Meeting the Heathcare Challenge of the 21st Century South Asia

It is a great challenge of the 21st century to provide the best possible universal health care at the lowest possible cost. It's in fact a dual challenge. While aging and obesity related diseases are the dominant concern in the West, there is continuing worry about more basic issues of hygiene, vaccination, nutrition and access to health care professionals in the developing world, including South Asia. What is common between these two is the increasing reliance on technology.





Technologies ranging from new toilets, water purification, bio-fortification, diagnostics and computing and communication to nano-biotechnology and bioengineering are being developed and deployed to prevent and fight all kinds of diseases around the world. In the video below I join a discussion of the current state of health care and how to meet the challenges of this century:



Vision 2047 from WBT TV on Vimeo.

Related Links:

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World Water Day: Water Scarce Pakistan 

Malnutrition Challenge in India and Pakistan 

Pak Lady Health Workers "Best in the World"

Obesity in America

India and Pakistan: Off-Track, Off-Target on Toilets

Fixing Sanitation Crisis in India

Food, Clothing and Shelter in India and Pakistan

Heavy Disease Burdens in South Asia

Peepli Live Destroys Indian Myths

India After 63 Years of Independence

Poverty Across India 2011

British Pakistan Wins "Re-invent the Toilet" Contest

Karachi Tops List of World's Largest Cities

With rapid urbanization in Pakistan, Karachi has become the world's biggest city with a metro area population of 18 million people, according to Citymayors stats published recently.

Karachi (Urdu: کراچی, Sindhi: ڪراچي, Karāchi) is followed by Mumbai, Delhi, Buenos Aires, Seoul, Jakarta, Manila, Sao Paulo, Shanghai and Istanbul making up the top 10 list. Bangladesh capital Dhaka is at number 12, barely missing a top 10 slot. Of these, Mumbai, Dhaka and Delhi also have the dubious distinction of making Mercer's list of world's dirtiest cities. In another survey, Mercer has ranked Karachi as the fourth cheapest city for expatriates.



The list of the world’s largest cities, by land area, is headed by New York Metro, with a total area of 8,700 square kilometers. Tokyo/Yokohama is in second place with almost 7,000 square kilometers, followed by ten cities from the United States. Mumbai (Bombay), with a population density of almost 30,000 people per square kilometer, is the world’s most crowded city. Kolkata (Calcutta), Karachi and Lagos follow behind.



In 2008, the US based NPR radio did a series on Karachi titled "Karachi: The Urban Frontier". It highlighted the following facts about Karachi:

1. Karachi is built along a natural harbor facing the Arabian Sea, and this central location between the Middle East and India has made Karachi an important trading port for hundreds of years.

2. Karachi encompasses both its old seafront district and a sprawling web of commercial and residential development that covers almost 1,400 square miles. Its contemporary landscape spans skyscrapers, posh golf resorts, congested roadways and sprawling squatter colonies.

3. The Port of Karachi handles 60 percent of Pakistan's cargo, and the Karachi Stock Exchange is one of Asia's most active trading markets (The data for 1999-2009 shows that Karachi share market significantly outperformed Hong Kong, Mumbai and Shanghai markets). The city's main industries include shipping, trade, finance, banking, information technology, manufacturing, real estate, media and education.

4. Like any big city, it has its share of problems. Pollution, crime, corruption and political volatility are just some of the issues confronting the 12 million to 18 million "Karachiites" who call this overcrowded city home. Karachi is 60 times larger than it was when Pakistan was created in 1947. And with the population growing at an annual rate of 6 percent, one of the biggest challenges for city officials is managing the tensions and violence that often flare along ethnic and religious lines.

5. Karachi is growing so fast that estimates of its population range from 12 million to 18 million. The country's financial capital is also a city where about half the population lives in illegal houses.

Here are some figures for Karachi population I received from the editors of citymayors.com:

YEAR Urban Population
1856 56,875
1872 56,753
1881 73,560
1891 105,199
1901 136,297
1911 186,771
1921 244,162
1931 300,799
1941 435,887
1951 1,068,459
1961 1,912,598
1972 3,426,310
1981 5,208,132
1998 9,269,265
2006 13,969,284
2007 14,500,000

Since Karachi population has been growing at about 4-6% a year recently, the 18 million figure for Karachi in 2009 makes sense.

The mayors of the world’s twenty largest cities are each responsible for more people than most national prime ministers. For example, London, ranked 20th in the world, has more residents than nations like Paraguay, Denmark, New Zealand or Ireland, and if Karachi, globally the largest city, was a country it would rank above Greece, Portugal or Hungary. The combined population of the world’s eight megacities - cities with more than 10 million inhabitants - comfortably exceeds that of Germany.



Urbanization is not just a side effect of economic growth; it is an integral part of the process, according to the World Bank. With the robust economic growth averaging 7 percent and availability of millions of new jobs created between 2000 and 2008, there has been increased rural to urban migration in Pakistan to fill the jobs in growing manufacturing and service sectors. The level of urbanization in Pakistan is now the highest in South Asia, and its urban population is likely to equal its rural population by 2030, according to a report titled ‘Life in the City: Pakistan in Focus’, released by the United Nations Population Fund. Pakistan ranks 163 and India at 174 on a list of over 200 countries compiled by Nationmaster. The urban population now contributes about three quarters of Pakistan's gross domestic product and almost all of the government revenue. The industrial sector contributes over 27% of the GDP, higher than the 19% contributed by agriculture, with services accounting for the rest of the GDP.



A 2008 report by UN Population Fund says the share of the urban population in Pakistan almost doubled from 17.4 percent in 1951 to 32.5 percent in 1998. The estimated data for 2005 shows the level of urbanization as 35 per cent, and CIA Factbook puts it at 36% in 2008. An expected positive consequence of the increasing urbanization of society in Pakistan will be the creation of over 100 million strong middle class by 2030, making Pakistan's grass roots democracy more viable and responsive to the needs of the people. This large urban population will not only create a domestic market for goods and services, but it can create a skilled work force that can be the engine of economic growth and source of innovation.

According to the 1998 census, Sindh is the most urbanized province with 49 percent percent of the population living in urban centers. NWFP is the least urbanized province with only 17 percent of its population living in urban areas.

With Pakistan already the most urbanized country in South Asia, Karachi's population has been growing at a rate of over 4 percent a year for decades, according to the editors at Citymayors.com. Karachi now accounts for about 12 percent of the nation's population, and Mustafa Kamal as its mayor is accountable to a larger population than the presidents or prime ministers of many nations of the world. As the nation continues to experience increasing rural-to-urban migration, the jobs of the big city mayors in Pakistan, particularly Karachi and Lahore, are becoming significantly more important and challenging than generally recognized. How these mayors deal with these challenges will largely determine the fate of the nation, in terms of education, health care, housing, transportation, industrial and service sectors' growth, job growth and overall economic activities, as well as the future of democracy.

When visitors see a squatter city in India or Pakistan or Bangladesh, they observe overwhelming desperation: rickety shelters, little kids working or begging, absence of sanitation, filthy water and air. However, there are many benefits of rural to urban migration for migrants' lives, including reduction in abject poverty, empowerment of women, increased access to healthcare and education and other services. Historically, cities have been driving forces in economic and social development. As centers of industry and commerce, cities have long been centers of wealth and power. They also account for a disproportionate share of national income. The World Bank estimates that in the developing world, as much as 80 percent of future economic growth will occur in towns and cities. Nor are the benefits of urbanization solely economic. Urbanization is associated with higher incomes, improved health, higher literacy, and improved quality of life. Other benefits of urban life are less tangible but no less real: access to information, diversity, creativity, and innovation.

In a recent interview published by Wired Magazine, Stewart Brand, "the pioneering environmentalist, technology thinker", and founder of the Whole Earth Catalog focused on the positive aspects of urban slums. Brand also made a counterintuitive case that the booming slums and squatter cities around the major urban centers in the developing world are net positives for poor people and the environment. Brand's arguments make a lot of sense, as long as there are representative city governments responsive to the growing needs of the new and old city residents.

Here's a video clip of Indian environment minister Jairam Ramesh saying "if there was a Nobel Prize for dirt and filth, India would win it hands down":



Related Links:

Karachi Tops Mumbai in Stock Performace
Eleven Days in Karachi
Citymayors website

Pakistan Most Urbanized in South Asia

Karachi: The Urban Frontier

Do Asia's Urban Slums Offer Hope?

Orangi is Not Dharavi

Climate Change Could Flood Karachi Coastline

Karachi Fourth Cheapest For Expats

Karachi City Government

Karachi Dreams Big

Challenges of the Decade 2010-2020 in South Asia and Beyond

Making predictions is hazardous business. After all, who would have forecast with any accuracy the Soviet defeat in Afghanistan and the fall of the Berlin wall in late 1980s, or the terrorists attacks of September 11, 2001, or the near-collapse of the US financial markets in 2008, the kind of events that fundamentally changed the world. This new decade of 2010-2020 could also bring long-lasting but hard to predict events that are described by Nassim Taleb as rare but high-impact Black Swan Events. However, I do think this new decade is likely to be defined by the fundamental issues of access to food and water, in addition to the continuing concerns about terrorism and security. Each of these challenges has the potential to precipitate major events that could bring about fundamental yet unpredictable changes in the world order.

Food:

A combination of population explosion, water scarcity, and climate change are causing serious concerns about access to affordable and reliable food supply in many nations. Climate change in parts of India has resulted in multiple crop failures after seven or eight bad years in a row, putting local people deeper and deeper in debt. An estimated 200,000 Indian farmers have ended their lives since 1997.

There has been a rush by some of the rich but food-poor nations to buy up farmland to grow food in poor nations, raising concerns about the potential for food riots. New ideas and technologies are required to bring about a new "Green Revolution" to feed the growing population of the world.

In June, news agency Reuters reported that the government of Pakistan had offered 404,700 hectares (ha) of farmland for sale or lease to foreign investors. It is the usual suspects of the Gulf states and South Korea who are the likely targets of the government's drive for investment. Oil rich, food poor states from the Middle East and food deficit prone South Korea have been spurred by the high food prices of 2007 and 2008 to increase their food security by investing in agricultural land abroad.

Also in June 2009, Swedish multi-national food company Tetra Pak announced the signing of an memorandum of understanding with local company Engro Foods to create a dairy hub in the Sahiwal district of the Punjab. The hub will serve 15 villages in the district and aims to promote more efficient production and bring smallholders into the formal dairy market chain.

In July, the Pakistani minister for investment said that the country would be happy to provide land for Korean companies to build food and dairy processing facilities, according to Pakistan Agribusiness Report. Also in July, the chief minister of the Punjab said that there was a large amount of interest in investing in the province's agriculture from Qatar.

Water:

The year began with an ominous warning by Sardar Aseff Ali, Deputy Chairman of the Planning Commission, about the potential for a water war between India and Pakistan. Such warnings clearly reinforce the gravity of the water situation, requiring creative solutions.

Water is becoming more scarce, and water wars are likely to erupt in several regions of the world. Among the 25 most populous countries in 2009, South Africa, Egypt and Pakistan are the most water-limited nations. India and China, however, are not far behind with per capita renewable water resources of only 1600 and 2100 cubic meters per person per year. Major European countries have up to twice as much renewable water resources per capita, ranging from 2300 (Germany) to 3000 (France) cubic meters per person per year. The United States of America, on the other hand, has far greater renewable water resources than China, India or major European countries: 9800 cubic meters per person per year. By far the largest renewable water resources are reported from Brazil and the Russian Federation - with 31900 and 42500 cubic meters per person per year.

According to the United Nations' World Water Development Report, the total actual renewable water resources in Pakistan decreased from 2,961 cubic meters per capita in 2000 to 1,420 cubic meters in 2005. A more recent study indicates an available supply of water of little more than 1,000 cubic meters per person, which puts Pakistan in the category of a high stress country. Using data from the Pakistan's federal government's Planning and Development Division, the overall water availability has decreased from 1,299 cubic meters per capita in 1996-97 to 1,101 cubic meters in 2004-05. In view of growing population, urbanization and increased industrialization, the situation is likely to get worse. If the current trends continue, it could go as lows as 550-cubic meters by 2025. Nevertheless, excessive mining of groundwater goes on. Despite a lowering water table, the annual growth rate of electric tubewells has been indicated to 6.7% and for diesel tubewells to about 7.4%. In addition, increasing pollution and saltwater intrusion threaten the country's water resources. About 36% of the groundwater is classified as highly saline.

The solution to the water crisis lies in better management of water resources to conserve water and new technologies to economically recycle or produce fresh water from sea water. For example, about 98% of the water in Pakistan is used in farming through a very inefficient flood irrigation method, leaving only two percent for other consumers and commercial-industrial users. A California study recently found that water use efficiency ranged from 60%-85% for surface irrigation to 70%-90% for sprinkler irrigation and 88%-90% for drip irrigation. Potential savings would be even higher if the technology switch were combined with more precise irrigation scheduling and a partial shift from lower-value, water-intensive crops to higher-value, more water-efficient crops. Rather than flood irrigation used in Pakistani agriculture, there is a need to explore the use of drip or spray irrigation to make better use of nation's scarce water resources before it is too late. As a first step toward improving efficiency, Pakistan government has launched a 1.3 billion U.S. dollar drip irrigation program that could help reduce water waste over the next five years. Early results are encouraging. "We installed a model drip irrigation system here that was used to irrigate cotton and the experiment was highly successful. The cotton yield with drip irrigation ranged 1,520 kg to 1,680 kg per acre compared to 960 kg from the traditional flood irrigation method," according to Wajid Ishaq, a junior scientist at the Nuclear Institute for Agriculture and Biology (NIAB).

Low-Cost Housing:

Housing construction by traditional methods has failed to keep pace with the rising demand, particularly in the developing countries like India and Pakistan experiencing rapid urbanization. New, cheaper and faster construction methods are needed to address the basic shelter needs of the people. There are a number of modular, pre-fabrication and rapid on-site assembly methods are being explored in developing nations.

Mass Literacy:

Literacy has become as fundamental a need as food and water in this day and age. And yet, UNESCO data indicates that 770 million adults around the world remain illiterate, over 35% of them in India. New focus and methods are needed to reach out to the illiterate masses of the world as part of a worldwide mass literacy campaigns.

Low levels of literacy continue to hobble many developing nations, limiting the productivity and economic opportunities for the growing young populations, and causing concerns about social and political instability and growth of international terrorism.

Health Care:

Access to healhcare in South Asia, particularly due to the wide gender gap, presents a huge challenge, and it requires greater focus to ensure improvement in human resources. Though the life expectancy has increased to 66 years in Pakistan and 63 years in India, it is still very low relative to the rest of the world. The infant rate remains stubbornly high, particular in Pakistan, though it has come down down from 76 per 1000 live births in 2003 to 65 in 2009. With 320 mothers dying per 100,000 live births in Pakistan and 450 in India, the maternal mortality rate in South Asia is very high, according to UNICEF.

International Terrorism:

The threat of global terrorism is likely to gain strength and spread with new bases in new geographies. A new and more creative and comprehensive strategy will be necessary to counter this growing threat in the realm of ideas and policies. Any new strategy must take into account the following facts to be effective:

1. Al Qaeda was an organization with central leadership, command and control located in Afghanistan prior to 911. But that is no longer true. According to former State Department official Mathew Hoh who served in Afghanistan, al Qaeda is an elastic, amorphous entity, one based not on geography but ideology. “Al Qaeda is a collection of ideas, of independent, autonomous cells,” Hoh says. “They don’t need a lot of funding. They need an apartment with an Internet connection.”

2. Even the 911 hijackers were not all recruited and trained in any one country. They came from different nations and were educated and trained mostly in the United States and Western Europe. What they shared in common was an ideology rather than a geography.

3. Hundreds of al Qaeda members, including many top leaders, have been captured or killed by Pakistani and US military in the region since 911. And yet, the violence is worse than ever before.

4. There have been multiple reports of al Qaeda popping up in several countries around the world such as Yemen and Somalia, confirming Mathew Hoh's arguments that al Qaeda is not confined to a particular geography in central or south Asia.


Security:

With increasing carnage in several countries, including Pakistan, and growing fears of terrorism, there is an urgent need to develop and use new tools, technologies and methodologies to anticipate and prevent acts of terror resulting in mass casualties.

Counter-insurgency:

There are many insurgencies growing around the world, including South Asia, in response to real or perceived injustices. In addition to the Afghan Taliban insurgency against foreign forces, other examples include Taliban and Baloch insurgencies in Pakistan, and Maoists and Kashmir insurgencies in India.

In addition to the political dialog to understand and address genuine grievances of the insurgents, there is a great need to develop techniques and training for counterinsurgency.

Green Energy:

Clearly, conservation alone will not suffice when it comes to the world's growing energy needs. There will continue to be significant research and development into exploiting energy from water, wind and sun, as well as innovation in safer and greener nuclear technology such as thorium nuclear reactors.

Extreme Affordability:

The incredible success of relatively inexpensive mobile telephones in poor nations, such as Bangladesh, India and Pakistan, has created the awareness among the big corporations and the entrepreneurs that the poor can be a very lucrative market.

Understanding the need to design for extreme affordability with scarce resources is giving birth to a new generation of entrepreneurs. These are entrepreneurs with a social conscience who are motivated by the desire to do good and do well at the same time. They are finding new ways to empower the poor by satisfying their basic needs, such as water, electricity and telephones.

Conclusion:

Regardless of any forecasts of the future, it is extremely important for all nations of the world, particularly the United States, China, the United Kingdom, Israel, Iran, India, North Korea and Pakistan to learn from the mistakes of the last decade to try and make the new decade a better stretch of ten years for the entire humanity. This will require sincere efforts and creative energies of the people from the aforementioned countries and the help of the rest of the world.

Related Links:

Water Crisis

Pakistan's Farmland Controversy

United Nations Literacy Decade

UNICF Country Data

Facts and Myths of Obama's Afghan Surge

Can Energy from Thorium Save Planet Earth?

Social Entrepreneurs Target India and Pakistan

Housing Construction and Economic Growth

Climate Change Worsens Poverty in India

Pakistan's Decade of 1999-2009

Godfather's Vito Corleone: Metaphor for Uncle Sam Today?

Marching Toward Hell by Michael Scheuer

Pakistan's Choice: Globalization or Talibanization

Soviet Defeat in Afghanistan

Karachi Stock Exchange Presentation

The 21st Century Challenges of Resurgent India

The pre-British, early 19th century Moghul India, described as caste-ridden, feudalistic and unmodern, was economically ahead of the rest of the world,including Britain and the US, according to S. Gururmurthy, a popular Indian columnist. The Indian economy contributed 19 per cent of the world GDP in 1830, and 18 per cent of global trade, when the share of Britain was 8 per cent in production and 9 per cent in trade, and that of US, 2 per cent in production and 1 per cent in trade. India had hundreds of thousands of village schools and had a functional literacy rate of over 30 per cent. In contrast, when the British left, India’s share of world production and trade declined to less than 1 per cent and its literacy was down to 17 per cent. And yet, in 1947, India had large Sterling reserves, no foreign debt, and Indians still had an effective presence in such trade centers as Singapore, Hong Kong, Penang, Rangoon and Colombo.

For decades after independence, however, the Indian economy remained moribund. While Nehru's Congress party government made significant investments in higher education under Education Minister Maulana Azad by establishing institutions of higher learning such as IITs (Indian Institutes of Technology), the pervasive License Raj hampered the entrepreneurial spirit of India. Fortunately, that began to change with the reforms initiated in 1991 by then Indian prime minister P. V. Narasimha Rao and his finance minister Manmohan Singh (now prime minister) in response to a balance-of-payments crisis. These reforms limited the scope of the License Raj (investment, industrial and import licensing) and ended many public monopolies, allowing automatic approval of foreign direct investment in many sectors. Subsequent governments of both major parties sustained and extended the reform process and accelerated India's economic growth.

Early investments by Nehru administration are now beginning to pay dividends. India has a large pool of English speaking college graduates. The nation is second only to the United States in production of doctors, engineers, and PhDs. Many of the world's top CEOs and business leaders are alumni of India's prestigious institutes of technology and management. With the large presence of IIT graduates in places such as Silicon Valley, India has become a highly respected brand name as a source of top talent around the world. What began as the massive but temporary Y2K work for India around the turn of the century, the country has now become a preferred destination for high-tech and business process outsourcing from the United States and Europe.

The economic reforms in India have unleashed the talent and the energies of its people at home and abroad to help build its economy and restore its place in the world as a major force. Many entrepreneurs of Indian origin (NRIs) are now setting up shops in India to do heavy-duty research and development as well as some manufacturing. With them, they are bringing US foreign direct investments ($13b in 2007 and growing) from large investors and Fortune 500 corporations to their home country, which helps create jobs and sustain the virtuous cycle of intellectual and economic development. Last year, the Indian GDP grew 9% and it is expected to grow another 7% this year, in spite of the current global economic crisis.

A recent Indian government advertisement in Fortune magazine explains the reason why India's economy has remained relatively unscathed by the global economic crisis. It says: India has taken a generally conservative approach to globalization, moving slowly to open its markets to the rest of the world. Moreover, the domestic Indian market has remained strong. The ad quotes Ron somers, president of US-India Business Council, as saying, "India's internal market is so massive that it can sustain shocks better than many countries." The fact is that India's economy does not depend much on exports to the rest of the world. It is, therefore, relatively less connected to the problems in the developed world. In fact, it stands to benefit from a dramatic reduction in commodity prices, such as oil, due to the world-wide economic slowdown.

While the Indian advertisement and government leaders present a very rosy picture of India's prospects, it is important for Indians and others to understand that there are significant risks in India. For example, the extreme Hindu Nationalists are continuing to stir up trouble in many parts of India. According to All India Christian Council, the 2008 violence has affected 14 districts out of of 30 and 300 Villages in the Indian state of Orissa, 4,400 houses burnt, 50,000 homeless, 59 killed including at least 2 pastors, 10 priests/pastors/nuns injured, 18,000 men, women, children injured, 2 women gang-raped including a nun, 151 churches destroyed and 13 schools and colleges damaged. The violence targeted Christians in 310 villages, with 4,104 homes torched. More than 18,000 were injured and 50,000 displaced and homes continued to burn in many villages. Another report said that around 11,000 people are still living in refugee camps.

People like Shiv Sena chief Bal Thackeray, BJP leader L.K. Advani and Gujarat Chief Minister Narender Modi represent the ugly underbelly of Indian democracy and a threat to India's secular constitution. Modi is currently in power in Gujarat, in spite of overwhelming evidence of his participation in 2002 anti-Muslim riots resulting in the massacre of thousands of Muslims. Mr. Advani has been held responsible for the destruction of Babri mosque and subsequent anti-Muslim riots. Mr. Thackeray is considered responsible for major anti-Muslim riots in Mumbai and continues to terrorize any one who disagrees with him.

The BBC reported yesterday on the "Hindu Terrorist" plot involving Indian military officers, a female priest and a little-known Hindu outfit called Abhinav Bharat (Young India).

The report said: It was in the aftermath of the 29 September bomb blast in the predominantly Muslim town of Malegaon in the western state of Maharashtra that the term "Hindu terrorism" or "saffron terrorism" came to be used widely. That was because the state police's Anti-Terrorism Squad (ATS) arrested 10 Hindus following the blasts and has said that it wants to arrest several more.

One of those detained was a female priest, Sadhwi Pragya Singh Thakur, aged 38, who has been accused by the ATS of being involved in the Malegaon blast. Her detention shocked members of the faith. So too did the arrest of a serving Indian army officer, Lt-Col Prasad Srikant Purohit, who the ATS says is the prime accused in the case.

According to an Indian writer Yoginder Sikand, some in India's Muslim minority have been radicalized by the actions of the Hindutva groups and their allies in the state and local governments. America's 'global war on terror' has provided a convenient cover to these Hindu groups and to fiercely anti-Muslim elements within the Indian state machinery to launch a concerted campaign of terror against Muslims. Large numbers of Muslims in various parts of India continue to languish in jails on trumped-up terror charges, suffering brutal torture as well as routine insults to their religion by police officials.

A rudimentary study of world history suggests that if the Indian political system can not find a way to marginalize and isolate Thackeray, Advani, Modi and other fanatics like them, India will continue to face threats to its secular constitution, its political stability, and its economic growth.

Prime Minister Manmohan Singh himself has called the Maoist insurgency emanating from the state of Chhattisgarh the biggest internal security threat to India since independence. The Maoists, however, are confined to rural areas; their bold tactics haven't rattled Indian middle-class confidence in recent years as much as the bomb attacks in major cities have. These attacks are routinely blamed on Muslim militants. How long will Maoists remain confined to the rural areas will depend on the response of the Indian government to the insurgents who exploit huge and growing economic disparities in Indian society.

In 2006 a commission appointed by the government revealed that Muslims in India are worse educated and less likely to find employment than low-caste Hindus. Muslim isolation and despair is compounded by what B Raman, a hawkish security analyst, was moved after the most recent attacks to describe as the "inherent unfairness of the Indian criminal justice system".

According to Pankaj Mishra, the author of Temptations of the West: How to Be Modern in India, Pakistan and Beyond, the names of the politicians, businessmen, officials and policemen who colluded in the anti-Muslim pogrom in Gujarat in 2002 are widely known. Some of them were caught on video, in a sting carried out last year by the weekly magazine Tehelka, proudly recalling how they murdered and raped Muslims. But, as Amnesty International pointed out in a recent report, justice continues to evade most victims and survivors of the violence. Tens of thousands still languish in refugee camps, too afraid to return to their homes.

Based on a quick review of India's current status and great potential, including its strengths and weaknesses, I strongly believe India is clearly on the road to greatness it deserves with its rich heritage as one of the oldest civilizations on earth and the world's largest modern democracy. India's challenge will continue to be in how well it negotiates the obstacles and potholes created by internal strife from growing religious and ethnic fanaticism, ongoing regional insurgencies, and increasing economic disparity.

Scaling K2, the Ultimate Challenge

Not only is it dangerous, climbing Mount Everest is not cheap, either in terms of lives or dollars. And yet, hundreds are drawn each year to climb it. Commercial expeditions can cost climbers $60,000 to $75,000 each. Nepalese government charges fees ranging from $25000 for one member expedition to $70,000 for seven members. The total cost for climbing is steep, according to CNN. An expedition to the world's second highest peak, K2 in Pakistan, runs around $50,000 per climber. A trip to Everest has the steepest price at $65,000. Individual climbers can easily spend $5,000 on equipment. The total Mt. Everest annual revenue runs into tens of millions of dollars and provides employment to several thousand people. 3,681 people have made the summit so far, but thousands more have tried. About 170 climbers have died in their attempts to reach the summit.


While Mount Everest is considered the tallest peak at 8,848 meters (29,029 feet), it is K2, believed to be the second tallest at 8,611 meters (28,251 ft), that is documented as the most dangerous. In fact, there have been rumors circulating in the mountaineering world that new measurements show that K2 is actually taller than Everest. Rumors that it might actually be much, much higher - 12 feet taller than Everest - began in 1987 after a British expedition measured K2 and found it to be 29,041 feet. If confirmed, this new measurement, along with the greater challenge of K2, could hurt significant tourist revenue stream of Nepal and bring it to Pakistan.

In contrast to Mt. Everest summit's total of 3,681 successful climbs, only 280 climbers have reached the K2 summit. "It's enormous, very high, incredibly steep and much further north than Everest which means it attracts notoriously bad weather," says Britain's most celebrated mountaineer Sir Chris Bonnington, who lost his colleague Nick Escourt in an avalanche on K2's western side during an expedition in 1978. In 1986 13 climbers were killed in a week when a vicious storm stranded numerous expeditions. It is often said that if you were to summit K2 with a climbing partner, it is best to say your goodbyes well ahead the descent, because the statistics claim that one of the two will not come back alive. 46% of the attempts end in death, most during descent, according to a K2 climbers website. The fatality rate for those who reach the summit at 27% is about three times higher than that for Mount Everest, according to BBC.

The latest news of more fatalities seems to confirm K2's status as the most challenging, if not the tallest. At least eleven climbers including three South Koreans, two Nepalis, two Pakistanis, and French, Serbian, Norwegian and Irish climbers had died on the mountain, according to Pakistani authorities. The climbers include Koreans, Pakistanis, Nepalis, a Dutchman and an Italian, reports say, but exact details remain unclear. As about 25 climbers descended from the peak of K2 in the darkness on Friday, an avalanche swept some climbers away and left others stranded. An Italian member of the group has been reached by Pakistani rescuers and taken to an advance base camp on the mountain. The latest reports indicate Pakistani military helicopters have rescued two Dutch climbers stranded on K2. The survivors are being treated for frostbite at Pakistani military hospitals, according to media reports.

While there have been many inspiring stories of success and survival of climbers after storms and avalanches on K2, the story of Greg Mortenson stands out. In 1993, Mortenson, an American from the state of Montana, went to climb K2 in northern Pakistan. After more than 70 days on the mountain, Mortenson and three other climbers completed a life-saving rescue of a fifth climber that took more than 75 hours. After the rescue, he began his descent of the mountain and became weak and exhausted. Two local Balti porters took Mortenson to the nearest city, but he took a wrong turn along the way and ended up in Korphe, a small village, where he recovered.

To pay the remote community back for their compassion, Mortenson said he would build a school for the village. After a frustrating time trying to raise money, Mortenson convinced Jean Hoerni, a Silicon Valley pioneer, to found the Central Asia Institute. A non-profit organization, CAI's mission is to promote education and literacy, especially for girls, in remote mountain regions of Pakistan and Afghanistan. Hoerni named Mortenson as CAI's first Executive Director. Reviewing Greg Mortenson's book "Three Cups of Tea: One Man's Mission to Promote Peace . . . One School at a Time", New York Times columnist Nicholas Kristoff argues "a lone Montanan (Mortenson) staying at the cheapest guest houses has done more to advance U.S. interests in the region than the entire military and foreign policy apparatus of the Bush administration". Kristoff quotes Greg Mortenson, an Army veteran, as saying “Schools are a much more effective bang for the buck than missiles or chasing some Taliban around the country".

While some international and Pakistani climbers and tourists may be dissuaded by the extreme dangers of K2 climbing (or rather descending) or the fear of the Taliban, many more would be drawn to it for the very same reason. As the stories of the challenging mountain reach the worldwide audience, I expect much larger numbers to flock to it for the risks and thrills it offers. With relatively modest investments for average tourists and serious climbers facilities such as access roads, hotels, restaurants, guided tours, a climbing history museum, a climbing skills school, mountaineering equipment and clothing stores, Pakistan can develop a strong revenue stream to create jobs, build schools and promote opportunities for the friendly natives in its picturesque northern areas.

Here's an excerpt from a recent Time Magazine article on Pakistan's tourism potential:

The truth is Pakistan could be — should be — an incredible tourist destination. It offers wonderful Mughal ruins, evocative British colonial architecture, world-class hiking and climbing in the Karakoram Mountains, gorgeous rolling green meadows, captivating culture, great food (especially the fruits and kebabs), and some of the best carpet shops in South Asia. Unfortunately, it is also regularly described as the world's most dangerous country — which, while more intriguing than slogans like "Malaysia, Truly Asia" or "I Feel Slovenia," is not exactly an inducement for people to visit.

Here's a video clip of a K2 Canadian Expedition in 2006: