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Friday, 12 March 2021

2020 in Review: Pakistani Students and the Pandemic


 By Asiya Jawed and Haleema Hasan 

Students in Karachi stage a protest against online classes 
Source: Scroll.in 


In April 2020, a month after the first coronavirus cases were detected, 300,000 schools closed in Pakistan and 46 million Pakistani students were forced to stay at home. Almost six months later, schools had only partially opened whilst students and teachers were still acquainting themselves with online learning methods. 

Source: Pakistan Social and Living Standards Measurement 2018-19

In this blog we review what 2020 looked like for Pakistani students, exploring the intricacies of class, gender and ethnicity amidst a raging pandemic. The year also saw consistent protests, struggles for student unions and politicization of students’ demands.  As with its impacts on other segments of society, the pandemic’s impact on students has been defined by their varying vulnerabilities and privileges, and the ways that these intersect.


Source: Pakistan Social and Living Standards Measu
Our monthly observatory panels, event tracking catalogue and key informant interviews for Navigating Civic Spaces in the Time of Covid-19 highlight Pakistani students’ problems amidst a global health crisis. Academics and students informed us that marginalized students’ problems were greater due to their intersecting vulnerabilities. Advocating for their rights became an arduous task in the current climate of shrinking civic space.

Class


Source: UNICEF, World Bank

The virus impacted students from low socio-economic backgrounds the most. The poorest households have the least access to education as the proportion of out-of-school children is highest in the lowest income quintile and rich households are more likely to use technology. Most Pakistani students can’t afford internet services or live in remote localities without reception. Despite these circumstances, educational institutions and the state chose to conduct online examinations and charge full fees even when students weren’t occupying campus spaces. 

Online learning became a logistical hassle for many living in remote and underdeveloped areas. An academic at University of Sindh, Jamshoro was shocked when she saw students in mud houses or sitting under trees to attend their online classes. At times she saw her female students sitting on the stairs in their houses because they didn’t have a private space without any noise. Substantial class differences heighten the disparities within the education sector, and female students are at a greater disadvantage.



Gender


After schools shut down, girls shouldered most of the work in the household or faced the risk of being forcefully married. However, this discriminatory period became a catalyst for several female students to voice their concerns. One of the most pertinent problems that female students raised through offline and online protests was on-going sexual harassment in educational settings. 


In November 2020, students of Karakoram International University (KIU) registered harassment complaints against the university’s scholarship officer but were instead booked on different charges and two of them even arrested. Although 300 students protested outside the Vice Chancellor’s (VC) office, they didn’t receive justice. The VC took notice of the complaints and set up a committee to probe the incident but there are many problems with such committees too. Rai Ali, a student leader, shared with us, “Female students have to be in rooms full of men and narrate what happened to them which can be an intimidating experience in itself as some of the men in those rooms would end up harassing the victim again.”


Just ten days before the KIU protest, female students studying in Islamia College Peshawar complained that the faculty and staff of the institution were sending them vulgar text messages, and harassing them under the garb of checking academic work. They held a “Girls Walk Against Harassment”, demanding the university to appoint a local person to address these complaints and the present committee to function in-line with the Harassment at the Workplace Act 2010. Other students utilized online platforms to address several harassment cases in elite institutes such as Lahore Grammar School (LGS) and Lahore University of Management Sciences (LUMS).

However, lack of gender justice in Pakistan transcends class privilege. Using online platforms has been risky for students as defamation laws are used in response to #MeToo. LUMS allegedly has a history of threatening women in such cases, with a student rightfully questioning, “[T]ell me — where do we go if not online? Who is there to listen to us?” While alumna of the school complained that the Office of Student Affairs discourages victims to file official complaints, it is also important to use existing accountability mechanisms in order to strengthen them. School administrations must understand the backlash and trauma that female students face when they come forward to complain, and build gender-sensitive committees with student representatives. 


Ethnicity and Locality

Source: Pakistan Social and Living Standards Measurement 2018-19
In addition to class and gender inequalities, provincial and ethnic vulnerabilities have played a role in how students were affected by COVID-19 and its restrictions. As Chart 3 demonstrates, the urban-rural divide is glaring in terms of access to online learning. Even within rural areas, learning losses differ by province (Table 1) with Balochistan largely faring the poorest.

Source: Constitution of Pakistan

Against the backdrop of staggering inequalities and a pandemic, students eventually resorted to protesting for their rights. In June, several of them were arrested for protesting in Quetta against HEC’s decision to conduct online classes despite structural failures such as power cuts and extreme dearth of internet facilities. The situation is worse for minorities like the Hazaras and those living in conflict-ridden areas of Khyber Pakhtunkhwa (KP) where political violence and deliberate state security measures have created conditions similar to lockdowns and quarantines long before the pandemic. Critics and protesters argue that the continuing suspension of the internet especially amidst shifts to online education are a violation of the constitutional Right to Education.

Source: The Diplomat, The News, Slate

Floods during the pandemic severely impacted rural Sindh’s already flailing education system with a massive power outage and schools used as shelters. In Punjab, there are glaring differences between the northern and southern districts with the latter performing very poorly in most education indicators. COVID-19 is worsening the situation in these areas. Despite the infection risk, students and teachers are forced to go to urban areas as there are no internet services.

Apart from National Cash Transfer schemes, little has been done specifically for these areas. The authorities responded to protesting students by mostly engaging in violence. Dismayed by the outcome, students filed petitions in high courts across Pakistan, which directed the Balochistan government to form a committee to address students’ issues. The government also requested the KP high court to restore internet connections but no action on either order has been reported yet.

There were some hopeful instances in these circumstances as well; Zong Pakistan secured a contract with Universal Service Fund to provide high speed internet in some areas of rural Balochistan; In KP, UNICEF’s  advocacy led to the development of online resources and better implementation of offline learning for students; rural Sindh has been reportedly more receptive to social distancing than urban areas and a radio is being leveraged there to discuss psychological wellbeing during the pandemic. Finally, the Punjab government has legally banned withdrawing South Punjab’s Annual Development Funds which were recently increased by 35%.

Intersections

These ethnically charged, gendered and class-oriented vulnerabilities do not operate in isolation. They are inextricably linked and exacerbate the impact of an event as severe as a pandemic. Baloch students not only face a dismal educational landscape but also financial constraints in accessing any available opportunities. The seats reserved for them in universities of Punjab were withdrawn and scholarships suspended between 2017 and 2020 amidst rising tuition fees and education transitioning online. After a students’ protest march in October 2020, the Governor of Punjab announced full and partial scholarships annually available to 3, 200 students from Balochistan, KP and Gilgit-Baltistan (GB) at varsities in Punjab. Although hopeful, we are yet to see these plans materialize.

Source: The Express Tribune, The Nation, The News, Twitter

Amongst students from these localities and class backgrounds, women are at a further disadvantage. For instance, in Sindh, less than 10% of tertiary students are women. The government also has a class-based response to harassment cases. The Punjab School Education Minister promised to deal with harassment complaints by LGS students personally and the Minister of Human Rights took notice of the allegations at the two “premier private institutions”. After students and alumna conducted a sustained online campaign, four employees of LGS were terminated while students from public universities were ignored, vilified or arrested.

Politicizing Students’ Vulnerabilities


Students demands and actions were often politicized by both the incumbent government and the opposition for their political expediency. While PPP Chairman Bilawal Bhutto supported MDCAT students, criticizing Pakistan Medical Council’s bureaucratic inefficiencies, PML-N leader Maryam Nawaz attended Baloch students’ protest. Both are part of the Pakistan Democratic Movement (PDM), an alliance of 11 opposition parties formed in September 2020. Our interview with Rai Ali revealed that shrinking civic space has forced students to turn to PDM even though they suspect the alliance will remain anti-establishment only until it assumes power itself. 


Recommendations and Conclusion


Source: BBC

It has been a long, trying year for students. However, trying situations are also opportunities for imagining better systems. Some ways to further affect change in the education sector include supporting the ed-tech industry, crowdsourcing and curating content akin to the Spanish Ministry of Education, further scaling up the use of radio for education, and investing in public-private partnerships similar to the model in Uruguay. Additionally, Mexico’s Telesecundaria is a good example for Pakistan to improve the quality of the Teleschool which was widely available but incomprehensible. 


Source: Budget 2020-2021

However, any response strategy is incomplete without addressing the demand for student unions. In 1984, student unions were banned because of their progressive work for students and the wider civil body. The pandemic has intensified the students’ perpetual need for a collective space. Rai highlights, “The teachers in our university have a union, the guards have a union but the only union that is missing is the student union… there are 95% students in a university but those 95% aren't given a chance to represent themselves.”

Source aku.edu


For students, 2020 has been rife with uncertainty, learning losses and protests. As their problems spiralled, Covid-19 became an impetus for them to push for their rights. However, their demands haven’t been fully addressed despite consistent activism. It is imperative that the state revives student unions, invests in long-term solutions and addresses the inequities marring the education sector now more than ever. 


Tuesday, 22 December 2020

Towards Universal Social Protection – the Story Thus Far

 By Haris Gazdar

Women and girls in Qamber, Shadakot, north-west Sindh. Picture credit: Wikimedia Commons.


This blog is based on a response by the author at the annual Sustainable Development Conference of the Sustainable Development Policy Institute on 14th December 2020.

Question

What major policy changes in existing national policies and programs you would like to see at federal and provincial government level to move towards universal social protection in Pakistan? 
  • Who do you think will be the main stakeholders? And do you find any torchbearer in this regard who can lead the process both at federal and provincial governments?
  • How important will be the role of the private sector in this regard and what can be done particularly to improve the public private partnership to move towards the universal social protection? Are there any best practices that you can share with us?
  • What do you think can be the strong foundations to build a business case for the universal social protection in Pakistan (particularly when there is always an argument of low fiscal space whenever there is a discussion on having a universal social protection system in the country)?
Answer

We have the bare bones of a universal social protection system which was established over a decade ago in the form of the Benazir Income Support Programme.  There are several important accomplishments to date, all of them achieved early on. And plenty of challenges.  The main accomplishments were:
Targeting from a well-defined universe
Delinking social protection from employment
Increase in scale with respect to fiscal outlay
Women as primary beneficiaries
Key partnerships between databases (particularly NADRA) and payment agencies (banks/Telcos)

In the initial period there was talk of the programme focusing on food insecurity, and the targeting mechanism did, indeed, help to identify the relatively food-insecure families.  But this thematic focus, or for that matter any other specific thematic focus, never really became a benchmark of progress.  The programme was far too engaged, perhaps for good reason, with achieving its own operational goals.

The move to universal social protection will require several important changes which must leverage the successes achieved over a decade ago:
Articulation of key social protection objectives – in my opinion food security should receive priority, but also economic vulnerability
Re-establish a clearer linkage with livelihoods and/or absence of livelihood opportunities, but also a focus on a range of vulnerabilities such as different ability, old age
Dynamic social registry with a rights-based approach and self-targeting (with various mechanisms for verification and audit of course).

Federal and provincial governments, and indeed local governments, have key roles and mandates in this regard.  For all the media presence and slick imaging, the repackaging of BISP (into Ehsaas etc) conceals a cold hard fact: the core of social protection system, which is the unconditional cash transfer (UCT) to women in poor households has not been maintained and updated.  The basic design requirement of renewing the targeting (or recertification) within 48 months of establishment has not be fulfilled – or around 2015. Five years on from that date, we have no clear indication of when the recertification (or the so-called National Socio-Economic Registry or NSER) will be carried out.

Under our current system the federal government enjoys taxation powers across a range of relatively higher-yielding heads of tax, and their performance in tax collection has been poor. Provincial governments have performed better since the 7th National Finance Commission. But until there is a major change in the tax mandates, federal government will continue to have the fiscal resources for social protection.

There is also a strong rationale for federal government lead in national redistributive transfers, and a whole range of untargeted subsidies are already routed through the federal tier.  Over the longer-term, the future of social protection is closely tied up with tax performance and reform. More on that in a bit.

Moreover, federal government also controls major official databases such as NADRA which have become indispensable – for good reason or bad – for the administration of social protection interventions.

But provincial governments and their local government partners (let’s be clear that constitutionally local government is a provincial subject), actually have presence on the ground, and have mandates in a range of areas where the next generation of social protection programming – food security, labour, agricultural workers, health, disaster management (partially), protection of the differently abled, education etc – will arise.  ‘Next generation’ in the sense of going beyond an unconditional cash transfer (UCT). 

Provinces need to build strong and dynamic social registries and federal government systems need to extend active cooperation and support in this regard. This is because under our constitutional system a dynamic social registry, which has close operational links with line departments such as labour, differently abled persons’ empowerment, health, population welfare, local government, agriculture, food etc. is only possible at the provincial tier.

The type of political reforms that will lead to these changes are similar in scale, or even the unfinished businesses of, reforms like the 18th amendment involving:
  • Recognition of right to social protection, including legal mandates and correspondingly protected fiscal allocations
  • Federal-provincial fiscal reforms including taxes and subsidies

                                                                             




Friday, 11 December 2020

Why COVID-19 is Fatal for Children

 By Syeda Haleema Hasan and Asiya Jawed

Picture credit: Marcos Cola, Pixabay


Trigger warning: abuse, assault, r*pe, kidnapping.

As we laud Pakistan’s fight against the pandemic, we shouldn’t overlook how the country is failing its children. Even though children are less susceptible to get infected with COVID-19, the virus is insidiously impacting them in myriad ways. Some of the effects of the pandemic have made their way into public discourse, such as the educational costs and health risks. However, COVID-19 has had a deeper impact on children. There is evidence that measures to curb the virus can have a colossal damage on children’s lives as confinement makes them vulnerable to exploitation and abuse. 

This blog explores child protection risks and their exacerbation as a consequence of COVID-19 confinement in Pakistan. We also unpack how children’s inherent vulnerability intersects with several other vulnerabilities such as those arising from their class and religion. Amongst many incidences of abuse, we focus on three tragic cases that received significant coverage: the abuse, forced conversion and child marriage of Arzoo Raja, Alisha’s rape by a trafficking ring, and Zohra’s assault and murder by her employers. We will also examine the role of state and society in these violations and propose possible remedial strategies.


Children’s vulnerability is marked by their developmental stage; they possess greater dependence on others and require a stable environment to regulate their emotions and behavior. Extended confinement at home is harmful for them because it disrupts their daily routine and limits their mobility. COVID-19 related confinement adds further health risks and fatalities, uncertainty, loss of livelihoods, and disruption in education. At the Collective, we are currently studying these and other impacts of lockdown on children’s well-being through a longitudinal comparative study called Family and Community in the Time of COVID-19 spearheaded by University College London

Confinement linked to the pandemic heightens children’s inability to escape abuse and/or access help. Pakistan witnessed a horrific rise in reported cases of child abuse and rape this year. The Sustainable Social Development Organization estimated during the lockdown period (April-June) there was a 400% spike in reported cases of child abuse, attributed to the proximity of abusers as most perpetrators are close relatives and trusted persons. As children spend significant time online, and in concentrated spaces with older individuals, grooming is also likely to increase. Some of these factors are evident in Arzoo's case, in which her parents entrusted their neighbors with the care of their children when they left for their day jobs. The neighbor who exploited this access, Azhar Ali, had cultivated Arzoo’s trust over time, manipulating her from a young age with gifts while deceiving her family.

COVID-19 confinement hasn't created abusive individuals out of non-abusive individuals, it has rather provided an opportunity for abusive people to justify their violence, as Zohra’s case reveals. The neighbors living in Bahria Town, Rawalpindi heard Zohra’s screams but didn’t notify the police or the media because they wanted to uphold the social image of their posh neighborhood. This injustice happened amidst rising COVID-19 cases in Pakistan, leaving Zohra trapped with her abusive employers as she was forced to work to avoid greater destitution.

Confinement related to COVID-19 is not linear and its effects are not equally distributed. For instance, poverty is a debilitating problem aggravating COVID-19 related child safety violations. Loss of livelihoods, job insecurity as well as delayed and reduced wages heighten frustration and stress, and contribute to an increase in abuse. Falls in expenditure and financial hardship have also been considered as strong indicators of abuse and neglect. Unemployment and child maltreatment are closely correlated as neglect rises by 20% with just a single percentage increase in unemployment.

In Alisha’s case, the promise of work and income compelled a woman to take her daughter and travel from Karachi to Kashmore despite the dangers that women are constantly navigating in Pakistan. Zohra’s parents sent their daughter to study in Rawalpindi but she was pressured to work for an employer who paid her uncle only Rs.3000 per month. Her employers also promised to give her an education but tortured and murdered her instead. Arzoo’s mother, on the other hand, worked in a school while her father was a driver. Both of them were unable to leave their jobs to tend to the children or arrange appropriate care while they were away. Poverty and hunger amplify the risks children face and without adequate safety nets, such violations will persist.

Religion is another factor exacerbating children’s existing vulnerabilities. The exploitation of religious minorities in Pakistan is pervasive and systematic; its roots date back to the country’s origins. Prejudices intensify during times of crisis when such populations are most disadvantaged. We witness how this widespread oppression manifests in Arzoo Raja’s case, where her minority Christian identity deepened her vulnerability and made her more susceptible to abuse.

Child protection risks during the COVID-19 crisis have also exposed the institutional and structural dimensions of the problem. Our media tracking for Navigating Civic Space in the Time of COVID-19 reveals state’s incompetency amidst burgeoning child abuse cases. For instance, the Sindh High Court approved Arzoo’s conversion to Islam and dismissed the case against the perpetrator initially, only ordering the child’s rescue after public and media pressure and Pakistan People’s Party Chairman Bilawal Bhutto’s intervention. Failure of due process such as medical examination and perusal of identity records are inexcusable shortfalls. Arzoo’s abductor and his family are also alleged employees in the Sindh police and water board, which only adds to their impunity.

Not only does the state fail to protect children, in some ways it directly abets injustices against them. Zohra was one of the 8.5 million child workers in Pakistan driven by her family’s poverty to work at an opulent household for a meagre salary. The government has failed to implement the Punjab Domestic Workers Act of 2019 effectively, which prohibits employing a child under the age of 15 years as a domestic worker in a household in any capacity. Human rights minister, Shireen Mazari called Zohra’s torture and murder, a ‘test’ case. Do we need such heinous crimes to transpire before we improve our accountability mechanisms? 

Even when authorities do intervene, their strategies are often ineffective or unsustainable. The ASI responsible for investigating the Kashmore case endangered his own daughter’s life to rescue Alisha, but was glorified by Prime Minister Imran Khan who awarded him two million rupees for this perilous act. It is alarming that our authorities have to enlist minors for rescue operations instead of training and mobilizing strong investigative teams and addressing structural deficits. 

There are possibilities of remedial measures to address these dire circumstances and the state has a key role. Some short-term response strategies could be the disbursement of child grants through existing mechanisms like the Ehsaas scheme that can help alleviate caregivers' burden and reduce risk of violence. Another immediate requirement is more robust information which can drive more comprehensive action; data should be disaggregated for gender, minority status, age, disability, geographic region and more.

Mobilizing existing resources, such as helplines, social workers, and shelter homes like the recent Panahgah project, specifically for children is crucial. State capacity can increase if it utilizes police personnel and volunteers through provision of virtual trainings to respond to child abuse cases, as in the case of Mexico. This can be further augmented through collaborations with civil society organizations such as Aahung and Sahil that work on child sexual abuse issues. The government’s child protection units in all provinces need adequate funding and staff to become fully operational. Distributing hygiene kits with awareness messages about gender-based violence, as done in Brazil, can prove to be an effective method during the pandemic. Remedial measures can also occur at the individual level by practicing social distancing and precautionary measures as the UN emphasizes that the “ultimate impact on children hinges on the virus’s longevity itself”.

Abuse, violence, and toxic stress coupled with confinement effects can result in lifelong challenges for children as their neurological development is likely to get impaired if necessary psycho-social support is not provided. The cost of COVID-19 confinement on our children is huge; Alisha is battling for her life, Arzoo still proclaims that she converted and married of her own free will, and we lost Zohra. The fact that a blog focused on children begins with a trigger warning for rape, abuse, assault and kidnapping speaks volumes. The immense cost borne by children should be incorporated in all COVID-19 preventative measures. Our state needs to actively work with frontline workers in social and medical care to counter existing harm and prevent future pitfalls especially in crisis situations. COVID-19 is fatal for children, and we are running out of time.

Thursday, 12 November 2020

Healthcare Workers’ Mobilization in Pakistan

 By Asiya Jawed



"Halima Leghari, President, All Sindh Health Workers and Employees Union with other health workers at the October 2020 protest in Islamabad"


Health workers around the world today are glorified for saving other people’s lives while risking their own during the Covid-19 pandemic. Yet the basic human rights of these vulnerable heroes are being undermined, as Amnesty International warns of another crisis in which thousands of health workers are dying to save others. The shortage of lifesaving protective equipment, coupled with unfair pay and lack of benefits in numerous countries, has forced health workers to mobilize and protest against the conditions in which they have to work during the pandemic.

In Pakistan, too, the rights and lives of health workers have been deeply compromised during the pandemic response. Since different cadres of health service providers already have a history of mobilizing, could their response to current risks provide the catalyst for them to join forces to transform the conditions of work in the health sector? Our research suggests this may be happening amidst the pandemic as they collectively act to bring forward new demands and solidify older ones.

At the Collective for Social Science Research, we have been following changes in civic space since Covid-19 first emerged in the country in March. This is part of the ‘Action for Empowerment and Accountability’ (A4EA) research programme - a multi-country study in collaboration with the Institute of Development Studies (IDS) - focusing on how social and political action impacts empowerment and accountability in fragile, conflict and violence-affected settings. We conduct detailed media tracking, monthly observatory panels, and interviews with civil society actors to discuss changes as they happen.

During March 2020, as healthcare workers in Pakistan began gearing themselves to fight the virus, the Punjab Assembly passed the controversial and contested Medical Teaching Institutions (MTI) Reforms Bill, ironically on the same day as the World Health Organization (WHO) recognized the spread of Covid-19 as a pandemic. The Act was formulated as a result of a deal with the International Monetary Fund (IMF) in May 2019, which stipulated cuts to social spending ultimately privatizing public health facilities. Health workers have been fighting against the draft Act for a year now; they created the Grand Health Alliance (GHA) to pressure the government to repeal the Act in Punjab. The protestors argued that the Act was harmful for both health workers and patients. It gives health workers the status of contractual employees as opposed to those within a civil service structure, thus affecting their job security. It is also ‘anti-patient’ because the privatization of healthcare will make it less accessible to the poor.

Even though GHA initiated its protests in Punjab, they now have chapters in all provinces. Pakistani doctors aren’t well-equipped to deal with Covid-19 patients - many doctors have lost their lives whilst saving Covid-19 patients due to high exposure to the virus. Doctors have protested for the provision of PPEs and against non-payment of salaries by boycotting OPDs and staging hunger strikes in urban centres. Dr. Alia Haider, a practitioner and activist based in Lahore, said when she went to hospitals to distribute PPEs, doctors demanded that the PPEs should be given directly to them instead of the superintendents. “If you are sending a soldier to the borderline, you equip them. You give them guns, bulletproof jackets etc. However, when doctors are going in the frontline to save patients, they aren't given any PPEs. So, this means that the government believes that a doctor's life is not as important as a soldier's.”

Our tracking of civic spaces during the time of Covid-19 has revealed that health workers have been arrested, baton-charged and shamed during protests for not being present in the frontline during the pandemic. For example, in Quetta, police
baton-charged and arrested several young doctors protesting for provision of PPEs and in Lahore, they thrashed  members of GHA protesting at a hunger strike. Dr. Haider claims health workers were demonized for demanding their basic rights, “There was always this notion that doctors and health workers are mostly working for their own means as they are closing down OPDs. But the real situation was totally opposite and we all got to see it. Balochistan's doctors protested, and they were arrested and put in jail for two days.”

Nurses hired during the emergency situation say they are being mistreated through inadequate provision of  PPEs and irregular salaries. During May, on International Nurses’ Day, they staged a sit-in outside the Karachi Press Club to draw attention to the reality that 40 nurses in Sindh were already infected with the virus. Months after the outbreak of Covid-19, nurses protested outside the Chief Minister’s house due to unmet demands but they were baton-charged and ten arrested. Still, they announced that they would not back down until their demands were met, and went ahead to join the LHWs in their October protests.

Moreover, amidst a massive public health crisis, the National Assembly passed a surprise bill mandating all medical students, many of whom began to volunteer after the spread of the virus, to give the National License Examination (NLE). Previously, only foreign graduates were obligated to give the NLE if they wanted to practice medicine in Pakistan. In another move, the Pakistan Medical and Dental Council (PMDC) was replaced with Pakistan Medical Council (PMC) to enforce the NLE. Prime Minister Imran Khan believes that mandating NLE will raise the standards of local medical and dental colleges to an international level, but medical experts deem it to be discriminatory and illogical. Students will only focus on clearing the NLE which will compromise their overall learning and adversely impact the quality of education.

Compounding the problem, PMC cannot regulate the fee charged by medical colleges which means that financial burden on students’ families will increase and several individuals won’t be able to afford the extortionate fee. The Young Doctors’ Association (YDA) staged several protests after this unnecessary bill was passed, and hashtags such as #werejectNLE and #werejectPMC began trending on social media. The Council, encompassing bureaucrats rather than medical experts, recently announced that it will conduct the Medical and Dental College Admission Test (MDCAT) without an academic board or medical authority mandated to design the syllabus and conduct this examination. Infuriated students filed a petition against MDCAT. After vigorous online activism, Sindh High Court delayed the examination for 15 days so the Council could develop a board and authority to meet students’ rightful demands.

Lady Health Workers are essential to Pakistan’s response under Covid-19, as the largest cadre of community-based healthcare providers in the country. LHWs have been mobilizing since 2010 against insecure working conditions, characterized by irregular and inadequate salaries, and part-time status as government employees. The pandemic has only worsened their situation.  

Halima Leghari, President, All Sindh Health Workers and Employees Union says LHWs haven’t been given any facilities or kits during Covid-19 and they are working on the frontline without any protection or security. They didn’t receive sanitizers or masks as protection from the highly contagious virus and purchased protective equipment themselves. She claims that LHWs in Sindh were receiving a health risk allowance since Covid-19 began spreading in Pakistan but that allowance halted in October, due to which health workers in Sindh began boycotting OPDs. Bushra Arain, President of Lady Health Workers’ Association also complained about the lack of requisite equipment and reported that it was difficult for LHWs continue their work as contraceptive supplies began running out and they were unable to fulfill their communities’ needs.

On October 14th, frustrated LHWs and pensioners staged a sit-in in front of the Parliament House demanding changes in the service structure, increase in pensions, life insurance, salary increases and protection in the anti-polio campaign. LHWs protested in dire conditions at D-Chowk in Islamabad for seven days and only ended their sit-in when government promised to meet their demands in the next few months.

With the healthcare system in Pakistan crippled already, it appears that health workers, essential but vulnerable, have no choice but to protest during these conditions of an unprecedented pandemic. Neglected demands coupled with unjust new regulations are forcing critical stakeholders from the health sector to stage collective protests to amplify their voices. Clearly, a pandemic is not the time to privatize the health sector, introduce NLEs or stop health risk allowances. Their demands should be a priority for government in its pandemic response, before the different cadres of health service providers unite in their refusal to work without adequate protections and conditions of employment.