Doctors’
Exodus Impedes Economic Progress
By Dr Syed Ehtisham
US
I came across
a report that spotlighted an alarming fact: Pakistan
was losing 1700 doctors every year to foreign countries!
Some individuals, for reasons best known to them,
have called it a worthwhile export and compared
it to the departure of US and European doctors for
the Middle East. It is unfair to make such a comparison.
Pakistan doctors’ exodus is more of an economic
necessity of the immigrants and is truly a great
loss of national assets. Remember that a considerable
amount of money is spent on the education and training
of a doctor (and other skilled personnel), be it
in the state or private sector. The USA and the
UK save the equivalent of a million US dollars per
doctor they accept.
Western doctors working in Mid-East are a part of
neo-colonial package. On top of that they make a
lot of tax-free money.
Pakistan is still under served in terms of the doctor-population
ratio. High-tech, state-of-the-art medical schools
and private hospitals serve only a tiny percentage
of the population. They cater to the class which
would otherwise go to the West for treatment. They
thus save money for those who do not need to save.
Pakistan is one of the lowest spenders of funds
on social welfare - education, health, creation
of jobs and construction of infrastructure even
among the under-developed countries. It is groaning
under a tremendous load of foreign loan which instead
of developing the economy is channeled back to donors
for overhead. It has hard time servicing the debt
(read interest). IT has started mortgaging and selling
natural resources as South American countries have
done. It is fast approaching the situation that
obtained in pre-Castro Cuba.
The country has retained the feudal and tribal system
which has the lowest productivity of all the economic
systems. The system requires protection from the
wrath of the people. It has co-opted the army as
the strong arm. It has patronized the mullahs who
provide "religious" justification for
all illegal and immoral acts and economic dissipation.
Bureaucrats trained and indoctrinated by the relics
of the Raj act as civilian enforcers.
I have just finished reading ‘Guns, Germs,
And Steel-the fates of Human societies’ by
Jared Diamond and am quoting the following: 'At
best centralized societies provide expensive services
impossible to contract on an individual basis, at
worst they become kleptocracies transferring net
worth to upper (ruler-ruling classes". Diamond
gave the example of Mobutu. We have had several
Mobutus - both of civilian and military kind, in
addition to the relics of colonial rule.
75% of the national budget is spent on "defense"
and interest payments. Mullahs vociferous about
banks giving interest bearing loans have never raised
even a whimper about "loan servicing".
I am paraphrasing "religion is too important
a business to be left to mullahs".
Leaving aside the class character of GOP (feudal-comprador
bourgeoisie) and GOI (government of India-proto-capitalist),
Army expenditure is the single most important factor
of sickeningly slow development of Pakistan's economy.
Half the budget is spent on it. All they are good
for is suppression of the people-and Kargil like
adventures as an excuse for over throwing a lawful
government. Bhutto had a good idea. He was developing
the Federal Security Force. You do not need a regular
army for gunning unarmed civilians down. A few atomic
bombs are sufficient deterrence to an invader.
Pakistan has only one possible military foe - India.
Essentially Kashmir is the only grave dispute between
the two sides. Pakistan should have realized after
the 1965 war that under no conceivable circumstances
would it be able to wrest control of the territory
from India. Why not accept the ground facts? India,
assured of non-interference from Pakistan, will
loosen its stranglehold on Kashmiris and the latter
would have a better life. Canada has far smaller
armed forces. The USA has no plans to take it over.
They share the same economic system. Pakistan could
develop its economy along the lines of India. Sounds
like good logic, except that the army will lose
the reason for its bloated existence, feudals will
lose their strong arm, mullahs will lose their clout
and bureaucrats will have to become civil servants.
Pakistan (West) started off with a population of
35 million in 1947. East Pakistan had 45 million.
India had 320 million. Current (estimated) census
is 160 million (more than 450% inflation), 145 million
(300% inflation) and 1100 million (340% inflation
Indian reactionaries claim with spurious justification
that greater increase in population is due to the
vast increase in the number of Muslims).
Pakistan does not need reforms, progressive legislation
and advocacy groups. Even if all the radical reforms
residing in the wildest dreams of arm chair socialists
were to be enacted, who would enforce them. To expect
the present dispensation to do it would be akin
to my favorite story of the Russian peasant in the
jaws of the wolf and a social worker appealing to
the better nature of the beast to let it go.
Pakistan requires restructuring of its economic
base. It is an impractical idea. South American
countries like Venezuela and Bolivia have launched
a restructuring program without the benefit of a
communist revolution. Their people are not better
educated or more developed than Pakistanis.
Pakistan needs a vibrant working class collaborating
with peasants and serfs. The intelligentsia needs
to get out of their ivory towers and lead them in
the field.
Free and fair elections are an essential first step.
Elections by themselves are a great learning process.
They can, in timeform a government which will take
rational decisions. Nawaz Sharif, despite all his
faults, was taking correct though admittedly clumsy
steps to control the monster that the army has developed
into. He was promoting trade with India.
To borrow another phrase winds of change are blowing
again. South America is waking up out of its supine
slumber. It is Asia's turn.
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