Pakistan / Yumna Ansari
The excessive use of police force combined with disregard for the poorest has characterized Pakistan’s governance. The country’s weak health system will need to undergo urgent reforms in order to meet the needs following the COVID-19 outbreak.
The government needs to urgently reconsider applying blanket measures in a nation renowned for its inequality and strife amongst its diverse political, religious, and social factions. As the number of cases rises, such policies may cause further social unrest and human rights breaches.
Background
Pakistan is a federal parliamentary republic comprising two houses known as the Senate and National Assembly. Currently, the head of the state is President Mr. Arif Alvi and Imran Khan is Prime Minister, who won the 2018 election with the pledge to end corruption.
Notwithstanding several social, economic, political and cross-border challenges, exacerbated by natural disasters, significant improvements in health have been demonstrated through a range of indicators over the last 25 years. However, Pakistan still lags behind some of its neighbouring countries, notably through healthcare service delivery.
In 2015, Pakistan had only 1 doctor per 1000 people, with nurses and midwives and hospital beds merely half of this figure – 0.5 and 0.6 per 1000 respectively. With a population of over 212 million people, it comes as no surprise that health personnel falls short of demand. Such figures are alarming, particularly given increasing needs following the COVID-19 crisis. It is estimated that a total of around 783 ventilators are available for use in Pakistan’s public and private hospitals.
The healthcare system consists of both public and private services and facilities. A focus on primary care is prevalent within the public sector, with outreach programmes such as Lady Health Workers (LHW) increasing grassroots coverage (see here). The private sector is composed of unregulated hospitals and medical practitioners. Complementary and traditional medicine and healers are also popular in Pakistan.
The country ranks low in terms of gross domestic product (GDP) with $1,482 per capita. In 2017, expenditure on health as a percentage of Pakistan’s GDP was 3%, with a per capita expenditure $44.59. This figure is well below the global average of health expenditure.
Civil and political rights
The lockdown of a country is an inherent violation of an individual’s civil liberties. Though some measures are a one-off, others can be more invasive – which could persist even after the virus subsides. By government command, the police and other law enforcement agencies have been given the license to exert further control over those who fail to conform to social distancing measures.
Friday prayers are a religious obligation amongst Pakistani Muslims and involve praying in congregation, which conflicts with government guidelines on social distancing. Worshippers have clashed with police attempting to disperse crowds at mosques. At times, clashes have become violent when worshippers throw stones and police firing shots in the air.
In another extreme case, police have beat up doctors participating in a sit-in protest against the lack of personal protective equipment (PPE) (see also here).
Social and economic rights
In a bid to curb economic fallout, Prime Minister Imran Khan announced the gradual reopening of construction, manufacturing and other related industries from April 15th.
In partnership with non-governmental organisations (NGOs), the Pakistani government has attempted to address the growing poverty through the distribution of food aid. However, such aid is failing to reach all groups. Christians and Hindus are being denied food aid on the basis of their religion – which is an egregios violation of Article 11 of the International Covenant on Social, Economic and Cultural Rights (ICSER). In times where unity is imperative to fighting the pandemic, the lack of regulation of NGOs and related authorities in the distribution of food and the subsequent perpetuation of religious discrimination is a key failure of the Pakistani government.
Another way in which social and economic rights have been violated is illustrated through the establishment of a so-called ‘quarantine’ camp provided by the provincial government in the border of Taftan, Balochistan — as the majority of COVID infections emerged from Shiite pilgrims who returned to Pakistan from Iran. The intention was to keep cases confined in Taftan, however, inadequate preparation and support produced an unsanitary hotbed for the virus. The environment is characterised by poor sanitation and a deficit of medical facilities. Basic testing facilities are unavailable.
