Social crisis looms in Pakistan as COVID-19 pandemic surges

The government of Pakistan and the various provincial administrations are in complete disarray in the face of the novel coronavirus pandemic. The country's principal health authority, the Ministry of National Health Services, has told Pakistan's Supreme Court it expects the outbreak in the country will increase rapidly this month to hit 50,000 cases by April 25.

Confirmed cases of COVID-19 have already risen above 4,100, with more than 60 deaths. This official figure is relatively low compared to neighbouring Iran and Western countries. A more realistic picture, however, is that a lack of testing is masking a far wider spread of the coronavirus in the poverty-stricken country with a population of over 200 million and a barely functioning healthcare system.

Fewer than 28,000 tests were performed across the country as of March 31, data reported by Dawn showed. Sindh had performed just 6,578 tests, although Karachi, the largest city in the province and in all Pakistan, is home to upwards of 20 million people. While the government claims it is urgently working to increase testing capacity, this panicked response only highlights its negligence and failure to contain and prevent the spread of the disease, despite repeated warnings from the World Health Organization.

In its report to the Supreme Court, the Ministry of National Health Services estimated that 2,392 patients will need intensive care and 7,024 will be in a serious condition by April 25.

According to media reports, in all of Pakistan there are just 2,200 ventilators, an essential medical instrument in caring for those seriously ill with COVID-19. The government has ordered 3,000 more. However, the shortages in the country go beyond ventilators and protective gear. They include a severe lack of facilities, equipment and personnel.

The hostility of the Khan government to any criticism of its criminally negligent policies was shown Monday, when police in Quetta beat and arrested dozens of doctors and health care workers. The medical staff were protesting a lack of personal protective equipment (PPE) at their workplaces.

After taking steps to leverage hotels and other buildings for health care use, the government claimed that there are 119,000 hospital beds in isolation wards and 162,000 beds in quarantine facilities. Pakistan’s strategic ally China is reportedly sending critical medical supplies and personnel.

However, the government has manifestly failed to intervene in any significant way to minimize the impact of the pandemic. After the Health Ministry’s report to the court, Prime Minister Imran Khan’s special assistant on health, Dr Zafar Mirza, downplayed concerns over the spread of the virus, saying, “At this stage, it is uncertain whether these figures based on different scenarios and assumptions are true or not.”

Whether intentionally or not, Mirza is merely blurting out the government’s policy to weather the pandemic while deviating as little as possible from the pro-investor economic “reform” program dictated by the International Monetary Fund (IMF).

Khan cynically sought to use the endemic poverty and precarious economic position of most Pakistanis to justify his government’s refusal to institute strict social distancing and an economic shutdown. He claimed that people “will die from hunger” if they cannot work and made a series of demagogic statements on television. However, his top concern was the economic impact lockdowns would have on business and the wealth and investments of the capitalist elite.

When the provincial authorities went ahead with the lockdown of cities with the assistance of the military, the Khan government promised 12,000 rupees or about US$71.75 relief for 67 million low-income earners. It is not clear how even this meagre sum will be distributed.

Khan’s Islamic populist Tehrik-e-Insaaf (PTI) government is struggling against already falling popularity. After ditching his cynical election promise of an “Islamic welfare state,” Khan has implemented the austerity demands of the IMF.

Underscoring its weakened position, the government’s appeals to limit mass gatherings have largely been rejected by the Islamic religious establishment. A gathering of up to 250,000 organized by the Islamic group Tablighi Jamaat in Lahore was called off only at the last moment after many participants had already arrived. Reportedly, the first two coronavirus patients in the Gaza Strip had travelled to Lahore for the gathering.

The debt-ridden economy is facing a worsening crisis. The government has requested emergency financing of $1.4 billion from the IMF in addition to the ongoing $6 billion bailout. IMF Managing Director Kristalina Georgieva, confirming that Islamabad has requested assistance, added that Pakistan “reaffirmed their commitment to the reform policies included in the current arrangement.” In other words, Khan has promised to continue socially incendiary pro-investor economic reforms and austerity measures no matter what.

According to the Pakistan-based The News, which cited “top sources,” the yet to be released third tranche of $450 million of the current bailout program “might be delayed for some time.” With less than $12 billion in reserves, any delay in the approval of the tranche will affect Pakistan’s ability to maintain debt repayment and pay for imports. The News reported that the IMF has agreed to consider the emergency funding, but both the IMF and the government have remained “tight lipped” about the discussions. The IMF will likely impose additional strict conditions before providing any further financing to Pakistan’s ailing economy.

The political crisis surrounding the Khan government is also deepening. The Washington-based Brookings Institution, commenting on Khan’s handling of the coronavirus in an analysis published on March 27, noted the “limits of his populism,” and “the precariousness of his position,” and advised him to “tread carefully,” because the army “is all too willing to swoop in to gain the population’s sympathy, reassert its role as the country’s one competent institution, and further consolidate its already considerable control.”

Khan’s populism is floundering on an unbridgeable social divide that is being exacerbated by his government’s loyal enforcement of the IMF’s dictates. The United Nations World Cities Report 2016 named Karachi’s Orangi Town as one of the largest slums in the world and found that the slum population is only increasing. The lockdown of Karachi imposed by the provincial authorities further exposed the social misery in Orangi Town.

Despite the use of force, the population could not “self-isolate” in the limited space available in their slum dwellings, forcing many to stay outside. This was especially true of children, who continued to roam the streets and play. Many families of these miserable dwellings sleep in shifts, a reality for South Asian slums in general. Sanitary facilities are also virtually non-existent in these slums, which are estimated to house more than half of the population in Karachi and Lahore.

Another group living in squalid conditions is the Afghan refugee population of 2.8 million. They often occupy mud or tarpaulin huts in designated camps or slums across the country, without any proper supply of drinking water or other sanitary needs.

According to Pakistani economist Hafiz A. Pasha, the poverty ratio in the country was 31.3 percent in July 2018 and is projected to hit 40 percent by July 2020. These grim figures, released prior to the spread of the coronavirus pandemic to Pakistan, were due to low economic growth, double-digit inflation, and the expected impact of IMF-dictated austerity.

The current crisis will sharply increase poverty. Behind the thin veneer of Khan’s “Corona Tigers Relief Force” and the like, close to half of the country’s population is facing a social and economic catastrophe.

The Khan government’s criminally negligent response to the outbreak was exemplified by the situation in the Taftan quarantine camp near the border with Iran. Those returning from Iran after the COVID-19 outbreak in that country were interned there.

The New York Times reported in March that part of the camp was burned down by the internees to protest the squalid conditions. “It was not an attack on the camp, but an attempt to rescue ourselves from the animal-like treatment we were receiving,” one protester told the Times. “We appealed to the government to treat us like humans, but it fell on deaf ears.”

Al Jazeera revealed that those held there were neither adequately tested for coronavirus nor treated for existing conditions. According to its March 25 report, 51 percent of all confirmed cases at the time in Pakistan could be traced back to Taftan. When the camp's incompetent administration was brought to the attention of the Islamabad High Court, it rejected the petition, declaring, “This is not the time to suspect the intentions of the state and get involved in differences.”