A criminal silence

Written July 18, 2014

All men are not created equal. One Israeli life is equivalent to 200 Palestinian lives. And, once again, the world has better things to do than stop Israel’s genocide.

It was not the kidnapping of three Israeli teenagers that started it. Two Palestinian boys, acting on their own, kidnapped the three teenagers hoping to use them as hostages to get Palestinian prisoners freed by Israel. One of the Israeli boys was able to call the police with his cell phone; the Palestinian boys panicked and killed them. Legal machinery and due process did not come into action — raw revenge did. Orthodox Jews, typically non-violent, burned Mohammad Abu Khdeir alive. His cousin, Palestinian-American Tariq Khdeir, was held down by an Israeli border police officer while another kicked and punched him in the face. Tariq miraculously survived. The US murmured a protest to Netanyahu and was told that the police officers had been suspended for 15 days, and might face criminal charges. Had it been an Israeli-American teenager bludgeoned by Palestinians, the story would never die.

The current rain of death on the Palestinians is about the usual thing: land. The very creation of Israel is based on the dispossession of Palestinians and their continued siege since 1948. Israel has long planned and carried out attacks on Gaza and the West Bank so that it can conquer more land, build more illegal settlements and reduce Gaza to an enclave surrounded by Israel so that the question of nationhood does not arise. This Israeli offensive began on July 8, 2014, a week into Ramadan. As many as 213 Palestinians, all civilians, have been killed, Israel’s air force has destroyed a mosque and leveled a rehabilitation center for the disabled. The water supply to Gaza has been affected to the point that the United Nations Refugee Agency (UNHCR) reports that 70 percent of its water is not potable. Four children, playing on the beach in Gaza, were murdered by Israeli fire.

That the children of Holocaust victims could wreak the same havoc on people whose land and homes they stole, and worsen their persecution with each offensive, is very challenging to the mind. Misfortune humbles most people; perhaps with some, victims become monstrous perpetrators. Those who cannot stop this atrocity just look the other way. The US, the country that has armed Israel into becoming the most sophisticated army in the world, can barely protest. The Israeli lobby has bought over essentially all of Congress and a word against Israel can guarantee loss of funding and votes in the next election.

For those, Muslims included, who think that Israel is retaliating against Hamas rocket attacks, I will quote Jewish-US philosopher and activist Noam Chomsky: “Israel uses sophisticated attack jets and naval vessels to bomb densely crowded refugee camps, schools, apartment blocks, mosques, and slums to attack a population that has no air force, no air defense, no navy, no heavy weapons, no artillery units, no mechanized armor, no command in control, no army...and calls it a war. It is not a war, it is murder.”

Also, Israel has the Iron Dome, a mobile missile-defense system that intercepts short-range rockets. The one billion dollar program, subsidized by the US, has served Israel well; Hamas rockets are either destroyed 90 percent of the time or land in fields.

Europe and Canada are the US’s little sidekicks so no expectations there. Pakistan protested but its redundancy on the world stage is a topic for another lament. The impotence of the Organization of the Islamic Conference (OIC) is even more pathetic than Pakistan’s. Iran is itself ostracized in the world community. Turkey is conspicuously mum. Saudi Arabia is too busy quelling revolt within the kingdom against its oppressive rule, as well as funding and grooming the Islamic State of Iraq and Syria (ISIS) in its agenda of killing non-Wahabi Muslims, especially Shias. Egypt, not an honest broker due to its anti-Hamas agenda, tries for a ceasefire and talks only to Israel. Hamas finds out through the media and justifiably refuses. How can there be a ceasefire without terms and direct discussion? Hamas, unaware that a ceasefire was in effect, continued rocket-fire and now Israel’s fans are screaming: “See? They do not want a ceasefire” and so Israel resumes its attacks. Brilliant PR move! Hamas’ terms of a ceasefire are reasonable: that Israel lifts the blockade of the Gaza Strip, ends aggression in the occupied territories and releases Palestinian prisoners.

The United Nations is made up of the leadership of these same sorry nations and the mumblings of Secretary General Ban Ki-moon are as worthless as they are incoherent.

In my despair I do see some hope. The Jewish Voice for Peace (JVP) is a US organization that works to achieve a lasting peace, which recognizes the rights of both Israelis and Palestinians for security and self-determination. It works through grassroots organizing, education, advocacy and media, and has 100,000 online activists. The JVP supports nonviolent efforts in the US and in Israel-Palestine to end Israel’s occupation, expand human and civil rights and implement a US policy based on international law and democracy.

The Boycott, Divestment and Sanctions (BDS) movement is big news in 2014. In 2005, Palestinian civil society issued a call for a campaign of boycotts, divestment and sanctions against Israel until it complies with international law and Palestinian rights. A truly global movement against Israeli apartheid is rapidly emerging in response to this call. The BDS movement covers all Israeli products but it reserves a special focus for companies that are actually involved in — and make hefty profits from — occupation policies. On your shopping trips you might want to avoid Hewlett-Packard, Sodastream, Victoria’s Secret, Jaffa oranges and Eden Springs Water to name a few. Netanyahu and his ministers consider BDS “the greatest threat to Israel” and Netanyahu mentioning it 18 times in his speech to the American Israel Public Affairs Committee (AIPAC) in March this year paradoxically focuses attention on Israel’s state-sponsored terrorism and spurs the BDS movement. 

And my perpetual, inveterate hope is in God who says, “They plan and God plans and God is the best of Planners” (8:30). The anguish of mothers who have lost their children, the cries of suddenly orphaned children and the hunger, fear and desperation of 1.5 million Palestinians is heard by the heavens in the guarantee: “And when My servants ask you concerning Me, tell them I am very near; I answer the prayer of the supplicant when he calls on Me” (2:186).

In blessing us with free will, God watches our actions. All-forgiving, He gives us chance after chance to shape up but when we wreak havoc and spread devastation on earth, God hits His tipping point. And then we really need to watch out.

Detoxifying mindsets

The military operation in Waziristan was a long-time coming. Great gains against entrenched terrorists have been made with air, and now, ground offensives. Fortunately Zarb-e-Azb has support all across the country.  

The Pakistan Protection Ordinance 2014 was just passed by the National Assembly giving dramatic and sweeping powers to the government in its fight against terror. Searches can occur without a warrant, militants can be shot on sight with orders from a Grade 15 police officer or higher, suspects can be kept in custody for 60 days after a judicial remand, and convicted terrorists could face 20 years imprisonment.  

Opposition groups, mainly the JUI and the PTI, and human rights activists have expressed immediate protests, fearing that the Pakistan Protection Ordinance would provide legal cover for the government’s repressive agenda. Especially after the police brutality in the Model Town tragedy, as well as the missing persons’ saga, these concerns are understandable.  

But to think that a military offensive in North Waziristan by itself would be enough to rid us of the daily ravages of terrorism is myopic at best. There are some built-in protections in the Pakistan Protection Ordinance to curb its abuse.  

Pakistan is at a point where there needs to be a multi-dimensional approach to free it of the chokehold of terrorism. In peaceful times we would have the luxury of safe-guarding human rights; at a time of war with an enemy that has invaded the hearts and minds of significant segments of the population, preserving the integrity of Pakistan, as well as countless lives and major national assets, far outweighs the possible violation of human rights.   

Zarb-e-Azb is an immediate surgical event; the Pakistan Protection Ordinance will serve to combat terrorism in the short to medium-term. They need to be bolstered by a well-organized and properly implemented effort to detoxify mindsets, for it is terrorism-condoning mentalities and America-Israel-India hating conspiracy theories that have created and sustained monsters in our middle.  

The Pakistani mind has undergone a gradual and sustained poisoning. The 1979 Russian invasion of Afghanistan created a refugee crisis in Pakistan, an already economically weak and overpopulated country. Prior to 1938 Saudi Arabia was only known for its vast deserts, and as home for Islam’s two holiest sites. As its oil industry progressed through the 1970s so did its hegemonic aspirations. Billions of dollars were, and continue to be, spent in its world-wide export of its literalistic Wahabi-Salafi ideology. A significant part of this move has been the literature that sports the stamp of the Saudi Religious Ministry.  

I grew up in a soft, attractive, tolerant and inclusive environment in Lahore and Karachi. We went to a milad every day in Rabiul Awwal, visiting shrines of famous Sufi saints helped me to reflect on how they formed and solidified their relationships with God. And the beautiful shalwar kameez worked for us in comfort, cover and style. The long arm of literalism ruined all that. Honoring Prophet Muhammad (PBUH) has to be guarded for it is considered bidat or innovation by some, paying respects to Sufi saints is classified as blasphemy and modesty is only defined by jilbabs (head to toe gowns), hijabs, niqabs and gloves. Never mind the prominent premise in Islam that all actions are judged by their intentions, and all intentions are known only to God.  

The Wahabi-Salafi mindset is devoid of the joy of faith. And it rationalizes corporal and capital punishment for offenses contrary to the five schools of Islamic jurisprudence.  

Poverty stricken, uneducated, disenchanted and hopeless segments of Pakistan’s population were swooped up as victims to an ideology that promised the nebulous but delivered death.  

Perhaps we need the creation of the Pakistan Protection Ministry, focused solely on the eradication of terrorism in Pakistan. Curricula in public and private schools as well as madrassahs need evaluation and necessary amendments. Perspectives on history is one thing but rewriting it altogether and inoculating young minds with extremism is quite another.  

Friday khutbas in mosques across the country need to be monitored as well. Notifications to all mosques of fatwas against suicide bombing issued by Al-Azhar University of Egypt as well as prominent Pakistani clerics need to be sent by the government to each mosque, and imams persuaded to regularly mention the sanctity of life as revealed in the Quran and practiced by  Prophet Muhammad (PBUH).   

The media has an important role to play especially in this age of technology and social media. Television programs with Islamic scholars like Javed Ahmad Ghamdi and Shujauddin Sheikh are not only packed with knowledge and infused with perspective; they are veritably nourishment for the soul.  

There can be no vacillation with regard to our commitment to banish terror from the boundaries of Pakistan. Each one of us needs to grasp this and promote it in every way on a daily basis.  

We are a nation made of the steely determination of Mohammad Ali Jinnah, the vision of Allama Iqbal, the brilliance of Dr. Abdus-Salam, the martyrdom of Aziz Bhatti and the courage of Malala Yousufzai, among numerous other inspirations. Together we can make Pakistan an icon of peace and progress; unity, faith and discipline can make it happen. I know so.

 

 

Perverse logic, incredible brutality

A bulldozer, stone throwing protestors, security forces, smoke and firing are reminiscent of Palestine. But this was Lahore and these weren’t rubber bullets but live rounds, not fired in the air but directly into abdomens and chests. The only commonality: unarmed protestors.

The police arrived late at night to remove barricades outside the residence of the Pakistan Awami Tehreek head, Dr. Tahirul Qadri. A High Court order legitimizing the barricades was shown by PAT to the police but dialogue deteriorated into baton charge. In the morning a new police shift arrived, reportedly 1000 strong, backed with armored cars. The bulldozer broke up the barricades and protestors began the pelting. Two women, sisters-in-law to each other, stood guard at the door of the house, probably thinking that police will be easier on women. They were shot at point-blank range and their bodies remained unclaimed till the violence resolved.

Out of the 12 dead, autopsies of seven, all of them PAT workers, reveal death by bullet wounds or excessive bleeding. Dr. Tahirul Qadri states that 15 more have died and the government is preventing families from receiving the bodies and that a total of 200 are dead or injured. He also makes the hair-raising claim that the arrested have been tortured with nails inserted in their bodies.

It is difficult to process that this battle happened in Model Town in Lahore. Foreign armies generally rain terror on other countries’ civilians. How could the police have killed their own countrymen? How could they have gone wild without orders from above?

The Taliban murders civilians in broad daylight, again and again, and rides away with impunity on motorbikes. They are almost never apprehended. Brazen attacks occur, like the beheading of our soldiers, and the Nawaz Sharif government exercises ultimate restraint and persistently tries dialogue. But barricades and the impending arrival of Tahirul Qadri invoke a mighty, murderous response.

Law Minister Rana Sanaullah claims that anti-Pakistan messages between PAT workers were detected and “no-go areas would not be tolerated”. Is there a comparison between the antics of the Taliban and the workings of the PAT? Since when did response become so incredibly disproportionate? Is the Nawaz Sharif government so disconnected with the people that murmurings between workers and barricades can precipitate killings?

Current events are replete with resignations of ministers when self-wrought tragedies occur. All over the world, except Pakistan. The inspector general of police and the deputy inspector general of police were quickly demoted to becoming officers on special duty, but I am hard-pressed to believe that the decision to deal with the Model Town barricades with an iron hand was that of the police. Such deadly police brutality has never been seen in Pakistan.

The Sharif government would have been able to stave off the cacophony of criticism and insults if Shahbaz Sharif had stepped down as Chief Minister. But what an outlandish concept! Power was attained with much pain; it can only be relinquished after much pain. Shahbaz Sharif has set up a judicial commission for the investigation of the Model Town tragedy. Only termites see those judicial commission reports and it is a well-known delaying tactic.

Public confidence in the government was at an all-time high with its decision to bombard Taliban hideouts in Waziristan. The most unlikely of people such as Imran Khan were on board and for about three days there was a rare sense of unity in Pakistan. But now the Nawaz Sharif government seems besieged.

If the intention was to scare people into showing up for Tahirul Qadri’s arrival on June 23, the exact opposite has occurred. There is an emotional line within us that inhibits impulsivity, risk taking and altruism. But brutal injustices shred this line and people are able to walk into war.

What is even more mind-boggling is why the Punjab government would be threatened by a preacher. Tahirul Qadri’s party boycotted the elections and his loyalists are limited in number. He is full of bluster and rhetoric and the idea of a “Green Revolution” appears far-fetched at best.

On his own steam, no pun intended, Tahirul Qadri would have been negligible and nothing beyond an irritant. But now we have the bandwagon effect: the combined self-righteous and self-promoting indignation of the MQM, PTI, PML-Q with the Pakistan Awami Tehreek has the ability to create quite the migraine for the government.

And if it topples the Punjab government it will be a well-deserved punishment. Like in army strategy, all actions must anticipate and fully prepare for their reactions. The Model Town tragedy will be an ignominious chapter in Pakistan’s history.

The heart-wrenching cry of the daughter and niece of the two murdered women ascended eerily to the heavens. And as promised, God will dispense discerning and timely justice.

The Taliban versus Pakistan

Terrorism in Pakistan plays out like clips from Hollywood. Ten men armed with backpacks and shopping bags full of sophisticated arms storm the cargo terminal of Karachi airport and hold the Airport Security Force, the army, police, Rangers and even the Special Services Group at bay for five and half hours.

Television media provides live coverage, with one of the reporters hitting the ground and breathing heavily into the mike while the camera zeroes in on one of the terrorists standing in plain sight on a roof top. It finally dawns on someone that they might be compromising the fight against the terrorists as well as the lives of the journalists so the coverage becomes a great deal distant.

We are always wiser afterwards. Now we’re crowing on how the army and other security forces were able to defeat ten terrorists. There was positivity and back-slapping all the way and questions of security lapses and intelligence failures were all shooed away.

And though I was very concerned about how the media was compromising the security forces’ efforts, the five and half hours of being glued to the television were very enlightening. The news then came out uncensored; the interviews were unvarnished. One said that there was no security forces response for the longest time after the attack. Another said that efforts were aimed at getting the terrorists alive and one had been so captured. Next thing, all ten terrorists were dead.

The cargo terminal entrance where the terrorists barged in at 11:25 pm is guarded by sleepy ASF workers who were about to go through shift change. That entrance is reserved for VVIP officials who receive smart salutes from the ASF and reward them with baksheesh. Gunning down the ASF was seamless for the terrorists who then ran a kilometer toward the Jinnah terminal in an effort to enter and hijack a plane. Thankfully the sprint was two kilometers and they met resistance half way.

It was nerve wrecking to hear that they had bunkered up on the runway and first off seven security personnel were killed and slowly, very slowly there was one and then two and finally all ten terrorists were killed. The death toll of the security forces keeps rising and is 17 at the time of this writing. And of greater concern, there are now three terrorists that have re-engaged the security forces.

Regardless of the Pakistanism “sab theek ho jayega” (everything will be alright) or the political chest-thumping that “we will never let this happen again” it is vital for the Pakistani nation to demand answers and insist on solutions.

Chief Minister Sind Syed Qaim Ali Shah pathetically stated that there were intelligence reports that important people or places were under threat, but that Karachi is such a large place, it is very difficult to know. I can essentially guarantee that the internal response to this intelligence was to beef up security for all the important people. I was mortified to know that he had arrived at the scene while the “ghamsan ki jang” (furious fight) was going on between the security forces and the terrorists, for his own security detail probably takes up a lot of manpower and space. He had to have been a hindrance.

The terrorists had come for the long haul; dates and dried food and water reminiscent of the Mehran naval base attack in 2011. Perhaps we did learn from the Mehran naval base attack for that took 17 hours to control and this took only five and a half.

The terrorist attack on Shia pilgrims returning from Iran on the same day got dwarfed in the news by the airport attack.

But like Bob Dylan asked “how many deaths does it take till we know that too many people have died”. Innumerable minorities, numerous religious devotees, several armed forces personnel, countless innocent people have died and audacious attacks on the Marriott hotel, the Mehran naval base and now the Karachi airport among others have occurred. But we are not up to self-examination: the media repeated ad infinitum that the attackers looked Uzbek. In the melee the media was told that the weapons were manufactured in India, and slowly but surely, it is being molded into a hunood-yahood-nasara (Hindu-Israeli-Christian) conspiracy.

Immediately after the 2005 London train bombings one of the friends of the terrorists said that killing Al-Qaeda operatives didn’t make a difference because, pointing to his head, he said “Al-Qaeda is inside”. Pakistan’s population has been similarly radicalized and like infection circulating through the bloodstream of a seriously sick patient, streaks of the population has bought into the Taliban ideology. And these streaks infiltrate the army, the government, the judiciary, educational institutions, mosques, the business community, onward to an infinite list.

We don’t dare question Nawaz Sharif’s commitment toward erasing terrorism. Why are we speechlessly tolerating absurdities in an interview he gave to the BBC a week ago that he was hoping for a peace deal with the Taliban? Why didn’t we see through Saudi Arabia pressuring us to send our military to combat Hafez Al-Assad in Syria? Why do we forget that Nawaz Sharif is beholden forever and ever to the Saudis for providing him amnesty after his Musharraf adventurism? We lend a blind eye to Saudi Arabia’s export of its violent and extremist Wahabi ideology.

The prognosis for Pakistan’s survival is grim as it is, it will become essentially zero if an immediate, concerted and mighty attack is not mounted on each and every militant holdout. And Taliban-like extremism in the population must be outed and punished publicly, swiftly and effectively.

Nawaz Sharif’s and previous governments have been wholly absorbed in shoring up money and power. It’s clear that Nawaz Sharif and company shed crocodile tears on the endless loss of life and economic damage in Pakistan. It might be instructive for Nawaz to remember that while the Taliban continue their volley of attacks in every province of Pakistan, pretty soon all that Nawaz Sharif will be ruling will be his bullet-proof Mercedes.

Speech at re-opening of Islamic Center of Greater Toledo

Dr. Mahjabeen Islam was president of the Islamic Center of Greater Toledo in 2012

Sunday, December 15, 2013
Assalamoalaikum and may peace be upon all of you!

Some events remain forever etched in our minds. You remember exactly where you were and what you were doing when they happened. Like 9/11.

And so it was for me for Sunday September 30th 2012.

I was doing rounds at Toledo Hospital and as is my custom, I had left my purse in the nurses’ station. When I came back from the patient’s room there was a flood of messages on my phone. The first I checked was from Imam Farooq: there had been a fire at the Center, the voice mail said. I raced down I-75 convinced that it was a false alarm or else a short circuit. From a distance I could see the ladder of the fire truck touching the minarets and a plume of smoke exuding from the side of the dome.

About 4 hours later Fire Marshall Frank Reitmeir told me it was no accident but arson instead. I remember driving home that night; numb, dazed, robotic.

The next day the Fire Marshall and Police Chief had us walk through the Islamic Center. I remember Jim Adray and me walking-rather wading-in a pitch dark Center. Surreal doesn’t describe it. The police’s flashlights darted across the soot-stained walls, the wet floors and the ceilings that seemed to have vomited bunches of wires. The large oval stain and burned carpet in the middle of the men’s prayer area became a sort of insignia of the arson.

Till today I have trouble accepting that in one fire Randy Linn had brought down the entire Islamic Center. Every room was damaged from the water of the sprinkler system.

I remember telling the Fire Marshall that I was a fan of the show 48 Hours and that we needed to find the arsonist in that time frame. Frank tried to hide his disdain for my 48 Hours mind-set. On Tuesday 20 minutes before it would have been 48 hours I called Frank and he said “funny, I was just getting ready to call you, we got him”. “48 hours, Frank” I said with much glee.

The Islamic Center had received threats a couple months before the arson and even though more than a year has elapsed since the arson, I still have trouble believing it sometimes.

Institution building and the placement of processes are very important to an organization. A few years ago we were able to develop a dynamic blast-mail system and it proved indispensable in our hour of grief. We used it to galvanize our community and many people still recall how much they appreciated being kept up to date with all that was going on.

BYOPR was a reverberant theme in those emails. Bring your own prayer rug. Cos we were uncertain if our makeshift arrangements would be adequate for prayer.

By far the most touching moment in those weeks was the united Friday prayer on the Friday after the arson. We had a large tent outside and all the mosques of Toledo cancelled their Friday services and their congregations came to the Islamic Center. A physician who is a member of another mosque was to take a flight that day but rescheduled it just so he could be at the united Friday prayer.

My voice broke as I condoled with the community and several men told me later on that my words had made them cry. We had an amazing sense of unity.

Our unity then was much like a Hadith (saying of the Prophet Muhammad, peace be upon him) “The similitude of believers in regard to mutual love, affection and fraternity is that of a body; when any limb of it aches, the whole body aches because of sleeplessness”

We had forgotten our differences and contrary opinions. A sense of shock and grief pervaded all the Muslims of Toledo.

The Multi-Faith prayer the following Sunday was much like the united Friday prayer-this time all faiths came together to help heal our hearts and minds.

I am a firm believer in the concept of God’s maslihah which translates into God’s reason, wisdom and will in everything that happens. In my limited comprehension, I felt that the arson was a call to unity and a demand for justice.

And though that day was able to galvanize the Muslims of Toledo, our continued unity remains a challenge.

Another very difficult point in this nightmare was to hear Randy Linn’s raw hatred toward Muslims when he spoke in court. He claimed it was Fox News that made him just jump up and do it.

I am grateful that Randy Linn was prosecuted at a federal level and I thank the first responders, the Fire Marshall’s office and the police department. My deepest appreciation goes to US Attorneys Steve Dettelbach, Ava Dustin and especially Bridgett Brennan for prosecuting this crime so well and achieving an exemplary sentence for Linn.

The true heroes in this are Randy Linn’s ex-wife, Karen and his co-worker Rikki Slattery. If they had not identified him, Linn could not have been prosecuted. If there were more courageous and principled people like them, the world would be a different place.

Our justice system did superbly with Randy Linn’s sentence, but every day one hears of more Trayvon Martins and Renisha McBrides who are denied justice because they are the wrong skin color.

There are way too many Muslim men that are denied employment or harassed at work because they have a beard. Too many women have to appeal to the courts to be able to wear hijab at their workplace. And Muslims do feel that they live under a state of siege.

As a nation we must move toward embracing the spirit of our constitution where we don’t discriminate on the basis of color, religion and ethnicity.

While we appreciate justice in the arson of the Islamic Center, all of us must first erase our own prejudices and then work toward the equal application of justice.

The great poet-philosopher of Pakistan, Allama Iqbal reflected on the premise of equality in the Quran when he wrote aik hi saf mein kharey ho gaye Mahmood o Ayaz, na koi band raha, na koi banda nawaz: that in the same line of prayer stood the king and the slave, there remained no distinction in status.

By Islam and the constitution of the US all men are created equal. I look forward to a day when our nation will make this a practical reality.

May God’s mercy and choicest blessings be upon all of you!

Controlling Ohio’s opiate epidemic requires a different treatment approach

http://www.toledoblade.com/OpEd/2013/12/08/Controlling-Ohio-s-opiate-epidemic-requires-a-different-treatment-approach.html


Action teams are combating the opiate epidemic, but they are missing the vital piece of promoting medication-assisted treatment


Four Ohioans die every day of opiate overdoses. Yet as daunting as the statistics are, the reality of treating the ravages of our opiate epidemic is even worse. Medication-assisted treatment has become essential.

In 2011, one in 20 Americans used prescription painkillers for nonmedicinal purposes. Hydrocodone, an opiate, is the most frequently prescribed medication in the United States. Between 2000 and 2009, the number of pregnant women who used opiates went up five times.

In the late 1990s, doctors were urged to consider pain as a vital sign. Powerful painkillers were developed and used effectively by competent physicians, but they also were diverted to “pill mills” that sprang up in Ohio and across the nation.

Some greedy or careless physicians prescribed opiates indiscriminately. Other doctors who suddenly realized the problem, or feared government regulation, summarily ended treatment with opiates. That forced many patients who had grown dependent on opiates to get their drugs on the street — or to switch to heroin.

Studies over the past decade have shown that opiate addiction is a chronic relapsing disease, like diabetes, hypertension, and asthma. Relapse rates for people who depend on opiates range from 40 percent to 60 percent — similar to the rates for these other chronic diseases.

Brain scans reveal structural and functional changes in the opiate-addicted brain. Blaming an opiate addict for relapsing is like scolding a diabetic for having high blood sugars.

Addiction crosses all boundaries of race, religion, ethnicity, education, profession, age, and wealth. I’ve seen a 65-year-old suburban professional who is addicted to oxycodone chat with a 25-year-old heroin addict, in a touching display of fraternity.

I have specialized in treating addiction for more than two decades. In that time, I often felt powerless as I recommended abstinence and counseling, only to see relapses and ruined lives.

Medication-assisted treatment changed that. Such drugs as methadone, buprenorphine, naltrexone, and Suboxone can be prescribed along with behavioral treatment, enabling patients to maintain sobriety and regain the ability to function fully.

Methadone is very effective for treating opiate dependence. But because of its potency and high risk of overdose death, it can be dispensed only in maintenance programs that require daily attendance and swallowing of liquid methadone in front of a witness.

Buprenorphine not only binds tightly to opiate receptors in the brain, it also can prevent stronger opioids, such as oxycodone and heroin, from doing so. Higher doses of the drug do not cause euphoria, lowering its potential for abuse.

In medication-assisted treatment, patients get a detailed evaluation, urine drug testing, counseling, assignment to a 12-step program, and a prescription for buprenorphine. Doctors who are not board-certified in addiction medicine can take an online course in buprenorphine and obtain a license to prescribe it.

A pregnant opiate addict should be cared for by an experienced addiction specialist. In that way, the buprenorphine dose is carefully adjusted, the pregnancy is protected, and the intensity of opiate withdrawal in the newborn baby — and the resulting hospital stay — are reduced.

Without treatment, pregnant addicts often use a potpourri of drugs. Such abuse sometimes kills their babies, or causes prolonged stays for newborns in an intensive care unit.

Toledo has its share of addiction specialists. But it also has Suboxone “cash-pay” clinics, where the only activity is the exchange of money for prescriptions. Just as painkiller pill mills created the opiate epidemic, Suboxone pill mills are implicated in overdose deaths.

Action teams convened by Gov. John Kasich and Ohio Attorney General Mike DeWine are doing great work in combating the opiate epidemic. But they are missing the vital piece of promoting medication-assisted treatment.

My family-medicine patients send me thank-you cards, but my opiate-addicted patients write thank-you booklets. One such patient was homeless and hopeless.

He dutifully followed a medication-assisted treatment program for a year. He now has a job, a new car, his own apartment, health insurance, and even a 401(k) retirement plan.

Our collective contempt for the disease of opiate addiction is based on ignorance and misinformation. Criminalizing addiction is inappropriate and ineffective; you can’t punish it out of patients.

Recognizing addiction as a disease, and getting more physicians certified to practice office-based opioid treatment in tandem with counseling and 12-step meetings, can quickly control Ohio’s opiate epidemic.

Mahjabeen Islam, M.D., practices in Perrysburg and specializes in addiction and family medicine.

US will pay a price for its hypocrisy on Egypt: Haroon Siddiqui in Toronto Star

Superb article in The Toronto Star by Haroon Siddiqui

http://www.thestar.com/opinion/commentary/2013/08/15/us_will_pay_a_price_for_its_hypocrisy_on_egypt_siddiqui.html

Opinion / Commentary


U.S. will pay a price for its hypocrisy on Egypt: Siddiqui

The U.S. and its allies have been enablers of the grave crimes committed by the Egyptian military.

By: Haroon Siddiqui Columnist, Published on Thu Aug 15 2013

There has always been a hierarchy to the value of life. Kings mattered more than peasants. Killing continental European colonialists in Africa or the British in India brought the wrath of the empire down on the natives, who were strapped to the cannons and blown to bits by the hundreds. The contemporary era, with its spread of democracy, globalization and greater egalitarianism, raised hopes that all human beings would have equal value.


But the murder of 2,977 innocents on Sept. 11, 2001, led to the killing of at least 100,000 Muslim civilians in Afghanistan and Iraq and Pakistan. An Israeli life is deemed infinitely more valuable than that of a Palestinian. Our own government in Ottawa makes no bones about caring more about Christians in Egypt and Pakistan than Muslim victims of similar religious persecution there or in Myanmar. When the West does care about Muslims, it does so for the secular “good Muslim,” not the Islamist “bad Muslim.”


When Tayyip Erdogan, Turkey’s thrice-elected “Islamist” prime minister, ordered tear gas and water cannons on peaceful protesters in Istanbul, he was duly reviled. But the Egyptian army that has been firing live ammunition into peaceful “Islamist” protesters and killing them by the hundreds in the last month has only been told, politely, of our “concern.”


On July 11, Ottawa raised just such a pipsqueak “concern.” Stephen Harper’s government was more emphatic as it condemned the shooting death of a Coptic Christian priest near El Arish. “The targeting of religious leaders is unacceptable.” Following the second massacre, July 27, in which about 80 protesters were gunned down, Ottawa was “deeply concerned and appalled” — and fixated on its clarion call for respecting “religious minorities,” namely Coptic Christians.


Barack Obama was also mostly silent about the two massacres. So was David Cameron. So was much of Europe. They had refused to call the July 3 military coup a coup. In fact, John Kerry passed the perverse judgment that in toppling the elected president Mohammed Morsi, the Egyptian army was “restoring democracy.” American annual aid of $1.3 billion was to continue.


It’s only now after Wednesday’s bloody massacre of pro-Morsi protesters that Obama stirred himself to shed crocodile tears. The U.S. and its allies have been enablers of the grave crimes committed by the Egyptian military as well of the Goebbelsian lies it has been peddling.


After each official atrocity, the army has under-reported the deaths and blamed the victims, accusing them of “inciting violence,” “hoarding weapons,” “torturing people in public squares,” “fomenting terrorism” and being “a threat to national security.” It has hurled a slew of charges against Morsi — murder, treason, espionage, conspiring with Hamas, attacking and insulting state institutions, etc. It has held him incommunicado, along with several top Brotherhood leaders. It has shut down a dozen pro-Morsi TV stations, with a nary a peep from free speech advocates in the West.


The U.S., the E.U and others have also been doing the Egyptian army’s bidding by calling on “all sides” to refrain from violence when, in fact, the violence has been almost always one-sided. Western governments and media have also accused Morsi of having been unduly partisan when, in fact, he was far less so than most ruling political parties in democracies. Proportionately, he appointed far fewer dummies than, say, Harper to the Senate, or the Republicans or Democrats named friends and funders to key posts.


Morsi was inept in the extreme. But he did reach out to his opponents who simply refused to accept their repeated defeats at the polls.


It has now been credibly reported that the secular anti-Morsi forces formed an unholy alliance with Egypt’s Deep State (the army, the intelligence, the security forces, the police, the interior ministry and its paid thugs, the judiciary and the bureaucracy), along with the beneficiaries of the Hosni Mubarak era (crony capitalists and corrupt politicians) to undermine the Muslim Brotherhood government. They collaborated in mounting mass protests, in a blaze of hateful anti-Brotherhood propaganda by both the state and privately-owned media, which heralded the unproven and unprovable claims that 20 million people had taken to the streets and 22 million had signed anti-Morsi petitions. Post-coup, acute shortages of gas and electricity miraculously disappeared overnight. Law-and-order situations improved in selective neighbourhoods.


Reportedly in on the plot were the intelligence agencies of Saudi Arabia, the United Arab Emirates and other oil-rich Gulf states except Qatar. They hate the Brotherhood, not so much for its Islamic ideology but the democratic threat it poses to their monarchies. They rewarded the coup with $12 billion in aid.


The army conveniently claimed that the coup was only a response to the people’s will. In turn, it has been forgiven all its sins — including the virginity tests on women protesters, and the shooting of Coptic demonstrators and running them over with armoured vehicles.


What we’ve witnessed is “fascism under the false pretence of democracy and liberalism,” said Amr Hamzawy, an Egyptian political activist and former MP.


All this will not be lost on the Muslim masses in Egypt and elsewhere. There will be a price to pay — we don’t quite know when and where and how. But as American pollster Dalia Mogahed, who has surveyed Muslim societies worldwide, says, it is useful to remind ourselves that “Al Qaeda was conceived in the prisons of Egypt and, contrary to conventional wisdom, not the caves of Afghanistan.”




Haroon Siddiqui’s column appears on Thursday and Sunday. hsiddiqui@thestar.ca