Social Track September 01, 2017

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environmental impacts of automobile project discussed

Are we there yet?

An overview of pharmacy practice in Pakistan

Page 8

Page 7

People’s right to wellness A weekly from Karachi

Special Focus on

Friday, September 01, 2017 Vol IV No 16-17 12 Pages I Rs. 30

Health Education Environment

Sindh awaits registration of new contraceptive implants

By Mukhtar Alam KARACHI: The Sindh Population Welfare department has sought a one time waiver from the federal government for procurement of improved subdermal contraceptive implants that work for three years or more, it emerged last week.

Sources in the department said that authorities have decided to do away with the long-acting reversible implants used at present and procure new ones that are produced in an european country.

The newly proposed userfriendly implants are, however, yet to be registered by the drug regulatory authorities in the country, a source maintained and added that the provincial population welfare department wants to have about 200,000 such implants for an onward supply to its hundreds of family welfare centres, hospitals and non-governmental organisation providing family planning services across the province.

It is learnt that the long-acting

reversible contraceptives including intrauterine device (IUd) and implants are methods that can be used by married women to space the births. Implants are effective contraception for an extended period without requiring the users to remember to take or use the contraception every day. ”The device is a small flexible rod inserted by a designated doctor or nurse under the skin of the upper arm, with a local anaesthetic, in a few minutes. It is like an injection and works for three to five years, but can be pulled out by a doctor or nurse any time to get the user’s fertility returned to normal”, according to experts.

An officer at the population welfare department said that the long-acting reversible contraception implants had gained popularity in the province in the last decade as a safe and effective contraceptive choice, along side the use of intrauterine devices, condoms and contraceptive.

"Following the phasing out of the one-rod implant (Implanon),

the population welfare department opted to procure two-rod implant (Jadelle), which is still in use, while efforts are also being made to procure the next generation single-rod implant (Nexplanon/Implanon). The newer implant features an improved, easier to use inserter and the addition of a barium marker on the implant making it more detectable by imaging techniques, particularly when it is taken out of a woman’s arm," the officer added, saying that various reports suggested that the implants are over 99 per cent effective and less than one woman in 1,000 is likely to get pregnant over three years.

According to Contraceptive Performance Report -2015-16, which has been compiled by the Pakistan Bureau of Staistics, in Sindh a total of 56,436 implants were performed on married women, in comparison to 54,993 performed in 2014-15.

Continued on page 2

Rain in Karachi- a disaster in disguise

Authorities of Karachi and Sindh governments inspecting the rainwater-inundated areas in Karachi, last week. — ST photos

As

per the weather pundits’ forecast, it rained for a comparatively longer time period in Karachi. A city that loves and whole-heartedly welcomes rain had little chance to enjoy nature's blessing this time, thanks to the people at the helm of affairs in the government.

The quarters concerned, who appeared helpless and engaged in blame games, ended up blaming the choked water drains and nullahs. Pakistan Army and Pakistan Rangers were called in to clear the underpasses and major roads that were full of rainwater. In many parts of the city and adjoining areas, people had to drain out water from their houses and streets, in addition to suffering damages to their property.

– News Desk

New population figures of Sindh PBS website

By Our Correspondent KARACHI: In Sindh, the South district of Karachi division and Jamshoro district of Hyderabad division witnessed the lowest average annual growth in urban and rural population, respectively,

since 1998 when the previous census was conducted.

In the census of 1998, the total urban population of Karachi South district was 1,478,047, which rose to 1,791,751 in 2017, according to the provisional results of the 2017 census that were

released by the statistics ministry of the federal government, last week.

While the newly found overall population of Karachi division comprising six districts is Continued on page 6

INSIde Editorial ...............Page 03 Health ..................Page 04 Special Report.....Page 07 Environment ........Page 08 Education ............Page 09 Mosaic .................Page 10

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2 I NeWS

I Friday, September 01, 2017

Sindh awaits registration of new contraceptive implants Continued from page 1

At provincial level, the overall contraceptive performance of the year 2015-16 compared with the previous year, has revealed an increase in Balochistan (4.7%) whereas a decrease has been noticed in the rest of three provinces, that is, Punjab(7.7%), Sindh(21.2%) and Khyber Pakhtunkhwa (11.3%).

The report said that significant decrease in Sindh during 2015-16 over 2014-15 is due to the launch-

ing of robust camping of Implants & IUds. However, during 2015-16, due to non – supply of Implanon coupled with irregular supply of some of commodities, the performance declined.

Overall Contraceptive Prevalence Rate on the basis of modern contraceptive methods (mCPR) during the year 2015-16 has been computed at 35.5%. In the Provincial / Regional setup, mCPR for Punjab is 38.9%, Sindh 25.0%, Khyber Pakhtunkhwa 46.0%, and Balochis-

tan 13.8%.

When contacted by Social Track, Syed Ashfaq Ali Shah, director Monitoring, evaluation and Planning of Population Welfare department, Sindh, said that the use of various implants during the last couple of years in Sindh has reduced the demand for other contraceptives like oral pills and IUds. "An implant is considered a substitute for 120 units of condoms and 15 cycles of Oral Pill (CoC&PoP) for a year," he added, saying his department

utilises awareness camps held frequently across the province every year for promotion of contraceptives.

“Our clients are now switching to long-acting reversible implants in view of its effectiveness and negligible complications.”

Shah Faisal Mahar, director Administration at the provincial population welfare department said that in view of non-availability of one or two rod implants internationally, his department has now decided to pro-

PWd contraceptive services YEAR

Condom

Oral Pills (cycles)

IUCD

Injectables (Vials)

Contraceptives Implants Surgery (Cases) (PCs)

USERS

CYP

2008-09

13150446

616955

181383

481149

45251

0

501826

1429161

2009-10

12060491

758369

141492

491576

38492

421

457661

1210472

2010-11

13379748

788688

127463

491980

30001

1677

452003

1070893

2011-12

16144384

805184

127927

371876

22860

849

449392

976634

2012-13

16377586

691497

87168

342148

17042

1143

390761

750411

2013-14

18351687

666376

86213

349985

23464

15714

430165

891909

2014-15

18575756

634755

64130

341807

28181

10380

405637

953170

2015-16

15929260

532131

38956

272416

24956

10152

328771

769411

Total

123969358

5493955

854742

3142937

230247

40336

3416216

8052060

source: Sindh Population Welfare department

cure latest version of single-rod implants, i.e. Implanon NXT which also contains small amounts of barium sulfate, which renders the implant plastic rod visible under X-ray.

He further says that the X-ray helps locate the implant at the time of its removal, in case it migrates from the original insertion site in the arm.

Mr Mahar informed that correspondents were in progress with the federal government's drug regulatory body for obtaining a one time permission to import the device from Netherlands while the related process of registering and pricing the implants in question is pending. "We have been informally told that Sindh’s request for the waiver will be considered at the earliest and a permission will be given for the procurement of the needed implants to avoid any crisis," he added and mentioned that the population welfare department has also decided to provide the new implants to NGOs providing the reproductive health services.

"To ensure maximum utilisation of the long-acting reversable implants in the province, population welfare has especially trained the family planning workers at its various training centres," Mr Mahar added.

OPINION I 3

I Friday, September 01, 2017

People’s right to wellness

Health & diseases, literacy & education, ecology & environment, housing, nutrition, living and poverty, mortality & migration, women & gender empowerment, human resource, energy, water & sanitation, public utilities, public health, population parameters, labour force & employment, forest, fossil fuel, global warming, climate change, science & technology, sports & youth affairs, food & fertilizer, transport & communication, information technology, natural resources.

3 ways to keep Rome’s fountains flowing

Health of Pakistanis at risk

R

ecently the media highlighted the long prevailing public health issue of the arsenic-contaminated groundwater in Pakistan. This time, major international news agencies and electronic broadcasts have also shown a keen interest in this growing problem.

Based on a new research published in a journal 'Scientific Advances' various reporters said that the unabetted contamination of water may threaten the health of 50 to 60 million people in Pakistan. The researchers claiming to have analysed data from samples gathered from 1,200 groundwater pumps between 2013 and 2015 in the country’s Indus River valley are reported to have combined their findings with hydrological parameters to generate a hazard map of locations at risk as well. The highest the scientists recorded is 500 micrograms per litre, while the World Health Organisation’s (WHO) safe guideline value is just 10 micrograms per litre, and anything higher than 50 micrograms per litre should be considered a danger.

"This is an alarmingly high number, which demonstrates the urgent need to test all drinking water wells in the Indus Plain", first author Joel Podgorski, a geophysicist at the Swiss Federal Institute of Aquatic Science and Technology (eAWAG), was quoted in the reports.

In addition, there is a growing evidence that natural arsenic levels are increased by extensive irrigation, the study underlined.

Arsenic poisoning is something that needs to be taken seriously.

Symptoms straight after being acutely poisoned can include vomiting, abdominal pain, diarrhea, numbness, and tingling sensations. Long-term exposure to even low concentrations can cause disorders of the liver, loss of cardiovascular and kidney function, developmental defects, neurotoxicity, diabetes, and various forms of cancer, according to experts.

After the latest research, country needs to grapple with this new arsenic emergency.

The research team in question found nearly two-thirds of the samples exceeded the WHO-recommended threshold, which calls for an integrated and concerted efforts on the part of policy makers in the government, executors, water managers, agriculturists, public health engineers and health managers as well as the academia, among others, who at least can propagate about the preventive measures among the population under threats.

In 2001, a report released by Unicef had suggested a high arsenic level in the underground water of Sindh. The Unicef investigations conducted in collaboration with government and private organisations, also warned of an emerging health problem.

It was revealed in the survey report in question that 1,978 water sources contained arsenic concentration up to 10 ppb, 209 sources remained between 10-50 ppb and 31 sources had arsenic concentration level above 50 ppb. dadu, Khairpur, Nawabshah and Thatta districts had a relatively higher number of concentration of arsenic in its water resources and it was said further that the situation could be alarming as other districts might also have arsenic contaminated water sources.

A search of relevant literature revealed that the Sindh environmental Protection Agency had been assigned the task of conducting extensive tests and taking measures to mitigate the impact of arsenic contamination. A project costing Rs50 million as a followup was also proposed to check the water in Badin, dadu, Thatta, Khairpur, Ghotki, Nawabshah (Benazirabad) and Jacobabad at that time, but little is known about the happenings on the ground. experts say that arsenic occurs in the ground as part of soil and rock, and during the last two decades or so it has been discovered in ground water in the US, Canada, Argentina, Chile, Mexico, Thailand, Cambodia, China, Taiwan, Japan, Australia, Nepal, India, Bangladesh, and some countries in the African continent as well.

The least we can do is learn from the experiences of these countries to improve life of people in our own country.

eXCeRPTS Dist. govts & people's aspirations: AFTER a long delay of several years, local bodies elections have finally been held in all provinces.

While KPK and Balochistan governments conducted such elections much earlier, the Punjab and Sindh held the elections recently on the advice of Supreme Court in which almost every political party and a majority of electorates took part with enthusiasm. ●

●

●

In Karachi, finally, the Muttahida Qaumi Movement won a majority of seats, while in Punjab's capital PML got a chance to install its mayor.

Although local government elections have been held on the directives of Supreme Court in the provinces, it is hoped that these set-ups would not be deprived of due funds, because if it is done, provision of clean drinking water, disposal of sewerage, and working of local government-owned schools and institutes and health facilities would suffer, and the entire exercise would become a mockery of the judicial directives.

Now, it is the turn of the provincial governments to devise a formula for distribution of resources at the district level and to let the district and union councils and towns and metropolitan corporations to do their work in a free and transparent manner so that they could serve the masses in a better way. After all they are the representatives of the people.

Social Track editorial, December 11, 2015

By Alberto Pallecchi

“J

ust the fountains are enough to justify a trip to Rome," said British poet Percy Bysshe Shelly.

He would probably be disappointed if he could see those fountains today. A harsh water crisis left Rome's famous fountains dry, with water rationing for residents being seriously considered.

Growing up in Rome, I had the privilege to live in the city with the most public fountains in the world.

For centuries Rome has been known for its arcing fountains and public baths, enabled by a favorable natural environment and ingenious engineering. By 97 A.d., Rome was served by nine aqueducts carrying an estimated one million cubic meters of water per day.

Today, Romans receive only half as much water per capita. The present crisis reflects conditions that policymakers must address now lest they become the new normal.

From ancient plenty to a thirsty present Rome's water system provides 1.4 million cubic meters of water each day (370 million gallons; that adds up to 500 million cubic meters or 132 billion gallons per year) to 3.7 million habitants, with most of it originating in distant springs. Seventy percent of Rome's water comes through a single aqueduct from a source 80 miles away.

Romans enjoy extremely pure mountain water, which is problematic when springs dry up. This year saw the second-hottest spring of the past 200 years in Italy, with temperatures 3.2 degrees Celsius (5.8 degrees Fahrenheit) higher than normal average, associated with a strong decrease in rainfall. data on WRI's Aqueduct platform shows Rome is in an area of medium to high overall water risk, with an extremely high level of baseline water stress. This indicator measures the ratio of total annual water withdrawals to total available annual renewable supply.

Higher values indicate more competition among users.

Lake Bracciano, a backup source from which the city gets 8 percent of its water, has been tapped over its normal capacity and is drying up at an alarming rate, with levels now so low that no water can be withdrawn without impacting the lake's ecosystem. Without that supply, Rome's water service company proposed to cut supplies for eight hours a day for 1.5 million residents, causing a political dispute between regional and local administrations.

While resources are short, too much water is wasted or inefficiently used. 44.4 percent of water is lost to leaks. And apart from public fountains, which have systems in place allowing the re-use of water for non-drinking purposes, there are several cases of less virtuous uses: one example is urban agriculture, still a widespread practice in Rome. The agricultural sector, which has suffered mightily from this drought, is also contributing to water scarcity in the region, as it relies on obsolete irrigation systems.

How to Avoid Crisis in the Future It hasn't always been this way. Thousands of years ago, aqueducts provided Romans with plentiful water.

Thanks to that innovation, and many since, there is a tendency in Rome to consider water an endless resource. Here are three stepping stones to consider as the city draws on its history of clever water management to confront the present crisis: ● Invest in infrastructure. The current water system serving Rome needs critical interventions to contain water loss and renew structures. A quarter of the city's pipes are more than 50 years old. Current investments are well below the per capita need; it would take 250 years to renew the whole system at the current pace.

Such investments would also represent an occasion to boost the local and national economy. Other examples of cities around the world demonstrate how it is possible to save money and generate profits by investing in natural infrastructure for water.

Continued on page 8

Chronic dysfunction ‘I

t is the chronic dysfunction and selfish ambition across the political spectrum that most prevent the changes that we deserve.' That was Miguel Syjuco writing about his country, The Philippines, in a New York Times op-ed last week. But he may as well have been saying that about Nepal.

There are other passages that are hauntingly analogous to Nepal’s current 3-party dictatorship: ‘…it seems that loyalty is first always to the self, and a far second to the country. Our rulers, however, would have us believe that they are our heroes.’

Or: ‘… as with (Game of Thrones) we can only watch and wait for the next episodes of deceit, betrayal, impunity and corruption. Meanwhile, our rulers readily wield accusations of contempt against any who refuse to cooperate. They miss the obvious irony. The contempt is ours, for them.

For respect is earned, never demanded. They forget who, in a democracy, has every right to demand leaders worthy of our respect.’

There is a message here for prime ministers who don garlands while parachuting in for 15 minutes on a floodravaged land, for presidents who close down half the capital when their motorcade moves anywhere, for Parliament that behaves like a Chamber of Commerce to pass bills favouring the medical-industrial complex, for self-important officials whose sense of entitlement extends to extorting those they are supposed to serve. ‘Respect is earned, never demanded.’

Last week’s flood disaster is not over. The bungling of relief and delays in reaching marooned

villages is a disaster within a disaster. The floods affected 20% of the country’s population, and exceeded the impact of the 2015 earthquake. A column of cloudbursts over the Chure Range was the trigger event, but there was sufficient early-warning, and the subsequent inundation was the result of decades of neglect and corruption by successive kleptocrats.

Poorly planned infrastructure, encroachment, deforestation, sand mining of river beds and raised road embankments right along the border that acted like dams: all played a part. The riverstook revenge, and nature punished us for our folly.

As our reports this week from Chitwan and Rautahat show, relief has been better organised and more fairly distributed in areas with newly-elected local governments. even if Kathmandu bungled relief, mayors and village council heads realised the disasters provide an opportunity to perform. There isn’t much accountability in evidence among public servants in Province 2, the worst affected by the floods and the only region which hasn’t had elections yet.

It may be a generalisation, but the moral of this story is that if there had been responsible local governments answerable to the people, the inundation would not be as extensive, and relief would be quicker and better coordinated.

To paraphrase Syjuco: In a democracy the people have every right to demand leaders worthy of our respect.

From Asia

Editorial/Nepali Times, Nepal

4 I HeALTH People’s right to wellness

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I Friday, September 01, 2017

Clear link between vitamin B intake and lung cancer B

vitamins are among the most popular supplements on the market in the United States. Some, like B6 and B12, are marketed and sold as products that can boost your energy. But a new study shows that using too much vitamin B6 and B12 dramatically increases lung cancer in men, particularly those who smoke.

New research suggests longterm, high-dose supplementation with vitamins B6 and B12 -- long touted by the vitamin industry for increasing energy and improving metabolism -- is associated with a two- to four-fold increased lung cancer risk in men relative to non-users.

Risk was further elevated in male smokers taking more than 20 mg of B6 or 55 micrograms of B12 a day for 10 years. Male smokers taking B6 at this dose were three times more likely to develop lung cancer. Male smokers taking B12 at such doses were approximately four times more likely to develop the disease compared to non-users.

epidemiologists from The Ohio State University Comprehensive Cancer Center -- Arthur G James Cancer Hospital and Richard J Solove Research Institute (OSUCCC -- James), Fred Hutchinson Cancer Research Center and National Taiwan University report their findings in the August 22, 2017 issue of the Journal of Clinical Oncology.

This is the first prospective, observational study to look at the effects of long-term high-dose B6/B12 supplement use and lung cancer risk. These supplements have been broadly thought to reduce cancer risk.

For this study, dr Theodore Brasky of the OSUCCC -- James, and colleagues analyzed data from more than 77,000 patients participants in the VITamins And Lifestyle (VITAL) cohort study, a long-term prospective observational study designed to evaluate vitamin and other mineral supplements in relation to cancer risk. All participants aged between 50 and 76 were recruited

in the state of Washington between the years 2000 and 2002. Upon enrolling in the study, participants reported information to researchers about B-vitamin usage over the past 10 years. This included dosage information -- a critical but often missing detail needed for strong risk assessment and association research.

For this new analysis, researchers used statistical techniques to adjust for numerous factors including: personal smoking history, age, race, education, body size, alcohol consumption, personal history of cancer or chronic lung disease, family history of lung cancer and use of anti-inflammatory drugs.

"This sets all of these other influencing factors as equal, so we are left with a less confounded effect of long-term B6 and B12 super-supplementation," explains Brasky. "Our data shows that taking high doses of B6 and B12 over a very long period of time could contribute to lung cancer

incidence rates in male smokers.

This is certainly a concern worthy of further evaluation."

Brasky notes these findings relate to doses that are well above those from taking a multivitamin every day for 10 years.

"These are doses that can only be obtained from taking highdose B vitamin supplements, and these supplements are many times the U.S. Recommended dietary Allowance," he said.

Two additional studies are underway at The OSUCCC -- James to further evaluate high dose, longterm B6 and B12 supplementation and lung cancer risk. One study will examine associations in postmenopausal women in order to confirm the current finding of no elevated risk in women. The second will examine B6/B12 high dose, long-term supplementation in a second large prospective study of men in an effort to determine whether the increases risk observed in the current study can be replicated.

Courtesy: ScienceDaily

Minamata Convention on mercury: a contemporary reminder

H

istory provides us with valuable lessons. The tragic Minamata Bay disaster in Japan (1950s) is a stark reminder that exposure to the element mercury and its compounds can impact human health, causing irreversible neurological damage and other issues such as psychosis. earth's health is also at risk. In the 2013 Global Mercury Assessment, the UN environment Programme (UNeP) reported that environmental mercury emissions can reach up to 8900 tonnes annually, of which 90% consist of anthropogenic emissions from processes such as ar-

tisanal gold mining, which is often unregulated and involves the forced labour of marginalised communities.

On Aug 16, UNeP announced that the Minamata Convention came into force. This Convention aims to protect human health and the environment from exposure to anthropogenic emissions of mercury and its compounds. By holding governments worldwide accountable for the mercury lifecycle, reparations to those affected will be made. Key agendas include banning new mines and phasing out existing ones by 2020, as well as implementing control measures to reduce emissions.

However, are the goals of the Minamata Convention achievable? despite years of negotiation, the Convention faces numerous hurdles, as we have reported in The Lancet.

The issues are complex and often politically motivated. In the USA, the Convention is threatened by the Trump Administration, which has delayed litigation in favour of repealing the federal mercury law. In Mexico and Indonesia, the use of mercury in artisanal gold mining has increased, further undermining the Convention.

To protect planetary health, the Minamata Convention must

be taken seriously. Recognition of the multilateral agenda of this Convention is essential, because it not only fulfils sustainable development goal (SdG) 3 (good health and wellbeing) and SdG 12 (life below water) but several other SdGs, such as ending poverty and sustaining affordable and clean energy. Ultimately, the Minamata Convention provides us with a contemporary reminder that action must be taken to avoid repeating the disasters of the past, with which human health and the health of our planet are inevitably intertwined.

— Editorial/The Lancet

Minamata Disease (mercury poisioning), a typical example of the pollution-related health damage in Japan, was first discovered in 1956, around Minamata Bay in Kumamoto Prefecture. In the late 1950s Minimata Bay became contaminated with Mercury from a nearby factory manufacturing the chemical acetaldehyde. Mercury, used in the manufacturing process, was being discharged into the Bay. Due to mercury's bioaccumulative properties, the fish in the bay were being over exposed to methyl mercury. The fish passed on the Mercury built up in their bodies to the fish-consuming residents nearby, many of which lost basic motor controls and began to act very irregularly.

— News Desk

Services of dr Pfau eulogised

By Our Correspondent KARACHI: Speakers at a memorial meeting said that the selfless leprosy healer dr Ruth Pfau will always be remembered as a hero who spent her entire life for the cause of humanity and services to the disenfranchised segment of the society.

Sindh Institute of Urology and Transplantation (SIUT) had organised the meeting to pay tributes to dr Pfau who passed away in Karachi recently.

SIUT director, Prof Adibul Hasan Rizvi recounted the services of dr Pfau, saying she

served the most vulnerable people of the society by treating the leprosy patients. "She devoted last fifty years of her life to fight leprosy in the country", dr Rizvi added and maintained that her tireless services enabled Pakistan to become “a Leprosy free country in 1996, as declared by World Health Organisation. dr Hasan said that in the early years of Pakistan, leprosy was considered to be a taboo rather than a disease and leprosy patients were ostracized, but the exemplary care and affection displayed by dr Pfau added a new chapter of service to humanity.

Paying tribute to the iconic German physician,

dr Pfau, other speakers including veteran journalist Zubeida Mustafa, Vice Consul of Germany, Mervyn Lobo and dr Mutahir Zia from Marie Adelaide Leprosy Centre noted that by heading the National Leprosy Programme in Pakistan and setting up Marie Adelaide Leprosy Centre in Karachi, dr Pfau changed the life of leprosy patients from misery to a meaningful and happy life.

Speakers also appreciated the fact that the deceased physician of German origin always identified herself as a Pakistani. "She used to maintain that if she were to be born again she would want to be born in Pakistan," said a speaker.

HeALTH I 5

I Friday, September 01, 2017

AKU session discusses vector borne viruses in post eid days

By Our Correspondent KARACHI: Medical practitioners have observed that the inadequate preventive mechanism and reported carelessness on the part of butchers and cattle handlers, may lead to increase of Congo-Crimean haemorrhagic fever (CCHF) cases in the country, particularly in the post eid-ul Adha days.

Health researchers and infectious disease specialists were addressing a capacity-building session arranged for Sindh-based doctors at the Aga Khan University (AKU), with the collaboration of World Health Organization (WHO) and directorate of Health Services, Karachi, last week.

The participants of the workshop largely focused on the risk of vector-borne diseases like CCHF, chikungunya, dengue, malaria, naegleria and West Nile virus and shared the latest knowledge in the diagnosis and management of complicated cases.

It was noted during the session that there had been a rising trend of CCHF cases, which were likely to intensify as eid approached.

“The absence of a screening mechanism for cattle and the prevalence of poor hygiene practices by butchers are two of the main reasons for new cases of this deadly disease,” said Professor Bushra Jamil from the department of medicine at AKU. experts mentioned that CCHF was a life-threatening illness that required immediate treatment.

Talking about the treatment of CCHF, an expert urged the doctors to quickly ascertain the patient’s history of interacting with

By Our Correspondent

KARACHI: KARACHI: Medical practitioners at a capacity building workshop at the Aga Khan University, recently..— ST photo

livestock and to urgently order specialised tests for CCHF. experts noted that cases of CCHF, a deadly disease which has been found in animals of Balochistan and Kashmir, are being detected in new areas of the country such as Bahawalpur in Punjab.

“The significant movement of livestock to cities during eid-ulAdha coupled with persistent rainfall is exposing new areas of the country to dangerous vectorborne diseases like CongoCrimean haemorrhagic fever (CCHF) and chikungunya.”

In another session, experts said that the country noticed its first-ever outbreak of the mosquito-borne disease -- chikungunya -- in Karachi in december 2016. Since then new cases have been reported in Thar as well, it was added and feared that heavy rainfall in areas with poor sanita-

tion facilities created an ideal environment for the breeding of mosquitoes carrying the disease in question.

Speakers noted that patients suffering from chikungunya often came to the hospital with highgrade fever: a symptom that is often seen with other diseases such as malaria and dengue. To identify the disease correctly and to rule out malaria, experts urged doctors to conduct blood culture and routine laboratory tests for every case of fever which requires hospitalisation. doctors should then concentrate on treating the effects of chikungunya such as severe joint pain. "Mild cases can be treated with painkillers, but if a patient is experiencing incapacitating pain that doesn't go away with regular analgesics then steroids should be used", according to the speakers.

Other sessions at the event saw health experts highlight the need to improve quality of country’s water supply to prevent cases of naegleria- a deadly brain infection. They also called on water supply agency of the government and local governments to improve systems to pump and chlorinate water.

Speakers shared that simple steps taken at home like adding two tablespoons of chlorine solution to water tanks can avert the onset of naegleria. dr Nida Siddiqui, a consultant on communicable diseases to the WHO said: “Pakistan is at a high risk of disease outbreak because of a range of factors such as overcrowded cities, unsafe drinking water, inadequate sanitation, poor socioeconomic conditions, low health awareness and inadequate vaccination coverage."

dow varsity participates in health exhibition

KARACHI: Sindh Governor, Muhammad Zubair inaugurating the DUHS pavilion at the recently held Health Asia Exhibition & Conference – 2017 at Expo Center, Karachi. — ST photo

By Our Correspondent KARACHI: dow University of Health Sciences (dUHS) partici-

drap to utilise funds for research

pated in 14th Health Asia exhibition & Conference 2017 which was held at expo Center Karachi, recently.

dUHS was represented by its nine constituent institutions namely dow Medical College, dow International Medical Col-

lege (dIMC), dr Ishrat-ul-ebad Khan Institute of Oral Health Sciences, dow International dental College, dow dental College (ddC), Institute of Health Management, Institute of Physical Medicine and Rehabilitation (IPMR), dow diagnostic, Research Laboratory and Riva Water in the exhibition.

Sindh Governor Muhammad Zubair, along with the university’s Pro-Vice Chancellor dr Khawar Saeed Jamali and Principal of dIMC Prof dr Zarnaz Wahid, performed the inauguration of the dUHS stalls in the presence of other senior faculty members.

Stall of ddC providing free dental check-up and awareness regarding dental problem and precautions attracted a large number of visitors. At the IPMR, the visitors were briefed about services of occupational therapy, neuro psychology, speech and language therapy, physiotherapy and autism.

KARACHI: The drug Regulatory Authority of Pakistan (drap) will shortly start utilising the amount collected annually by the federal government as contribution towards the “Central Research Fund” from the pharmaceutical firms operating in the country.

This was disclosed by the chief executive officer (CeO) of drap dr Muhammad Aslam in his talk with a group of health reporters at a hotel, recently. Before meeting the newsmen, Mr Aslam also held a meeting convened to review the developments related to accreditation of the federal government run Central drug Testing Laboratory from the World Health Organisation.

A couple of weeks back, leaders of Pakistan Pharmaceutical Manufacturers'’ Association presenting their demands at a press conference had also stressed the need for utilising the central research fund maintained by the federal health ministry.

“Pharma companies have been contributing a significant amount every year towards the fund in question since 1976 for doing research on the development of new medicines”, the leaders had maintained.

Under the Sub-Rule 14 of Rule 19 of the Licensing, Registering and Advertising Rule,1976 (LR&A Rules), a pharmaceutical company is required to contribute one per cent of its gross profit towards the Central Research Fund to be maintained by the Federal Government.

However, under the provision to this Sub Rule 14 of Rule 19, the Central Research Board may allow portion of such contribution to be spent by the firm / pharmaceutical company itself for research and development of new drugs or for establishing research laboratories, when it is satisfied that such expenditure is being utilised for the said purpose.

When attention of the drap chief was drawn on subject, he said that an amount to the tune of Rs 600 million has accumulated under the central research fund after the establishment of drap. "Now it has been decided that a committee would be soon formed to ensure a judicious utilisation of the fund by engaging qualified individuals and researchers or institutions from the public and private sectors, who are willing to undertake programmes on “public interest issues”, he added.

Replying to a question, he said that he had information that some of the funds, which were collected under the provisions of the drug Act 1976 till the time of devolution of the health sector related activities to provinces, had been spent for some endeavours made by certain researchers. However, this time we will ensure transparency and applications will be invited formally from all deserving quarters through advertisements.

Continued on page 8

6 I SPeCIAL RePORT

I Friday, September 01, 2017

New population figures of Sindh Continued from page 1

PBS website

16,051,521 in the current census, with an urban annual growth rate of 2.43% and rural growth rate of 5.56%, Karachi South’s urban annual population growth rate has come as 1.02%.

However, the rural population of Karachi West district has been recorded at 283,247, with an average annual growth rate of 7.34%the maximum among all districts of Sindh.

Karachi West was followed by Malir district with a rural population of 937,922, with an annual growth rate of 5.08%.

Karachi’s latest rural population is 1,141,169 in comparison of 407,510 of 1998.

On the other hand Jamshoro’s rural population is now 558,955, with an average annual growth rate of 1.30%. The rural population of the district

was 437,282 in 1998.

However, Jamshoro data shows a yearly increase of 5.94% in the urban population, the highest rate in all of the districts. The urban population of the district was 144, 812 in 1998, which has increased to 434,812 now.

Tharpakar followed Jamshoro with an urban population of 132,071, against 46,145 of 1998, with an average annual growth rate of 5.68%.

According to 2017 census, the overall annual growth rate in the case of Tharparkar is 3.15%, while Jamshoro’s is 2.85%. Tharparkar’s rural population is 1,517,590 now, with an average annual growth rate of 2.98%.

As per the latest census results, the overall population of Sindh is 47,886,051, with an average annual growth rates of 2.46% (Urban) and 2.36% (Rural), against a total 207,774,520 of Pakistan.

TABLE - 7: POPULATION OF MAJOR CITIES CENSUS - 2017 POPULATION TOP 10 CITIES CENSUS - 2017

CENSUS - 1998

2

3

1 KARACHI CITY

14,910,352

9,339,023

LAHORE CITY

11,126,285

5,143,495

FAISALABAD M.CORP.

3,203,846

2,008,861

RAWALPINDI CITY

2,098,231

1,409,768

GUJRANWALA M.CORP.

2,027,001

1,132,509

PESHAWAR CITY

1,970,042

982,816

MULTAN CITY

1,871,843

1,197,384

HYDERABAD CITY

1,732,693

1,166,894

ISLAMABAD METROPOLITAN CORP

1,014,825

529,180

QUETTA CITY

1,001,205

565,137

TABLE - 5: DISTRICT WISE POPULATION BY SEX AND RURAL/URBAN CENSUS - 2017 SINDH POPULATION - 2017 ADMINISTRATIVE UNITS

HOUSEHOLDS

1

2

SINDH

2.41

RURAL

4,185,828

11,919,109

11,056,183

301

22,975,593

14,744,436

107.80

2.36

URBAN

4,399,782

13,007,937

11,900,295

2,226

24,910,458

15,695,457

109.31

2.46

1,055,050

3,176,416

3,015,803

161

6,192,380

4,210,650

105.33

2.05

717,961 337,089

2,176,351 1,000,065

2,062,803 953,000

36 125

4,239,190 1,953,190

3,001,041 1,209,609

105.50 104.94

1.83 2.55

177,867

515,480

490,778

39

1,006,297

727,190

105.03

1.72

125,341 52,526

363,684 151,796

345,486 145,292

0 39

709,170 297,127

536,883 190,307

105.27 104.48

1.47 2.37

185,143

564,843

524,307

19

1,089,169

677,120

107.73

2.53

140,872 44,271

433,475 131,368

402,076 122,231

5 14

835,556 253,613

509,199 167,921

107.81 107.48

2.64 2.19

223,154

682,859

658,148

35

1,341,042

924,294

103.75

1.97

155,051 68,103

480,164 202,695

463,297 194,851

17 18

943,478 397,564

690,371 233,923

103.64 104.03

1.65 2.83

261,331

778,249

746,093

49

1,524,391

1,001,608

104.31

2.23

140,795 120,536

419,609 358,640

403,141 342,952

4 45

822,754 701,637

596,129 405,479

104.08 104.57

1.71 2.92

207,555

634,985

596,477

19

1,231,481

880,438

106.46

1.78

155,902 51,653

479,419 155,566

448,803 147,674

10 9

928,232 303,249

668,459 211,979

106.82 105.34

1.74 1.90

972,569

2,865,909

2,672,444

202

5,538,555

3,447,935

107.24

2.52

639,691 332,878

1,879,470 986,439

1,759,544 912,900

38 164

3,639,052 1,899,503

2,256,444 1,191,491

106.82 108.06

2.54 2.48

296,670

849,226

797,051

41

1,646,318

968,797

106.55

2.82

223,706 72,964

640,467 208,759

602,300 194,751

13 28

1,242,780 403,538

764,799 203,998

106.34 107.19

2.58 3.65

412,857

1,240,424

1,163,806

104

2,404,334

1,547,751

106.58

2.34

280,079 132,778

839,708 400,716

788,759 375,047

17 87

1,628,484 775,850

1,042,543 505,208

106.46 106.84

2.37 2.28

263,042

776,259

711,587

57

1,487,903

931,387

109.09

2.49

135,906 127,136

399,295 376,964

368,485 343,102

8 49

767,788 720,115

449,102 482,285

108.36 109.87

2.86 2.13

2,039,954

5,495,980

5,096,242

413

10,592,635

6,829,537

107.84

2.33

1,292,254 747,700

3,475,736 2,020,244

3,228,139 1,868,103

75 338

6,703,950 3,888,685

4,439,953 2,389,584

107.67 108.14

2.19 2.59

359,376

932,488

871,979

49

1,804,516

1,106,272

106.94

2.60

282,574 76,802

731,235 201,253

682,883 189,096

20 29

1,414,138 390,378

872,490 233,782

107.08 106.43

2.57 2.73

286,810

797,857

752,385

24

1,550,266

1,106,717

106.04

1.79

217,340 69,470

601,163 196,694

565,927 186,458

7 17

1,167,097 383,169

871,600 235,117

106.23 105.49

1.55 2.60

434,869

1,145,788

1,053,510

165

2,199,463

1,494,866

108.76

2.05

71,523 363,346

189,696 956,092

177,009 876,501

3 162

366,708 1,832,755

233,568 1,261,298

107.17 109.08

2.40 1.98

180,922

523,259

469,839

44

993,142

582,094

111.37

2.85

103,199 77,723

296,145 227,114

262,809 207,030

1 43

558,955 434,187

437,282 144,812

112.68 109.70

1.30 5.94

143,023

396,799

372,518

32

769,349

494,244

106.52

2.35

110,382 32,641

302,258 94,541

284,485 88,033

16 16

586,759 182,590

380,934 113,310

106.25 107.39

2.29 2.54

153,018

406,754

375,193

20

781,967

513,702

108.41

2.23

136,397 16,621

362,585 44,169

333,675 41,518

2 18

696,262 85,705

452,667 61,035

108.66 106.39

2.29 1.80

165,503

432,746

404,112

29

836,887

493,526

107.09

2.81

114,105 51,398

297,324 135,422

277,764 126,348

6 23

575,094 261,793

344,944 148,582

107.04 107.18

2.72 3.02

131,565

350,010

327,202

16

677,228

438,624

106.97

2.31

RURAL URBAN

103,853 27,712 184,868

276,338 73,672 510,279

258,833 68,369 469,504

7 9 34

535,178 142,050 979,817

338,254 100,370 599,492

106.76 107.76 108.68

2.44 1.84 2.61

RURAL URBAN

152,881 31,987

418,992 91,287

384,754 84,750

13 21

803,759 176,058

508,214 91,278

108.90 107.71

2.44 3.51

2,770,074

8,439,659

7,610,365

1,497

16,051,521

9,856,318

110.90

2.60

193,871 2,576,203

606,588 7,833,071

534,499 7,075,866

82 1,415

1,141,169 14,910,352

407,510 9,448,808

113.49 110.70

5.56 2.43

538,983

1,543,950

1,427,349

327

2,971,626

2,277,931

108.17

1.41

538,983

1,543,950

1,427,349

327

2,971,626

2,277,931

108.17

1.41

509,239

1,528,019

1,379,225

223

2,907,467

1,472,896

110.79

3.64

509,239

1,528,019

1,379,225

223

2,907,467

1,472,896

110.79

3.64

327,518

943,546

848,010

195

1,791,751

1,478,047

111.27

1.02

327,518

943,546

848,010

195

1,791,751

1,478,047

111.27

1.02

634,459

2,065,847

1,848,553

357

3,914,757

2,089,509

111.75

3.35

44,051 590,408

149,220 1,916,627

134,014 1,714,539

13 344

283,247 3,631,510

73,568 2,015,941

111.35 111.79

7.34 3.14

421,618

1,284,015

1,172,737

267

2,457,019

1,561,742

109.49

2.41

421,618

1,284,015

1,172,737

267

2,457,019

1,561,742

109.49

2.41

338,257

1,074,282

934,491

128

2,008,901

976,193

114.96

3.86

149,820 188,437

457,368 616,914

400,485 534,006

69 59

857,922 1,150,979

333,942 642,251

114.20 115.53

5.08 3.11

800,528

2,218,094

2,010,485

104

4,228,683

2,585,417

110.33

2.62

648,103 152,425

1,801,103 416,991

1,626,359 384,126

37 67

3,427,499 801,184

2,087,397 498,020

110.74 108.56

2.64 2.53

286,547

778,172

727,650

54

1,505,876

1,006,329

106.94

2.14

209,861 76,686

558,838 219,334

521,274 206,376

12 42

1,080,124 425,752

683,876 322,453

107.21 106.28

2.43 1.47

301,625

882,365

767,266

30

1,649,661

914,291

115.00

3.15

274,691 26,934

812,320 70,045

705,251 62,015

19 11

1,517,590 132,071

868,146 46,145

115.18 112.95

2.98 5.68

212,356

557,557

515,569

20

1,073,146

664,797

108.14

2.55

163,551 48,805

429,945 127,612

399,834 115,735

6 14

829,785 243,361

535,375 129,422

107.53 110.26

2.33 3.37

947,435

2,730,988

2,551,139

150

5,282,277

3,510,036

107.05

2.17

693,948 253,487

1,979,861 751,127

1,844,839 706,300

33 117

3,824,733 1,457,544

2,552,091 957,945

107.32 106.35

2.15 2.23

374,609

1,064,484

992,509

64

2,057,057

1,319,881

107.25

2.36

270,891 103,718

761,365 303,119

707,277 285,232

10 54

1,468,652 588,405

920,185 399,696

107.65 106.27

2.49 2.05

275,693

832,569

779,747

57

1,612,373

1,087,571

106.77

2.09

212,073 63,620

637,153 195,416

595,399 184,348

19 38

1,232,571 379,802

855,746 231,825

107.01 106.00

1.94 2.63

297,133

833,935

778,883

29

1,612,847

1,102,584

107.07

2.02

210,984 86,149

581,343 252,592

542,163 236,720

4 25

1,123,510 489,337

776,160 326,424

107.23 106.70

1.96 2.15

KAMBAR SHAHDAD KOT DISTRICT

LARKANA DISTRICT RURAL URBAN SHIKARPUR DISTRICT RURAL URBAN SUKKUR DIVISION RURAL URBAN GHOTKI DISTRICT RURAL URBAN KHAIRPUR DISTRICT RURAL URBAN SUKKUR DISTRICT RURAL URBAN HYDERABAD DIVISION RURAL URBAN

2,404,324

BADIN DISTRICT RURAL URBAN DADU DISTRICT RURAL URBAN HYDERABAD DISTRICT RURAL URBAN JAMSHORO DISTRICT

1,550,266

RURAL URBAN

1,612,373

MATIARI DISTRICT RURAL URBAN SUJAWAL DISTRICT RURAL URBAN TANDO ALLAHYAR DISTRICT

1,612,847

RURAL URBAN TANDO MUHAMMAD KHAN DISTRICT

2,199,463

THATTA DISTRICT

2,,057,057

993,142

KARACHI DIVISION RURAL URBAN KARACHI CENTRAL DISTRICT RURAL URBAN KARACHI EAST DISTRICT RURAL URBAN KARACHI SOUTH DISTRICT RURAL URBAN KARACHI WEST DISTRICT RURAL URBAN KORANGI DISTRICT RURAL URBAN MALIR DISTRICT RURAL URBAN MIRPUR KHAS DIVISION

836,887

RURAL URBAN MIRPUR KHAS DISTRICT RURAL URBAN THARPARKAR DISTRICT RURAL URBAN UMER KOT DISTRICT

979,817

1,649,661 677,228

769,349

1,804,516

1,073,146

RURAL URBAN SHAHEED BENAZIRABAD DIVISION RURAL URBAN SANGHAR DISTRICT RURAL URBAN NAUSHAHRO FEROZE DISTRICT RURAL URBAN

16,051,521

781,967

1,505,678

8 108.58

RURAL URBAN

1,524,391

7 30,439,893

RURAL URBAN

1,487,903

6 47,886,051

KASHMOR DISTRICT

1,646,318

ALL SEXES

2,527

RURAL URBAN

1,341,042

5

22,956,478

JACOBABAD DISTRICT

1,231,481

TRANSGENDER

4

1998- 2017 AVERAGE ANNUAL GROWTH RATE 9

24,927,046

RURAL URBAN

1,006, 297

FEMALE

3

SEX RATIO 2017

8,585,610

LARKANA DIVISION

1,089,169

MALE

POPULATION 1998

SHAHEED BENAZIRABAD DISTRICT RURAL URBAN

SPeCIAL RePORT I 7

I Friday, September 01, 2017

P H A R M A C I S T S D AY fession of pharmacy evolved in the West, especially in USA. In the early 1960s, pharmacy practice changed its focus from industrial and compounding pharmacy towards patient-oriented and hospital-based practice. Gradually, practice-based programmes were renamed as Pharmd programmes.

One of the early institutions to start this practice was the University of California at San Francisco.

This clinical and communitybased pharmacy model was largely welcomed in all parts of the world and later adapted by the United Kingdom and some other european countries. In the mid1980s and 1990s, Asian and Middle eastern countries such as UAe, Kuwait and Saudi Arabia also jumped on the bandwagon recognising the patient-oriented role of the pharmacist.

Malaysia and Hong Kong were early adapters to include clinical and social aspects of pharmacy in their syllabi; later they started a master's degree programme in clinical pharmacy. Soon other

KU Pharmacy faculty building. - ST File photo

Are we there yet?

An overview of pharmacy practice in Pakistan

By Jamshed Ahmed It’s 3am in the morning. The plane from New York just landed at Quaid-e-Azam International Airport. One of the passengers needed some medicines so he stopped at a pharmacy on his way home. To his surprise, the attending pharmacist wasn’t a pharmacist at all, rather a man in his mid thirties who could barely understand medical jargon but appeared well-versed in medicine names.

This is the typical scenario in Pakistan where unqualified personnel are free to run a business as serious as a pharmacy. In Pakistan, pharmacy education was already there when it came into existence, but it has been neglected and has failed to contribute significantly to national healthcare.

Though the number of pharmacy institutions rose significantly in the country over the years the change is more quantitative rather than qualitative. In

2004, the Higher education Commission (HeC) of Pakistan revised the pharmacy syllabus and changed the four-year bachelor of pharmacy (B.Pharm) degree to a five-year doctor of pharmacy (Pharmd) degree.

It was expected that the syllabus revision would substantially transform the pharmacy outlook but it still shows insufficiencies and shortcomings and does not meet the international standards.

Let’s take a look on how the pro-

Asian countries such as Korea, Taiwan, Japan and China also reshaped their syllabi and subsequently started offering postgraduate studies in clinical pharmacy. Thailand has recently implemented a Pharmd programme and has established a college of pharmacotherapeutics. data proves the fact that all these programmes are clinically oriented with the US providing the lead. The purpose of practicebased Pharmd models in these

countries was to focus on patient care rather than pure management.

On the other hand, Pharmd in Pakistan is remotely related to this model. The clinical and social aspects of pharmacy have largely been missing. The content and subjects in the final year (fifth year) are just an extension of the first four years. Areas such as pharmacogenomics (how an individual's genetic makeup affects the body's response to drugs), pharma-co-informatics (drug information) and the use of traditional medicines have also mostly been overlooked. Subjects such as drug abuse, geriatric pharmacy, patient counseling, patient compliance, research methods and evidence-based medicine also failed to make their way to the curriculum.

We can also not find important topics like pharmacoeconomics (economic evaluation of drugs) and pharmaco-epidemiology (drug utilisation studies), public health pharmacy and drug policy.

This is interesting that subjects have been named as clinical pharmacy but the substance and content have little relevance to the concept and practice of clinical pharmacy. There is no hospital attachment and training, which is indeed central to this concept though a few institutions are making an attempt to cater to this need.

The syllabus overly emphasises quality control, pharmaceutical chemistry, pharmaceutical analysis, pharmaceutics and other physical and biological sciences, which have already been replaced with more relevant subjects not only in Western countries but also in some of the Asian countries.

The weakness in pharmacy education has relegated the pharmacy profession and hindered pharmacists from consolidating their role. As a result, pharmacy practice has been affected and subsequently poses adverse effects on the country's healthcare sector.

Continued on page 11

Role of pharmacists – the future is now

By Umaima Muzzammil According to a definition presented by the World Health Organisation (WHO) in 1948, Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. Studies have proved that optimum objective of better healthcare delivery system is obtained by engagement of multidisciplinary teams. The professional roles and responsibilities of pharmacists towards the healthcare system have evolved from merely compounding and dispensing to extended pharmaceutical care.

A paradigm shift in pharmacy practices in 1990 has promoted pharmaceutical care as a philosophy and standard of provision of care for patients. The concept of ‘The seven star pharmacist' states and recognises that a pharmacist should be a compassionate care giver, decision maker, active communicator, lifelong learner and good manager while possessing good leadership qualities and the

ability to be a teacher and researcher. This notion was expressed by the International Pharmaceutical Federation (FIP) and WHO. Pharmacist are professionals uniquely qualified and trained to understand the principles of quality assurance, they appreciate the intricacies of the distribution chain and the standards of maintaining efficient stock and turnover, possess expertise in pricing structures applied to medicinal products, are responsible for the custodianship of technical information on the product available in the market and provide an interface between the duties of prescribing and selling medicines. The competence of a pharmacist around the world is already proven and established. The pharmacy services are evidently directed towards the administration of the pharmaceutical services; in drug regulations and control; formulation and quality control of pharmaceutical products; in the inspection and assessment of drug manufacturing facilities in assurance of product quality throughout the drug distribution

chain; in drug procurement; in the national and institutional formulary committees.

Among the total number of pharmacists in Pakistan, approximately 55 per cent are engaged in the production of pharmaceuticals, 15 per cent are engaged in working for the federal and provincial drug control authority and hospital pharmacy, another 15 per cent are in sales and marketing of pharmaceuticals, only 10 per cent are in community pharmacy and the remaining five per cent are in teaching and research.

The role of pharmacists is recognised universally in all disciplines of healthcare although the healthcare system of Pakistan has yet to recognise and implement this role.

Pakistan extends from the mountain valleys of the Himalayas to along the Arabian Sea bordering India, China, Afghanistan and Iran. With a population of approximately 202 million, Pakistan’s healthcare system has been confronted with problems of inequity, scarcity of resources, inefficient and untrained human resources, gender insensi-

tivity, etc.

Pakistan is facing a very precarious economic situation and there is a need of innovative health reform, which will not be established if the pharmacist's role is not implemented and practiced. The country needs to address the lack of pharmacists in public health services and the lack of pharmacists in community pharmacies.

— The author is a pharmacist and a business graduate.

I

n conjunction with the World Pharmacists day (WPd), Social Track is reprinting two of the write-ups it published earlier, in view of their relevance to the role of pharmacists in the health care system in the country.

World Pharmacists day, established by the International Pharmaceutical Federation, falls on September 25 every year. "From research to health care: Your pharmacist is at your service” is the theme of this year's WPd. – News Desk

8 I eNVIRONMeNT / eNeRGY

I Friday, September 01, 2017

environmental impacts of automobile project discussed

KARACHI: Sepa officials and proponents and consultants of an automobile project during a public hearing, last week. — ST photo

By Our Correspondent KARACHI: Lucky Cement, a subsidiary company of Yunus Brothers Group, having established an associated company to manufacture, assemble and market KIA cars and light commercial vehicles in the country, will start manufacturing vehicles at a dedicated plant planned in Bin Qasim Industrial Park, Bin Qasim Town, Karachi, in 2019.

The chief executive of Kia Lucky Motors Pakistan Limited, Mohammad Faisal, the proponent of the automobile plant in quest at a public hearing conducted by the Sindh environmental Protection Agency (Sepa) said that his company, in collaboration with Kia Motors Corporation, South Korea, will establish the plant on a 100-acre piece of land in BQ industrial area, where initially 25,000-30,000 units of vehicles will be manufactured annually, which may increase to 50,000 vehicles per annum in the later course of time.

He said that his company has all intentions to have an environment and worker friendly production unit.

“The construction phase of proposed plant will begin as soon as a “no-objection certificate” is issued by Sepa against the environmental impact assessment report for the project submitted to it. Kia Lucky Mo-

tors will start rolling out cars in 2019”, Mr Faisal added, saying any decision about the price and model of the vehicles planned will be made at some later stage.

Replying to another question, he said that the initial manufacturing will largely base on the imported components, but proportion of the locally prepared components and accessories will increase gradually.

Sepa director (Technical) Viqar Hussain Phulpoto, who presided over the statutory proceedings related to the environmental impact assessment report titled “Greenfield Auto Manufacturing Plant in Bin Qasim Industrial Park”, in his concluding remarks, said that being an environmental watchdog his agency was fully aware of the issues pertaining to the establishment of an automobile plant and marketing of the cars, and will ensure that they are addressed sincerely.

He mentioned that Sepa after due scrutiny of the project and its environmental impacts on the surroundings and other resources will issue certificate for the construction phase of the plant only, while another inspection will be made before allowing any manufacturing operation at the plant.

“We will asses the status of compliance of Sepa’s condition during the construction phase of the project”, he added and agreed

KARACHI: Participants of Sepa’s public hearing. — ST photo

to the concerns of the participants of the hearing that the production- phase environmental hazards, solid and waste-water management, occupational health and safety plans always remain sources of concern in such sectors. earlier, representatives of eMC Pakistan Ltd, the firm that conducted the environmental impact assessment of the auto manufacturing plant, in their presentations, said that after reviewing the proposed project activities and making assessment of the potential impact of the activities on the area’s natural, socioeconomic and cultural environment, appropriate mitigation measures have been recommended to keep the adverse environmental impact within acceptable limits.

Participants were informed that the project has provisions for installation of abbettment technologies to minimise exposure to hazardous substances and to control the release of emissions of volatile organic compounds during painting and finishing operations.

Adequate measures to control any accidental release of hazardous substances on site or in transit have also been suggested to avert environmental impacts in relation to soil, groundwater and surface water contamination and occupational health and

safety.

“Solid wastes may arise from several sources during assembly including packaging– reusable or disposable including metal, racks, bins and containers, wood pallets, cardboard, plastic, polystyrene and polythene film.”

"However, all hazardous and non-hazardous wastes will be disposed of through ePA approved contractors," the consultants added.

They further said that the proponent of the project is committed to develop occupational health and safety plan in view of the possible health impacts that include prolonged overexposure of workers over years to different chemicals and gases.

“Moreover, employees will be trained in the correct selection, use and maintenance of personal protective equipment against the noise generating machines.”

The consultants observed that the project site had no sensitive areas including the protected sites, wildlife sanctuaries, game reserves or national parks, archaeological or heritage declared sites in its neighbourhood.

Moreover, a careful implementation of the environmental management plan will ensure that the environmental impacts are proportionally managed and minimised, they concluded.

drap to utilise funds for research Continued from page 5

Doctors-pharma relations: Talking up other questions pertaining to the reported nexus of pharmaceutical firms and physicians for promotion of certain drugs and their sale, Mr Aslam said that drap wanted to break the “unethical relationship” that finally yields benefits for both the companies and the doctors and overburden the patients and their family members financially.

“We have finalised the draft of regulations

and rules curbing the questionable relationship between pharmaceutical industry and doctors practicing in Pakistan”, he added saying the draft will soon be floated for receiving comments from the stakeholders. “Th e proposed set of regulations will also be vetted by the law division of the government before any enforcement.”

According to him, drap wanted to have a code of ethics to regulate the pharma industry and doctors for elimination of uncalled practices and saving the doctors from indulging in

out of way money making and facility hunting.

In this regard, Pakistan Medical and dental Council (PMdC) will also be given some role against doctors who are found practicing unethically and prescribing unnecessary medicines to patients in exchange of monetary benefits, cash, foreign and local tours besides several other incentives.

However, he indicated that the pharma firms willing to facilitate the physicians, both in the public and private settings, may be al-

lowed to contact the management of the hospitals for nomination of doctors for international conferences, seminars and training, instead of contacting them directly. Thus, genuine efforts made by the pharma firms towards grooming and updating of medical professionals will not confine to certain groups of doctors sent abroad repeatedly.

"We at drap are of the view that penalties and criminal cases should be lodged against pharmaceutical companies who are “bribing the doctors”, drap chief dr Aslam maintained.

3 ways to keep Rome’s fountains...

Continued from page 3 ● Make Rome drought-resilient with forward-looking policies. Take el Paso, Texas, which has beaten the worst drought in a generation with simple but efficient measures such as reducing the water sprayed on gardens by replacing thirsty plants and offering rebates to install more efficient air-

conditioning systems, washing machines and toilets. Legislation at the national and local level shouldn't be limited to contingency measures, such as the ordinance recently introduced by the Rome Municipality to ban the use of drinking water for other uses, but should look at scenarios that take advantage of periods of abundance.

● Adopt a circular economy model for water. To address current and future shortages, a paradigm shift is needed in the way water is used and re-used to make sure water retains full value after each use and eventually flows back into the system. Recent technological advances have made possible a circular water economy where businesses enhance productivity, consumers benefit

from lower costs of ownership and natural capital is relieved from pressure.

Rome wasn't built in a day. Nor will water stress be solved overnight. Nevertheless, it is exactly from a crisis that can come out a new model of prosperity, making the eternal City ready for the global water challenge of the future.

Courtesy:WRI

edUCATION I 9

I Friday, September 01, 2017

Researchers reveal presence of violence in low-income areas

By Our Correspondent KARACHI: Unfolding some of the findings of their three-year long research work Gender and Violence in Urban Pakistan, a group of educationists linked the scarcity of civic amenities in cities of Pakistan to breeding of violence. dr Nausheen H Anwar of the Institute of Business Administration (IBA) Karachi, dr daanish Mustafa of Kings College London and dr Amiera Sawas of the Imperial College London made a presentation on their research in question at a forum at IBA, recently. They conducted the research with the support of the International development Research Centre (Canada) and the department for International development (UK). dean and director of IBA Karachi, dr Farrukh Iqbal, who chaired the proceedings, said that his institute would continue to support such research studies in collaboration with foreign universities in future as well for overall social uplift and improvement of dwellers of the Pakistani society.

“The fact that vulnerability and lack of access to infrastructure like water supply and sanitation including solid waste management are associated with higher violence levels proves there are material drivers to violence. This means if addressed, violence could be mitigated,” the research report suggested.

There was a consensus among the various speakers of the forum that people living in settlements of lower income groups in the city continue to face violence within and outside their households owing to virtual collapse of essential civic services related to water supply, sanitation, municipal waste disposal, transport, mobility and health services.

“This violence affects all genders, including men, women and transgenders, and generally cuts across social classes in different ways.”

About 2,445 households in 12 low-income working class neighbourhoods in Karachi, Islamabad-Rawalpindi were surveyed to explore the themes of the research in the light of the

KARACHI: A researcher from IBA presenting details from her research work on Gender and Violence in Urban Pakistan at a forum arranged by IBA Karachi.— ST photo

various forms and effects of violence that exists in the urban centres.

The study showed that Karachi outweighs Rawalpindi-Islamabad in terms of petty and political violence.

As many as 12 areas were selected for the survey, out of which seven were in Karachi –Ghaziabad, Ali Akbar Shah Goth, Christian Colony, Gulshan-i-Bihar, Raees Amrohvi Society, Mansoor Nagar and Lines area.

Over 88 per cent respondents of the surveys in Karachi reported being a victim of violence either outside their homes by strangers or within their households or residential localities by their family members or acquaintances. In Rawalpindi and Islamabad, about 35 per cent respondents reported being subjected to violence by strangers.

“A higher incidence of psychological violence is reported for Rawalpindi and Islamabad.”

Highlighting the findings, one of the survey-report co-au-

thors, dr daanish Mustafa said that urbanisation and development of Karachi didn’t take into account all the vulnerabilities and socio-economic hardships of its people living in impoverished neighbourhoods.

He said that rapid expansion and urbanization of cities like Karachi, Rawalpindi, and Islamabad had been done in such a manner that people belonging to poor economic background had been left with no option other than to establish their residential settlements near or in plains of intra-city channels like Malir, Lyari River, or Lai Nullah where they face serious health and social hazards throughout the year and especially during monsoon season. dr Amiera Sawas said that major gaps in demand and supply of essential civic services like water, health, and electricity had been making residents of low-income residential settlements vulnerable to violence within and outside their households. dr Nausheen Anwar said that her team has also tried to find solutions that are pragmatic.

Later, taking part in the panel discussion, Ms Anwar said that urban planning and development was being carried out in Karachi in a haphazard and ill-planned way resulting in a greater carbon footprint causing serious environmental degradation as well. dr Noman Ahmed of Ned University of engineering & Technology said that major social issues in Karachi had emerged owing to controversies related to control and ownership of lucrative swathes of land in the city as rival quarters having vested interests in real estate affairs had fought with each other to control them.

Former senator Javed Jabbar, Sheema Kirmani, dr Huma Baqai, journalist and social commentators Muqtida Mansoor and Afia Salam and Farhat Parveen of National Organisation for Working (Now) Communities also participated in the discussion.

The resilient spirit of Pakistanis

By Our Correspondent KARACHI: dow Medical College (dMC) organised a seminar titled Pakistan’s 70 Years Journey; ‘Success and failure’, last week at its Arag Auditorium.

A noted history teacher dr Syed Jaffar Ahmed was the guest speaker of the seminar, which was, among others, attended by dMC Principal Prof Kartar dawani, editor of monthly Herald, Badar Alam, senior faculty members and students.

In his speech, dr Ahmed referred to the founder of Pakistan, Mohammad Ali Jinnah’s speech of August 11,1947. "Mr Jinnah at that time had said that every citizen of Pakistan will have equal rights and there will be no discrimination of any kind on the basis of religion, sect, color or cast."

The historian also commented that there are vast gaps between the rich and the poor people of the country. "80 per cent resources

are being used by the 10 per cent rich people of Pakistan and the rest of the people have access to only 20 per cent resources."

Sharing his views, he further said that Pakistani nation has a tendency to survive hardships. “Pakistan has been facing floods almost every year but as a nation, we have a resilient power among us which lets us rebuild our homes and lifestyles after every flood.”

He also discussed about the heavy earthquake of Abbottabad in 2005. “Whole Pakistani nation had come together to reconstruct the affected areas.”

He noted that people from middle-income groups were very keen to invest in their children’s education, instead of building their homes. He further said that female students were in majority in Pakistani universities, which indicated the positive behaviour of parents towards education of their daughters.

Prof Amjad Siraj also spoke on the occasion.

KARACHI: Senior journalist, Badar Alam presenting books on behalf of DMC to guest speaker, Dr Syed Jaffar Ahmed. — ST photo

ICCBS signs MoU to benefit tech startups

By Our Correspondent KARACHI: International Center for Chemical and Biological Sciences (ICCBS), University of Karachi, signed a memorandum of understanding (MoU) with Momentum Tech Conference (MTC) with an idea of strengthening startup eco-system in Pakistan.

The aim of the agreement is to connect Pakistani entrepreneurs with people from around the world working on innovative disruptive technologies to create the knowledge economy that can drive Pakistan’s growth in long term. Momentum Tech Conference is a leading startup technology conference and exhibition, said a KU press release.

According to the agreement, the momentum will give space to ICCBS Startups in

KARACHI: Prof Dr Iqbal Choudhary of ICCBS and Syed Amir Jafar of Momentum exchanging documents. — ST photo

Momentum’s 2018 conference & exhibition.

ICCBS based startups will have access to

momentum’s network of mentors, which will include prominent CeOs, industry ex-

perts and startup founders.

ICCBS director Prof dr M Iqbal Choudhary and Chief executive Officer Momentum Syed Amir Jafari signed the MoU on behalf of their institutions.

Representatives of MTC, Hamza Awan, Head of Marketing, Anum Shakeel, Muhammad Faizan Shoaib, and officials from ICCBS including dr Hina Siddiqui and Syed Azfar Hussain Manager Technology Incubator & Industrial Park were also present on the occasion.

Speaking on the occasion, Prof Choudhary stressed the need for building academia-industry linkages. He also emphasised the need for technology entrepreneurship in Pakistan and its vital role in the uplift of economy.

10 I ROUNd-UP

I Friday, September 01, 2017

KARACHI: President FPCCI, Zubair Tufail presenting a shield to former Governor of the State Bank of Pakistan, Dr Ishrat Hussain, after a seminar on “Export Competitiveness” orgnised at the Federation House.— ST photo

KARACHI: NBP President, Saeed Ahmed with his bank’s snooker team during the 9th NBP Ranking Snooker Tournament, recently— ST photo

KARACHI: Sindh Chief Minister Syed Murad Ali Shah handing a shield to captain Pakistani cricket team, Sarfraz Ahmed during a friendly cricket match organised by old NED University students, recently. — ST photo

KARACHI: Pakistan’s nuclear scientist, Dr Abdul Qadeer Khan being presented with a shield at a seminar on “Pakistan’s Scientific Achievements in the last 70 years”, recently. — ST photo

KARACHI: Volunteers, students and IBA administration receiving certificates for their participation in TCF Alumni Development Programme at a ceremony, recently.— ST photo

KARACHI: Chairperson Sindh Board of Investment, Naheed Memon and the Chairman of Czech-Gulf Business Council, Robert Pergl signing a MoU for cooperation in promotion of investment and trade opportunities in Sindh.— ST photo

NeWS I 11

I Friday, September 01, 2017

Rekindling the youth patriotism

Are we there yet?

An overview...

Continued from page 7

KARACHI: Historian and intellectual, Dr Syed Jaffer Ahmed addressing the Hamdard Naunehal Assembly. — ST photo

By Our Correspondent KARACHI: "A meaningful training and increased level of commitment can help Pakistani youth succeed in all walks of life with flying colors", this was reiterated by various speakers at a meeting of Hamdard Naunehal Assembly Karachi Chapter, last week.

The meeting was held on the theme of “Power in united Pakistan” at a local hotel, with noted Pakistani historian and intellectual, dr Syed Jaffer Ahmed as chief guest.

Speaking at the session, dr Sara Salman head of Sindh Office of World Health Organization, said, “We are one and we shall remain one. We may have made some mistakes and as a result those nations whom we taught to walk, are now far ahead of us.”

She continued, "However, it is never too late, we still have great

capacity to develop our country and we can do so by increasing our level of commitment."

She further said that history has been witness that whenever any enemy has cast a bad eye toward Pakistan, its citizens have proved themselves indispensable.

Commending the speeches delivered by the young speakers, she said that they send out a hope that the future of Pakistan would be in safe hands as the youth of Pakistan makes up for about 70 percent of the population.

"Hamdard has done many good things for the betterment of Pakistan particularly in the field of health, so we hope World Health Organisation's cooperation with Hamdard Foundation would continue to thrive," dr Salman asserted.

The Naunehal moot witnessed students making speeches, reciting holy verses and na’ats, singing national songs and dua-i-Said.

Commending the work and standard of Hamdard Naunehal Assembly, dr Syed Jaffer Ahmed said that he had seen the assemblies of Pakistan, Bangladesh and other countries at work, but Naunehal Assembly had its own attractive way of proceeding and training of children.

"One should have to appreciate the vision of Shaheed Hakim Mohammed Said, who had established this wonderful forum for children as these forums and schools are responsible for laying the foundation of nations," he added.

Noting that the condition of schools and education in the country has turned bad, he said that this happened because of wrong policies and priorities that were adopted by the successive governments. “None of the governments have given any priority to education.”

He suggested that the sphere of

activities of Hamdard Naunehal Assembly be extended as this forum was destined to play an important role in reconstruction of the nation.

Hakim Mohammed Usman, deputy director of Hamdard Foundation Pakistan said that the need of the hour is for Pakistanis to stand united. ‘We should follow the principles of Quaid; “Unity, Faith, discipline” in order to overcome our weaknesses and to collect the fruits of progress and prosperity” Young Speakers Hamna Shakil, Sajid Ali, Marya Ameer, Tahrim Zaheer, Omer Alam Zeb, Shaukat Ali and Aleezah Orooj also spoke at the occasion.

Three students of Hamdard Public School were awarded cash prizes on securing IV and V position in a WHO international poster competition - 2016.

Teachers, parents and students also attended the meeting.

Business reporting, a neglected beat in Pakistan

This practice needs to be changed as new graduates are not trained to meet the challenges they will face in the healthcare system.

Most of the pharmacy graduates in the country are underutilised and have nominal roles in national healthcare policy. The Pharmacy Council of Pakistan carries a heavy responsibility of reviving the pharmacist’s role as pharmacists view them as their guardians.

The council should also draft guidelines to improve professional pharmacy practice in the country.

Higher education Commission (HeC) Pakistan is keen to establish and encourage research in the country but this exercise would be futile without prioritising research areas.

Research projects should be granted on the basis of practical implications such as drug use in society and research and development of new pharmaceutical processes and molecules.

The pharmaceutical industry should also be bound by the state to start meaningful collaborative projects with educational institutions.

HeC should send academics to foreign institutes of higher learning in the above-mentioned deficient areas of pharmacy. Without these steps the future of pharmacy education and practice in Pakistan will always fall short of its true role and potential.

— The author is associated with a pharmaceutical firm as chief operating officer.

Integrated higher education system stressed

By Our Correspondent

KARACHI: Business and finance journalists after a training session organised at IBA’s Centre of Excellence in Journalism, recently. — ST photo

By Our Correspondent KARACHI: The Centre of excellence in Journalism (CeJ) at the Institute of Business Administration arranged a training session in collaboration with Citibank N A, Pakistan for about 20 Pakistani business and finance journalists at it’s facilities, recently.

A senior journalist and editor (business) at daily dawn, Khurrum Husain led the threeday training course that covered topics like challenges in writing business-oriented stories, types of sources and how to use them, understanding economic reports and documents, liquidity and currency markets, im-

portant milestones in the Pakistani financial sector, and how to conduct economic interviews.

Several experts, including CeJ director Kamal Siddiqi, economic analyst Shabbar Zaidi, head of legal for Citibank Pakistan Shaharyar Nashat talked about topics of journalistic ethics and reporting, earning reports and balance sheets, role of the regulator in the Pakistani economy, respectively.

Former Governor of State Bank of Pakistan, Salim Raza facilitated a session on liquidity and currency markets.

Mr Husain emphasised that business and economic journalism differed from other

types of journalism as it required journalists to have specific technical skills about business and economic concepts.

“Without this fundamental knowledge, one cannot be successful in this beat.”

Mr Siddiqi said that one of the weakest areas in terms of reporting in Pakistan was business journalism due to the fact that business journalists were poorly trained and were sometimes unable to fully comprehend issues related to finance and economics.

“This also translates into comparatively fewer investigative stories on the financial sector, as well as allied areas like trade, business and industry.”

KARACHI: Sindh Governor Muhammad Zubair has said that the liberal arts model is the only one which produces well-rounded individuals with a multitude of skills.

He was speaking as chief guest at an interactive session with the student community at Habib University (HU), recently. He spoke about the need for higher education, in particular a Liberal Arts education.

He further said that with a liberal arts background, students will not only benefit themselves, but the society as a whole will be benefited when they will go out into the corporate world.

The discussion centered on the need for a more integrated approach when it comes to higher education in Pakistan, as well as the government’s role in certain key issues in Karachi.

“With the current unrest and growing political turmoil faced by the global community, it has become essential that students have a basic understanding of different skills, such as social issues and the impact of technology and are armed with the ability to look critically at every situation.”

The governor was received by Ali Habib, Chairman, Indus Motors, and Wasif Rizvi, President, Habib University.

People’s right to wellness

Friday, September 01, 2017

KARACHI: Senior KMC officer, Muhammad Rehan Khan, briefing Sindh Governor, Muhammad Zubair about his latest photo exhibition at the Frere Hall, recently. — ST photo

Photographer exhibits Pakistani beauty

By Our Correspondent KARACHI: A senior officer of Karachi Metropolitan Corporation, Mohammad Rehan Khan, an amateur photographer, held yet another exhibition of his photos depicting precious moments and sites of Pakistan for three days at the Sadequain Art Gallery, Frere Hall, last month.

Sindh Governor Muhammad Zubair along with Commander Karachi Rear Admiral Ather Mukhtar and Karachi Mayor Syed Wasim Akhtar inaugurated the exhibition held in connection with Independence day celebrations. deputy Mayor Arshad Vohra and parliamentary leader in city council Aslam Afridi were also present on the occasion.

After inspecting the exhibition comprising of photos taken by Mr Khan in different cities of Pakistan, the governor said that the photographer has gathered all Pakistan under one roof, which is a commendable thing.

“This exhibition offers all the aspects of our

history and tourism in an attractive manner.

The exhibition in question –discover Pakistan --was fourth of its kind, which showcased the exhibits of indigenous culture, social bonds and beauties. Mr Khan had also organised an exhibition of his works titled “explore Pakistan” at the Arts Council of Karachi two years ago.

Mayor Akhtar said that the latest exhibition by Mr Khan presented a beautiful mirror of country’s historical buildings and monuments. "It also depicts our culture and heritage," he added.

A large number of citizens visited the exhibition and praised the photographer for his awesome collections and presentation of photographs.

Mr Khan told this scribe that he always remained in search of beautiful places, people, their culture and historic sites, which sometimes proved as a painstaking process as well, but he was always felt compensated when the art lovers and critics received his works warmly.

Printed at Maz Prints and published by Mukhtar Alam Khan for Mak News Network, R-331, Block 20, F. B. Area, Karachi. email: socialtrackpk@gmail.com. Phone: 021-36366759