Pakistanis are living longer but not healthier lives

ISLAMABAD: People in Pakistan are living longer, but not happily.

It is not a political statement but the finding of a worldwide study that the longer living Pakistanis are spending more time in ill health.

International researchers working for the Global Burden of Disease project reported that in 2013 migraines, chronic obstructive pulmonary disease and diabetes were among the 10 leading causes of ‘years lived with disability’ (YLDs) in Pakistan.

Other leading causes included hearing loss, anxiety disorders and neck pain.

Titled “1990-2013: A systematic analysis for the Global Burden of Disease Study 2013” the study was led by the Institute for Health Metrics and Evaluation at the University of Washington, and is based on data of 301 acute and chronic diseases and injuries in 188 countries.

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Death rates are falling faster than those of nonfatal diseases and injuries

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People are living longer in Pakistan despite spending more time in ill health because rates of non-fatal diseases and injuries decline more slowly than death rates, the study explained.

For both sexes combined, the leading causes of YLDs remained largely the same during the period 1990-2013. But they take an increased toll on health due to population growth and aging, it said.

It also shows that musculoskeletal disorders – which include shoulder injuries and fractures from osteoporosis – have replaced diarrheal diseases as a leading cause of YLDs for Pakistani women. In the 23 years the study covers, iron-deficiency anemia at 11 per cent was the smallest percentage increase among the top causes of YLDs while musculoskeletal disorders as the cause increased by 163 per cent, and diabetes by 170 per cent.

Diabetes YLDs for men in Pakistan increased by 100 per cent and depression by 94 per cent during those years, while that from iron-deficiency anemia declined by 9 per cent.

“The health of Pakistanis is increasingly threatened by non-communicable diseases such as depression, chronic back pain, and migraines,” said Dr. Zulfiqar Bhutta, co-author of the study and founding director of the Centre of Excellence in Women and Child Health at the Aga Khan University in Karachi.

“At the same time, diseases like iron-deficiency anemia, chronic obstructive pulmonary disease, and diabetes are also costing people in Pakistan many years of healthy life. It is critical that we understand which diseases and injuries are causing disability so that we can effectively allocate resources for national planning,” Professor Bhutta added.

Globally, the YLDs increased from 537.6 million in 1990 to 764.8 million in 2013 for both sexes.

Men and women around the world share the same leading causes of YLDs, with the exception of schizophrenia as a leading cause for men and other musculoskeletal disorders for women. Musculoskeletal disorders, mental and substance use disorders, neurological disorders, and chronic respiratory conditions were the main drivers of YLDs in 2013. The disease burdens of both low back pain and depression have increased more than 50 per cent since 1990.

Researchers found that as people aged they experienced a greater number of ailments resulting from non-fatal diseases and injuries. Many people also suffered from multiple conditions at the same time.

Although the impact of YLDs increases with age, 81 per cent of the 2.3 billion people who suffered from more than five ailments were younger than 65 years old.

War and conflict was a leading cause of YLDs in several countries in 2013, including El Salvador, Guatemala, Lebanon, Peru, and Syria. In Cambodia, Nicaragua, and Rwanda – war was the top cause of YLD.

“What ails you isn’t necessarily what kills you,” said Dr. Christopher Murray, Director of the Institute for Health Metrics and Evaluation in Washington. “As non-fatal illnesses and related ailments affect more people of all ages, countries must look closely at health policy and spending to target these conditions.”

Vice Chancellor of Pakistan Institute of Medical Sciences (Pims) Dr Javed Akram while talking to Dawn said that people have to change their lifestyle to avoid the disabilities.

“We have the worst lifestyle in the world. Children play games on computer instead of grounds. People eat fast food instead of normal diet. Government does not have a health policy. And imagine Pakistan is to become the third most populous country of the world in 2042,” he said.

He said that 15 percent population is affected with diabetes and it is increasing because people are not ready to change their lifestyle. They would wait long for the lifts rather climb the stairs to second and third floors,” he said.

Health expert Dr Waseem Khawaja said that focus groups should be made to do counseling of people affected with different diseases.

“Moreover, government should spend money on rehabilitation of people. NGOs should also come forward to resolve the issue,” he said.

Published in Dawn, June 9th, 2015

Want a 'special' paratha? Maantu Gul Kitchen serves fare from Hunza with a twist

I wouldn't want to put anybody off by calling it a dhaba, but Maantu Gul Kitchen isn't your average dhaba anyway.

A couple of years ago, I was traveling the country for a research assignment and ate at quite a few legit, roadside, in-the-middle-of nowhere dhabas. All of which were so grey and beige and dusty.

So the first thing that sets Maantu Gul Kitchen apart is how green it is. Tucked away behind the trees adjacent to the Faisal Mosque with a well-tended green lawn at the front, it doesn’t really look like a typical dhaba. But as you walk in and settle down, it feels just like one.

Paratha galore

As far as food goes, the dhaba has all of the standard fare to offer: chai, daal, karahi, and most of it is very good. But the parathas are a cut above the rest.

They have plain, aloo (potato), beef and chicken parathas. For the ultimate mega paratha, order Maantu Gul's Special Paratha, which is loaded inside and out, stuffed with potato and beef inside and topped with chicken, cheese, and egg. However the melt-in-your-mouth plain cheese paratha is my favourite. Paired with a tall glass of lassi and an omelette, it makes for a close to perfect breakfast.

In fact, you can get pretty much everything on the menu with cheese if you wanted. Want some pakoras? Get them with cheese. Aloo paratha? Add some cheese. Now I haven’t tried this one, but the menu says you can get Mitha Paratha with cheese too.

With love, from Hunza

The head chef and owner, Aslam Pervez, is from Hunza and reluctantly came to Islamabad over a decade ago for medical reasons. After high school, he enrolled in Hashoo Foundation’s Hospitality Management Training Program and has since worked at hotels like Pearl Continental, Marriott and Serena. About two years ago, he decided he wanted to open a place to call his own, and Maantu Gul Kitchen was born.

Running his own establishment has allowed Pervez to introduce his customers to some traditional Hunza cuisine, like Dawdoo soup, Chap Shuroo (bread filled with a spiced chopped beef mixture), Mantu (steamed dumplings filled with meat) and Chamus (apricot juice). The Chap Shuroo left me unimpressed (overstuffed with an extremely hot spicy filling) but the Mantu dumplings were quite good.

Most dhabas are often males-only establishments, but not this one. Granted the male:female ratio is around 17:2, but at least you won’t be the only woman there. They even have a curtained section if you want ‘parda’ for privacy. Maantu Gul Kitchen is always busy and on weekends you’ll see a lot of families there for breakfast. It’s a great spot for a post-work chai-and-paratha snack too.

However, it's good to know that the service can be a bit slow and you'll be paying a bit more than usual for your paratha.

But go to Maantu Gul Kitchen because there's nothing else like it — you will not be disappointed.

From the kitchens of Aslam Pervez: Chamus recipe

Aslam was generous enough to share his recipe for Chamus (apricot juice) with us. It’s very easy to make, all you need are apricots and water, and no additional sugar is required. It’s good for you too; apricots and apricot juice are an excellent source of vitamin A.

Ingredients

500g dried apricots

1 litre boiling water

Method

In a large glass or ceramic bowl, add the apricots and pour the boiling water over them. Cover the bowl and leave the apricots to soak for 1 hour.

After an hour has passed, squash and mash the apricots with your hands to blend them into the water. (You may use a potato masher for this step but, according to Aslam, the juice is tastier when this is done by hand.) You should end up with have a thick pulpy orange-coloured mixture.

Strain the apricot mixture. Store the strained liquid in the refrigerator until the juice is thoroughly chilled.

Tip: The juice is quite thick, so you can thin it out a bit by adding water, if you prefer.

I wish to inspire girls in subcontinent to play tennis: Sania Mirza

NEW DELHI: Outside Bollywood films, Sania Mirza might be the only Indian success welcomed as warmly in Pakistan and the 28-year-old expects her doubles feats to inspire girls on both sides of the border to pick up a tennis racquet.

Mirza has long been the face of the women's game in India and her high-profile cross-border wedding to cricketer Shoaib Malik five years ago placed her in a unique position.

Her rise to the top ranking in WTA doubles was hailed in both countries, though they remain suspicious of each after fighting three wars since independence in 1947.

Malik's international career has stalled since his last one-day match two years ago, but Mirza last month became the first Indian to climb to the top after winning the Family Circle Cup in Charleston, South Carolina, her third successive title partnered with Martina Hingis.

“It feels good,” Mirza said in an interview.

“Me and my husband, we live in a kind of extraordinary situation because we both are professional athletes from different countries who still represent their own country after marriage and I don't think that happens very often.

“We both are very active, still playing and it's great if it can inspire not just people in India and Pakistan but hopefully girls can pick up tennis racquets in the whole subcontinent, really think that sports can be a career option.

“That does not come first to the head of any girl or parent ... Whether it's India, Pakistan or anywhere in the subcontinent, I'd like to believe people hopefully will get a little inspired by this and hopefully things change.”

Once a top 30 singles player with a potent forehand, Mirza was the first Indian to win a WTA singles title in 2005, but after battling knee and wrist injuries, feels her switch to doubles has been vindicated.

“I ended my singles career solely for the reason that my body was not just able to take it anymore,” said Mirza, calling it a “surreal feeling” to top the doubles rankings.

“I had three surgeries in seven-eight years and in those years ... it was either playing doubles or not playing tennis at all. I love tennis too much to have given up on it so soon.”

Finally at peace, Mirza has set herself a couple of goals.

“It would be great to try and get records on how long I stay there and definitely try and win a women's doubles grand slam which has not happened. I have come close so many times even though I won mixed grand slams. Hopefully try and end the year at one, if not this year, next year.”

Internet.org: An offer so great that it’s not

I have changed five Internet connections in the course of a year, broadband, mifi, cable net, fibre optic and evo-shevo you name it, each one worse than the other.

It’s as if my workplace is entirely jinxed and we should give up any hopes of ever having a functioning internet connection. A connection so excruciatingly slow that it made me miss the old dial-up days.

Given the horrors I and numerous Internet users in Pakistan suffer from, you can excuse me for being terrified over the launch of internet.org, which, on the face of it, appears to bring you the internet for free, a place where everyone can now connect and explore the big web, an offer so great that in fact it’s not.

Also read: ISP insider: How my search for faster internet in Pakistan drove me up the wall

In reality, internet.org provides you access to limited, ad-filled websites that are chosen by Facebook, it creates a wall garden for users who can’t afford much, where their accessibility is limited and date compromised.

Let me explain this in more detail, the apps available through internet.org provide access to limited websites by surpassing SSL, that in human speak means your messages, photos and all other information is travelling through an open postcard without an envelope and thereby being read by advertisers, facebook, governments and creepers central. Any and all information is easily accessible on the network.

Take a look: The rise of mobile and social media use in Pakistan

Now imagine watching one of your favourite TV series or music video online and each time you click on to view it your Internet slows down considerably.

You log on to Skype, Google Hangout or Jitsi and the minute you hit call, the Internet quality turns so bad that you can hardly speak. Annoyed much?

This is the kind of menace that platforms like internet.org are encouraging, whereby your service provider will now discriminate your accessibility based on the services you are using. It’s already begun, some telecommunications companies have now started charging customers for whatsapp calls, and it’s only a matter of time when your ISPs will start charging you for using services that were otherwise free.

See: Pakistan among 10 worst countries on internet freedom index

Some of us have been using the Internet for several years; we have had our experience with stumbling on different sites, trying and quitting various social networks.

However, the big corporations and governments now want to change all that for the next billion who will come online in the coming decade. They want to shape access for those who can’t afford it as well as those who can.

It wasn’t enough that the corporations and the governments were in cahoots, using our data to make profit or justifying their greed for total control; now they also want discriminate further by fracturing the way we will connect and communicate.

Is 3 Bahadur teaching our kids the right lessons about good and evil?

Stories of heroes are also stories about villains. The arc of a heroes’ journey may be the very stuff of the plot, but it’s the existence of villains that compels that rise.

We see the same in 3 Bahadur, the latest film from Pakistan that’s all the rage.

Also read: Why you should watch 3 Bahadur, Pakistan's first animated film

A trio of heroes — school friends Amna, Saadi and Kamil — gain superpowers when they demonstrate a desire to combat the thugs that terrorise their town, Roshan Basti. The thugs are underlings of the evil overlord Mangu who gained his superpowers after pledging allegiance to the devil incarnate, Baba Balaam. The heroes' acquisition of superpowers is staggered; the more bravery they show, the more powerful they become.

The heroes are adequately fleshed out — there's Amna, whose speed, strength and sass make her the centre of attention; smart and serious Saadi with a tragic backstory; and Kamil, who's endearingly silly but kind to a fault. There's a balance of brawn, brains and heart in this superhero trio.

But one feels that the portrayal of the villains is not so nuanced; in fact, it wouldn't be a stretch to say that very little is known about the villains, nothing except their evil intentions and ultimate defeat.

Baba Balaam is fiery, fanged and in Mangu's words, "so hideous", which is indication enough of his devil-on-earth status.

Mangu is large, intimidating and malicious enough to pose a credible threat to the 3 Bahadurs, and his slightly kooky gang of thugs, drawn in a variety of shapes and sizes, flash enough steel to have us convinced of their menace. But the inner psyches of these villians are left largely unexplored.

What ever happened to back stories?

Who Baba Balaam actually is, where he came from, and how he came to amass all the evil power in the world is left to each viewer's subjective interpretation.

Which is fine, because we assume him to be the devil incarnate, and don't as such need further explanation of his evil. But the lack of explanation continues with the other villainous characters...

We wonder: why is Mangu a kidnapper (which, by the way, was his job even before he became a supervillain)? And why does he want to rule the world? There is a tangential reference to his lust for power — "Did you not want superpowers so that you may rule the world? Isn't that why you kidnapped the little girl today?", asks Baba Balaam of Mangu — but it's difficult to connect that with his kidnapping gig.

We don't know what made Mangu go over to the bad side. Was it jealousy, like Snow White's stepmother who is envious of her beauty? Was it wrath, like the Fairy Godmother in Shrek who resolves to have Shrek's head because she felt her son, Lord Farquad, who was hopeful for Fiona's hand, had been slighted? Even Maleficent had a broken heart. But no explanation is given for Mangu's drive to take over the world, at the expense of other people's misery.

Moreover, why are Mangu's cronies carrying out his bidding? Is it easy money? Are they jobless and poor? Is loyalty to Mangu their safety blanket? We can infer several reasons for their thuggery, but the film's intended audience of kids, however smart, may need more information — and here's why:

Born rotten?

When I was younger, I used to think of chors (thieves) as a different breed of human, and wonder where they came from. This view of the world was incorrect and unfair, and thankfully I grew out it, eventually coming to the realisation that while human beings can become deeply flawed over time, no one is born rotten.

Why is it important that we understand the roots of evil rather than writing it off as preordained?

For one, we would like kids to learn compassion and empathy, to understand that even the worst people around us are like that for a reason. Identifying that cause of cruelty or injustice helps dismantle it in a more long-lasting way. We have to arrest the dangerous tendency to wish away, or execute, or banish people who are unlike us. Even if they're scum.

In the absence of any context for or explanation of the evil in 3 Bahadur, we may be telling kids that it's okay to think of people as inherently evil, rather than the product of their environments, and thus incapable of reform.

(Spoiler alert) In real life, criminals can't be sent hurtling through the fourth dimension, like Mangu's end, nor can they fade into oblivion, like his thugs. We need to be more realistic.

A deeper characterisation of the villains would not only humanise them, but also enhance kids' understanding of the many messages in 3 Bahadur.

(Spoiler alert) By the end, the 3 Bahadurs have trounced the thugs and maimed Mangu, but in an interesting and literally last-minute twist (in a scene shown after the credits rolled), the devil remains undefeated. Maybe we should expect a sequel, one in which the 3 Bahadurs are meant to come to a more nuanced understanding of evil.

If we give 3 Bahadur the benefit of the doubt, it makes sense for a franchise to build its foundation and place all the focus on the heroes in the first installment. After all, the heroes are what draw the audiences in and have their colorful characters plastered on all sorts of merchandise. Perhaps that's why the villains of 3 Bahadur are one-note, just serving to necessitate the trio's ascent to superheroic status.

Generic villains may work for Marvel and DC, but for a film that aims to teach kids a thing or two about good and evil, villains work best when fully realised with backstories and motivations that go beyond simply taking over the world.

3 Bahadur did half the job in setting the stage for deeper exploration of evil, but barely addresses its root causes or the possibility of reform. Maybe the sequel will address these angles, but it's a lesson delayed.

Mango exports fetch $1.1m in five days

KARACHI: Pakistan has exported around 2,200 tonnes of mangoes, fetching $1.1 million, since the start of export season on May 20.

All Pakistan Fruit and Vegetable Exporters, Importers and Merchant Association’s (PFVA) Research and Development Chairman Waheed Ahmed said mango was being exported to Saudi Arabia, the United Arab Emirates (UAE), Iran, Afghanistan, CIS countries and Oman, among others.

He said the fruit was being exported for about $500 per tonne this season compared to $250 last year.

He attributed improved earnings to the government ban on using wooden boxes for fruit and vegetable exports.

Ahmed said a delegation of Iranian Quarantine Department is also coming this month to review the prospects of hot water treatment plants.

Some exporters are already making shipments to Iran after getting approval from the quarantine department.

Mango exports to Iran would rise further if plants are approved during the visit, he added.

Around 29 hot water treatment plants are operational this year as compared to last year’s three.

“Exporters are hopeful that mango shipments would cross the export target of 100,000 tonnes fetching $60 million compared to 94,000 tonnes ($48 million) last year,” he said.

Pakistan is expected to produce around 1.8 million tonnes mangoes this year.

Published in Dawn, May 26th, 2015

Pakistan’s cricket isolation comes to an end today

The game will start at 07:00 pm local time.

Pakistan (squad): Shahid Afridi (captain), Sarfaraz Ahmed, Ahmed Shehzad, Mohammad Hafeez, Mukhtar Ahmed, Noman Anwar, Shoaib Malik, Umar Akmal, Mohammad Rizwan, Anwar Ali, Hammad Azam, Immad Wasim, Bilawal Bhatti, Wahab Riaz and Mohammad Sami.

Zimbabwe (squad): Elton Chigumbura (captain), Sikandar Raza, Chamu Chibhabha, Charles Coventry, Graeme Cremer, Craig Ervine, Roy Kaia, Hamilton Masakadza, Christopher Mpofu, Tawanda Mupariwa, Richmond Mutumbami, Tinashe Panyangara, Vusi Sibanda, Prosper Utseya, Brian Vitori and Sean Williams.