The Shower of Shoes

 Personal issues and struggles are one thing; for them to be partnered up with a national and global fiasco feels like Bugs Bunny flattened out by a truck. 

My first major trauma was at age 12 when I lost my brothers to a car accident. I remember thinking that life would be a cakewalk thereafter. How could it possibly get worse? But it did. Five years later my father died while playing tennis. My tack changed suddenly, and thereon, I have waited for the other shoe to fall. And life has delivered. Again, again and yet again. Personal issues and struggles are one thing; for them to be partnered up with a national and global fiasco feels like Bugs Bunny flattened out by a truck. 

 

Witnessing a pandemic

We would read about pandemics in books of history and medicine. To see it unfold before our eyes, and to live in the richest country in the world with five million infected and over 160,000 deaths is surreal. And if masks are not worn there could be 300,000 deaths by December 2020. How wearing a mask infringes on one’s liberty is still difficult for me to comprehend. What I do know is that this refusal is bare selfishness. I did telemedicine with a patient who called with classic Covid-19 symptoms. “We went to a winery and all the people that went there are Covid-19 positive”. I asked if they had been wearing masks. “Of course not!” she said, a touch derisively. 

 

My little neighborhood will contribute to the 300,000 deaths also. Two houses down, they’ve brought a portable swimming pool and the children are squealing as they jump in the water. And the adults enjoy their beers sitting in clusters. Masks you ask? Duh! 

 

A pandemic of dysphoria

I was never into parties and used to create excuses not to attend. This strange time brings the aphorism that man is a social animal into painful focus. That I cannot jump up and even go for lunch with a friend, only serves to deepen this strange dysphoria.  Michelle Obama has been frank about her low-grade depression. In each patient visit I make sure I ask about an increase in anxiety and depression. It is remarkable that the reply is essentially always in the affirmative and I have to determine whether my advice, professional counseling and/or medication are needed. Perhaps this state of being dispirited is the result of tackling the assault at us at so many levels-social, emotional, financial and physical. After my father’s death, I followed the textbook and dutifully suffered a major depression. And have always lived in fear of a recurrence. I recognize that this dysphoria is different and that I am not alone. Perhaps that is what adds to it. It is so rare to come across people who are loving this leisure; if there were more of them, perhaps they could do a collective yank and the blues would disappear. 

 

Backyard chai 

Utilizing her vacation, a cousin who lives in Philadelphia decided to visit family in Ohio. I hastily put together chai on our patio and felt this great mood change after she and her husband left. And now my backyard chais are a wonderful treatment option for the Covid blues. Just need cloud cooperation;  sometimes “taking a raincheck” becomes literal.  

 

An epidemic within a pandemic

Addictions in general, and opioid use disorder in particular, are greatly worsened by social isolation. And these strange times call for social isolation. Opioid overdose deaths were over 70,000 in 2019 and over the last several years we have recognized that opioid use disorder was an epidemic in the US. The shameful governmental response to Covid-19 has had a downstream effect on the epidemic of opioid use disorder. The greatest obstacle to recovery has been access to treatment and during the lockdown and subsequent scaling back of activity at treatment centers, the epidemic within the pandemic got a lot worse. People are also using alcohol to treat the multiple struggles that have suddenly surfaced. Unemployment, social restrictions, financial stringency, isolation, family dysfunction, illness/infection, depression, anxiety push people for the reprieve that alcohol gives. The health care system is so flawed and overwhelmed that the opioid epidemic is necessarily taking a backseat to the Covid-19 pandemic. 

 

The year of death

I do not recall a single year in which every other day brought the news of deaths of people that we knew, the way that 2020 has. A classmate and another classmate’s wife died of Covid-19. My best friend’s mother died of natural causes. A classmate’s 32- year old daughter died recently, leaving a 17 month and a three- year old child. And the volley continues reliably. I have a momentary fear of checking my phone, for fear of having to write “To God we belong and to Him is our return”, again. 

 

Recognizing racism

Perhaps the only good part of 2020 has been the Black Lives Matter Movement. While the mind rages against the brutal murder of George Floyd, the heart knows that his blood was not in vain. And that of innumerable innocents through decades of police brutality and institutionalized racism. But the road is long. And we must see this through. 

 

With the weird dysphoria that Covid-19 has created and the repeated assaults one has had to suffer; I don’t have to wait for the other shoe to fall. They're falling one after another; a veritable shower of shoes. 

 

Keep Throw Change

Many years ago I was talking to a physician colleague who is also in solo practice. I asked her how she made it, as she only worked in the office, and didn’t do hospital rounds. Her response has stayed with me and I dredge it up when the going gets tough. She said: my needs are not that many.

I coined the KTD acronym and Marie Kondo became the millionaire. Decades ago yielding to my near-OCD clutter-phobia, I created a method to deal with organizing rooms. It is simple and works well: you start from one corner of the room and for each item ask the question of whether you should keep, throw or donate it. Marie Kondo has the exotic Japanese twist to basically the same premise. And I certainly don’t identify with the rolling up of clothes instead of regularly folding them that she does. 

With the Covid-19 crisis we can extrapolate the KTD practice to what has suddenly become a massive individual, national and global issue. And the KTD can become KTC, keep, throw, change.

Individual

I want to keep the breakfasts with my mother with no background pressure of things to do. Also the drives with my family in which the conversations are deeper and more spiritual as the content has shriveled, being that interaction with friends has gone down, and mundane stuff has exited. 

Health and time

Prophet Muhammad (peace be upon him) said that the two most valuable things we have are health and time. And I want to treasure these. I had a schedule before Ramadan and now that fasting is here, the schedule has to change a bit but productivity, contentment and joy lie in creating another schedule and then dutifully following it. Being near-OCD, multitasking, female and physician have been assets to me. And though time now does not run away from me like it used to, I want to keep valuing it and harnessing it, and keep it front and center, as life slowly returns to normal. 

Rushing around

We’ve got to get rid of the rushing around. A lot of us realize that all we were doing was jogging on the spot. We’ll need to choose how we will fill our day. A conscious, perhaps a written plan, is vital to reintroducing items in our schedule. Life has this bad habit of descending into automatic chaos unless you rein it in, train it. Whether it is office or house work, it is essentially endless and can swallow you whole if you’re not careful. We must be controllers of our time, not let it control us. Which reminds me of another Mahjabeenism: if you don’t lead life, it tends to lead you. 

My needs are not that many

Many years ago I was talking to a physician colleague who is also in solo practice. We were discussing the challenges of practice and not wanting to be bought out by hospitals and dealing with practice finances. I asked her how she made it, as she only worked in the office, and didn’t do hospital rounds. Her response has stayed with me and I dredge it up when the going gets tough. She said: my needs are not that many. Cloistered at home we realize that our needs are really not that many, and as we return to normalcy, not immediately expanding our needs is paramount. 

Life trajectory

All this time has afforded us a unique, albeit forced, opportunity to assess the trajectory of our lives. Professionally and personally we can assess and decide what combination of keep, throw, change we should use. 

Quran immersion

For years I have wanted to reach a point of understanding the Quran when it is recited or read. Even before the Covid-19 crisis, I’ve been working with the Quranic app and it is amazing in the way that it teaches Quranic Arabic. The current cloistering situation lends another unique opportunity for Quran immersion. Previously in Ramadan iftar parties and taraweeh prayer really ate into the already chopped up day. I’ve discovered another great book that takes each Quranic Arabic word and places the English meaning below it The Glorious Quran Word to Word translation. Hopefully when Ramadan ends I will continue to have a daily relationship with the Quran. 

National

Daily condolences

Pre-Covid I would write a condolence message once a month or maximally every two weeks. Muslims write the Quranic text of “to God we belong and to Him is our return”. Last week I had pasted it in Arabic calligraphy to someone. This week I have sent condolences twice each day. It first started with deaths narrated on television, then of relatives of friends, then distant relatives. I dread how it is closing in. This has to stop. 

Social inequity

The tales are harrowing. “I used to earn $250,000 a year and now it is zero” said a radio interviewee. “Thank you for donating to our fitness club” is gratitude from a business owner who needs donations to get through this crisis. Seeing the miles-long car lines in Texas to get donated food is difficult to process in our minds. Is this America? A Mercedes in the line gets its turn. The owner can get his car payment deferred for a month or two but has clearly run out of money for groceries. It seems people have become paupers overnight. The factors that have led to the tremendous inequality in our society need to be redressed. 

Stampede through the eye of a needle

The CARES Act 2020 through the Paycheck Protection Program was intended to help small businesses across America. But appears that no safeguards were put in place and the stampede through the eye of the needle got sharks across America, with slick lawyers and smooth relationships with bankers, to run it dry within a week. 71 publicly traded companies received $300 million of the $346 billion that was allocated to help small businesses leaving many small businesses out in the cold. Even though payroll documentation has to be provided, and the assistance was meant for companies with less than 500 employees, the loophole that Shake Shack used was of having less than 500 employees in one location. Due to public condemnation, Shake Shack has returned  the $10 million assistance it got, but the other billionaires are enjoying the money. This ever-widening gap between rich and poor also needs to be addressed urgently, and quickly become a thing of the past. 

The great equalizer

Covid-19 takes the rich, famous, regular and poor, and its humiliation of America is hard to process. Regression to the status of a developing country, and the dubious distinction of being the world’s Covid hotspot is ignominious. Americans deserve better than the performance of the federal government having essentially no stockpile of ventilators and personal protective equipment and the lack of an integrated federal and state response to tackle the pandemic. Our disaster response needs urgent and intense overhaul. 

Medicare for all

The first domino has fallen. More than 16 million Americans have filed for unemployment which terminates their health insurance. Our health care system was already very flawed, leaving large segments of the population uninsured due to the ridiculously high monthly insurance premiums. That flaw is now going to involve a large swath of the population. Medicare for all is the only way that the sequelae of Covid-19 can be addressed. 

Trump’s tyranny

If a person in any organization had suggested that disinfectant be inhaled, ingested and injected, they would have been fired on the spot. There is a rise in emergency department visits of people that have done exactly what Trump suggested three days ago and the number of calls to Poison Control have skyrocketed. Perhaps there should be a class-action lawsuit against Trump for aggravated assault or attempted murder. Whether we use the T for throw or the C for change, Americans must act in November to remove the embodiment of lies, the spectacle of stupidity and the epitome of incompetence that Trump is. We should try to retain a smidgeon of respect in the world community. Four more years is akin to a death sentence especially after our Covid suffering. 

Tariq Jameel too

Tariq Jameel is a Pakistani preacher a’la Billy Graham. He is charismatic and has a large following in Pakistan. His lectures have been attempts at humor, with superficial and distorted religious teachings. The fake-crying really gets me. As does the fact that seemingly educated people, including Prime Minister Imran Khan and former Prime Minister Nawaz Sharif,  just love him. His latest edict is that the Covid-19 pandemic occurred because women are shameless and not properly clothed. Religion in Pakistan, as elsewhere, is a multimillion-dollar industry and especially in Ramadan, the money really flows. Revolutionary poet Habib Jalib has a beautiful verse: 

Muflis jo agar tan ki qaba baich raha hai

Waiz bhi to minbar pey dua baich raha hai

Doanoan ko hai darpaish sawaal apney shikam ka

Ik apni khudi, aik khuda baich raha hai

The poverty stricken is selling his clothes

And the preacher sells prayers at the altar

Both are faced with the question of hunger

One is selling his self-respect, the other is selling God. 

There is no priesthood or confession in Islam; it is entirely deeds based. On the Day of Judgement we will be presented with a pictorial representation of our worldly life and our accounting will be individual, with no parents or preachers intervening. The accounting of religious clerics however will be a notch, or many, above the simple individual accounting that we will endure, because they have the ability to guide or misguide large groups of people. Previously the flock was restricted to the mosque and its surroundings; with the advent of technology, it now is millions at a time worldwide. It behooves the likes of Tariq Jameel to remember that frank misguidance of millions of people will be an insurmountable obstacle on the Day of Judgement. Pakistanis would be well served to listen to the calm, logical, scientific and current-day applicable lectures and interpretations of Javed Ahmad Ghamdi

Global

Climate change

The videos and photos of the skyline of cities around the world since the Covid-19 quarantine are quite stunning. The clarity of the air and the chirping of the birds is such a balm in these troubling times. As the pandemic subsides the world must actively decide on what industries it will re-allow and the massive polluters it should not. Passivity in this regard should be avoided. We have damaged the planet enough; it is now a time of introspection and revision. 

Cooperation

Cooperation among world health bodies such as the World Health Organization, the United Nations, The World Bank etc. are vital so that we truly work together as we are all in this together. Trump’s bullying and threats first to the United Nations and then to the World Health Organization should cease. If it is one thing that Covid-19 has demonstrated is that it will attack nations of all stripes and the best response is a concerted and not divided one. 

We are taught that after fasting in the month of Ramadan, or after Hajj the Muslim pilgrimage, one should work toward and notice a change in ourselves. Similarly we should keep the valuable, discard the unnecessary, and change some issues/people as we emerge from our Covid-19 quarantines. And as documented in world history and known individually, if we don’t learn from our mistakes, we are made to repeat them. The price next time might be incalculable. 

COVID-19 Cloistered Syndrome

Even though we are cloistered in luxury, it feels like incarceration. The human mind takes a while to process trauma but knowing this does not seem to reduce its impact. My mind goes through these cycles of dread.

I am terrified of, and at the same time fascinated with, blindness and imprisonment. Only because I know I couldn’t handle either. Thus 48 Hours, Forensic Files and 20/20 are my favorite shows. The point when the murderer is sentenced has a particular impact on me because of the essential impossibility, in my mind, of spending 30 years or life in prison without the possibility of parole. 

The cycles of dread

Even though we are cloistered in luxury, it feels like incarceration. The human mind takes a while to process trauma but knowing this does not seem to reduce its impact. My mind goes through these cycles of dread. Starts with the morning when the bed is a magnet and I am steel. Email’s been checked, Whatsapp’s been checked, articles have been read. And then the mental persuasions begin: “come on get out of bed, it’s gonna be ok” and variations of the same. 

Each day is more onerous than the last, because the case-rate and fatalities are so much higher. On March 1^st 2020 there were 89 Coronavirus cases in the US. By March 7^th there were 446, by March 14^th 2,776, by March 21^st there were 23,432 and by March 31^st 186,258 people were infected! And as of April 2^nd there were 243,134 cases in the US and 5,864 deaths, and on April 8^th 427,824 cases and 14,721 deaths. We used to casually use the word exponential, now we see it every day.

So one option is not to watch or read anything related to the COVID-19 pandemic. But that doesn’t work for me. And this week it is people we know who are in the ICU; statistics are so different from when a disease hits home like that. And as the days go on, those episodes of paralyzing dread become sickeningly familiar. 

Sunlight the savior

Even a twenty-minute walk does wonders. “I can do this” and “this too shall pass” become fulfillable mantras. Just the pre-walk is like a one-hour vacillation of the fight between the “go” and “don’t go” voices in my head. And the sinking realization that it has come to this; an activity and numerous others that were automatic in the past are actual projects now. 

Bankruptcy

A physician colleague just posted something hilarious and horrid: “if this saga continues, I will have something in common with Donald Trump, Chapter 11”. And speaking of Trump there is first the specter of small businesses going out of business and then suffering Trump’s press briefings and manifest incompetence. 

Small businesses are seeing a 70-80% reduction in activity. And this applies to a large swath of businesses from manufacturing to medicine. A bipartisan CARES Act 2020 was passed but has run into all kinds of snafus, and the immediate provision of $10,000 to small businesses and the Payroll Protection Program seem like they may not materialize or will arrive when irretrievable damage has been done. The consequences of this are not just small businesses filing bankruptcy, but millions of people losing their health insurance. Which in turn make a recession a definite, and the Second Great Depression a probability. Scaling back, pre-retirement or retirement plans are so much more palatable when they are done on our time; having them shoved in your face just worsens that cycle of dread. 

Tyrannical Trump

Never fails that when I am trapped in the kitchen cooking dinner, Trump’s press briefings are on and all channels carry them. Piled on top of the cloistered blues is the tyranny of Trump. It is hard to comprehend that the President of the United States would bully reporters, call the World Health Organization names, peddle hydroxychloroquine repeatedly, lie blatantly, fight with all things Democrat, alter facts whimsically and be altogether rude, grandiose and delusional. With the reverberant theme of “it is this way because I say it is”. And the citizenry has no recourse. “The  CDC recommends face masks but I won’t be wearing them” is Trump’s typical of “do as I say and not as I do”. The cycles of dread are fueled with the sickening realization that a petulant teenager has the lives of millions on his narcissistic little hands. 

All this time

Time was that vacations and staycations were just so awesome. Now time hangs heavy and the voices that propel to action feel shrill. I used to dream of a sabbatical when I would write my book. That the day is filled with telemedicine, cleaning, napping, cooking, the news and bed makes my self-worth tank. And I re-read those self-affirming memes that soothingly forgive you for essentially becoming a lump of lard. 

Fat on the other side

I’m very fat-phobic and my children accuse me of wanting to commit fat-icide. My mother and aunts were fabulous cooks; and round and rolly to prove it. And it was so plain that most, if not all, famous chefs are obese. So I figured I would dislike cooking and that would take care of any roundness that might threaten me. One of the memorable things of this cloistering will be that I discovered the joys of cooking. The family appreciating the meal every evening, is truly one of the greatest joys I have ever felt. Fortunately for me, I don’t have a sweet tooth and am not a stress eater; quite the South Beach lo-carb diet queen. That I have never been skin-and-bones is all my mesomorphic build, genes and metabolism-as rationalized by all overweight folks. Used to weigh myself once a week, now it is every day. The cycles of dread, my molasses like inertia, the specter of a financial fall, the disgust of governmental corruption and incompetence, the sadness of the national and global death toll and the fury of how this pandemic could have been handled differently will all be there. But at least I won’t be fat on the other side. 

The World on Reboot

On one fine day in Wuhan China the novel Corona virus traveled from bat to human and then between humans. And in that sentinel event, God conveyed, again, that He was in control. 

Like in a bad chapter of a sci-fi novel, the Corona virus pandemic will kill many and leave many in sudden poverty. It is indeed surreal to comprehend that in our lifetimes we will have seen a pandemic and likely The Second Great Depression. 

“These pandemics are on a one hundred-year cycle, almost like clockwork” said Dr. Nasir Husain, an infectious disease consultant. This piqued my curiosity, so I looked it up, and he is right. The Great Plague or The Black Death in 1347 killed an estimated 75-200 million. The world got a bit of a respite until the Italian Plague of 1629 which killed 280,000. Then the plague of Marseille in 1720 killed 100,000. The Spanish Flu, or the influenza pandemic in 1918, is estimated to have killed 17-50 million people. And in 2020 the Coronavirus.

At the time of this writing there were 307,725 Covid-19 cases and 13,054 deaths worldwide. Sadly by the time you read this, you will note that that the cases are exponentially higher. 

The slow unfold

The WHO vacillated a bit before it called the Coronavirus outbreak a pandemic. And after it did, instead of our government going on overdrive and doing a national clampdown, the country got split between people calling it overblown (Trump fans) and others demanding immediate action (labeled the liberals). At the time of this writing, only three states, California, Illinois and New York have gone into lockdown and it feels like this is a developing country, with the government’s focus on censoring the news and not wanting to face the rising numbers. There is a shortage of ventilators, ICUs, personal protective equipment and even masks. We have a defense budget to invade and destroy other countries, but we cannot protect our own. Trump was informed of the Covid-19 threat in January 2020 but did nothing about it. Instead our corrupt Congresspersons sold and bought shares on the stock market, feared the Coronavirus threat in private and denigrated it in public and boasted of our preparedness to tackle it. 

Every day my strategy of medical practice changed. On Friday, March 13, we worked on advising people observation when they called in with respiratory symptoms, and examined some that came for unrelated visits but had respiratory issues. By Monday March 16, we converted to telemedicine, except for having to physically see some patients who I cannot prescribe medication to without a urine drug screen.  

The Second Great Depression?

America has slowly closed down. The Stock Market is reminiscent of the Great Depression. Unemployment claims are surging and it is predicted that they might reach an unprecedented territory of 2.25 million. How does a country recover from that? My private practice has been scaled down to the point that survival beyond 30-45 days at this pace is difficult to envision. I’m trying to hold on to my employees because starting from scratch when all this is over, is not a good move. Other small businesses in America cannot do this. To come to terms with the sudden change in our fortune-with little work and the stock market crash-just adds to this one word that my mind keeps churning up. WHAT?! Seems we will spend the next couple decades getting out of this medical and money mess. Which looks like the Second Great Depression to me. 

Stages of Grief

To think that the entire world is going through Elizabeth Kubler-Ross’ Five Stages of Grief is also weird. For a few seconds in the morning while the brain is still half asleep there is respite. And then it suddenly hits; and for me it is mainly denial/disbelief at what just got unleashed, and anger at our government for its incompetence and the deaths of thousands. Hopefully, not millions. 

Individual and national arrogance

All those aphorisms of “we’re in this together” and “it’ll never be the same again” suddenly stop being corny. When we go away on vacation, almost invariably, we reboot, we reflect. From existential questions to simpler ones like where am I headed or should I consider a career change. With this Covid-19 induced forced vacation, the world is on reboot; our questions multiply and the answers seem to hide. We took so much for granted: parties, concerts, travel, shopping. If I dare plan a quick grocery stop now, the yelling chorus from my daughters is enough for me to want to jump off the cliff instead. Groceries must be delivered. 

All of us have had varying levels of arrogance and have doled out injustice. As we are cloistered in our homes a personal inventory is very much in order. This is the time to repair relationships and ask for forgiveness. And most of all, put down the smartphone and just sit and talk to your family. Indulge them. Especially if you are a parent, realize the anxiety, however camouflaged, that your children are going through and alleviate it. Reassure your parents and friends and keep the conversation positive. Arrogance in Islam is akin to shirk or the sin of association, for arrogance can only belong to God. 

National arrogance, especially the arrogance of American leadership, appears to have not even been lightly dented by the massive catastrophe that the Coronavirus pandemic is.

In the war and devastation in her country, the very young Syrian child, just before her death said "I will tell Allah every thing". It seems that Allah listened.

No one speaks of the American killing of one million Iraqi civilians on the basis of the lie of Iraq having weapons of mass destruction. The incarceration and torture of millions of Uighur Muslims in Xinjiang China is not spoken of, even by Muslim countries, for fear of Chinese trade reprisal. Israeli apartheid and the daily brutalization of Palestinians is presented to the world with a switch of victim and aggressor. The world, even Saudi Arabia and the United Arab Emirates, both hungry for Indian trade and money, looks away as India continues the ethnic cleansing of Muslims and has kept Kashmiris in lockdown for nine months now. Iran has suffered a significant Covid-19 toll but America refuses to lift sanctions, and innocent Iranians suffer the lack of basic medical care. Even the desperation of our own citizens doesn’t return us our humanity and compassion. 

Who’s in control?

On one fine day in Wuhan China the novel Corona virus traveled from bat to human and then between humans. And in that sentinel event, God conveyed, again, that He was in control. 

Jawad Ahmad, a Pakistani singer, introduces one of his songs with a poetic representation of the Quran and Hadith in the form of a conversation between God and us, in which God says:

Oh son of Adam
There’s something you want and something that I want

But what will happen is what I want

So submit yourself totally to what I want 

And perhaps I will give you what you want

But if you are disobedient and rebellious with what I want

I will tire you out in your pursuit of what you want

And in the end it will always be what I want

Submission

The only sanity is in submission. Entirely to God’s will. Stay at home, be kind to your family, strengthen your spirituality, learn new skills, wash your hands, take every precaution and stop panicking. God’s got this. Wa uffawidu amri ilallah inallaha baseerun bil ibad: I entrust all my affairs to God; indeed God is aware of His servants. (Quran 40:44)

China's pre-genocide of Uyghur Muslims

It was a wonderful start to Imran Khan’s ascent to premiership that the Dutch cartoon contest was cancelled. Appears Foreign Minister Qureshi was convincing in his dialogue with the Dutch and a crisis and killings were averted. This foreign policy winning streak is continuing, at least in some sensitive issues.  

“China is treating Islam like a mental illness” is the title of an article in a recent issue of TheAtlantic. And the deeply nationalistic, hardline rule of President Xi Jinping looks at Islam like the diseases of depression or addiction. He has interned one million Uyghurs in internment camps, called “re-education camps” to “cleanse” the mind of Islam which is likened to an ideological illness, akin to a virus in their brain. Here they are brainwashed to praise the Communist Party, sing nationalistic songs all day, study President Xi’s vision of China, confess to and apologize for praying. They are also forced to eat pork and drink alcohol. For resistant subjects there is torture, solitary confinement and death. 

The Qing Dynasty reasserted control of Xinjiang in the 19^thcentury. Xinjiang, population ten million, is in northwest China and borders Pakistan’s Gilgit Baltistan to the south. The Uyghurs are Turkic people, linguistically, culturally and ethnically close to Central Asia, despite a long history of Chinese rule. In 1933 and again in 1944, ETIM or East Turkestan Islamic Movement, tried to secede and China responded ruthlessly. Chinese officials deny the existence of the internment camps, and have hinted at terrorist activity in Xinjiang, but there is no evidence of this. 

Many of the Han, the predominant Chinese group, have migrated to Xinjiang in another effort toward Sinification of Xinjiang. This Sinification was proceeding at a languid pace until a couple of years ago when Chen Quanguo arrived. Quanguo had created an intense surveillance system in Tibet from 2011-2016 and was so successful in crushing dissent there, that his system has been implemented in Xinjiang. 

It is this century’s new Gulag. And is considered pre-genocidal. Reminiscent of the Rohingya genocide by Myanmar. 

Teachers ask children to spy on parents and report their praying or reading the Quran, neighbors spy on neighbors, the entire population is monitored through GPS technology and DNA-sampled. Men are sent to internment camps, and satellite images show expansion of the internment camps, and in some villages men cannot be seen, only women and children. There are ghost towns where no one talks to others. Women are sent to internment camps also.   

Ramadan is banned, no beards or veils can be publicly visible, passports have to be surrendered and saying salam-alaikum can send you to an internment camp. Qurans have been burned and mosques have been closed down. Factories and hospitals are converted into re-education camps. When they come a black hood is placed over the head, and in the internment camps prison uniforms, shaved heads and political indoctrination begin. Baths are rare and washing of hands and feet is not allowed, as it resembles ablution. If the prisoners comply they are released, if they do not, insanity or death await. Those who have left the internment camps and then China itself have told the same story of conditions in Xinjiang. 

Assimilation into the Chinese mold takes the form of internment camps and orphanages, both of which are overflowing. Communistically called “child welfare guidance centers” these massive orphanages house Uyghur children separated from their parents, where they are locked up like farm animals in a shed. Sinification of these children, needless to say, is easy. 

Rebiya Kadeer, President of the World Uyghur Council said: “the real intent is to eliminate Uyghurs as a distinct ethnic group”. Turkey and Malaysia have protested but the most vocal protest has been from the most unlikely places: US Vice-President Mike Pence called on the Chinese government to release the one million prisoners that it is holding in re-education camps for political indoctrination and denunciation of religious beliefs. US Senator Marco Rubio and American UN representative Nikki Haley have been similarly excoriating.  

China has arrested 50 Uyghur women married to Pakistani men in Gilgit-Baltistan. And Pakistan has done nothing in response. 

Pakistan’s Federal Minister for Religious Affairs, Pir Noorul Haq Qadri, recently said that strict regulations and laws fuel rather than counter extremism. To promote religious harmony, China should exercise patience, the minister told China’s ambassador to Pakistan, Yao Jing. He also suggested that a delegation of Pakistani scholars should visit Xinjiang to help. 

Canceling the Dutch cartoon contest was important, and kudos to Religious Affairs Minister Qadri for protesting to China.  Seems Pakistan is trying to be the voice of the Muslim world. These efforts are a good start but have not continued with the war in Yemen. More on that travesty another day. 

Mindsets, Mercy and the Qatra effect

We might be witnessing a tectonic shift in Pakistan’s socio-politics. Prime Minister Imran Khan’s address to the nation was so ambitious that some think he has promised the nation the moon. 

In individual lives and those of nations, idealism is a good thing, particularly when it is backed up with a solid action plan. In goal setting you shoot for the stars, and settle for an average or slightly above average result. Cynicism and supercilious criticism only perpetuate the status quo. And if there is one nation on earth that cannot survive the status quo it is Pakistan. 

Imran Khan had an exhaustive list and dealt with education to agriculture, corruption to climate change. His reading glasses are testimony to the fact that he had a thought out plan of action for each item. As an aside, I must say, that his reading glasses have to go. During his oath taking, it was hugely awkward to see him flip out his sherwani and dig out his glasses. He needs a quick visit to an ophthalmologist who will fix him up with trifocals so when he talks and then reads, he doesn’t have to go from handsome to grandma; he would just keep the trifocals on and rest his arm from the back and forth, and sport a scholarly look all at the same time.  

The changes that Imran Khan lists are only possible with a change of mindset. Seventy-one years of explosive population growth, an imploding economy topped with baffling corruption has served to fashion the Pakistani psyche. Time was that the middle class, the classic perpetuators of morality, maintained integrity and faced adversity with the rules they grew up with.  But who can live on love and fresh air? Especially over the last thirty years or so, you see survival of the fittest on full display. 

My first brush with corruption was in 1982 when the clerk in Dow Medical College’s office demanded money for release of my mark sheet. But 2016 will go down in my family’s history as giving all of us PTSD, post-traumatic stress disorder. My mother, my daughter and I had traveled to Karachi so that Ammi could collect my late father’s pension. In current day Pakistan, your two options to get anything done are doling out money or applying influence. Those government servants know how to break you. I chose influence application to greasing palms. And my distress was worsened at the plight of the many desperate faces roaming those halls that didn’t have the connections I did. 

The trend isset at the top. Everything, small or substantial, matters. To his credit Imran Khan knows this. His ill-fitting sherwani caused a buzz on social media and it seems a regular tailor stitched it. Brave to wear a Peshawari chappal at his inauguration. Wearing that chappal, Imran Khan gives many messages; he is thumbing his nose at Western culture, showing pride in our own and underscoring simplicity. When there is no fear of retribution and the Whistleblower Law comes into effect, there will be a nationwide movement to self-correct. Or else get turned in. 

That Islam insists on honesty and principles becomes an empty lecture when leaders drive away in bullet and bombproof Mercedes and BMWs, not one but fifteen at a time, into mansions with 500 servants and food to feed a squadron. A three-bedroom home with two cars is a great start! Changing that mindset that has been groomed and nurtured for decades is the challenge. Except for the elite one senses a national enough-is-enough frustration. How and why is life so difficult at every step from the time one gets up till the day is done? 

There is in fact a danger of the pendulum swinging the other way and the elite and corrupt getting street justice. Imran Khan assiduously avoided vengeance. And it is important to maintain this. A mindset change has to happen but it must be modulated to achieve results and not revenge. 

I was very touched by his repeat explanation of creating rahm or mercy in our hearts. One really notices its absence in Pakistan. How do people live with themselves spending millions of rupees on a wedding outfit and the many wedding functions, when all around them are starving children begging on the streets? Mercy has been squashed out of our hearts and we’re blind to the misery around us. I was looking through clothes at a boutique on M. M. Alam Road in Lahore in July 2013; most of the outfits were Rs. 25,000 and above. The power went out and the generator quickly hummed in. Under his breath the salesman said that the power outage didn’t matter to him for his six children sweated in the day and studied by candlelight at night. I asked him how much he made and he said Rs. 25,000 a month. I left the store and cursed our nation’s inequity.

Qatra qatra darya ban jaata hai-drops coalesce to form a river. The cost of the Bhasha Dam is estimated to be Rs. 1450 billion. The small Rs. 10 SMS donation created by the Supreme Court, and then larger donations from Pakistanis and Overseas Pakistanis, can be the drops that can easily coalesce to give us the dam. 

All of us, within and outside Pakistan should do at least one thing to change things. Plant a tree, clean your street, educate a child; the opportunities are limitless. Imran Khan has great minds in his cabinet and advisers. In five years if we achieve even half of his “lofty” goals, we will easily see Naya Pakistan. 

Pakistanis bailing out Pakistan

Any ray of hope for Pakistan seems quickly clouded by its dire financial straits. Not handled wisely the State Bank of Pakistan’s minuscule reserve of $9billion can pose an existential threat for Pakistan. 

In May of 2018 the State Bank of Pakistan’s external debt was $91.8 billion, a whopping 50% increase over the last four years. Servicing this debt keeps us in the rewind and repeat cycle. An urgent and multipronged approach will be needed to yank Pakistan out of this quagmire. 

In his somber and statesmanlike speech after the July 25 election, Imran Khan called overseas Pakistanis “our biggest asset”. Harnessing the financial power of overseas Pakistanis might be a very effective part of the urgently needed multipronged strategy to heal Pakistan’s financial crisis. 

There is something mysterious and magical about love for Pakistan. My American born children don’t understand it. You’ve got to feel it to know that there is a lot you would do for Pakistan. Many expatriate Pakistanis, like me, are deeply grateful to Pakistan for making us all that we are today. I can never completely repay Pakistan, Civil Hospital Karachi and Dow Medical College for making me a physician, essentially for free. In its time of desperate need, Pakistan should capitalize on this love-guilt-debt emotion that numerous expatriate Pakistanis feel.

I came to the United States for residency training with plans to return on its completion. When the time came to return, there was a spate of killing of Shia doctors in Pakistan. My former husband is Shia and we thought it wise to not endanger the family. Till today I remember how I wilted inside.  And, outside, dropped roots that ensured that returning would not happen. 

According to the Ministry of Overseas Pakistanis and Human Resource Development, there are 7.6 million Pakistanis who live abroad. In 2017 they sent remittances to Pakistan totaling $20 billion. 

Political commentators Rauf Klasra and Amir Mateen have come up with a brilliant idea that can Band-Aid Pakistan, at least for the present. Each overseas Pakistani is urged to transfer $1000 to their families’ or their own accounts in Pakistan, with instructions to not draw it for at least one month. Considering 7.6 million overseas Pakistanis are members of families, if we were to take one third of the 7.6 million and persuade them to send $1000, it amounts to over $2 billion. This could go toward debt servicing, so the chasing-our-tail phenomenon with regard to the external debt stops. 

In addition to the average expatriate Pakistani, there are the billionaires. Like Pakistani-American Shahid Khan who owns the Jacksonville Jaguars an American professional football team, as well as the Fulham Club a British football team and an automotive company. His net worth is $8.5 billion. British-Pakistani Anwer Pervez is owner of Bestway and United Bank and has a net worth of $3.8billion. Pakistani-American Ashar Aziz is owner of FireEye, a cyber security company, and has a net worth of $1billion among many other very wealthy overseas Pakistanis. 

Omar Aziz, the future finance minister of Pakistan, has not ruled out any measures to deal with Pakistan’s debt, including reaching out to the IMF. Perhaps reaching out to overseas Pakistani billionaires and multimillionaires to donate to reduce Pakistan’s debt, or lend money at no interest, is doable. 

The Ministry of Overseas Pakistanis ought to create two departments; one called “Donation for Debt Reduction” and another called “Loans for Business Development”. Legal framework should be created quickly to protect the overseas donor and lender. If overseas Pakistanis are assured that their donations or their loans will be assiduously protected and channeled appropriately, we just might have an ongoing stream of money that will bolster Pakistan quickly and effectively. The loans for business development should be based on the micro-financing concept of Nobel Prize winner Muhammad Yunus. Low interest or interest-free loans to families to start businesses will reduce unemployment and raise people out of the poverty that Imran Khan spoke of repeatedly. 

“There’s a tide in the affairs of men, which when taken at its flood leads onto fortune” said Shakespeare. There is a Naya Pakistan fervor in Pakistan and among expatriate Pakistanis; we should pivot quickly to capitalize on this. That magical love for Pakistan is at its peak, full of hope and yearning. 

It is little that we overseas Pakistanis want in return. The right to vote in Pakistan’s election-not traveling to Pakistan-but where we live and in a Pakistan embassy or consulate. Eliminating red tape, politics and competitiveness when we try to bring our talent to Pakistan. We don’t want to usurp jobs, we just want to help, for instance in creating addiction centers, with the latest technology, to combat Pakistan’s drug epidemic. 

Finger pointing is now pretty pointless. We can all take the responsibility to redress the havoc wreaked by past misgovernance. Instead of international banks or the Chinese always bailing out Pakistan, the average, wealthy or super-wealthy overseas Pakistani could really help. Our guilt will be assuaged and our hopes realized.