Wednesday, February 11, 2015



The Burn and Children Care Charity Organisation (BCCCO) deserves generous appreciation and help 

The Mayo Hospital is located on Hospital Road, at the time of its construction in 1870 a peaceful street in the midst of a beautiful town.  It is now a dirty, overcrowded road with all the attendant pollution, not a salubrious location for sick persons.  The hospital is housed in its original buildings with subsequent additions, including a burns unit within the department of plastic surgery. That burns unit at Mayo Hospital is the only burns unit in a city of over eight million people.  It is located on the third and part of the second floor of the department of  Accident and Emergency and can be accessed either by a flight of stairs, whose walls  are splattered with paan stained spittle, or by a lift whose walls are also splattered with paan stained spittle.
It was freezing cold the day I visited this ward.  The landing outside the ward was full of patient relatives (take that as a pun), seated or lying on mattresses. Children accompanying these attendants crawled on unbelievably dirty floors. Sanitation is clearly not a priority for this hospital but it is also a luxury for the burns ward which leads a precarious existence fighting eviction, shortage of funds, and trained ancillary staff.
feb15-off3Dr Omer Nazir, a medical registrar showed me around the burns unit which is divided into several sections. The pediatric ward is occupied by children and their mothers. Some of these children have undergone surgery to correct cleft palates, others are survivors of burns which occur all too often in the overcrowded conditions in which most people live in this country. A small boy adjusted his jacket with raw hands before allowing me to photograph him. An even smaller girl opposite stared apathetically at me out of one small eye, the other lost in a turban like bandage covering burns on her head.
The walls of the pediatric ward are brightly painted. Dr Nazir told Pique these were commissioned by a non-profit organisation, the Burn and Children Care Charity Organisation (BCCCO). ‘They also donated that,’ he said, pointing to the split air conditioner above the door and said that the bathrooms throughout the unit had been renovated and much of the equipment also donated by the same group. A special tub donated by them is used to remove exudate from the wounds which if left on the skin hardens and causes terrible deformities and infection.
‘The BCCCO donates medicines and equipment worth one to two lacs to our ward every month,’ Dr Nazir said.
The burns ward at Mayo receives no government funding, which, considering the over a thousand burn victims presenting here every year poses questions regarding government priorities.
To find out more about an organisation that makes this crucial donation every month I visited Samina Afzal who is now the President of the BCCCO.
feb15-off2‘This group was started twelve years ago by Samina Manzar,’ Samina told me, ‘and it now has around a hundred and fifty members, mostly housewives.  We hold a general body meeting every month to discuss requirements and collect monthly dues.’
With these dues and other donations from both members and non members the BCCCO has also provided a filter plant, food and clothing during the earthquake in 2005. But their real mission is to support the burns ward at Mayo, whose other major support comes in the shape of two meals a day for the patients and an attendant provided by the Gourmet group of bakeries from their kitchen on the hospital premises.
The burns ward was in terrible shape twelve years ago. Bit by bit the BCCCO renovated the premises, provided air conditioners, a kitchen, and set up a small and separate ICU, a mini emergency and an operation theatre.  In addition to the medicines they donate they try not to turn down any special request for additional medication or equipment.
The BCCCO offers support to patients only, in itself a remarkable and important feat.  It is unable to help the patients’ families for whom support is also sorely required, especially if the burn survivor is the sole bread winner. In the case of serious burn injuries in particular, the period of treatment and then convalescence is very long.
Ali  (names have been changed) was a forty year old donkey cart driver from Kamoki  who was burnt in an accident between his cart and a tractor.  He received burns to eighty percent of his body. Not knowing what to do with him his relatives left him in a corner to die where a friend found him a week later. The friend took him to the burns unit at Mayo hospital where Ali’s nose and his hands were painstakingly reconstructed.  Ali is now working as a donkey cart driver again. He was in the hospital for an entire year.
‘The doctors at the ward are excellent,’ Samina said. ‘Some of them have resigned from jobs in other countries to work in Pakistan.’
feb15-off4Pakistan needs such people, its issues are so daunting. Of the male patients treated at the burns ward most are survivors of accidental burns. But almost half the female patients have been deliberately burnt.
Maria was a first year medical student who took the bus to medical college every day and looked forward to a career as a medical practitioner. One day she received a proposal of marriage which was not accepted. Angry at the refusal the young man threw acid on Maria as she waited for the bus, burning her beyond recognition. After several months in hospital Maria is still undergoing re-constructive surgery but she has returned to medical college.
Fouzia was doused with petrol and set on fire by her husband because she would not make over her property to him. She suffered agonising burns but the worst of her suffering resulted from her own children shrinking from her, she was so badly disfigured. She was hospitalised for six months.
Burn survivors require special equipment. Among the items donated by the BCCCO is a special fluidized bed costing over fifty lac rupees, with a mattress containing sodalime beads. The soft, cool  beads cause minimum pressure and absorb the exudate from burn wounds which would otherwise prevent the wound from drying and cause infection.
feb15-off5Burns survivors also require specialised care. ‘We need a full time trained anaesthetist for the ventilator and also nurses trained specially to care for burns,’ Dr Nazir says.
A surgical tower is being constructed on the premises since 2006, and it is not yet complete.  Whenever it is, the department of plastic surgery is to get the top floor, and will share the premises with the burns unit.  That burns unit will include hydrotherapy, and an ICU equipped with a ventilator, and separate wards for acute and chronic burns.
Let us pray for that happy outcome, and work towards it.
The BCCCO may be contacted at:



A fascinating research on the remote tribal valley of Harban by J├╝rgen Wasim Frembgen

I reviewed ‘Wrestlers, Pigeon Fanciers and Kite Flyers’ recently, another book written by Jurgen Wasim Frembgen.  That was co-authored by Paul Rollier Frembgenan.  ‘The Closed Valley,’ a 2014 publication is also published by the Oxford University Press but is authored by Frembgen alone.  The title refers to the remote tribal valley of Harban high in the Himalayas of northern Pakistan in the Gilgit-Baltistan region.
Closed ValIey is an ethnographical work, which is an anthropologist’s research in a cultural context alien to him.  The research is conducted by listening, looking, and questioning, and by examining casual conversations conducted in ‘the field.’  It is a pity that this region, so fraught with danger, restricted the scope of the author’s research.  Jurgen admits that the text is unsatisfactory as a result, but that it reflects his experiences in literary form.
I did not pick either book for Frembgen’s writing style which although refreshingly simple is not always grammatical. Instead I recommend both books, and definitely this one for the fascinating information it contains. How many of us after all, know anything about Harban or its people, or where Sazin is, to the east of which the Harban valley lies?
Jurgen Wasim Frembgen is an Islamist, anthropologist, writer and Senior Curator of the Islamic Collection at the Munich State Museum of Ethnology, a Professor of History of Religion and Culture of Islam and a visiting Professor in Lahore, and the U.S.
The Harbani’s reputation of being suspicious, unpredictable people, relentlessly cruel in exacting revenge attracted Frembgen to the region.  Distrusting the stereotype, and the colonial British description of Harbanis as ‘lawless’ he wished to study the society for himself.
feb15-book2It took almost ten years to research this book, and each visit involved much effort and not a little danger and hardship. Here’s an example: I know the matter weighs more heavily with some people than with others, but to  answer the call of nature while staying  in Harban Frembgen was faced with the absence of toilets in the home of his host, a member of the district council, no less. He waited until it was dark, then followed a small, slippery path leading to a densely wooded grove of oak trees carrying a roll of toilet paper, and an electric torch, trying to protect himself from thorny leaves as he tripped over stones, and crossed rivulets. It crossed his mind that he may encounter other people also bent on a similar mission as there was ample evidence that the slope was used extensively as a toilet by the entire population of the village. It was a dilemma he could not resolve how to behave if he did meet someone at such a time. In fact Frembgen was luckier than he realised at the time that this never happened, because men in Harban answer the call of nature only once the sun is up.  The darkness before is reserved for women to ensure their privacy. In Harban (as elsewhere in Pakistan) a man’s honour is defined by the honour of the women of his family.  For a woman to be caught in the buff would probably fall well into the category of staining the family honour, leading to a feud.
Such feuds, blood feuds conducted to avenge a perceived insult to honour are an ever present threat in this region. They are often conducted over an entire lifetime and are handed down to subsequent generations.
Religion, brought to the region by sufis suffered the inevitable interference. The Tablighi Movement forbade music, and women from assembling in the town centre where once women met to discuss community issues. The local Maulvi looked reproachfully at the author when he wished him ‘Khuda Hafiz,’ and changed the phrase to an emphatic ‘Allah Hafiz,’ ‘the distinct mark of new religious correctness.’
At Harban among many others Frembgen met Niamat Gul, a carpenter and weaver. Gul was normally paid in quantities of clarified butter. Everything in his house was a product of domestic craftsmanship, the material used almost all of it natural. A carved board used for praying, smooth with use, shone honey-yellow in the sun. The tobacco came from his own garden. Nowhere did the author see an object made of plastic.
This un-spoilt environment has its ups and downs. The fact that Niamat Gul is paid in clarified butter is deliciously quaint. Yet clarified butter does not buy education. Frembgen’s host expressed the hope that education, economic development of the valley and accessibility to the outside world would end the tradition of blood feuds plaguing his society, although presumably indoor toilets would also help.  Either way the first step is to discover the region, which is where this book can make a difference.



It seems a bit unfair to expect the Prime Minister or any other government minister to worry about the power crisis. After all who in Pakistan worries about the Maori in New Zealand, or about the koalas in Australia? No one. You cannot expect the man in the street to care about the welfare of a people as remote as the aboriginal people of an alien country when their own welfare is so questionable, or about the capacity of a given habitat to sustain koalas, when their own habitat in Pakistan is so threatening.  So why expect the Prime Minister (or any other minister) to care about people whose life is as remotely different to theirs as the common man’s, when their own positions (I’d say ‘jobs’ but that implies work) are so precious?
Our leaders are of the people and by the people, and although not for the people, they are definitely for themselves which considering they are of the people comes to the same thing if you look at it closely. That’s a bit ambiguous but it sounds impressive, just as the Minister for Petroleum’s explanation of the petrol shortage: Speaking at a press conference in Islamabad Mr Abbasi said, “In January, the daily demand of petrol rose from 12,000 tonnes to 15,000 tonnes.  As a result, there has been a shortage and we are managing it.” Just in case that was too easy he added helpfully that ”there was a fall in prices, people bought more petrol and hence there was a decrease in reserves.”  Good he clarified that. I was imagining it was more demand than petrol that created the crisis.
But back to the other point; it is worth considering the rarefied air our government ministers breathe in their own little bubble, free of power load shedding, electric, water, gas and now petrol. As frustrated citizens in the Punjab spent their day queuing at petrol pumps  (and battling electric and gas load shedding) our PM virtuously cancelled a trip to Switzerland (bidding au revoir but not adieu  to the cheese fondues and cream chocolates) and spent a few hours updating himself on the situation. Still updating mind you, after being in government for a year and a half with the crisis looming since well before. Rather pathetic, what? And then, after updating himself and firing a few officials to make it all look good he returns home with a tank full of petrol to a house blazing with heat and in the summer purring with air conditioning. Koalas? Maoris?
(By the way, I’d like to completely go off the track here and mention another perk enjoyed by government officials.  According to a 2013 update to the Members of the Parliament Salaries and Allowances Act of 1974* a government servant is entitled to dental treatment, artificial limbs, joints and implants, and ‘the facility of circumcision’.  I know this has nothing to do with the subject at hand but I’ve been wanting to share this information for a while.)
My suggestion is therefore that seeing our government is so much for itself rather than for the people, to cut off gas, electricity, petrol and water allowance to government residences. Which means that here’s what a typical day might be at the Sharif household with its bubble considerably pierced if my suggestion is followed:
NS: Let’s have some nihari.
KN: There isn’t any.
NS: (Missing the shortness in her tone) All right let’s have some of that biryani.
KN: You’ll have to eat it cold.
NS: (amazed) What do you mean, Kalsoom! How can biryani be eaten cold!
KN: It can be if the microwave doesn’t work.
NS: Go get another one then. I WANT BIRYANI!!
KN: (finally snapping) I’ve heard nothing but ‘I want biryani’ from you all these years! Let me tell you something I want now…I WANT ELECTRICITY! No microwave will work without electricity.
NS: (digesting the information and coming to a cunning conclusion) How about the choola? That doesn’t require electricity!
KN: (shortly) no, it requires gas.
NS: Well then send the bloody driver to get some biryani from somewhere!
KN: You big *%**” there is NO power! NO gas, NO electricity and NO petrol! And in case you want to wash your hands off the situation there is NO water either. Go put that in your pipe and smoke it.
Headlines in the national papers the following day: SHARIF SETTLES THE CRISIS. COUNTRY OUT OF THE WOODS (where it had been cutting trees to burn as fuel).
It was Robert Frost who said, ‘The best way out (of a given situation) is through’. He was right, with one proviso: While going through a crisis you must take certain people with you who unless they experience something for themselves are perfectly capable of shoving others into the mess and walking away happily. Call it in sleeping in the same bed as the Maoris and towing the koalas into your home. I’m sure it would work, only the the towing company is likely to lose its license faster than they can say ‘Incompetent!’