Apathy and incompetence

We have an opaque lens of self-reflection towards well-being — particularly of those who are not in our field of view

These days, you have to fit a certain mould to be newsworthy. If it is not related to terrorism or the most recent flavour of the day, Yemen, it is not interesting for anyone, media or the civil society. Being from Balochistan is certainly not going to help you jump the queue on the long list of problems that concern us, for example the size of the gathering in NA-246. So when reports started emerging earlier this week that a number of children had died due to substandard measles vaccines in Balochistan, the report was a mere space filler. The story, that is still developing, is tragic on so many levels and while an op-ed cannot enumerate all that is depressing about this story, I will focus on two main points.

First is our collective apathy. We have an opaque lens of self-reflection towards health and well-being — particularly of those who are not in our immediate field of view (also known as three to four major cities). Not far behind the apathy is the attitude of those whom we have entrusted to be the custodians of health. When the issue was brought up in the Balochistan Assembly a couple of days ago, the first reaction of the provincial health minister, Rehmat Saleh Baloch, was that the children probably died of other diseases. Indeed, the government is right in ensuring that all judgment should be held off until a rigorous and detailed investigation is completed, but blaming the victims for their misery is both unjust and insulting. Instead of demonstrating empathy and support for the families and ensuring that the government will do everything in its power to get to the core issue, the first posture we take is that of deflection of blame and blaming the victim. How does the minister know that these poor children “probably” had underlying medical conditions? How does he know, for a fact, that these vaccines were not tainted?

The minister followed up this rebuttal in the assembly with a news conference where he claimed, “More than a million children have so far been vaccinated during the last four days in 30 districts of Balochistan … there would have been more deaths if vaccines were not good or expired.”

This shows profound simplification of the problem; a simplification that is both ill-informed and dangerously inaccurate. Just because there have not been more deaths does not mean that the quality is good! For the sake of argument, let us assume that millions of vaccines have been received, what makes one think that the entire batch would be bad? There is no reason to assume that every single vaccine, that has been procured, is bad. There is ample data, should we bother to look at published research, to show that bad quality products may be a few or many. There is no a priori reason to assume anything without rigorous testing. What if some bad ones got mixed up? What if some were of good quality and others were not? Is ‘too few deaths’ a sign of good quality?

Beyond the deeply saddening rhetoric of those in power, there is also the very delicate issue of vaccinations in Pakistan. The Government of Balochistan has recently embarked on a massive measles vaccination campaign that is long overdue. Given the complex challenges in the polio campaign, any negative news about vaccines in the measles realm can be damaging both for the province and our public health in general. That said, at this point, what we need is more transparency, not less, and a real commitment with action to build trust through better governance. Blaming the poor kids or making dubious sweeping statements is hardly the way to go.

Apathy and incompetence reinforce each other, but should we try, we can turn the tide. The civil society, over the last few months, has shown resolve and a steely commitment on a host of important national issues, needs to fight not only for those whom we lose to terrorism and intolerance, but also for those who we are on the verge of losing through our profound apathy and deep incompetence. 

Published in The Express Tribune, April 21^st,  2015.

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