doing agricultural stuff, for no pay, or having lots and lots of kids. When women move to town, it's better to have fewer kids, bear down, and get them some education, some economic opportunity. Women become important, powerful creatures in the slums. They're often the ones running the community-based organizations, and they're considered the most reliable recipients of microfinance loans.
Wired: How can governments help nurture these positives?
Brand: The suffering is great, and crime is rampant. We made the mistake of romanticizing villages, and we don't need to make that mistake again. But the main thing is not to bulldoze the slums. Treat the people as pioneers. Get them some grid electricity, water, sanitation, crime prevention. All that makes a huge difference.
The effect of urbanization in defusing the "population bomb" mentioned by Stewart Brand does make sense in Pakistan's context. With increasing urbanization, Pakistan's population growth rate has declined from 2.17% in 2000 to 1.9% in 2008. Based on PAI Research Commentary by Karen Hardee and Elizabeth Leahy, the total fertility rate (TFR) in Pakistan is still the highest in South Asia at 4.1 children per woman. Women in urban areas have an average of 3.3 children compared to their rural counterparts, who have an average of 4.5 children. The overall fertility rate has been cut in half from about 8 children per woman in 1960s to about less than 4 this decade, according to a study published in 2009.
Dramatic declines in fertility are not necessarily good for society. In a book titled "The Empty Cradle", the author Philip Longman warns that the declining birth rates around the world will cause many social and economic problems. As a consequence of declining fertility, by 2050 the population of Europe will have fallen to what it was in 1950. Mr. Longman says this is happening all around the world: Women are having fewer children. It's happening in Brazil, it's happening in China, India and Japan. It's even happening in the Middle East. Wherever there is rapid urbanization, education for women and visions of urban affluence, birthrates are falling. Having and raising children is seen as an expense and a burden.
"So we have a "free rider" problem. You don't need to have children to provide for your old age -- but the pension systems need them." Says Longman, referring to the coming Social Security crunch as the number of retired people rises faster than the number of workers.
In a recent interview with Wall Street Journal, Pakistan's former finance minister Salman Shah explained that "Pakistan has to be part of globalization or you end up with Talibanization". "Until we put these young people into industrialization and services, and off-farm work, they will drift into this negative extremism; there is nothing worse than not having a job," Shah elaborated. But increasing urbanization in South Asia represents both a challenge and an opportunity for India, Pakistan and Bangladesh. It is a challenge because it imposes a rapidly growing burden on the already overcrowded megacities such as Mumbai, Delhi, Dhaka and Karachi. Such a massive challenge will require a tremendous focus on providing housing, transportation, schooling, healthcare, water, power, sanitation and other services at an accelerated pace. But if this challenge can be successfully met, there will be an opportunity to develop the human potential of the rural poor and employ them more productively in the growing industrial and services sectors in the cities. In the case of Pakistan, if the level of robust economic growth, human development and increased urbanization can be sustained to significantly enlarge the South Asian nation's middle class, then there can be hope for genuine and durable democracy to thrive.
Related Links:
Light a Candle, Do Not Curse Darkness
Total Fertility Rates for Countries of the World
Urbanization in Pakistan Highest in South Asia
Orangi Pilot Project
Orangi Beats Dharavi
Can Slumdog's Success Improve Lives of Poor Children?
Dr. Akhtar Hameed Khan
UN Population Fund Report 2007
Urbanization Levels of Countries of the World
Eleven Days in Karachi
Karachi: The Urban Frontier
Slums Offer Hope
Urbanization Challenges in Pakistan
World's Dirtiest Cities
Karachi Fourth Cheapest for Expats
Cities and Environment
Pakistan's Choice: Talibanization or Globalization
Patterns of Urbanization in Pakistan
Threre are more reasons to migrate to Canada
1 year ago
20 comments:
Government giving assistance is generally looted by the corrupt governance.
People have to raise themself by forming small community / society :
1. Education
2. Family after job
3. Small family.
In fact in india, the educated and people in good economic position have lesser children and the people below povery level have more children due to the following :
1. Source of income
2. No higher aspiration and entertainment leaving sex as the only entertainment
3. Early marriage and children even before getting jobs.
Population of india has gone by thrice in the last 100 years and that has great major economic and social problem
Somewhere following of the policy of china of small family will help country to recover
Life is a ravine of sh-- except for those who find the right treadstone.
My brother has a what I would call a really nice home in Defense. He has six servants.. He has to do this to keep up with all the other homeowners around him who do the same.
Each servant gets around Rs. 10,000 per month, not enough to live in luxury by any means. So for each one good home, there are six slum-dwellers at least.
Shams,
These are service sector jobs. And these jobs pay more than the alternatives your brother's servants have on the farms.
But don't count on these guys doing what they are doing now for long. As soon as these guys land industrial jobs in formal economy, they'll leave. So there is more mobility in cities than in villages. And their children have a better chance of attending schools or getting health care in Karachi than in their villages.
Riaz:
What you're saying is what should be happening, but unfortunately it is not so because industrial jobs and formal economy is on the decline. The rural poor come to the cities and mostly get employed in the informal sector, similar to domestic help as Shams's brother's case. Shams can confirm better but most likely his brother would be having a lesser no. of servants in the past than now, because industry was performing better before.
Suhail,
Unfortunately, I have to agree with you that there are problems at least in the short term with stalled economic growth in Pakistan. But I am hopeful it's going to change for the better. The long term trend is that urbanization will continue in Pakistan and it will change the balance of political power in favor of the urban middle class in the next two decades. All the forecasts for Pakistan indicate that urban population will equal or exceed rural population by 2030. I remain optimistic in the long run.
Suhail, Riaz,
In 2030, Pakistan will have a population of 640 million, compunding at nearly four percent annually. That ought to make the whole country one big f----- village full of nothing but slum. Unless of course nature takes its course, and wars, hunger, natural events or disease balances the land-to-people ratio.
Re. Suhail's point that my brother probably had fewer servants sometime ago, I and my family grew up in what I still consider a slum house. My brother had no servants as late as 1995, and he lived in a 2 bedroom rented apartment.
The trend in Pakistan is very different now. Slums are growing at a tremendously fast pace, making the entire city of Karachi one big slimy slum and a village. It will be a misnomer to call it an urban area.
Shams,
Pakistan's population growth rate in 1.8%, not 4%, and it is trending down with urbanization. It was 2.17% in 2000.
As to the growth of slums in Pakistan, I am not sure what your definition of a slum is. To me, Dharavi in India or Kiberia in Kenya are slums. Lyari in Karachi is a slum.
But Orangi Town is not a slum in terms of the quality of its housing or the services available to its residents. It started life as a 'kutchi abadi' or squatter settlement for the large influx of refugees in Karachi from East Pakistan (often mistakenly called Biharis) after the fall of Dhaka in early 1970s. It consists of an area larger than 25 square miles (versus 0.67 sq miles in Dharavi) with a population of over a million (versus over 700,000 residents of Dharavi). Most of Orangi's population increase in the last three decades has come from the growing rural to urban migration, particularly of ethnic Pushtoons from the North West Frontier Province (NWFP). Shanties have now grown into single or two level cement houses over the years and a large number of schools have been operating successfully, sending the poorest children into the best educational institutions of the city. A significant population of educated middle class has grown in Orangi. There are a number of small businesses and a cottage industry, started by budding entrepreneurs and funded by microfinance efforts in the area. The city of Karachi has built roads into Orangi to provide improved access for the residents. Like any other growing and poor urban neighborhood, Orangi has its share of problems. Pollution, crime, corruption and political volatility are just some of the issues confronting Orangi residents. A hospital was built in the community in the 1990s community in the 1990s. While Dharavi has only one toilet per 1440 residents and most of its residents use Mahim Creek, a local river, for urination and defecation, Orangi has an elaborate sanitation system built by its citizens. Under Orangi Pilot Project's guidance, between 1981 and 1993 Orangi residents installed sewers serving 72,070 of 94,122 houses. To achieve this, community members spent more than US$2 million of their own money, and OPP invested about US$150,000 in research and extension of new technologies. Orangi pilot project has been admired widely for its work with urban poor.
in 84 position India grow at
1.55% and 63 position at 1.95%
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2002rank.html?countryName=Pakistan&countryCode=pk®ionCode=sas&rank=63#pk
Riaz:
Although urbanization is increasing, the parliamentary constituencies remain unaltered under our constitution. So even if urban population increases to 51%, their representation in our parliament will remain the same as now. On its own things will not change; the change has to be forced upon our present ruling elite to accept a new balance of political power favoring the urban classes. In fact this should have happened even now as the urban population being the sole tax contributors, are already funding the entire govt expenses so should have control over it too. For this transformation to happen, it is necessary that our urban middle classes are aware, organized and willing to aid the change whenever the conditions are ripe for it. Unfortunately, this aspect is missing and that is one main hurdle to our not being able to achieve this transformation.
As regards Orangi, it started out as a slum but self help organized by OPP has resulted in its becoming pretty developed by third world standards. What I've seen of Dharavi in Slumdog, Orangi should not be compared with it. But then Dharavi will probably not be as bad as shown in Slumdog, where the intent was to highlight its ugliness.
Regarding the future, I'm an optimist too; reason being that despite the suicidal tendencies of many of our socially important classes and incompetence of most of our rulers, we're still there. So we should not lose hope of betterment in the long run.
Riaz,
You must have a pretty skewed definition of a slum. In New York city, most of Brooklyn and Bronx are considered slums, and in California, East Okaland and East Palo Alto are considered slums as well. But we all know that each of those locations are about ten times cleaner and urbanized as Saddar in Karachi, let alone Orangi.
In 2030, Pakistan will have 1.8 persons per square meter, or 1.8 million per sq.km of livable land. That is a f---- slum of a country.
See below.
As for your and CIA's estimates of Pakistan's population growth rate, I think you are both wrong. CIA says it is about 2.5 %, and there are some sources that say it is 1.999%. The fact is that in 1998 census, Pakistan showed a population of 130.5 million (http://www.un.org/esa/population/publications/prospectsdecline/sathar.pdf). However, in 2008, it is estimated at 177 million (https://www.cia.gov/library/publications/the-world-factbook/geos/pk.html). That comes to 3.2% annual, compounded.
That still comes out to 360 million people by year 2030. Pakistan has a total land area of 770,000 sq. km, and only 200,000 sq.km. of it is usable. Therefore, in 2030, there will be 1.8 million people per sq. km., or 1.8 persons per sq. meter.
Your calculations and projections are still way off and not usable at all.
Shams,
I think your definition of a slum essentially categorizes almost all of the cities in developing nations as well large parts of the developed world as just slums...and it just doesn't make any sense.
My source for Pakistan's 1.8% pop growth rate and trend is http://www.indexmundi.com/g/g.aspx?c=pk&v=24
Your assumption of 177 m population in 2008 is not supported by any estimates that I have seen.
As to the population density of Pakistan, it is currently at 510 per sq km, ranking it at 53rd in pop density among 238 countries and territories. Even if it doubles as you incorrectly argue, it will still be fairly low compared to dozens of other countries. See this list here: http://en.wikipedia.org/wiki/List_of_countries_and_dependencies_by_population_density
Now compare Pakistan's 510 with India's 890 , Japan's 870 and UK's 640 per sq km. Do you think the population density of Japan and UK qualifies them as slums? As to your arguments about what us usable land and what is not, each of the countries I mentioned have the exact same issues.
Riaz,
Your calculations are wrong and your sources are even wronger, but it is your logical reasoning that is the wrongest.
Pakistan is no Japan or UK, since paindus are missing from those two countries.
Pakistan's estimate of 177 million population is in CIA world factbook. I gave the source in my email, which is https://www.cia.gov/library/publications/the-world-factbook/geos/pk.html.
As an engineer, you should be able to do compound projections yourself - if it is 130.5 in 1998 and 177 in 2008. If you can't, try this http://www.moneychimp.com/calculator/compound_interest_calculator.htm.
Give it up.
Shams,
You are right: Pakistan is no Japan or UK, since paindus are missing from those two countries.
Do you think there were never paindus in these countries? Where did all these people in Japan or UK come from? Weren't they all agrarian villagers prior to the industrial revolution and urbanization in these two nations? Isn't that how almost all of the so-called industrialized wold came into existence through a process of rural to urban migration, slum-dwelling and finally real cities? Pakistan is going through that process now at an accelerated rate.
As to your persistent reference to 177 million pop estimate by CIA in 2008, please look more carefully. The website says it's an estimate for June, 2009, not 2008. Even if you buy it, which I don't, the CAGR over 11 years (1998-2009) comes to 2.8%.
The fact is that the total fertility rate has come down from about 8 chilren per woman in 1960s to less than 4 this decade.
http://www.pakjs.com/journals/25(3)/25(3)3.pdf
Here's a British report of India complaining about "poverty porn":
Diplomatic officials are preparing to lodge a complaint with Ofcom, the media watchdog, about the content of McCloud's Channel 4 series, Slumming It.
In the two-part documentary, the Grand Designs host visited Mumbai's squalid Dharavi slum. It showed children living amongst open sewers, dead rats and toxic waste, and residents scavenging on the city's rubbish dump.
Sources say the Indian High Commission in London granted a filming permit in the belief that McCloud was making a programme highlighting Mumbai's architectural history, and officials were horrified to see the end result.
"We thought it would be about the architecture of Mumbai but it was only about slums, nothing else. He was showing dirty sewage and dead rats, children playing amongst rubbish and people living in these small rooms. He never talked about architecture at all.
"This was poverty porn made to get ratings, and we are upset," the source said.
"Many people know India but for people who don't travel, they will think all of India is like this. Of course it will affect our tourism. It is not representative at all.
"We are not saying, 'Don't show Dharavi', but the show was not balanced. There is so much more to Mumbai and so much more to India."
The original synopsis submitted by the programme-makers said: "Kevin McCloud's passions are buildings and people and he will explore the architecture of Mumbai... Maharashtrian, British, Gothic and post-modern."
The source said: "When the production company applied, they said the name of the documentary was going to be Grand Designs. They said it was part of a 'celebration of all things India' and that he would look at different kinds of architecture. He didn't do any of this.
"Only occasionally did he mention the community spirit and the low crime rate and the fact that rubbish is recycled there.
"People forget that this nation is 60 years old. We are a young nation and it's not easy to bring 300 million people out of poverty just like that."
Slumming It was part of Channel 4's ongoing Indian Winter season. Of the five programmes shown so far, four have been set in the Mumbai slums, including a 'Slumdog' version of The Secret Millionaire.
The source accused Channel 4 of "cashing in on the success of Slumdog Millionaire", the Oscar-winning film which kicked off the season.
McCloud has praised the community spirit in Dharavi, claiming that the British government could use it as a model for "social sustainability". The Prince of Wales has hailed Dharavi as a model for urban planning.
In a joint statement, Channel 4 and the production company, talkbackThames, said: "We have not received a complaint from the India High Commission. The programme explores if city planners and architects can learn from the way Asia’s biggest slum has evolved and developed high levels of sustainability. Kevin McCloud follows everyday life in Dharavi and the film is a balanced and insightful account of his experience there.
"While it raises issues such as acute levels of poverty and the lack of sanitation, the programme also highlights many positive aspects of life in Dharavi such as the real sense of community as well as low levels of crime and unemployment. We believe that the film raises some important points around the issues of poverty, sustainability and city planning and is clearly in the public interest.”
Here's a Seekingalpha report commenting on McKinsey study of Indian urbanization:
... new labor force will also be relatively young compared to other BRIC countries. The median age for the Indian population is 25.3 years—lower than Brazil (28.6 years) and well below China (34.1 years) and Russia (38.4).
In order to meet the needs of this urban class, MGI estimates India will need:
* $1.2 trillion in capital investment
* 2.5 billion square meters of roads to be paved
* 700-900 million square meters of commercial and residential space
* 7,400 kilometers of subways and transportation to be constructed
To put these figures into perspective, the investment amount needed is about one-third of India’s total GDP in 2009. And if 700-900 million square meters of real estate sounds like a lot, that’s because it is. India would need to build a city the size of Chicago every year for the next 20 years in order to create enough commercial/residential space.
While these numbers are staggering, perhaps the most important figure for commodity demand is MGI’s projections on the growth of India’s middle class. MGI estimates that India will have 91 million middle class households by 2030, that’s more than a 300 percent increase from the 22 million they have today.
As we’ve said many times before, the growth of the middle class in the developing world, especially in Asia, is a key driver of demand for oil, steel, copper, cement and countless other resources because the wealthier these people are, the more they will consume.
This mass of people will likely demand better housing, better roads, better goods— in all, a higher quality of life than what’s been available to them in the past. The resulting pressure this could have on commodity demand is the X-factor that we believe makes this cycle different than anything we’ve experienced in the past.
I agree there will be massive migration in India;but, not driven like China. It will be driven by rural failure. There are few jobs in urban India already, where will so many more jobs come from in future, if India doesn't fundamentally change its policies....
Most population growth in India is coming in the backward and poor northern states. Will these youth be able to fill the jobs that do open up in urban India?
Here is a Times Online report about slum population swelling in India:
The number of people living in slums in India has more than doubled in the past two decades and now exceeds the entire population of Britain, the Indian Government has announced.
India’s slum-dwelling population had risen from 27.9 million in 1981 to 61.8 million in 2001, when the last census was done, Kumari Selja, the Minister for Housing and Urban Poverty Alleviation, said.
The figure is the latest illustration of how India’s recent economic boom has left behind millions of the country’s poorest people, raising fears that social unrest could undermine further growth.
India’s economy has grown by an average of 8 per cent annually over the past four years, and yet a quarter of its population of 1.1 billion still lives on less than $1 (50p) a day.
The expansion of India’s slums is partly due to the rise in India’s total population, which increased from 683 million in 1981 to 1.03 billion in 2001.
That has been exacerbated by mass migration from the countryside as millions of farmers have forsaken the diminishing returns of small-scale agriculture to seek the relatively high wages of manual labourers in India’s cities.
But the ballooning slum population is also evidence of the Government’s failure to build enough housing and other basic infrastructure for its urban poor, many of whom live without electricity, gas or running water.
India’s largest slum population is in Bombay, the country’s financial and film capital, where an estimated 6.5 million people – at least half the city’s residents – live in tiny makeshift shacks surrounded by open sewers. Bombay is also home to Dharavi, Asia’s biggest single slum, which is estimated to house more than a million people.
Delhi, the national capital, has the country’s second-largest slum population, totalling about 1.8 million people, followed by Calcutta with about 1.5 million.
Mrs Selja says that it will cost India four trillion rupees (£49 billion) to build the estimated 24 million housing units needed to accommodate India’s slum-dwellers. She has called for the Government and the private sector to address the problem jointly and has launched several schemes to provide basic public services to slum-dwellers. But civil rights activists accuse the Government of willfully neglecting India’s slums, while favouring commercial property developers who often bribe local officials and fund politicians’ election campaigns.
“The rise in slums is due to the lack of affordable housing provided by the Government,” said Maju Varghese, of YUVA Urban, a nongovernmental organisation that has been working with the urban poor for more than 20 years. “The Government has withdrawn from the whole area of housing and land prices have gone to such heights that people can’t afford proper housing,” he said.
http://www.timesonline.co.uk/tol/news/world/asia/article1805596.ece
While Pakistan's HDI of 0.504 (2011) ranks it among UNDP's low human development countries, its largest city Karachi's HDI of 0.7885 (2005) is closer to the group of nations given high human development rankings.
In a regional human development analysis for Pakistan done by Haroon Jamal and Amir Jahan Khan of the Social Policy and Development Centre (SPDC), Karachi ranks at the top with HDI of 0.7885, followed by Jhelum district's 0.7698 and Haripur's 0.7339. Lahore has HDI score of 0.6882 and Rawalpindi 0.638.
Karachi often makes news for its recurring episodes of violence which claim many innocent lives. Yet, the city continues to be a big draw for large numbers of rural migrants looking for better economic opportunities. In spite of the many problems they face, it's a fact that even the slums in Karachi offer them better access to education and health care--basic ingredients for human development.
When visitors see a squatter city in India or Pakistan or Bangladesh, they observe overwhelming desperation: rickety shelters, little kids working or begging, absence of sanitation, filthy water and air. However, there are many benefits of rural to urban migration for migrants' lives, including reduction in abject poverty, empowerment of women, increased access to healthcare and education and other services. Historically, cities have been driving forces in economic and social development. As centers of industry and commerce, cities have long been centers of wealth and power. They also account for a disproportionate share of national income. The World Bank estimates that in the developing world, as much as 80 percent of future economic growth will occur in towns and cities. Nor are the benefits of urbanization solely economic. Urbanization is associated with higher incomes, improved health, higher literacy, and improved quality of life. Other benefits of urban life are less tangible but no less real: access to information, diversity, creativity, and innovation.
http://www.riazhaq.com/2011/11/karachis-high-human-development-index.html
Here's an Express Tribune story of a Pakistani young man of humble origins helping terror victims after studying Emergency Medicine at Yale:
.Today, Razzak is a renowned emergency medicine expert and the executive director of the Aman Foundation. He started his schooling at a humble primary school in Lyari, completing his secondary education from Nasira School in Depot Lines. Not one to be held back, the hard-working student subsequently attended Adamjee Science College where his impressive grades and unbounded enthusiasm won him a scholarship at the prestigious Aga Khan University Hospital (AKUH), the top private medical institution in the country.
---------
In collaboration with the Edhi Ambulance Service, an arm of the philanthropic Edhi organisation and the largest volunteer ambulance network in the world, he researched and analysed road traffic injuries and emergency cases. Edhi had a mountain of documentation for every call and every case it had handled in the last two decades. The downside? None of it was digitised, so he spent days sifting through it manually.
The experience stayed with him, and the data revealed a disturbing pattern. Gruesome injuries, often suffered by the poorest members of society, were often improperly handled by well-meaning doctors, simply because of a lack of know-how. These mistakes frequently, and literally, led to the loss of life and limb.
Yet, Razzak soon realised that he needed more professional training and specialisation courses before he could progress further. He sat for the US Medical Licensing Exams (MLE) and had observations at the Beth Israel Medical Centre, New York, and the Yale-New Haven Hospital, Connecticut. In 1996, his residency and training programme at Yale University’s School of Medicine started and in 1999, he was given the ‘Best Trainee’ award by the State of Connecticut.
On the personal front, Yale was also important for the doctor since he met his future wife there. Following graduation, the two stayed in the US for a few years, always looking forward to the time when they would return home. “The plan was always to come back,” says Razzak. “That’s why we never bought a house, never completely settled in.”
Before they could come back, Razzak did his PhD in Public Health at the world-renowned Karolinska Institutet in Sweden, where he focused on the use of ambulance data for monitoring road traffic accidents. Finally, in 2005, the studious boy from Kharadar returned to Pakistan as a successful, qualified expert in emergency medicine.
He joined his alma mater, AKUH as a faculty member and went on to successfully found Pakistan’s first emergency medicine service (EMS) training programme at the university. “There were many doctors who were awarded their degrees without ever administering cardiopulmonary resuscitation (CPR) as it wasn’t a requirement,” he reveals.
This changed when his EMS programme became a mandatory rotation that all students had to serve. Subsequently, Razzak went on to build and head a new emergency department. Yet, the battle was just half won. Students in the new department faced a dilemma, similar to the one Razzak had as a student. They were required to go to the United Kingdom to sit for their exam, otherwise they would not be considered qualified.
-----------
Determined to remove, for others, the hurdles that he himself had crossed only after many toils, Razzak collaborated with the College of Physicians and Surgeons Pakistan (CPSP) to organise a curriculum for the specialised field. The first batch for this course was enrolled last year. Now students wanting to specialise in emergency medicine will be able to obtain certification in their chosen field, without having to travel abroad....
http://tribune.com.pk/story/300042/positive-pakistani-call-of-duty/
Here are excerpts of a Washington Post report on faltering family planning effort in Pakistan:
The government says it is committed to slowing population growth, which it referred to in a report last year as a “major impediment to [Pakistan’s] socioeconomic development process.” But public health experts say they have seen little beyond lip service.
In rural areas, access to family planning services is limited and hampered by deteriorating security, while government health workers are overburdened. International donors want bang for bucks, and working in the countryside is more expensive, said Mohsina Bilgrami of the Marie Stopes Society in Pakistan, another nongovernmental organization.
Greenstar is the country’s largest contraceptive provider, but “we’re a drop in the bucket in a country of 180 million,” said Shirine Mohagheghpour, the technical adviser for Greenstar, an affiliate of the Washington-based Population Services International. “You have to do this community by community.”
Shahid keeps her message basic. In one colorful illustration she shows on home visits, grimy children wail in a tattered house. In another, a mother shakes a rattle at a baby, a father frolics with a toddler and a child reads a book in a tidy dwelling. Intrauterine devices can help make the second picture a reality, she says.
“You can live tension-free,” she said to a room full of women in Mirwah. “Your husband will be happy. Your mother-in-law will be happy. You can pay attention to the children you already have. If you continue having children year after year, you will get sick.”
In urban, middle-class areas, the message is slowly resonating. Two hours away, in the city of Mirpurkhas, a similar discussion with women and a few mothers-in-law sparked boisterous discussion. Several said children were simply too expensive.
“If it’s a sin, there shouldn’t be doctors who offer it,” one said of contraception, eliciting nods.
At a private clinic in Mirwah, a woman named Buri, 35, said firmly that a small family is best. But it was too late: Married at age 13, she was pregnant 12 times before she opted for tubal ligation, a sterilization procedure. Ten of her children lived. None attends school.
“They are uninterested in school,” she said. “Parents are too busy in the fields to pay attention.”
Next to Buri lay her sister-in-law, silently shivering under a floral sheet, in labor with her first child. Presiding over the scene was their mother-in-law, a woman in ornate silver jewelry, who matter-of-factly stated that the newborn should be the first of at least eight.
http://www.washingtonpost.com/world/asia_pacific/family-planning-is-a-hard-sell-in-pakistan/2011/11/08/gIQANeGcuO_story_1.html
Here's a NY Times story about Dharavi slum that illustrates entrepreneurship at the bottom:
At the edge of India’s greatest slum, Shaikh Mobin’s decrepit shanty is cleaved like a wedding cake, four layers high and sliced down the middle. The missing half has been demolished. What remains appears ready for demolition, too, with temporary walls and a rickety corrugated roof.
Yet inside, carpenters are assembling furniture on the ground floor. One floor up, men are busily cutting and stitching blue jeans. Upstairs from them, workers are crouched over sewing machines, making blouses. And at the top, still more workers are fashioning men’s suits and wedding apparel. One crumbling shanty. Four businesses.
In the labyrinthine slum known as Dharavi are 60,000 structures, many of them shanties, and as many as one million people living and working on a triangle of land barely two-thirds the size of Central Park in Manhattan. Dharavi is one of the world’s most infamous slums, a cliché of Indian misery. It is also a churning hive of workshops with an annual economic output estimated to be $600 million to more than $1 billion.
“This is a parallel economy,” said Mr. Mobin, whose family is involved in several businesses in Dharavi. “In most developed countries, there is only one economy. But in India, there are two.”.....
Similar to Dharavi, Karachi's Orangi town is an example of undocumented entrepreneurship in the shanties. From garments to leather to furniture, there are many small cottage industries operated by small entrepreneurs in Orangi town.
Post a Comment