Health and Poverty

All Power to the people was one of the four fundamental principles of Pakistan People’s Party’s (PPP) politics. People were promised provision of basic needs and basic rights under successive PPP governments.  Provision of Rs. 1000 to each poor household under Benazir Income Support Programme (BISP) is one such initiative taken by PPP in this regard.  Assessment of this initiative begs four basic questions? What do we understand by poverty? How do we identify the poor? How do we help poor in reducing poverty with their own efforts? And where does BISP stand in reducing poverty with the power of the people?

Numerous studies on poverty have identified two major causes of poverty in Pakistan; lack of income generation opportunities and burden of health related expenses which can be reduced by improving water and sanitation services and performance of public health facilities. Water borne diseases are major cause of sickness in low income communities. In Golra village in close vicinity of Islamabad 80% of the people are Hepatitis carriers. Due to poor designing, budgeting and implementation of water supply and sanitation schemes their maintenance cost increases significantly. In the case of one rural community in Tharparkar every household is required to pay Rs. 1000 per month for diesel expenses for pumping water. This happens because communities are not consulted during the planning stages and PHED engineers don’t know low cost alternatives. In other cases medical bills are many times the Rs. 1000 to be given to each family. On treatment side there are hundreds of non functional basic health units. Adamjee Insurance’s micro health insurance gives health coverage of up to Rs. 25,000 per person per annum to one couple and all their siblings for a premium of Rs. 500 only. Something like this does not make people dependent on government dole outs and offers a practical sustainable solution of poverty.

Income generation is possible through skill improvement, provision of credit or building assets. Poor people can earn their living with pride and honour if they are provided access not cash. Disbursement of cash will make them dependent as ODA has made our entire country dependent on borrowed resources and advice. If PPP government seriously wants to improve monetary position of the poor it should reduce the heavy cash burden on the poor cased by indirect taxation. Our poor people contribute more than 60% of taxes to the economy and a significant amount of foreign exchange through remittances. If indirect tax on dally consumable for the poor is eliminated they will not need Rs. 1000 per month and not feel obliged for receiving back a fraction of what they already contribute through tax payments.

We need to systematically analyze and respond to poverty alleviation and strengthening the power of the people. It should not be continuation of systematically disabling the poor in the name of enabling them.