Juxtaposition : The Neighbouring Broadcasts

Here's my overview of the virtual media approach and their respective impacts and comparisons thereof.

Body mists and colognes
Indian adds focus more on how the locals can curb their odour and reach work pain free. One dad constantly spraying himself after baby sitting is one thing people could relate to rather than a teacher powdering herself and luring the school children into sensing her feminist statement.
Though both sides have the same mind set but the chunky humour pouring from the Indian adds is to die for. If Kitkat talcum powder was taken over by our neighbours, I bet I too could have given in; too classy for competition!

Domestic paints
A beautiful model clad in an evening crepe walking past purple matt walls of virtually strange world opposed to real inhabitants of a home working bits and pieces for a meaningful transformation. The idea of how simple enamel can change your life jolts the consumer mood to get in touch with colour that instant.  Indian ads display weather changes, envious neighbours and friendly spaces. Also, their painted homes include real people, real furniture and real paint too!

Online merchandise
The online shopping ads are perhaps the best broadcasts. They range from couples having a cute feud over furniture, secretly browsing  jewellery and real life situations over exchange polices and returns. The virtual home decor not only offers a wide range of articles but also the ease of access screaming out in every advertisement. A delivery man hands out a recite post delivery to the happy customers and the recipient wife elbows her hubby for a quite gesture out of the pocket; that's when the delivery man quotes "please, save it". The whole point of the exchange was that delivery had absolutely no strings attached! It really set me free...

Fairness frenzy
I have seen very inspiring commercials on Indian telly. Let's begin with a simple soap. A dusky young women, out in the fields, dressed in army shorts and tank top humming an empowering melody. That soap was to wash you free of dirt; perhaps what all kinda soaps do. Moreover in this other fairness commercial, a young girl was shown travelling around the world and not just talking selfies and running into her old flames but doing charitable work, planting trees amid scorching heat and delivering to the masses on a common ground. The fairness cream was embodied under the slogan "for a glowing skin and attitude". So Im guessing she's not worried about her "Rishtas" at this point! I do agree with sharing the same values, however the Indian audience often advance to empower their dusky feminists.


Beverage Rage, Crackers and Sweet Indulgence
Apart from crass lingua, the seemingly sovereign adolescents enter into a dream world of endless possibilities like air walking, wind surfing, and of course, the wings... Indian challengers target real girls and boys in real circumstances. A young desi gal carrying a back pack stresses out on a missed train and ends up in a long cue of ticketing. She finds a masala lemonade and drinks her heart out however, it doesn't put her out of her misery, just puts an end to her thirst on a hot day! Simple and solacing. Adding sexism to  fruit juice or milkshake is absolutely demeaning and could prove damaging to our kids opening their lunch boxes. Most chocolate and other savoury broadcasts rotate around beautiful models clad in red carpet attire, at the edge of their apartment space secretly indulging in the dark confection, dawdling the day away. However we came up with a rusty relationship put to fire with a touch of chocolate in one of the recent adds; it was sweet and romantic. Also, I would rather prefer crackers tossed around amid a group of individuals on a beach than a girl liking the crinkle crisp out of them!

Motor Vehicles
The vehicular traffic is a huge attraction in India, especially the mini scooties and bikes. Scooties though not a thing yet in Pakistan; but all advertisements are very edgy and autonomous for the bold and the beautiful flaunting risks, challenges and opportunities for women. The cars on the other hand apparently serve as a medium towards school, a fun gathering on the beach, a routine visit to the doctor's and forever nursing grandma. Despite all motor adds being monotonous, on the Pakistani tube, "mein te honda hi laisan" which has years of wisdom is cultural in itself and I like it.

Protein shakes and Young World
A local brand advocating butter as a healthy part of a growing child and iron deficits are sure to top the list. The neighbours have stepped ahead with a story of ingenuity waiting to unfold where a mum assists her child in sport activities; to empower him further, she swims and races with him. This advertisement limned great zeal and parent involvement in juvenile years.Then are the biscuits - does a pack of lip smacking snacks illuminate your dancing skills? Get two individuals happily married? or Fuel energy into a boring feast? Don't even get me started over cooking oils and molanas in it!

Internet and Services
Indian tele-networking adds are by far the most humorous, showing young generation making use of the Internet to the best of their interests. We all might use the connection the same way, however the ideas and future models that Indian telly delineates is absolutely out of the box. Lads opening up restaurants, girls setting up small scale businesses, the unfortunate masses educating themselves and senior citizens working their way ahead all twisted with a bit of humour. Since Internet is faster than the speed of light and sound these days, it's very important how we shape the virtual world for our future generation. Sadly, our crust maintains it on a prolonged talk time  and did I mention talk time?

Des Sports
Advertisements get a whole lot cheesier during periodic match months with both neighbouring countries airing colourful patriotism throughout. Incorporation of sodas, special services, eatables and even dishwashers highlight seasonal fever which catch much attention and provoke actions. Get-togethers involving all age groups and endorsing athletic kings ignites our dormant culture and values. Formerly, both the countries have come up with slightly racy broadcasts however, by the end of the inferno, there are always winners and losers.


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Biomedical Weaponry - A Medical Faux Pas

Just as a “disasters are an opportunity for development”, the Second World War is known to give birth to “huge advances in medical knowledge and surgical techniques”. This article would provide you with the highlights in history of the friendly use of medicine out of which some good and bad has resulted. If I poisoned your fields with bio-agents as an answer to your attempt to poison mine; it can be dually regarded as good and bad. Biological warfare is a deliberate use of various agents to spread disease amongst plants, animals, humans and everything and anything.

Some of the most common, deadly agents known to have wiped out populations are as follows: Among bacteria are Anthrax, Plague, Tularemia, Brucellosis, Q Fever. Among viruses are Smallpox, Viral Equine Encephalitis and those responsible for Hemorrhagic Fever (Filo/Flavi Viruses); and toxins include Ricin, Botulinum, Mycotoxins and Saxitoxin.

Wars forced companies to develop highly effective medicine and techniques on an industrial scale. Pre-war penicillin discovery by Sir Alexander Fleming increased the chances of survival of appalling casualties and henceforth the treatment. In addition to pioneering the work on skin grafts and blood transfusion, refining in the war years were preventive medicine for malaria, tetanus, gangrene, pneumonia and gonorrhoea.

Poor man’s atom bomb: The Romans attempted the first ever use of biological weapons (BW) by poisoning water supply of the enemies using battered animals. Later, this thought was elaborated by the Mongols in 1346 who used corpses infected with plague instead of animals to stretch a bigger picture. In 1710, the Russians defeated Swede enemies by plague-infected corpses. The British didn’t lag behind who in 1767 aided the Indians with blankets initially used to protect smallpox victims.

 A popular weapon, Anthrax was first used by the Germans in 1916. They also used Glanders, which is an infectious disease cause by Bacterium Burkholderia Mallei to infect equestrians and feed to allied forces. Romanian sheep, Argentinean mules and American horses, all had been used to feed the human agenda.

The Japanese stepped in to poison Soviet water supply with intestinal typhoid at the former Mongolian Border in 1937. Ever since, Japan began its Offensive program in to which at least 10,000 prisoners have given their lives to. Japanese plague-fans dropped rice and wheat mixed with plague carrying fleas over China and Manchuria.

In 1942, the US began their Biological Offense program. Various tests were conducted henceforth in San Francisco and New York. Germans too tasted the use of offense in 1945 followed by Iraq which embarked to develop a biological offensive program which included toxins like botulium toxin, aflatoxin and anthrax.

In 2001, the anthrax attacks in the United States, also known as Amerithrax, occurred over the course of several weeks beginning on Tuesday, September 18, 2001, one week after the September 11 attacks. The Daschle Letter contained 2gm powder in an envelope, containing 100 billion – 1 trillion spores (10 (11) – 10 (12) cfu) were mailed to several media offices and two Democratic U.S Senators, killing 5 people and infecting 17 others.

Several reasons may advocate bioterrorism. A biological agent self-replicates within the victim, has relatively low costs of production, requires a small dose (1gm of toxin could kill over 1 million people), appropriate particle size and stability in aerosol, ease of dissemination, insidious symptoms, prolonged incubation period and difficult detection. Owing to multiple feasibility features, a biological attack could be planned and placed on a moving or stationary position. Also, the ease of modes (frozen/dried) and methods of delivery (bomblets) have also been described.

 BW still depends upon the susceptibility of the aggressors and Mother Nature; temperature and sunlight, environment persistence of some agents like anthrax, relatively longer incubation period, advanced and specialized infrastructure for development among others maybe limiting parameters. Not only are a wide variety of biological agents genetically being modified to withstand antibiotics and other treatment regimens, but also mocking sensitive detection systems. I find it extra-ordinary to have SARS, MERS and other challenging diseases with resistance patterns escalating regions. Some difficult whereas some easy to grow; incapacitating agents like VEE, Bacillus Anthrax, Plaque, Yersinia and various forms that cause Hemorrhagic fever have high fatality rates once established in a non-immune host.

Viruses are quite attractive weapons from a both engineering/harvesting technique which is a rather effortless and treatment complexity. If you sense an unusual disease entity, large numbers of civilian and military casualties, aerosol route, morbidity limited to the localized geographical area, multiple dead animals; run for your lives! The unusual pattern of victims showing at a health site and vague clinical features should raise suspicion for a covert biological poisoning. Accessible laboratory screening should be implemented immediately and common bio-agents should be cultured by standard methods until specifications can be made available.

 More specific methods include Mass spectrometry for toxins, antibody and antigen tests, DNA probes and Detection of metabolic products. Vaccines, anti-virals, antibiotics and other antidotes should be available en masse to avoid overwhelming supplies. Common sources like food and water should be protected, vector control measures, indoor movement, issuing Personal Protective Equipment may all be temporary measures.

 Conventional decontamination methods like chemical, heat or UV may also be utilized. Such detention tactics are deemed impractical and reason for terrorists to continue to implement attacking strategies. Development of the public health systems, public education and programs (workshops/drills), governmental incentives for research and development into biological attack and countermeasures since biological weapons are now being engineered; all have been undertaken to forbid the use of biological weapons.

 The strategies have been targeted to enhance disaster preparedness and response capacity, when initiatives should strictly be taken to promote preventive tactics, interdicting arsenal, registering/documenting purchases, imposing strict penalties and regular screening and inspection of suspected regions. Disaster management should come into action when a biological intervention is suspected. Disaster Management should be an Integrated System of Hospital Management.

 Dr.RezwanNaseer, General Director of Punjab Emergency Service (Rescue 1122) proposed a Disaster Preparedness program. Dr.Naseer anticipated a safety community development program through injury prevention research, school safety program, community safety officers and teams etc. The program is to expand to other provinces of Pakistan; in KPK, AJK, GB and Baluchistan.

Dr.SherazAfridi, Accident and Emergency – Khyber Teaching Hospital, introduced a MIMS course, Major Incident Medical Management Support. The aim of such a service was to provide the knowledge and skills needed to effectively manage the scene of a major casualty incident supported by a “Methane Message” for better understanding.

M: My call/sign/name. Major incident STANDBY or DECLARED.

E: Exact Location.

T: Type of Incident.

H: Hazards, present and potential.

A: Access and egress.

N: Number of severity of casualties.

E: Emergency services – present and required.

 Certain systems which have been developed to detect biological attack are: SMART (Sensitive Membrane Antigen Rapid Test) JBPDS (Joint Biological Point Detection System) BIDS (Biological Integrated Detection System) IBAD (Interim Biological Agent Detector) and The Tactical Biological Standoff Detection System. Bio-terrorism Outlawing Washington Conference (1921–1922), the Geneva Conference (1923–1925), and the World Disarmament Conference (1933) forbade the use of BW.

However, The Geneva Protocol did not prohibit the development, production and stockpiling of biological weaponry. Failure to decommission the arsenal is perhaps best illustrated by the super powers. There are several events in history of a seemingly incidental or offense free warfare, while pushing agendas for peace, sponsoring and staging attacks and establishing grounds for hostile purposes. When our great doctors, health workers, activists and freedom fighters rising to the challenge of the civilian war magnificently are being shut out from raising their voice, who am I write this peace on warfare when the global voices are now silent?

 There remains no time to ponder anxiety, panic or psychological effects among the civilians in attempt to train them against a possible biological attack, applying to both attacking and attacked nations. Rampant bio-agent use for a personal crusade has indoctrinated the methods and availability of sophisticated techniques without considering the consequences. For instance, product tampering (Tylenol tampering cases of the 1980s); attacks on specific ethnic population; sabotage of specific food item (the lacing with cyanide of Chilean grapes in March 1989); attacks directed at one of a country’s agencies or departments (anthrax mailings in 2001). Whether you call it an arms trade or a defense fair, weapons regardless of their kind will continue to be sold to the dictators, which would follow military intervention and a flow of protesters wrapped in an anti-intrusion agenda; giving rise to nothing but massacre; an exhausting merry-go-round.

The Government Luncheonette

My practical venture, ideally the taste of reality began when I stepped out as a fresh graduate embarking on a journey to minus insult to injury, joining a government hospital as per PMDC requirements for a stretch of 12 months. A new graduate sticks out like a sore thumb and so did I. After braving the series of delays in the entrance exam, I was finally handed out my choices for the year. 

Ideas of lending a helping hand to help fill the void and several other encouraging designs were running through my veins. At the time, I felt like a ninja, perhaps a doctor without a border. With most of the government vainness out in the open, how vulnerable was I? Highlighting a series of events and outcomes, I have divided the government setting into 8 subcategories, each with its own surprises.

 The Parfait Healthcare Delivery System:Hospital and hygiene go hand in hand. The sanitary situation in every department lacks even the generic rules of waste disposal method. Beginning from basic techniques, there lacks a concept of waste segregation.

 The containers are not color coded differentiating them from sharps and other forms of risk waste which burdens the waste management plan. The risk waste like pharmaceutical, genotoxic and chemical waste fall into the same bin which is mishandled thereby adding to the health risk. The ambulating services within the hospital responsible for moving patients from one unit to another don’t meet the standards as quite.

 The vain chain to making a request via land line towards the main office to the arrival of the ambulance is enveloped in endless delays pushing caretakers to take charge and conduct the patients to the desired destination. Often, there were several intensive care patients within the unit required shifting with oxygen; sadly, both the nursing attendants and oxygen showed no avail. Patients referred from the main emergency to the corresponding department are seen stretching across the hospital, braving the heat and confusion.

 The blood bank and laboratory are perhaps the only operating units with order. However, collection units servicing the admitted patients in every department had been closed a year ago due to which all samples are directed to the main laboratory by the patient/patient’s attendants, even an arterial blood gas sample dipped in ice-cold water. According to a local perspective, the laundry and food services have little to offer too.

The Individual Unit: A doctor too is a human being you know, and hence a potential candidate entitled to safety, security, privacy and well-being. Through the course of my rotations in the major departments, there were no private rooms assigned for interns, let alone for boys. We either shared a room with the members of the opposite sex or didn’t have a room at all and therefore took shelter in the nursing staff’s shack where we were not welcomed.In the brighter cases where we had a place to settle down after prolong duty hours, the restrooms were devoid of a necessity called water (I didn’t complain of the hygiene at all at this point). Moreover, the rooms often became flooded with the senior on call duty doctors with the juniors compromising their happy hour or adding to the pile. Attacks on personal lockers and unrestrained theft were next that rocked my world.

The Nursing Posse: Here I would like to speak of “some and not all” nursing staff who fail to deliver nursing care and indulge in illegal practices of selling off the healthcare goods to make a handsome living. Every department is allotted a budget that covers certain departmental expenses. Some turn over their departments into a new system, others drive the budget into their pockets. Mostly, I was requested to return used voiles and document disposables consumed at a duty the next morning to a senior staff member. The staff member at various events refused to handout important healthcare materials deemed necessary for post-operative patients and insisted they be ordered by the attendants of the hour. Ruckuses were often sparked following an ample spending on their behalf which was totally justified. On the flip side, some staff members remained true to their responsibilities and did more than their capability to offer help.

The O.T Blues: The sketch of an operation theatre felt like a blue area, highly disinfected, with limited personnel and a protocol that followed. If you should know everything, the theatres were often crowded with interns more than desired. Moreover the practice of proper theatre specific attire including a foot and head gear, scrubbing details and bringing unauthorized personal articles were far from supervision. The advent of disposable gowning and draping is a dream which is yet to come true. Given the resources, I believe the hospital still makes the most of it. However, the smallest details of observing proper measures before, during and after a procedure need a reality check. In the unlikely event of an instrument/machinery running out of order is only followed by a feud and the blame game. Also, patient privacy is still misunderstood and incompletely sought after and the concept of medical ethics in the OT has a supporting role to play.

 The E.R Bloom: The emergency from a distance gave me the chills. It’s been updated into a new building, with central conditioning system instated, separate areas of major trauma departments including a resuscitation room, emergency serial reporting and a theatre. I believe the ER should be a place with absolutely no shortcomings. To begin with, the patients and scores of attendants scramble and split to locate stretchers to put them out of their misery. In case you require wheelchair, you would have to ambulate at least 10 times to find the right person to reason with. Once in, the patients meet their amateur interns and are treated in accordance with the emergency decrees and senior reporting.

 In the morning when most seniors and head staff report to duty, things maintain order. However, as the sun dusks, the ER becomes an independent entity which has rendered the ER helpless and in-efficient. The freedom proceedings range from disappearing from duty hours, making medical supplies in need unavailable, illegal medico-legal practices, misguiding the patients in terms of remote access and pharmaceutical crimes. Not to mention the security of the healthcare workers which often falls into great danger when important personnel, drunkards or criminals arrive for healthcare delivery in the wrath of night. The security officials allocated for their purpose are found napping and sipping in their booths. Obviously, surveillance and profiling hasn’t worked.

The Secret Society: This society only comes to being in events of an emergency. By that I mean foreigners touring for funds/donation, senior accountability, employment/sacking, greetings from highlife, and… can’t think of anything else.The patient welfare fund doesn’t approve of your poverty unless the secret society authorizes. Serology, MRI, thyroid/bone scanning and others forms of expensive reporting harbor bad news to the unfortunate masses. Also, in the event of a mass/multiple casualty when reporters gather around for scoop, the personnel arrive for a routine visit touching only the outskirts of the area. To my surprise, there were more than single units reserved for mass emergencies. These rooms were equipped with automatic monitoring systems, in-built laboratory, quick serial assessment structures and restrooms. I discovered this mode of personalized care when it played host to an official who presented with a low blood-sugar level.

 Us: Speaking so much of the bitter truth, I have thought of nothing positive except the doctors. Because doctors do not discriminate, healthcare belongs to everyone!

An Ode To The Wheels Within

It was just another rough day at the hospital when my friend invited me to a cycling endeavor on the streets of Karachi. I thought to myself, “cycling, in Karachi? Why would someone pursue cycling had they been on good terms with the gym? Or risk their lives to flaunt their recreational mood on a good day? Could it be safe keeping in mind the safety concerns and political unrest for the past few years? What do medical professionals do in their idol space? I sat behind a desk flooded with in-patient files broadening my perspective on harmless fun in Karachi. Being an adventure aficionado, I left behind a lot of memories of creative writing and favourite sports which began their slow decline as I entered the realm of medicine.

Taking the sage advice, we decided to ride solo because my friend feared I will unleash my wilderness on to the streets. However I kept my cool and didn’t hit the roads and limited my edition to parking spaces and sea front. After much decent practice, we departed succeeding morning prayers and embarked on different routes decided prior to departure. Over the weekends, mums and their little duckling joined the ride and suddenly, I felt I was riding into another dimension. Cycling re-defined life in Karachi and the peloton I cycled with totally had me re-imagine its limits. Every Sunday, over 100 cyclists joined and rode into different parts of Karachi; of course the line of travel were carefully selected in accordance with the safety concerns. The group also announced competitions by the kilometer and planned trips to slightly remote islands, beaches and highway.

During one of my rides, I met a woman who owned a 1000c.c motor bike and professed her lifestyle and the taboos attached to it. Her rousing story moved me when she disclosed how she performed daily chores including going to work on her motor bike. Graduating from foot to cycle empowered me with my right to move around freely. When deepika defined her choice to arrive late from work, I thought why not ride to work? I found it difficult initially as people cooled their eyes off, followed me briefly, mouthed obscenities, and mistook me for a daughter of anarchy; nonetheless, the chauvinists failed to throw me off my pedal. Using cycle as means of transportation to work gained me a space in the parking lot though it did prompt an ongoing war between the motor lads and I. people en route became accustomed to my standard routine and I was praised by my fellow colleagues who drove my confidence over. 

The government perhaps could join in hands to promote this two-wheeled action and act upon building a network of segregated lanes for bikers for a safer journey and prevent danger posed by trucks and construction roads. However, one of the paradox elements of cycling in Karachi is that it's not as safe as people might think. Female riders suffer disproportionately as drivers are impatient against their slower average speed. We need to polarise all the fractious groups into a united front to get these basic facilities take form. Perhaps, with the advent of metro bus facility which apparently in shambles, and lack of divided lanes for heavy and long vehicles; cycling network is eagerly awaited by the connoisseurs of the pedalling platoons.

My story is perhaps another women empowerment story on wheels, defeating the conventional notions of female domesticity. However this story only implies to me and perhaps people like me. Just like how deepika’s movement implied to her only. Where women’s participation in variously areas of workforce is debated, this could hopefully abrogate the poison from reflection over several issues associated with women and their right to move freely. Defying the repressive tradition, women should use this mode of transportation to reach schools and offices, healthcare facility and other workplaces.  I’m content with the activity as it keeps me fit and healthy, mentally empowering and physically forward. Perhaps a hashtag trend could spell out which way the masses pedal! 

The Five-point Palm Heart Exploding Technique

No, this is not an elaboration of bill’s death over the hands of Beatrix kiddo. Instead, a five point notice of what we need to notice!  Here are a few points which may prove our sub-optimal decision-making abilities and re-think the holy month’s blessing.

 Astray point no. 1 - A month prior to the arrival of the holy mirth; the conspicuous display of same old articles in new packaging and attractive bargains provokes the holy genie in us and we begin listing our purchases and start nagging our folks. The billboards, TV commercials and print media are splattered with appealing chaffers and we end up stocking the most un-wanted items off the shelves. Carbonated sodas, flavored concentrates, and the mother of all the frozen items are a few felons that occupy our depots. The important buys of the month turn into tons of unnecessary stock that ends up in our storage rooms wiling our funds.

Astray point no. 2 - the most deploring branding is of apparel. The holy month is preceded by Eid festivities however; the clever branding attracts the women cohorts into exorbitant clothing and related cops. I often find myself preoccupied with tailors and several designer lines to choose from, leaping from one mall to another. Female masses baffled by the marketers, various brands release other captivating advertisements announcing their volume 2 following the first phase of Ramadan which proves our insanity and spur. With designers hitting a high note over their sartorial games, as a result, we end up doubling our purchases.

Astray point no. 3 - the transmission on the tube is disturbing, informative and entertaining all together. The inspiring programs lined up for the holy month does answer our pleas and adds to our entertainment in general. However, shouldn’t we employ this time in the recitals, remembrance and prayers? The viewership often justifies their clung attitude of watching these broadcasts with getting through the prolong duration of the fast. Ramadan themed programs televise a population hysterical over freebies amid other things. The viewers lose control of their dignity and some hosts stripped off their integrity!

Astray point no.4 – the aftaar and sahoor culture is a major curb of them all. The practice of midnight matches, snacking and hangouts prefacing sahoor is a norm and the reason behind our early rise nonfeasance. The eateries too don’t lag behind flashing their inaugural deals to cater to the famished following. I attempted to break my silence at one baggy marquee however found myself in shambles. Fried stuffing, creamy delicacies, carbo packed sandwiches and meat starters satiate one’s appetite and we often fail to flourish at main course. Oh sorry, there was no main course! Also, most luncheonettes lack a separate prayer area for the females. Where prayers and silent submission in supplication should always forgo sahoor and aftaar yet I find people orating at considerable length on just about any subject…

Astray point no. 5 – despite the brutal heat wave that struck various parts of the country, masses sizzle outdoors appeasing into unnecessary activities; women at the malls, boys at hangouts, children at summer camps and men perhaps driving everyone around. This time of the year, we prepare ourselves for prayers, forgiveness and mercy. Therefore, do not get lured into cunning on-goings; do not be bothered by perplex festivities… help yourselves revive your religious functioning as it should prove to be a cut above the rest!