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Does Pakistan mean what it says about bilateral trade?

It is true Pakistan has opened its doors to over 85% of items to be exported from India but it still does not permit 1,209 items, which includes automobiles, many pharmaceutical products, agricultural produce and textile items like polyester

When the new government is formed, in about two weeks' time, one of the most important foreign policy announcement would relate to India's relations with neighbours, the South Asian Association for Regional Cooperation (SAARC) group, and the world powers at large. There is no doubt that the new government would like to extend its hand of friendship and understanding with all the countries, with particular reference to Pakistan and China on one hand, and the rest on the other.


In the last few months, we have senior ministers from Pakistan coming to India and talks have been going on at various levels, soon after Nawaz Sharif took over as Prime Minister. One of the earliest of his acts was the proposal to obtain electricity supplies from India, through our transmission towers linked to theirs. After initial enthusiasm, a Pakistani delegation was to arrive and finalize the deal. They never came, having called off the visit at short notice.


Soon thereafter, the Commerce Minister turned up. Khurram Dastgir Khan, while attending the SAARC meeting, stated that "market access is more important than MFN (most favoured nation) and said this would take some more time". Nothing really happened after that.


Now, the Pakistani High Commissioner, Abdul Basit, in an interaction with women journalists, has expressed hope that the new government would help to establish a conflict-free relation with Pakistan; "we would like to have peace through dialogue and engagement." He is reported to have said: "it takes two to Tango!". Earlier, Nawaz Sharif's government was keen to focus on regional security without which development was not possible in the area.


While talking to the journalists, Abdul Basit once again called for India to reduce subidies on some items of export interest to Pakistan, and has reiterated his hope that the new government at the Centre would do so, as this will enable Pakistan to permit import of all items from India.


Last year, Islamabad had "promised" to do away with all import bans by 31 December 2013. it had also promised to allow trade of all products through the land route instead of expensive sea-route. Neither of these happened. However, early this year, both countries had agreed on an arrangement under which India would reduce subsidy on items that can be exported by Pakistan but could not be implemented as the model code of conduct came to play, according to Abdul Basit. Therefore, the whole issue has to be revisited once the new government is in place.


New Delhi, on the other hand, has been demanding non-discriminatory market access, which basically means all Indian items to be sold in Pakistan. This is the key condition that New Delhi has laid down before Islamabad for restarting bilateral trade dialogue. It is hoped that the new Government would reiterate the stand taken earlier.


It is true Pakistan has opened its doors to over 85% of items to be exported from India but it still does not permit 1,209 items, which includes automobiles, many pharmaceutical products, agricultural produce, textile items like polyester.


These trade issues can and should be again discussed on a priority basis and should be settled within a time frame set mutually by both sides. However, there are a few important issues that also needs to be tackled with the Pakistani government, that covers the following:


a) acceptance and firm commitment by Pakistan to stop minting and smuggling counterfeit Indian currency through various channels. There is enough forensic proof that can be provided to Pakistani government itself; if not to a third party like the World bank or International Court at the Hague. Indian economy is being ruined by these fake notes, which were initially in Rs500 and Rs1,000 in denominations. Now, these are being made in smaller denominations, such as Rs5, Rs10, Rs20, Rs50 and Rs100 and the grass root population being hurt. This must stop at all costs.


b) if land border has to be opened fully, India needs to install advanced x-ray equipment to prevent currency and drug smuggling which are going on with impunity


c) if one has to assume that LOC (line of control) is actually manned by Pakistani Army personnel, how come the so-called Jehadis escape their detection and creep into India to create terrorist activities?


We had enough of talks and assurances. It's time that the new government takes firm steps to extend the hand of friendship for Pakistani people and reiterate their willingness to go the extra mile, but their government needs to fix these issues immediately.


No more talks. We need actual action.


(AK Ramdas has worked with the Engineering Export Promotion Council of the ministry of commerce. He was also associated with various committees of the Council. His international career took him to places like Beirut, Kuwait and Dubai at a time when these were small trading outposts; and later to the US.)


Are Modern Hospitals Death Traps?

Here is some startling data from the UK hospitals, supposed to have high standards of cleanliness

“The very first requirement in a hospital is that it should do the sick no harm.”Florence Nightingale.

In the 18th century, when hospitals opened in England, the mortality of hospitalised patients was almost 100%! So was the situation in Scutary in Istanbul during the Crimean War where all seriously injured soldiers died in the makeshift hospitals on the war front, until Florence Nightingale went there. This hospital-death syndrome was called hospitalism, for short. Florence brought it down to 40%, simply by cleaning the soldiers and their wounds, bandaging the wounds and feeding them with nutritious meals. She called herself the ‘General of buckets, soaps, food, bandages and scrubs’.

Now, with all the advances in hospital-care, including the fashionable intensive-care units (ICUs), surely things should be better. After all, even small hospitals in remote areas have so-called ICUs, even if they do not have round-the-clock medical cover. Well, I was reading in The Daily Mail of 17th April, en route to London, a story about hospital infection deaths in the UK which has the best infection-control care today. The highest body of medical audit in that country, National Institute of Clinical Excellence (NICE), was concerned about the very high mortality in seriously ill patients admitted to the hospitals there due to hospital-acquired infections (nosocomial).

In England, a small country, one in 16 patients is developing infections in NHS hospitals because of poor staff hygiene. NICE says that 300 patients a day, or 300,000 a year, are infected by a member of the hospital staff or by dirty equipment. This may directly kill 5,000 patients in one year and contribute to another 15,000 deaths. God only knows the figures for our hospitals in India, even as we seem to have borrowed the American practice of getting 90% of their profits by keeping dying patients, for the last 10 days of their sojourn on this planet, in the ICUs.

Also, in August, when the newly-qualified doctors join duty as house officers, the infective death rate goes up so sharply that the Association of British Medical Schools has come up with a graded joining date for them—half of them starting in September instead.
The deputy director of NICE, professor Gillian Leng, called a press conference to share the concern of the authorities as British hospitals are again going back to the 18th century hospitalism! This has been attributed to the staff, especially doctors, not washing their hands between seeing patients. The more senior the doctor, the less s/he washes hands! Doctors’ hands, their neck ties, stethoscope chest pieces, cell phones and their white aprons had more deadly germs than the hospital floors.

Hospital administrators have been warned to be very strict about compliance with the hand washing instructions and also with a new dress code. Some hospitals have banned cell phone use by doctors and nurses in the wards. Some ICUs have sterile stethoscopes and do not allow doctors to take their own inside.

Illness depresses the human immune system. This is worsened by antibiotics and other drugs that the patients are injected with which destroys the main organ that keeps our immune system fit, viz., the human gut. When the gut starves, the gut bacterial flora changes; the friendly germs die in large numbers. NICE now cautions British doctors to be parsimonious with antibiotic prescriptions. NICE says that no antibiotic should be administered for common cold, feverish cold, sore throat and flu-like illnesses, the so-called minor illness syndromes, which form the bulk of patients on a given day, especially in winter.

I am sure, the situation in Indian hospitals is worse than the one in the UK; but we do not keep our records accurately which are anyway rarely audited. Many smaller hospitals do not have mechanised laundry and the linen is washed by ordinary washer-men. We, the doctors, should be more careful and responsible in this. Let us make our hospitals patient-friendly and safe for the patients. Let us also do more research to find out how not to depress the human immune system in the hospitalised patients which might go a long way in reducing infection-related needless deaths.

Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS.



Professor Dr BM Hegde

3 years ago

Hospitals started in the UK in the 18th century and not 8th century.

Vijayasimha Vellanki

3 years ago

I have experienced this first hand even at the prestigious Escorts Heart Institute, New Delhi.

My 7-month old son who went through an open heart surgery contracted Candida in the ICU. That extended his stay by 21 days and each extra day was a torture for him and us. It not only compounded the risk to his life, but also required administration of the dreaded Amphotecerin-B which was also very expensive.

In the recovery ward, 5 out 6 kids had some form of infection, and one of them passed away. Needless to say, we were scared, and thank our stars that our child came out alive.


3 years ago

There was an orthopedic surgeon in a particular hospital. He came from a Communist background and therefore selected for MBBS course in Russia. He came back to India after his Medical education. He started "serving" the people. He was very "expert" in orthopedic surgery - his "expertise" was that he could even bend a straight bone !!. One fine morning he started treating accident victims. OMG ! after years of his experiment with "guinea pigs", he indeed became a master in surgery.

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