Countering terrorism through health activities.

By

Dr Ghayur Ayub

Terrorism started creeping into Pakistan from Afghanistan in the 1990s. In late 1996 I was appointed as Director General of Health by the interim government of Meraj Khalid and stayed in that position till October 1999. During my tenure, I realised that ministry of health could indirectly help the government countering terrorism by using three health activities:  

1. Health and mosque initiative 

2. Primary Health Care and Family Planning program (PHC & FP)  

3. Poverty alleviation program  

1. Health and mosque initiative 

It came to my notice that a nongovernmental organization (NGO) in Rawalpindi had involved a religious madrasa in health activities. I visited the madrasa and was surprized to find a unique way of interactive work between a religious seminary and preventive as well as curative healthcare system. On preventive side, the students took part in outreach health activities such as polio vaccination or awareness campaigns on sanitation etc. On curative side, an outpatient department (OPD) and a day-care operating theatre was set up within the premises. The OPD was open to patients of all creed, colour, cast and religion. The students were brought in groups to help patients in OPD activities. The operation theatre was open for day-care surgeries. Local surgeons would come and perform minor surgeries three times a week. At the end of the day, the patients were discharged to take medicines at home and advised to return for post operation check-ups. Medicines were provided free of cost. In addition to teaching school curriculum, students were asked about their experiences in OPD and outreach preventive health activities. At the end of Q&A the teachers would correlate this humanitarian service to the spirit of Quran and Hadith teachings. Showing religion and welfare activities on a same platform turned out to be the most practical way of teaching true Islam. 

I was impressed by the change in the attitude of students and teachers alike. Unlike other seminaries, there was no hate or resentment towards other sects. The teachers were teaching and the students were following the true essence of Islam. Majority of these students were the future custodians of Mosques and Madrasas. I realised Pakistan needed this type of religious teaching. I took the local WHO team to know if a project could be materialized. The response was positive. A paper was prepared and I discussed it with senior management in Geneva. It was agreed to take it up as an official activity. Ground work was prepared and it was decided to sign an agreement on October 18, 1999 in Islamabad between WHO and the health ministry to start pilot projects in all four provinces. The agreement never saw light of the day as government was toppled a week before. Therefore, a golden opportunity was lost which could have helped the country counter terrorism in a more practical and mallow way.

2.  Data Bank

In 1998, the terrorists increased their activities mostly originating from Afghanistan. After crossing the porous border they involved local people in their heinous crimes. Because of no census there was no demographic record of families. It encouraged other terrorists increase their activities. Thus terrorism became free for all. Finding no up-to-date census record I thought why not prepare a health demographic map of the country which would give a complete picture of public health. The map would help researchers conducting studies on chronic diseases such as diabetes, arthritis, heart failure etc, not to mention acute contagious diseases prevalent in the country. The advantages were enormous. At that time, the ministry had a work force of 44,000 Lady Health Workers attached to Primary Health Care and Family Planning program (PHC & FP) spread all over the country. Using that force, we could have made a comprehensive health data map by collecting blood samples and even finger prints. A computerised record of blood groups, DNAs and finger prints be stored at the central Data Bank. The finger prints could have also been beneficial to election commission. The whole process was going to take up to six months to complete. 

Besides the health projection of the nation, Data Bank would have another benefit too. The terrorists always leave behind finger prints and blood samples at the crime scenes. Those samples could be mailed immediately to the data bank for matching. Thus in a short time, the miscreants could be identified and speedy action be taken before they disappear or cross Pak-Afghan border.  

The plan was to start this process in the tribal areas. I called a meeting of foreign donors. They appreciated the idea but showed reluctance to supporting it, calling it “too enthusiastic”. The meeting took place well before 9/11. Had the activity been given a go-ahead at that time, we would, by now, have had a tool to curb the present-day terrorism.

By reactivating this activity Imran Khan can help the country not only in making a precise health demographic map but also help in curbing terrorism.

3. Poverty alleviation program

In 1994, a time-tested WHO health activity, Basic Minimum Needs program (BMN) later renamed as Basic Development Needs program (BDN) was introduced by the Ministry of Health in the four provinces of Pakistan. It was a microeconomic program which was successfully operative in the third world countries to alleviate poverty. Acknowledging the successful results of pilot projects, the Government incorporated it into the 9th Five Year Plan in 1998. 

In my role as DG Health I wanted to extend the program to tribal areas where poverty was the main reason of public misery and frustration. The religious madrasas took advantage of that and started admitting poor students providing free education, boarding and other financial assistance. A few of those madrasas went one step further and used religious education to promote terrorism. To alleviate poverty and thus counter terrorism, I decided to launch the program in tribal region. It was decided to start the project in Kurrum agency as it was surrounded by Afghanistan on three sides and widely exposed to terrorist infiltration. The program was set to launch in February 2000. The plan was to extend it to other parts of tribal belt. It never materialized as I was removed from the post in October 1999 and the new regime closed all the new projects. Had this program given a chance to flourish, I am of the opinion that the poverty and its side effect – terrorism, would have diminished to a large extent. 

If the government is serious in tackling terrorism, these three health activities would help Pakistan counter it in an indirect but effective way. 

End