Bare below the elbows...

The NHS' “Bare Below the Elbows” policy requires that to prevent the spread of infections, health workers should not wear watches, rings (other than wedding rings) and should be bare below the elbows. This is based on research showing that bacteria can survive on sleeves and from there spread to patients on contact. Some Muslim female health workers, and 'community' leaders, have raised concerns about this policy.

A number of options are being discussed, including sleeves that can be easily rolled up on patient contact. My own view is that Islam is sufficiently flexible to take account of necessity. If there is scientific evidence for the survival of bacteria on sleeves, and transmission from there to patients, then out of necessity, there should be no obstacle to women health workers being bare below the arms.

Dependency culture...?

I enjoy studying the welfare state. It is a fascinating topic. This is because, although the details are boring and technical, underlying the welfare state are principles of compassion and humanity. Another reason for my interest is that, as so frequently happens, there is a conflict between the stated, noble, intentions and operation in reality.

Every area of the welfare state has examples of this dichotomy between reality and intention. Take child protection. We condemn the welfare state as a meddling nanny when happy families are broken; we condemn it for not doing enough when tragedies, such as the case of Baby P, happen. Yet we accept the principle that the state should have a role in helping vulnerable children.

There is, in other aspects of the welfare state, a conflict between the wish to help and the need to prevent making people dependent on state help. Take the case of financial help given to the unemployed. A perpetual challenge has been how to help those who need it, without, especially for those lacking skills, making people think hard and fast before accepting jobs that would make them only marginally better off ( or not better off at all, or, taking everything into account, worse off).

If the state is contributing significantly towards your mortgage payments, and you are not a skilled professional, you will think hard before accepting a job that could make you worse off. It is natural to make such calculations; it is totally unreasonable for there to be an expectation not to think in this way. Similarly, there is a huge disincentive to taking on short term contract work.

I am not sure what the solution is to these problems. Means testing, or targeting help to those who need it most, sounds great in principle, but for it to work, we all need to be saints.

BNP member list

This week saw considerable controversey about the release of the personal details of BNP members. Some people could hardly contain their glee, arguing that members of other parties do not hide themselves. Others argued that BNP members have rights too. Although Labour or Tory members do not need to hide, there would be an outcry if their personal details were published online. I agree with the latter view.

The list itself, easily available, contains 12801 entries. I am sure there must be social scientists somewhere analysing the data, though there isn't much to go on, apart from personal details. I suppose it does help in identifying the national distribution of members.

Of the 12801 entries, roughly 2400 are female (18.7%). 40 have the title of Dr before their names; 5 are reverends. There are even afew lords, ladies and knights, though I do not know if these titles are geniune. My own city, Birmingham, has around 220 members, including some who are from predominantly Pakistani/ Asian areas. Most of the members are from what could be called deprived areas, though there are several from more affluent areas.

Film news.....from Mirpur

Those who watch satellite channels of the DM Digital, KBC and Aapna TV sort, will know of a new genre of film and drama coming from Pakistan. I am referring, of course, to Potahari/ Pahari entertainment. The Potahar region of Pakistan is in fact a cultural entity that includes the Mirpur district of Azad Kashmir.

Now I hear that a new Pahari amateur film has as its leading actors at least 4 people from my own village, Chattroh. The film, Mara Sajan Pola (My naïve lover), is currently making the rounds in England. As a first amateur attempt, it’s actually an extraordinarily good film, well shot, the story moves quickly and there is a good dose of unique comedy.

Potahari/ Pahari films and dramas, helped by the rise of niche satellite channels, are increasingly becoming popular. Given the resemblance of Urdu and Hindi, Lollywood’s Urdu outputs do not stand a chance next to Bollywood. And Lollywood’s punjabi films are ridiculous, with every sentence delivered in earth shattering tones. The gap thus left is filled by Potohari films, which are in general more realistic and touch relevant themes, including the Pakistan/ England link.

The 'government' of 'Azad'Kashmir should take note and offer a cultural policy. It is clear young people want this; note how popular Bollywood movies, despite being banned, are in AK. I doubt, however, if anything will change. Culture does not go beyond recital of the quami-tarana and afew poems by Iqbal. The private sector is taking the initiative.

Good times on credit

It has become something of a statement of the obvious to say that over the past decade or so the material standard of life has increased by leaps and bounds. For example, ownership of material possessions, such as mobile phones, ipods, etc, has increased tremendously. That much cannot be denied.

But looking at it now, after the credit crunch, it seems all this prosperity has been achieved not by high paying, quality jobs, but on credit. Unprecendented levels of consumer credit, which have become clear since the crunch, are evidence of this.

With quality jobs shifting to low wage economies and being replaced by McJobs, it seems permanently low interest rates have been one way for the Western governments to ensure living standards do not fall for their citizens.

Holy Punches!

Those who saw the news last night would have seen images of Greek Orthodox and Armenian monks trading punches at the Church of the Holy Sepulchre, Old Jerusalem. The scenes brought to mind an incident, in which two mullahs exchanged slaps, I witnessed in the late 80s.

The point at issue was the vexed question of whether fasting should start the next day or not. As many people know, this is a difficult issue because it depends on the sighting of the new, thin crescent moon. The fact that the date of the new moon can now be scientifically calculated seems irrelevant, as does the fact that the new moon may have been sighted in other countries.

Anyway, this brawl that I remember started when one of the clerics rather naively suggested that the mosque just follow the decision of the majority. The other cleric was having none of this pragmatism. And so slaps ensued.

I am unable to empathise with those who take part in these petty disputes. What drives them? I just cannot get into their mind to see what is behind it. Take the issue of the sighting of the moon. Clerics in the UK are willing to say their prayers at precise times, such as 5:33 or 7:47. Where does this precision come from? It does so from the Met Office. Yet why not rely on the Met Office for the sighting of the new moon? What, in principle, is the difference between the two?

The former Pakistani Prime Minister, Z A Bhutto, talking about the mullahs once said “I have no time for those who argue as to which nostril to clean first”. That is one statement with which, in this day and age, one can easily empathise.

False hope....

Medical experts, backed by the charity Sense About Science, have expressed concern about the safety and efficacy of many web based remedies being offered to people who are unwell and suffering. In most cases, they just offer false hope at great cost.

I am similarly concerned about some of the adverts I have seen in the free Urdu newspapers, which offer, not just medical advice, but a solution to all of life’s problems. One spiritual healer claims to solve any problem, from impotency to recalcitrant children. Another promises that your stubborn sweetheart will fall at your feet after a (costly) visit.

These can be dismissed as entertainment, but some make more serious claims, such as to cure chronic conditions, such as diabetes, or even life threatening diseases such as cancer. Recent years have seen a proliferation of these free newspapers, which contain little original news (just poor quality re-wording of news from more established sources), and many adverts. The problem is that these newspapers are read by the most vulnerable - older Asian men who have little understanding of other sources of information to confirm or disconfirm what they read.

Marriage.......

The marriage arrangements of British Mirpuris are changing drastically and quite rapidly. Young people - boys and girls- are demanding a greater say in the choice of partner. In many cases, parents merely rubber stamp the decision taken by their son or daughter. This is, in general, a positive development. It is only right that those who will have to spend their lives together should be able to choose who they will do so with.

Another way in which marriage is changing among Mirpuris is that young people are increasingly less likely to stick around in loveless marriages, as witnessed by rising rates of divorce and marital disharmony. In a sense, Mirpuris are becoming mainstream, where rates of divorce are already high (though they have fallen recently).

Is it a positive development that many Mirpuri youngsters, unlike their parents and definitely grandparents, are no longer willing to stick around in loveless marriages? That is a difficult question; in general if children are involved, my view is that people should make an extra effort to stick. In other cases it is more difficult. Whatever the answer, utmost care and attention is required in selecting marriage partners.

Line of Control...

The Line of Control that separates Indian and Pakistani Kashmir was opened to traders this week. News reports showed the 'Prime Minister' of Pakistani Kashmir releasing a bird in the direction of Indian Kashmir, which promptly flew back. Whether it was meant to be a symbol of peace, or freedom on this side in contrast to the Indian side, or both, I do not know.

If Kashmiris from the two halves start visiting each other more, they will start to compare. It is natural to compare. What will Kashmiris from one side make of the other?

Those from the Indian side visiting Pakistani Kashmir may, initially, be struck by the large palatial buildings, particularly in the Mirpur district. The more perceptive will soon realise that these are most definitely not the symbol of prosperity overseen by Pakistan. They will realise that most of these impressive buildings are empty and their owners living in cramped terraces in the UK.

Beneath this superficial veneer, they will see a decrepit infrastructure, roads in a state of disrepair, poor quality healthcare, a state education system that has collapsed (note the popularity of private education) and bickering over relatively minor things.

Indian Kashmiri visitors may well also note the bickering over the short Dhangali Bridge, which, in the greater scheme of things, should be relatively easy for Pakistan to construct. They may well contrast this, unfavourably, with the recent launch of the rail link between Delhi and the Indian Kashmir. While we bicker over a puny bridge, they have a rail service!

Back to blogging....

I have been away for many months from blogsphere as there is no point writing when the words will not out. To write effectively requires inspiration and passion; else there is no point, unless you write for a living, where it is deemed fine to concoct artificial sentences.

Anyway, I hope to write a blog regularly now, at least one per week to begin with.

To kick off, a word about two issues. First the banking crisis. I began blogging in 2004 partly in response to the financial bubble, particularly as it affects housing. Now the chickens have come home to roost. The impact of what we are witnessing should not be underestimated. A massive paradigm change is taking place. RIP neoliberal economics; interventionism is back in. If the banks can be rescued, many other industries will be wondering why not them.

The second important change since I last blogged is the fact that Zardari is now the president of Pakistan. That the most corrupt person in the history of Pakistan, and someone who would no doubt get a front seat in an international contest of corrupt politicians, should become president is a tragedy and does not bode well for the future of the country. This man combines corruption and incompetence. Faced with court cases, he claimed to suffer from several mental ailments. Either he lied or he didn't. Either way, he is not fit to be president. Alas the sycophants who tail him do not realise this, or refuse to accept it.

Education

To roughly translate and apply a Mirpuri proverb, these days if you pick up a stone the chances are that there will be a degree lying under it. The widening participation agenda has done more than widen access to higher education. In the process, the content has been dumbed down. So much I was able to glean from the pages of the Times Higher while I was working at a leading University. There was scarcely an issue that didn’t contain academic moans about declining standards.

Given this, the arrogance displayed by some Mirpuri parents when talking about their graduate children is totally misplaced. Of course, there are some very high achievers, both academically and in careers. For these, actions speak louder than words: their self evident position makes unnecessary any overt arrogance. In general, however, going to a University (normally a post-92 one; i.e. an ex-Poly) is no big deal. You don’t even need decent A, level grades to do so. No wonder academics complain about students who can’t spell or construct a half decent paragraph.

Benazir and Pakistan

Pakistanis are still in a state of shock less than a week since the assassination of opposition leader Benazir Bhutto (BB). The assassination, on 27 December, came at the end of bad year for Pakistan. Even the arguably good news, like the growth rate and economy, has a negative driver: the dollars coming in as part of the US war against terrorism package.

There's no shortage of material to read about the assassination and its aftermath, on the net and elsewhere. So here's some brief points to add to the mix.

First, the government, as on other matters, is suffering from a massive credibility gap. Its version of how BB died, and who may have killed her, is believed by very few. Political murders are rarely solved in Pakistan. We still don't know why the first Prime Minister of Pakistan, Liaqat Ali Khan- after whom the park where BB died was named- was killed. Neither do we know much about why Zia was killed. There's plenty of speculation. We will probably never know who killed BB.

Second, the People's Party has harmed its democratic credentials by keeping the reins of power in the party within the Bhutto family. There are plenty of able people in the party (e.g. Aitzaz Hassan, the lawyer who caused much headache for the government in 2007).

Third, the current 'caretaker' government has been wrong to postpone the general election. This is clearly a political decision taken in view of Musharaff's declining popularity. It is also to minimise the chances of the People's Party capitlising on the sympathy vote.

Changing nature of work

Once upon a time, work was about making things or doing things with others. You made loo rolls, cars, pens, clothes and stilettos. Or you did something to someone: you took their money and saved it in your bank, you gave it back to them when they wanted it. You examined them and gave them medicine or a bandage. And so on in a number of other occupations…
Now doing useful things like this has become tangential. Those who make things are now based in the faraway abroad, like India and China. True, we still do things to others, like treat their halitosis and take money from them (though not give it them, as the card now does that). We also do a lot things of questionable value to others, like give them nail jobs and enhance their body parts.

But the main way in which work has changed is that a lot it is done for it’s own sake, with no obvious end in sight, even a superfluous one like a nail job. How many people now spend their whole working day gawping at a PC screen, writing memos, sharing email funnies and having endless cups of coffee. Even if they are conscientious workers and forgo the coffees and personal emails and web surfing, the substance of what they do serves no clear purpose.

Not surprisingly, jobs of this sort are not very secure. Whereas manufacturing jobs are being shifted overseas, the vulnerability of the non-jobs I am talking about is to constant change and restructuring. For the workers, the survival strategy is to be adaptable and take on a new opportunity arising from the restructure or to move out, often to another non-job. Those who become wedded, for too long, to particular ways of doing things do not last long. To succeed, you must be able to condemn your past and jump onto the latest fad.

Situation in Pakistan

How’s this for a crime reduction strategy: lock up the potential victims? If the victims are safely in jail, no harm can come to them. That seems to be the perverse logic of the stated reason for the declaration of emergency in Pakistan. For if the fight against terrorism is the main reason, then what other logic is there to locking up secular and left leaning politicians, lawyers and community workers? Religious fundamentalists detest such people. Imran Khan was actually handed over to the authorities by the student wing of the fundamentalist Jamat-e-Islami. So much for enlightened moderation, or Musharaff’s roshan khayali.

We all know, of course, that Musharaff is following the logic of all dictators, especially Pakistani ones. That is the quest to remain in power at all costs, presented as being in the interests of the nation. The nation will disintegrate if the dictator does not remain in power. So the biggest obstacles to this, the courts and secular leaders, need to be removed. The fundamentalists, on the other hand, can be useful, for the dictator can say to his masters, the US: “look what you’ll get more of if I am not around.” Last time it was in the national interest that the dictator remains in power we had Zia, keeping the commies at bay. All the current problems were the result.

Many commentators have likened the situation in Pakistan to Iran just prior to the fall of the Shah. That analogy is probably not wrong. Musharaff is extremely unpopular at the moment- which probably accounts for why Benazir, having had corruption charges dropped, is hardening her stance against the government and sounding out to other opposition parties. No body wants to be seen shoring up a dictator when the whole of society is in revolt.

Alternative medicine

Alternative medicine covers a wide spectrum, from the credible, such as herbal medicines, to the ludicrous, such as healing by touching. Along the spectrum, the habits of us Mirpuris probably lie closer to the ludicrous end, as shown by the popularity of pirs, or faith healers.

Often those who visit pirs have vague, undefined symptoms, such as ‘tightness’ in the head or aching bones. Some people may well experience a reduction in symptoms after a visit to the pir, but this is more to do with dubious symptoms together with the mental reassurance which goes with visiting a pir, as distinct from a three-minute visit to a more bureaucratic NHS doctor.

In so far as pirs offer reassurance and comfort, there is nothing wrong with visiting them. They can, for example, be part of the disease management process. But to suggest that the intervention of a pir can affect a biochemical change in the body, and thus cure an illness, is ludicrous.

Attitudes to work

When I arrived in the office yesterday morning, I noticed something interesting. A cleaning lady, not far off from 60, had her leg bandaged up and was supported by a crutch. Yet she had come into work. After exchanging the normal Monday morning greetings, she explained what happened and was grateful that her employer had shown consideration by adjusting her duties. She seemed pleased by that.

She should really have been at home, yet her situation got me thinking about work and health and attitudes to them. I tried to imagine British Mirpuri and Pakistani women of a similar age- and indeed a large number of men of that age. When our people reach that age, they start complaining of health problems. Sometimes they are real, like heart disease. At other times, the ailments are undefined and unspecific- just severely aching bones, tiredness, breathlessness and the like. Heaven forbid that they should work. Those that do are often dismissed as wretched.

Ramadan

In the last week of Ramadan, it is well to do a sort of spiritual stock take. Has spirituality gone up, down or remained the same? I suspect in most cases it has made no difference, because, unfortunately, for most people fasting is no more than a ritual, albeit a very painful one. Few people understand the enormity of a month in which deprivation of bodily needs becomes the key to spiritual nourishment.

Abstaining from food and drink is only one aspect of Ramadan. The other crucial part is abstaining from other vices- like lying, back biting, hurting the feelings of others and waste and a litany of other vices. On all these accounts, people fail. I see evidence of these and other vices everywhere, with not even a special attempt being made to control them.

Of Monks and Lawyers

What do monks and lawyers have in common? At first sight, you may say very little. One group cultivates the spirit; the other gathers gold. In South Asia, though, they do have something in common: opposition to military dictatorship. Pakistani lawyers were out on the streets months before Burmese monks did the same. Both have been met with an iron fist.

Here the similarity ends. In Burma, the monks are the good guys, with whom Brown and Bush are happy to associate and to deliver homilies to their tormentors. In Pakistan, the lawyers are on the wrong side. They are opposing a good guy, our military man.

Let those Western leaders who like to sit on a pedestal to lecture the wrong sorts of dictators know that such ironies are not lost on people.

Depression

Depression, we are told by the World Health Organisation, is more disabling than angina, arthritis, asthma and diabetes. This may sound counter to what most people think, but it does raise the question, what is depression and what makes it a distinct illness? There is no shortage of definitions of depression. Extreme form of sadness is central to all.

I think three points need to be borne in mind in any discussion about depression.

First, it is an illness that has only relatively recently entered common parlance. I have a lucid memory stretching back to the late 1970s. Yet I do not recall common discussion of depression then. Now, over two decades later, it is discussed even in the villages of India and Pakistan. What has happened? Has depression increased, or have people found a single word to describe what were previously considered disparate symptoms, such as headaches, anxiety and sadness?

Second, depression has become a convenient and acceptable word to mask serious mental illness. What I mean is this: in some cases, what the person is suffering from is not depression, but a serious psychotic illness that affects the thought process. In other words, it is more respectable to admit to depression than to losing touch with reality.

Third, where the intense sadness is related to extreme life events, for example bereavement, loss of job and loss of house all occurring at once, can that be regarded as illness? Is it not normal to have extreme reactions to extreme events? In some cases, then ‘depression’ is not an illness but a reaction to life events. It is important to know this, because the solution lies in tackling the problems, not in taking tablets or making the person feel better when objectively their life situation has little to make them feel good about.

So I would say the medical term depression should be reserved for cases where extreme sadness is not based on life events or is totally out of proportion to any problems and where the thought process remains intact.

Vartan-bhanji

My English friends are fascinated by the concept of vartan-bhanji, the custom of reciprocated gift giving. Although they engage in gift giving and receiving with close family- brothers, sisters, parents, grandparents, nephews, nieces etc- they are surprised to learn that the vartan-bhanji extends to those people from the extended family with whom you have only a very tenuous link. They are also surprised by the occasions which prompt the need to make a gift to comparatively distant relatives: marriage, the birth of a son, the arrival of someone from Pakistan and weddings (and the various customs that, over an extended period of time, take place during a wedding).

Vartan-bhanji is more than just gift giving. It is a formal process that cements extended family relations. To not engage in vartan-bhanji, or not to reciprocate a previously received gift when the occasion demands, is to express displeasure at the other person and to sever links with them. And these are noticed by others. At weddings, for example, people will notice if a certain family is not present and will enquire about the reason.

Like many other customs, vartan-bhanji is also coming under a strain in the cut and thrust of urban UK living, where extended families can often be separated by hundreds of miles. As a result, the occasions that prompt the need to make a gift are gradually contracting.