Wednesday, December 23, 2009

Pakistan Water Woes

Pakistan’s Water Woes.
Dr Meher A. Zaidi.
As Pakistan faces acute water shortages and crises in distribution and division of water resources occurring, the following misunderstandings need to be cleared , problems addressed and clear solutions and remedial plans of actions  made to be taken .
1.    The Indus  Water Treaty / partition of waterheads and river flows in Pakistan:
On Pakistan’s creation in 1947, the Punjab was an irrigated heartland and supplied by rivers Indus, Jhelum, Chenab, Ravi, Beas, and Sutlej. A treaty between India and Pakistan was negotiated bt the World Bank to give Pakistan the rights to use water in Indus, Jhelum, Chenab which comprises some 75% of the whole flow of the Indus water system.Large dams like Tarbela were built and link canals were built which supplied Punjab’s agricultural  fields. India eventually built dams over the rivers Ravi, Beas and Sutlej water heads which emanate in India and China. Eventually these rivers have run dry in Pakistan.
The debate raging in Pakistan and especially the Sindh province which is at the tail end of Indus, is that what is the future of this river and why was the Indus Water Treaty negotiated in which we sold these rivers to India. Recently due to stoppage of water in large areas in Pakistani Punjab, large crops were destroyed and effected the already deteriorating economic situation.
2.    Sindh is opposing the Kalabagh dam as there is  a perception that it’s construction will further decrease downstream flow to Sindh province, particularly the deltaic area.
(see article Sindh’s opposition to dams by Akhtar Ali
3.    Pakistan is already  one of the most water stressed countries in  Asia, and according to the     World Bank due to a high population growth, water will become a scarce commodity.
How does water become scarce in Pakistan?
Pakistan is one of the world’s most arid countries. The average rainfall is under 240 mm per year.The Indus river system supplies 180 billion cubic meters of water.the population is 160 million people. As there is only one river system which caters to the whole country, the decrease in rainfall, environmental effects, wastage of water and misuse will result in acute water scarcity.
4.    salinity is a major problem.approximately 15 million tons of salt are accumulating in the Indus basin every year, and the saline water ingresses into overpumped fresh water aquifers. Delta is degrading by silt and ocean is coming up. Pollution, industrial waste and agricultural pesticide use is also affectingthe quality of water for drinking purposes.( See Guidelines for drinking water quality.
5.    The massive disconnect between public, bureaucracy and policy makers adds to the already chaotic deficiency in indigenous experts  on water management. Due to the lack of problem- solving and  consensus building approach, the water woes are compounding.
Recently on a  Karachi visit, the president made some statement about cutting down Punjab’s water in certain river and a very pungent conflict situation developed between Sindh and Punjab. This somehow ‘put the lid on’ situation is controlled for a while  but the simmering continues. Lack of political consensus leads to lack of political will.
6.    Governance issues are affecting the  implementation of quality projects. The world Bank states that the factors affecting implementation are;
·       Weak planning and management.
·       Litigation related to land acquisition
·       Non-compliance with agreed resettlement and rehabilitation programs
·       Lack of attention to environmental issues
·       Delays in procurement.
·       Delays in preparation of accounts and carrying out audits
·       Lack of preparation for transition from construction to operation.

7.    Financing problems of water infrastructure. Corruption is also a major  hurdle here as there is a lack of transparency in all such programs.
8.    India produces more crops per acre per cubic meter of water while Pakistan has much less productivity.

Solutions and Plans of Actions on Some of the Above Mentioned Problems:

The need for urgent action on solutions ha sto be taken as conflict resolution measures as Pakistan is already riddled with conflicts and add to it the future of food shortages and we will be unable to handle any conflicts.
We have to take the  ‘Problem Solving and Consensus Building Approach’
The first priority is developing a socio-political consensus of all the stakeholder provinces and building an adequate political will to resolve the water division issues.
President Zardari and the Pakistan Peoples Party stand at the advantageous prepice of history today, where they will be able to solve the  Sindh’s water issue and amicably resolve the conflict of opposition to dams and develop building of Dam’s infrastructure for the benefit  of Pakistan as a whole.
For the first time in Pakistan’s history and at a crucial  juncture, the World Bank and ADB and all the other developmental bodies should help Pakistan build it’s water infrastructure as a representative government is in place to carry out a consensus approach.
This opportunity lost will be disaster.due to environmental effects, the glaciers will melt and there will be flooding of the rivers. This will be the opportune time for dams’ and reservoir storage. These will have to be in place already. The next phase will be that of drought . Many areas of Pakistan especially those in Baluchistan are already in drought phase next to Afghanistan.Water management and use practices will have to be inculcated beforehand.
The  antagonistic attitude of Sindh’s nationalists to Indus Water Treaty has to be changed and countered in  the true context of what this treaty actually means.What is India’s stand on this issue and what is Pakistan’s stand.
As most of the 90% irrigated land in Pakistan with rivers with heads not inside it’ s territory, a major challenge was created. Both Pakistan and India agreed to work with the World Bank to solve the issue and equably and amicably resolve the water division issues. The first proposal was of a asingle integrated basin authority. This was impractical and was rejected. During the negotiations the following things were noted;
Pakistan was given 75% of waters of the system including full use of Indus, Jhelum and Chenab except for some use by Kashmiris.This was not driven by legal principles by principles of  water engineering and economics. India was permitted to tap the considerable hydropower potential of Pakistan’s three rivers before they entered Pakistan. ( the current Daimler- Bhasha dam is one such contentious project over which negotiations are being done in a very large influx of water to Pakistan irrigated crop is blocked.).
This treaty was not first but best for either side.
Indian parliamentarians objected to Pakistan’s 75% water share  as violations of principles of ‘ equitable utilization’. Ironically speakers in Lok Sabha in 1960  debated the same way and criticized the government of India for a policy of appeasement aned surrender to Pakistan and ‘other ‘ Indian interests had been let down in the same way as Sindhi nationalists accuse the Pakistan government nowadays. However, President general Ayub Khan said ‘we have been able to get the best that was possible ‘.’ Very often  the best is the enemy of the good and in this case we have accepted the good after careful and realistic appreciation of our entire overall situation’.They based the agreement as realistic and pragmatic.
The treaty was again reaffirmed by the presidents of both the countries in the recent past.
After this as part of the Treaty , the canals and Dams’ infrastructure was built. This brought a fundamental change , where storage and dams is the main feature of development and management of water resources.
The Tarbela dam has given both direct and indirect benefits ( direct benefits assessed by Pervaiz Amir exceeded 10%. It’s impact on economy is massive, about 40% of population benefits from it’s water, 30% of installed generation capacity.
Indirect benefits are increased outputs of agricultural commodities, increased seeds, fertilizers, pump sets,deisal engines, electric motors, tractors, fuels, and electricity, increased job creation, increased food processing such as sugar factories, oil mills, rice mills, bakeries etc,.
Electricity production( Hydropower) directlyimpacts and increased output of industry such as steel, chemical, textiles. Pervaiz Amir in his study for the World Bank says that the indirect impact is considerably  larger and adds to the benefit by dams.
The Sindhi peoples should take this into consideration and the federal government should devise ‘ an industry or income generating opportunity to Sindh in exchange  for consensus for a dam’ program. This income generating opportunity/ industry should be set up in rural and under –developed areas of Sindh where local crops such as sugar cane, cotton etc., should be utilized.
The Water Accord 1991 does solve a lot of problems  like entitlements, use of water by other provinces till the province uses full quota of it’s share etc and should be followed.

Some measures to reduce water stress suggested by experts are;
·       Development of more dams and storages,
·       Dater entitlements, and water rights,
·       Unbundling, and competetiveness,regulation,
·       Transparency in governance,
·       Building up water knowledge base and capacity for water management,
·       Financial and investment improvement,
·       Human resource base
·       Linking agriculture and industry.

Water management awareness and improved practices should be devolved at community level. The local bodies , councilors, nazims are a good base at grass roots level. Sustainable use of water resources should be taught and practiced at the community level.
As many measures of water logging and salinity reduction previously improved the land especially in Sindh, same measures and also the management and abatement of pollution in drinking water reservoirs and sources should be improved.
Governance in water issues should be improved and all things should be mad transparent .Public information on all issues should be available easily, corruption should be addressed immediately and very sever punishments instituted.
Effective measures to improve yield/production per acre of crop per d4rop of water should be taken.
Only urgent and consistent measures to improve the water crises taken now , will reduce conflict looming large on the horizon.

( Source: World Bank, Internet, Akhtar Ali, Dawn Newspaper.)

Monday, November 09, 2009

Women's Health, A Most Vulnerable Hinderance In Socio- Economic Development.

The United Nation's Women's health report is released.The various aspects of women's health and how it affects the development paradigm are reflected in the initial press release. .The point  I noted most is that no matter what paradigm you see it from, human development and social justice are directly affected and very seriously affected by women's health.

In Pakistan there is a true picture of this reflected in every aspect of a person's life. If the mother is young she is affectted by morbidity ,childbirth complications, anemia,mental health problems like depression, osteopenia etc. Her productivity both as a homemaker and her work like in agriculture,worker in factory, house help etc is severely affected. She is under constant stress to provide income to support the family and now increasingly in large urban areas. The domestic or household help workorce is coming  from  Southern Punjab where poverty is leading the rural population to increasingly migrate to urban areas like Karachi, Lahore, etc to  f ind jobs as domestic help..These women constitute  a major household help workorce and are not registered as such. Their work carries no acknowledgment from the labour department and they get no benefits as a group of workers. For health needs they visit private practitioners ,often quacks in 'Katchi Abadis' or slums where they are residing in overcrowded , unhygeinic conditions. Their water supply is often contaminated and they use unboiled water for drinking and cooking also. It is to be mentioned here that the girl child is equally vulnerable as she often goes to 'work' with her mother and if she stays back often 'looks after' her other younger siblings. The staying back ordeal exposes her to hazards such as child abuse, fire or c ooking accidents and other mental stresses and problems. Not going to school is just one aspect of her deprivation.The irony is that the religious people in Pakistan who are otherwise so vehement in opposing UN and WHO work are not even inclined to acknowledge this problem. They are not concerned with addressing the health issues and neglect and poverty related issues in Pakistan. They can do much to help as they have vast resources, means and influence in Pakistani society.
The health issues faced by poor women in Pakistan are kaleidoscopic. All aspects as mentioned by Dr. Chan are represented here. It is high time that the governments, civil society organisations and religious groups realize the gravity of the situation and address these issues in an urgent basis. The incidence of violence against women, now also in the context of conflicts of terrorism targetting girls education is increasing . This will again adversely affect womens health and thus the health of the nation that is Pakistan.
We need to prioritize and devise a plan o action to improve the health and well being status of Pakistani women keeping in mind the millineum development goals. The UN and WHO are already working to help in Pakistan.We can gain much from them. There is a dire need to take the religious groups and organisations on board and build their confidence in institutions to improve women's health and socio-economic status in Pakistan.

Monday, July 13, 2009

Millineum Development Goals Report 2009..A Short Synopsis.

As the MDG report is released, the G8 Summit is over in LAquila, Italy.
Mr Ban Ki-Moon in his foreword of this report stressed the need to strengthen global cooperation and solidarity and to redouble our efforts to reach the MDGs and advance the broader development agenda.He urged the global community ,in view of the global economic crises, not to turn its back on the poor and the vulnerable. It seems that the leaders of the G8 have listened to his advice and pledged some aid like $20 billion especially for food growing in Africa.
This economic crises has slowed and reversed progress on some of the eight goals as commented in the report.
Poverty: It was seen that from 1990 to 2005, the number of people living on less than $ 1.25 a day, decreased from1.8 billion to 1.4 billion,but due to the crises ,in 2009 this will be increased to an estimated 55million to 90 million people.This was not anticipated.
Hunger: The earlier trend of decrease in hunger was reversed in 2008 due to high food prices and even falling food prices in 2008 have not been translated into benefit for the poor.
Children: These are the most vulnerable and most in developing regions are underweight for their age, stunting their prospects for survival,growth and long term development.This report emphasises the fact that the child nutrition target will not be achieved and will be eroded by higher food prices and economic turmoil.
Gender Equality and Unemployment: The unemployment in 2009 could reach 6.1 to 7.0 % for men and 6.5 to 7.4% for womenWomen also emain trapped in underpaid and insecure jobs.
Maternal Health and Mortality: This area has made least progress so so far.The reduction in donor funding will further aggravate the situation.
Export Revenues: This has decreased and this will further deteriorate.
Environment: The measures to achieve environmental goals will not improve and deforestation will continue. Water crises looms large.
The lower level of aid may reverse the gains made so far.

It lists the successes so far as:

  • Those living in extreme poverty in developing regions has decreased slightly more than a quarter in 2005 compared to almost half in 1990.
  • Major accomplishments were also made in education,where primary education enrolement reached 88% in 2007 especially from 83% in 2000.Sub-Saharan Africa and Southern Asia enrolement increased by 15 percentage points and 11 percentage points respectively from 2000-2007.
  • Under five mortality rate declined from12.6 million in 1990 to 9 million in 2007.Key interventions like insectiside treated bed nets to fight malaria ,second chance immunisations to fight measles hav e made a remarkable difference.
  • Environmental actions like 97% reduction of consumption of substances that deplete Earth's protective Ozone layer by global actions and cooperation.
  • Efforts to improve the living conditions of the urban poor must pick up speed and extend even further.As the developing countries' cities rapidly expand this improvement has to keep pace.
  • Preservation of natural resource base such as fisheries, forests ,water must be priority.

Sunday, June 21, 2009

Prevention Of Typhoid in Pakistan

As discussed in seminar on Typhoid in Pakistan. ,Typhoid is a major disease burden in Pakistan. It is almost endemic in urban densely populated slum areas of major cities like Karachi, Hyderabad, Lahore, Rawalpindi.( /National).The mechanism of safeguarding the water supply of drinking water is deficient. A new safe drinking water policy is bieng announced ( see pg 3 of Dawn newspaper/National) but let us hope this is carried in its true spirit.
The true picture is that the urban workers be they domestic servants, cooks, resturant and eatery workers are never screened for Typhoid and Hepatitis. Inspite of appearing to look modern no safety precautions, screening , vaccinations are carried out. Most are carriers of Typhoid and these bacilli are secreted in stools . As no standard operating procedures are carried for pre food handling there is abundant carraige under finger nails. The excreta contamination of drinking water supply is also massive as most pipes for fresh water supply and waste disposal are running parallel in urban areas with frequent overlapping and mixing of two streams. Also sewerage and waste is bieng disposed without treatment directly into rivers and streams. This is bieng taken directly into drinking water supply. The chlorination and some substandrd cleaning is bieng done. This is never made public and no public interest group or government agency is monitoring this. This has to be made public so that there is pressure from public for improving standards. Only doing conferences and announcements of policies by ministers will not solve the problem. Our whole attitude to safeguarding health of the people has to be more proactive with open access to cleaning procedures with more awareness of these issues. Also the affluent citizens need to take more of these issues up as causes and help the administration and the public health officials in a more problem solving way.
There is a need to take up public health issues as serious priority and increase the budgetary allocation .Also there is a dire need to be more proactive in fighting Hepatatitis and Typhoid.only a thrust on war footing will help fight theses menaces.

Saturday, June 06, 2009

Water An Expensive Commodity.

Pakistan is facing acute water shortages already. Due to climate change the precipitation will decrease in Pakistan. Already there are many areas facing a drought like situation.As each Pakistani city is teeming with millions of people and there is acute shortage of clean drinking water, the conservation measures have to be taught and taken by the municipalities as a priority task.Pakistani cities are bieng polluted by industrial and chemical wastes,all ending up in drinking water reservoirs. there are no laws and no treatment facilities. The water bieng supplied to large cities like Karachi with a population of over 16 million people is not passed through a very stringent or modern treatment plant. The piped water is also supplied to very large worker population which live in large urban slums mainly by hydrants and tanker mafia. the quality of this large water supply is very questionable. non of the tankers are owned by any companies. There is no water testing of the drinking quality of these tankers. The inner tank cleaning is neither checked or tested by any inspector or any administrative authority. The hydrants where these tankers are filled from are also not checked for the quality of water, whether fit for drinking or not. The water supplied to such a large population results in diseases of stomach and intestines both of the men workers and their families. As I work on social basis as doctor with some of these people I have seen over the last 30 years the growth both physical and mental slow down amongst the children of such areas. These children due to repeated stomach and intestinal infections,suffer from malnutrition and anemia. Malnutrition is also due to the fact that an average family size is atleast 8 persons including parents and the GDP is very low and a large number(40%)live below poverty line that is less than $1 a day.There is no food shortage as such but as Roti(bread) prices have increased the food intake is also lessening. Due to anemia and malnutrition especially protein calorie malnutrition ,these children have less resistance to infection and infestation. As the water is polluted and contains worms etc.,there is a vicious cycle of disease and diarrhoea and anemia and malnutrition. The average worker family spends about 40% on medicines and that too preferably on the earning member. The child and the female child especially remains the last priority for medical treatment.
I need to write a seperate post on the health access and services to these families. So the water shortage and its pollution impacts negatively on the these slum dwellers health. This will manifest in so many problems which I will discuss later.
There is a dire need for the city government to link up development plans with access to clean drinking water and health.For providing better water environment and clean drinking water in such communities I have few suggestions:

The idea of water board as a supplier organistaion should be changed and made an user organisation.The areas should be under control of regional communities which should form water clubs at very small areas level. In Karachi we have local bodies such as councils, which are perfectly suitable to manage their water problems. These groups will not only monitor their supply but also be able to check and standardise water quality.These should then have link with local health officer so that the incidence of diarrhoeal diseases is monitored and controlled. This kind of activity does not need a new infrastructure or money input. All these systems are in place it only needs awareness in communities and they will form their own bodies once they know the advantages in combating water pollution and maintaining water quality.
The mayor of Karachi(Nazim) should form water checking team under his direct care which checks the water tankers water quality also.On this he should not compromise anymore as the burden of disease is increasing and taking its toll on the productivity of the city. All social aspects are directly linked to water quality.
These ideas will be further elaborated in later posts.
As a commodity the value of water is not only increasing in the pricing context but as a value for decreasing or affecting other development parameters such as productivity,health index, morbidity, mortality,burden of disease etc. We need to approach this problem in a more holistic and sociological way in order to find solutions in way of human progress and harmony.

Tuesday, March 31, 2009

Impending Water Crises In Pakistan

As Pakistan faces an impending water shortage, the emphasis should be on conservation and good water management. Some household tips to reduce wastage are as follows:
Keep the physical count of amount of water used for different purposes such as drinking,cooking,kitchen washing, linen washing, lawn watering, porch washing,car washing, toilet flushing .We have installed brackish underground water pumps and seperate storage which we are using for garden watering, toilet flushing, porch washing. Toilet flushing consumes a lot of water so the use of brackish water helps a lot.
It is essential to train children to turn off the tap while applying toothpaste to brush, while brushing teeth, using shower water judisciously like wetting body and head quickly and then applying shampoo and soap over body while the shower is turned of . Rinsing head and then body sytematically. I have seen if water is mixed in a bucket and then used, water is saved much easily.
The children should be shown the water sources and how they are depleted and we should make them realize conservation.
Children should be taught to wash dishes at an early age so that they understand water conservation.