Haq's Musings

Riaz Haq writes this data-driven blog to provide information, express his opinions and make comments on many topics. Subjects include personal activities, education, South Asia, South Asian community, regional and international affairs and US politics to financial markets. For investors interested in South Asia, Riaz has another blog called South Asia Investor at http://www.southasiainvestor.com and a YouTube video channel https://www.youtube.com/channel/UCkrIDyFbC9N9evXYb9cA_gQ

Monday, April 27, 2026

A Personal Story: When My Heart Stopped in San Francisco

On the morning of April 13, 2026, a surgeon named Cain, stopped my heart at a San Francisco hospital to graft two bypass veins to restore full blood supply to my heart. It's a procedure called CABG (coronary artery bypass graft pronounced like the vegetable), that seems to have become fairly routine in modern times. Dr. Brian Scott Cain was assisted by Dr. Danielle Holland, a cardiovascular anesthesiologist. Prior to the procedure, Dr. Cain told me he had done nearly 4,000 such operations in his 20 years as a cardiovascular surgeon. In terms of risk, he said, there was a 1% chance of death and 2% chance of stroke during surgery. But the upside after successful surgery is a significant improvement in quality of life.

In a Chair on 4th Day in Hospital, With Chest Scar Clearly Visible

By the time I woke up in an intensive care unit (ICU) a few hours later, I was told it all went smoothly.There were no surprises. Dr. Cain informed me that my heart is in good shape. I was kept in the ICU for less than 24 hours. In these 24 hours, I sat up in a chair and had breakfast, then walked with the assistance of a walker before being transferred to a regular hospital room.

The reason I ended up getting CABG surgery has to do with the fact that I started experiencing shortness of breath during long walks and strenuous exercise. When I told my cardiologist Dr. Lucas Christianson about it, he ordered a perfusion stress test, also known as nuclear stress test. The results were abnormal, indicating two blocked coronary arteries.

I received good care from doctors, nurses and other staff in the regular hospital room. They made sure I was cared for and fed well. In addition to daily visits by Dr. Cain and other doctors, there were multiple daily visits by respiratory therapists (RT) and physiotherapists (PT) designed to ensure full restoration of my lung function and ability to walk on my own. Vital signs (temperature, blood pressure and blood oxygen saturation level) checks every 3 hours and regular blood draws meant I could not sleep much. Pretty soon I was asking to be discharged so I could go home and catch up on my sleep. My doctors assured me it was their goal too but they wanted to make sure that the red blood cells and electrolytic balance were restored and my edema (excess water retention) reduced to nearly pre-surgery levels. In addition to visual checks of my feet, I was weighed everyday to ensure I was losing retained water from surgery.

I was discharged from the hospital on April 19, exactly 6 days after surgery. I was told that this is fairly normal. There was another CABG patient of Indian origin in the room next door. He was there for 10 days and stayed there when I was discharged. Apparently, the surgeon discovered he had deep vein thrombosis (DVT) during surgery that complicated his situation.

Dr Cain somehow learned that I am a Pakistani-American. He told me he mentioned it to a fellow cardiovascular surgeon named Dr. Ahmad Sheikh who confirmed to him my national origin. I personally do not know Dr. Sheikh but I am acquainted with his family. In fact, my wife and I were invited to attend his sister's wedding in Fremont, California.

Looking through the hospital window, the one thing that struck me was how many Waymo robotaxis were ferrying passengers through the streets of San Francisco. Waymo is owned by Google. Its cars are made by Jaguar. They are fitted with LIDARs (Light detection and ranging) which constantly scan the vehicle's surroundings to create 3D scanned images of all objects around it. In addition, there are multiple radars and cameras which provide inputs to a computer that operates the vehicle. My wife drove to the hospital but both of my daughters used Waymo robotaxis. They both felt comfortable riding in the back seat of a vehicle with no human driver.

Thursday, April 9, 2026

US-Iran Ceasefire: Pakistan Saves "A Whole Civilization"

Both the American and the Iranian delegations are expected to begin peace talks in Islamabad tomorrow after the announcement of the Pakistan-brokered ceasefire. The US team is led by Vice President J.D. Vance and includes President Trump's envoy Steve Witkoff and the president's son-in-law Jared Kushner. The Iranian team includes Parliament Speaker Mohammad Bagher Ghalibaf and Foreign Minister Abbas Aragchi. Mohammad Ghalibaf is a former IRGC (Iranian Revolutionary Guard Corps) commander with close ties to the hardliners.

The Islamabad meeting has come as a result of the tireless efforts of the Pakistani leaders to stop the war since it started on February 28 with the US-Israeli attack on Iran. But these efforts took on special urgency on the morning of April 7, when President Donald Trump posted an ominous warning on Truth Social: "A Whole Civilization will die tonight, never to be brought back again". "We will find out tonight, one of the most important moments in the long and complex history of the world", Trump added. The ultimatum to Iran sent shockwaves around the world because it is a fact that the president of the United States controls one of the largest stockpiles of weapons of mass destruction (WMD). The post came out at 8 AM US East Coast time when it was 8 PM in Islamabad. Immediately, Pakistan's Prime Minister Shehbaz Sharif and Field Marshal Asim Munir stepped up their frantic efforts to save the world as Trump's deadline approached. The world heaved a sigh of relief when, about an hour before Trump's deadline, the US president acknowledged and positively responded to a Pakistani proposal to accept a two-week ceasefire which was also approved by the Iranian leadership. The oil price dropped and the stock markets rallied in the hope of a permanent end to hostilities.

President Trump's Post Accepting Ceasefire with Iran

After the ceasefire announcement two days ago, Pakistani leaders have organized a US-Iran meeting scheduled for Saturday in Islamabad. JD Vance, the Vice President of the United States is traveling to Pakistan to lead the US delegation for talks with Iran's Foreign Minister Abbas Aragchi.

Iran's 10-Point Proposal For Peace

Iran's 10-point proposal that Trump referred to in his post as the basis of US-Iran talks includes the following:

1. Guarantee that Iran will not be attacked again.

2. Permanent end to war, not just a ceasefire.

3. End to Israeli attacks in Lebanon.

4. Lifting of all US sanctions on Iran.

5. End to all regional fighting against Iranian allies.

6. Iran would reopen the Strait of Hormuz

7. Iran would impose a $2 million fee per ship transiting Hormuz.

8. Iran would split these fees with Oman.

9. Iran would establish rules for safe passage through Hormuz.

10. Iran would use Hormuz fees for reconstruction instead of reparations.

Europeans and Japanese Leaders Thank You Letter to Pakistan

These are high-stakes negotiations that could fail but just the fact that the two sides have agreed to talk gives the world some hope of a better outcome. Meanwhile, many world leaders have thanked the Pakistani leaders for stepping up at a crucial time. But many in Pakistan's neighboring country of India are very unhappy about Pakistan's role in it. For example, Indian Foreign Minister Subrahmanyam Jaishankar has derided Pakistan as a "dalal" (pimp) country. He is clearly unhappy that his country's campaign to isolate Pakistan has backfired. In fact, Pakistan's geopolitical profile has particularly risen after the country's robust response to what the Indian Prime Minister called "Operation Sindoor" which he launched against Pakistan last year in May.

Wednesday, April 1, 2026

Out of School Children: ASER Pakistan Reports Substantial Increase in Enrollment

The Annual Status of Education Report (ASER) Pakistan 2025 national report, officially released on March 26, 2026, shows that the number of "Out of School Children" (OOSC) aged 6-16 years in Pakistan is now 5 million, not 25 million generally reported. "The findings on access are encouraging. Enrollment levels are high, with 92.2 percent of children aged 6–16 in school and only 7.7 percent out of school", says the ASER Pakistan 2025 report. ASER Pakistan is a citizen-led initiative, primarily led by Idara-e-Taleem-o-Aagahi (ITA) in collaboration with various national and international partners to promote foundational learning. It also works closely with over 10,000 volunteers and numerous local civil society organizations such as the Aga Khan Foundation (AKF), PAL Network (People's Action for Learning), UNESCO and federal and provincial government departments in Pakistan.

Enrolling Out of School Children in Pakistan. Source: ASER Via Bilal Gilani

The latest ASER report contains a table showing that the 6 to 16 age group has around 66 million boys and girls. Based on these numbers, the out of school children's population is now 5.3 million. Of the total number of enrollees, 62% attend government schools and 27% are in private schools.

Number of Out-of-School Children 6-16 Years is 8% (5 million). Source: ASER Pakistan 2025

The number of out-of-school Pakistani preschoolers in the 3-5 years age group is 41%, according to the ASER Pakistan 2025 Report. It indicates that most Pakistani parents do not send their children to school before age 6.

Number of Out-of-School Children 3-5 Years is 41%. Source: ASER Pakistan 2025

Earlier, the Household Integrated Economic Survey (HIES) released by the Pakistan Bureau of Statistics (PBS) in December 2025 put the OOSC figure for children 5-16 years at 20 million. One important difference is the age bracket: ASER's figure of 5 million is for 6-16 years while the HIES figure of 20 million is for 5-16 years.

While the public spending on education remains low in Pakistan, the private sector spending is higher. Recent data indicates annual education expenditure exceeds Rs. 5 trillion ($18 billion), driven by roughly Rs. 2.8 trillion in household spending (private) and Rs. 2.23 trillion in government (public) funding, highlighting a major shift towards private financing.

The total (public+private) spending on education has been rising. In 2024-25 it was $18 billion in USD terms, twice the national defense budget of Pakistan. This appears to be driving higher school enrollment. In addition to increasing access, the key challenges for Pakistan include improving learning outcomes and reducing drop-out rates at higher grade levels.