RIP
Milan Kundera, renowned Czech writer and former dissident, dies in Paris aged 94

 Czech-born author Milan Kundera looks on in Prague, Czech Republic, June 27, 1967. Milan Kundera, whose dissident writings in communist Czechoslovakia transformed him into an exiled satirist of totalitarianism, has died in Paris at the age of 94, Czech media said Wednesday, July 12, 2023. (Jovan Dezort/CTK via AP, file)



Czech-born writer Milan Kundera looks on in this file photo taken in May 1968. Milan Kundera, whose dissident writings in communist Czechoslovakia transformed him into an exiled satirist of totalitarianism, has died in Paris at the age of 94, Czech media said Wednesday, July 12, 2023. (Pavel Vacha/CTK via AP)



Czech-born writer Milan Kundera looks on in this file photo taken in 1963. Milan Kundera, whose dissident writings in communist Czechoslovakia transformed him into an exiled satirist of totalitarianism, has died in Paris at the age of 94, Czech media said Wednesday, July 12, 2023. (Nesvadba Frantisek/CTK via AP)

BY LORI HINNANT AND ELAINE GANLEY
Published, July 12, 2023

PARIS (AP) — Milan Kundera, whose dissident writings in communist Czechoslovakia transformed him into an exiled satirist of totalitarianism, has died in Paris. He was 94.

The renowned author died Tuesday afternoon, his long-standing publishing house Gallimard said in a one-sentence statement on Wednesday. It confirmed that he died in Paris but provided no further information.

The European Parliament held a moment of silence upon news of his passing.

``The Unbearable Lightness of Being,’’ Kundera’s best-known novel, opens wrenchingly with Soviet tanks rolling through Prague, the Czech capital that was the author’s home until he moved to France in 1975. Weaving together themes of love and exile, politics and the deeply personal, Kundera’s novel won critical acclaim, earning him a wide readership among Westerners who embraced both his anti-Soviet subversion and the eroticism threaded through many of his works.

“If someone had told me as a boy: One day you will see your nation vanish from the world, I would have considered it nonsense, something I couldn’t possibly imagine. A man knows he is mortal, but he takes it for granted that his nation possesses a kind of eternal life,” he told the author Philip Roth in a New York Times interview in 1980, the year before he became a naturalized French citizen.

In 1989, the Velvet Revolution pushed Communists from power and Kundera’s nation was reborn as the Czech Republic, but by then he had made a new life — and a complete identity — in his apartment on Paris’ Left Bank.

“Milan Kundera was a writer who was able to reach generations of readers across all continents with his work and achieved world fame ...” Czech Prime Minister Petr Fiala tweeted in the Czech language. “He left behind not only a remarkable work of fiction, but also an important work of essays.”

He offered condolences to Kundera’s wife Věra, who guarded her reclusive husband from the intrusions of the world. It was not immediately clear whether his wife was at his side.

To say his relationship with the land of his birth was complex would be an understatement. He returned to the Czech Republic rarely and incognito, even after the fall of the Iron Curtain. His final works, written in French, were never translated into Czech. ``The Unbearable Lightness of Being,’’ which won him such acclaim and was made into a film in 1988, was not published in the Czech Republic until 2006, 17 years after the Velvet Revolution, although it was available in Czech since 1985 from a compatriot who founded a publishing house in exile in Canada. It topped the best-seller list for weeks and, the following year, Kundera won the State Award for Literature for it.

Kundera’s wife, Vera, was an essential companion to a reclusive man who eschewed technology — his translator, his social secretary, and ultimately his buffer against the outside world. It was she who fostered his friendship with Roth by serving as their linguistic go-between, and — according to a 1985 profile of the couple — it was she who took his calls and handled the inevitable demands on a world-famous author.

The writings of Kundera, whose first novel ``The Joke’’ opens with a young man who is dispatched to the mines after making light of communist slogans, was banned in Czechoslovakia after the Soviet invasion of Prague in 1968, when he also lost his job as a professor of cinema. He had been writing novels and plays since 1953.

Kundera’s name was often floated as a candidate for the Nobel Prize in Literature, but the honor eluded him.

“The Unbearable Lightness of Being” follows a dissident surgeon from Prague to exile in Geneva and back home again. For his refusal to bend to the Communist regime the surgeon, Tomas, is forced to become a window washer, and uses his new profession to arrange sex with hundreds of female clients. Tomas ultimately lives out his final days in the countryside with his wife, Tereza, their lives becoming both more dreamlike and more tangible as the days pass.

Jiri Srstka, Kundera’s Czech literary agent at the time the book was finally published in the Czech Republic, said the author himself delayed its release there for fears it would be badly edited.

“Kundera had to read the entire book again, rewrite sections, make additions and edit the entire text. So given his perfectionism, this was a long-term job, but now readers will get the book that Milan Kundera thinks should exist,” Ststka told Radio Praha at the time.

Kundera refused to appear on camera, rejected any annotation when his complete published works were released in 2011, and, earlier, would not allow any digital copies of his writing, reflecting his loyalty to the printed word. Today, however, a Kindle version of “The Unbearable Lightness of Being” is offered on Amazon and Google Books.

In a June 2012 speech to the French National Library — which was re-read on French radio by a friend — he said he feared for the future of literature.

“It seems to me that time, which continues its march pitilessly, is beginning to endanger books. It’s because of this anguish that, for several years now, I have in all my contracts a clause stipulating that they must be published only in the traditional form of a book, that they be read only on paper and not on a screen,” he said. “People walk in the street, they no longer have contact with those around them, they don’t even see the homes they pass, they have wires hanging from their ears. They gesticulate, they should, they look at no one and no one looks at them. I ask myself, do they even read books anymore? It’s possible, but for how much longer?”

In 2021, Kundera decided to donate his private library and archive to the public library in Brno, where he was born and spent his childhood. The Moravian Library holds a vast collection of Kundera’s works. Donated items include editions of Kundera’s books in Czech and some 40 other languages, articles written by and about him, published reviews and criticism of his work, newspapers clippings, authorized photographs and even drawings by the author.

In recent years, Kundera allowed the translation of his late works in French into Czech.

Despite his fierce protection of his private life — he gave only a handful of interviews and kept his biographical information to a bare minimum — Kundera was forced to revisit his past in 2008, when the Czech Republic’s Institute for the Study of Totalitarian Regimes produced documentation indicating that in 1950, as a 21-year-old student, Kundera told police about someone in his dormitory. The man was ultimately convicted of espionage and sentenced to hard labor for 22 years.

The researcher who released the report, Adam Hradilek, defended it as the product of extensive research on Kundera.

“He has sworn his Czech friends to silence, so not even they are willing to speak to journalists about who Milan Kundera is and was,” Hradilek said at the time.

Kundera said the report was a lie, telling the Czech CTK news agency it amounted to “the assassination of an author.”

In a 1985 profile — which is among the longest and most detailed on record, and examines Kundera’s life in Paris — the author foreshadowed how much even that admission must have pained him.

“For me, indiscretion is a capital sin. Anyone who reveals someone else’s intimate life deserves to be whipped. We live in an age when private life is being destroyed. The police destroy it in Communist countries, journalists threaten it in democratic countries, and little by little the people themselves lose their taste for private life and their sense of it,” he told the writer Olga Carlisle. “Life when one can’t hide from the eyes of others — that is hell.”
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Associated Press journalists Karel Janicek in Prague, Czech Republic, Amer Cohadzik in Sarajevo, Bosnia and Herzegovina and Raf Casert in Belgium contributed to this report.

Canada’s Indigenous women forcibly sterilized decades after other rich countries stopped

Decades after many other rich countries stopped forcibly sterilizing Indigenous women, numerous activists, doctors, politicians and at least five class-action lawsuits allege the practice has not ended in Canada

By MARIA CHENG

 AP Medical Writer
July 12, 2023

May Sarah Cardinal sits for a portrait outside the Law Courts building in Edmonton, Alberta, Canada on Thursday, May 25, 2023. Cardinal said she was pressured into having her tubes tied when she was 20. “The doctor told me: ‘There are hard times.
The Associated Press

TORONTO -- Decades after many other rich countries stopped forcibly sterilizing Indigenous women, numerous activists, doctors, politicians and at least five class-action lawsuits say the practice has not ended in Canada.

A Senate report last year concluded “this horrific practice is not confined to the past, but clearly is continuing today.” In May, a doctor was penalized for forcibly sterilizing an Indigenous woman in 2019.

Indigenous leaders say the country has yet to fully reckon with its troubled colonial past — or put a stop to a decades-long practice that is considered a type of genocide.

There are no solid estimates on how many women are still being sterilized against their will or without their knowledge, but Indigenous experts say they regularly hear complaints about it. Sen. Yvonne Boyer, whose office is collecting the limited data available, says at least 12,000 women have been affected since the 1970s.

“Whenever I speak to an Indigenous community, I am swamped with women telling me that forced sterilization happened to them,” Boyer, who has Indigenous Metis heritage, told The Associated Press.


Medical authorities in Canada’s Northwest Territories issued a series of punishments in May in what may be the first time a doctor has been sanctioned for forcibly sterilizing an Indigenous woman, according to documents obtained by the AP.

The case involves Dr. Andrew Kotaska, who performed an operation to relieve an Indigenous woman's abdominal pain in November 2019. He had her written consent to remove her right fallopian tube, but the patient, an Inuit woman, had not agreed to the removal of her left tube; losing both would leave her sterile.

Despite objections from other medical staff during the surgery, Kotaska took out both fallopian tubes.

The investigation concluded there was no medical justification for the sterilization, and Kotaska was found to have engaged in unprofessional conduct. Kotaska's “severe error in surgical judgment” was unethical, cost the patient the chance to have more children and could undermine trust in the medical system, investigators said.

The case was likely not exceptional.

Thousands of Indigenous Canadian women over the past seven decades were coercively sterilized, in line with eugenics legislation that deemed them inferior. In the U.S., forced sterilizations of Native American women mostly ended in the 1970s after new regulations were adopted requiring informed consent.

The Geneva Conventions describe forced sterilization as a type of genocide and crime against humanity and the Canadian government has condemned reports of forced sterilization elsewhere, including among Uyghur women in China.

In 2018, the U.N. Committee Against Torture told Canada it was concerned about persistent reports of forced sterilization, saying all allegations should be investigated and those found responsible held accountable.

In 2019, Prime Minister Justin Trudeau acknowledged that the murders and disappearances of Indigenous women across Canada amounted to “genocide,” but activists say little has been done to address ingrained prejudices against the Indigenous, allowing forced sterilizations to continue.

In a statement, the Canadian government told the AP it was aware of allegations that Indigenous women were forcibly sterilized and the matter is before the courts.

“Sterilization of women without their informed consent constitutes an assault and is a criminal offense,” the government said.

“We recognize the pressing need to end this practice across Canada,” it said, adding that it is working with provincial and territorial authorities, health agencies and Indigenous groups to eliminate systemic racism in the country's health systems.

Boyer, the senator collecting data on the issue, recalled once being approached by a tearful Indigenous woman describing her forced sterilization.

“It made my knees buckle to hear her story and to realize how common it was,” Boyer said. "Nothing has changed legally or culturally in Canada to stop this.”

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Indigenous people comprise about 5% of Canada’s nearly 40 million people, with the biggest populations residing in the north: Nunavut, Yukon and the Northwest Territories.

The more than 600 Indigenous communities, known as First Nations, face significant health challenges compared to other Canadians. Suicide rates among Indigenous youth are six times higher than their counterparts and the life expectancy of First Nations people is about 14 years less than other Canadians.

Until the 1990s, Indigenous people were mostly treated in racially segregated hospitals, where there were reports of rampant abuse.

It’s difficult to say how common sterilization — with or without consent — happens. Canada's national health agency doesn't routinely collect sterilization data, including the ethnicity of patients or under what conditions it happens.

In 2019, Sylvia Tuckanow told the Senate committee investigating forced sterilizations about how she gave birth in a Saskatoon hospital in July 2001. She described being disoriented from medication and being tied to a bed as she cried.

“I could smell something burning,” she said. “When the (doctor) was finished, he said, ‘There: tied, cut and burnt. Nothing will get through that,’” Tuckanow said, referring to her singed fallopian tubes. She said she hadn’t consented to the procedure.

The Senate committee's work was prompted by a previous 2016 investigation led by Sen. Boyer into about a dozen forced sterilizations of Indigenous women at a Saskatchewan hospital.

In November, a report documented nearly two dozen forced sterilizations in Quebec from 1980 to 2019, including one woman who said her doctor told her after bladder surgery that he had removed her uterus at the same time — without her consent.

The report concluded that doctors and nurses “insistently questioning whether a First Nations or Inuit mother wants to (be sterilized) after the birth of her first child seems to be an existing practice in Quebec.”

Some women were not even aware they were sterilized.

Morningstar Mercredi, an Alberta-based Indigenous author, was sterilized as a 14-year-old, but didn’t find out until decades later when she sought help after being unable to conceive.

“I went into a catatonic stage and had a nervous breakdown,” Mercredi wrote in her 2021 book, “Sacred Bundles Unborn.”

She told the AP the cost to First Nations peoples of coerced sterilizations was “staggering,” noting the procedures were previously routine in Indigenous residential schools and hospitals.

“These many generations of Indigenous persons denied life is an effective genocide,” she said.

The Senate report on forced sterilization made 13 recommendations, including compensating victims, measures to address systemic racism in health care and a formal apology.

In response to questions from the AP, the Canadian government said it has taken steps to try to stop forced sterilization, including investing more than 87 million Canadian dollars ($65 million) to improve access to “culturally safe” health services, one-third of which supports Indigenous midwifery initiatives.

Last year, the government allocated 6.2 million Canadian dollars ($4.7 million) to help survivors of forced sterilization. It said the Senate report was “further evidence of a broader need to eliminate racism” and acknowledged that bias in the health system “continues to have catastrophic effects on First Nations, Inuit and Metis communities.”

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Dr. Alika Lafontaine, the first Indigenous president of the Canadian Medical Association, recalls times in his own training when it was unclear whether Indigenous women had agreed to sterilization.

“In my residency, there were situations where we would do C-sections on patients and someone would lean over and say, ‘So we’ll also clip her (fallopian) tubes,’” he said. “It never crossed my mind whether these patients had an informed conversation" about sterilization, he said, adding he assumed that had happened before patients were on the operating table.

One problem, Lafontaine said, is that many First Nations women must fly hundreds of miles south to deliver their babies. “That happens because we literally did not build any health facilities where Indigenous people live,” he said.

Gerri Sharpe, president of Pauktuutit Inuit Women of Canada, said health centers serving Inuit women often aren’t staffed by Indigenous people, resulting in translation problems. For example, in Inuit culture, people often communicate with facial expressions, like raising their eyebrows for “yes” or wrinkling their nose for “no.”

“Doctors will be speaking, and they look to the woman to acknowledge something. When she (raises her eyebrows), the doctor labels it as ‘non-responsive,’” Sharpe said.

Dr. Ewan Affleck, who made a 2021 film, “ The Unforgotten,” about the pervasive racism against Canada's Indigenous people, said the way forced sterilization happens now is more subtle than in the past. He noted an ongoing “power imbalance” in the country's health system. “If you have a white doctor saying to an Indigenous woman, ‘You should be sterilized,’ it may very likely happen,” he said.

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There are at least five class-action lawsuits against health, provincial and federal authorities involving forced sterilizations in Alberta, Saskatchewan, Quebec, British Columbia, Manitoba, Ontario and elsewhere.

May Sarah Cardinal, the representative plaintiff in the Alberta case, said she was pressured into having her tubes tied after having her second child in 1977, but the doctor never explained the procedure was irreversible.

“The doctor told me: ‘There are hard times ahead and how are you going to look after a bunch of kids? What if your husband leaves?’” Cardinal told the AP. “I was afraid if I didn’t go through with it, they would be angry with me, and I didn’t feel like I had a say.”

Cardinal only realized she had been a victim of forced sterilization when her daughter, Anita, pieced it together after watching a video in a university class about eugenics and forced sterilization.

“My mother had always told me she wanted more children but that she didn’t have a choice,” Anita Cardinal said.

May Sarah Cardinal said she recalled her doctor asking if she and her husband were “native” Canadians and wondered why that should make a difference.

“I would see mothers with their kids and my heart ached not to be able to have more,” she said.

—-

Kotaska, the ob-gyn who carried out the surgery that left an Indigenous woman sterile in 2019, was the president of the Northwest Territories’ medical association and held teaching positions at several Canadian universities.

Documents show an anesthetist and surgical nurse became alarmed when Kotaska said during the surgery to remove the woman's right fallopian tube: “Let’s see if I can find a reason to take the left tube as well."

Kotaska told investigators he was “voicing his thought process out loud” that removing both tubes would lessen the woman’s pelvic pain, the documents say.

Describing Kotaska’s actions as “a violation of his ethical obligations,” investigators suspended Kotaska’s medical license for five months, ordered him to take an ethics course and reimburse the cost of the inquiry. The Northwest Territories health department said it was the first time a “non-consensual medical procedure” had been referred for investigation.

The woman is suing Kotaska and hospital authorities for 6 million Canadian dollars ($4.38 million).

There was no suggestion in the documents that Kotaska was motivated by racism. Kotaska declined to comment to the AP.

The Canadian government would not comment on Kotaska's actions but said forced sterilization is illegal and prosecutable under Canadian criminal law. The Royal Canadian Mounted Police in the Northwest Territories said there is no criminal investigation into Kotaska.

“People don’t want to believe things like this are happening in Canada, but cases like this explain why entire First Nations populations still feel unsafe,” said Dr. Unjali Malhotra, chief medical officer of the First Nations Health Authority in British Columbia.

Despite Canada's reputation as a progressive society, its continued forced sterilization of Indigenous women puts it alongside countries like India and China, where the practice mostly affects women from ethnic minorities.

In Europe, forced sterilizations affected more than 90,000 Roma women in past decades in the Czech Republic, Slovakia, Hungary and Bulgaria. Court rulings, apologies from the governments, reparations programs and modified health policies have mostly stamped out the practice; the last known forced sterilization on the continent was in 2012.

In 1976, the U.S. found that forced sterilizations happened in at least one-third of the regions where the government provided health services to Native Americans. The U.S. government has never formally apologized or offered compensation.

Indigenous leaders in Canada say an official apology would be a critical step towards rebuilding the country's fractured relationship with First Nations people. Only the province of Alberta has apologized and offered some compensation to those affected before 1972.

Mercredi said she continues to endure the repercussions of being sterilized without her knowledge decades ago.

“Those who subject women to this must be held accountable,” she said. “No amount of therapy or healing can reconcile the fact that my human right to have children was taken from me.”

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

In fight against Canada fires, dancing South Africa crews are a familiar and uplifting sight

By NOAH BERGER Associated Press
July 11, 2023, 10:51 AM


South African firefighters Dawid Fransies, right, and Sthembiso Gama prepare tools during their morning meeting in Fox Creek, Alberta, on Tuesday, July 4, 2023. Several countries, including South Africa, deployed firefighters to Canada to help local efforts t...Show more
The Associated Press

FOX CREEK, Alberta -- Some three dozen South African firefighters, clad in their bright yellow jackets and dark blue pants, danced, sang and cheered in a sprawling parking lot close by the majestic woods of central Alberta. The mood was light as the men and women smiled and clapped, some taking out smartphones to record video of their dancing colleagues before heading off to another day battling the fires raging through Canada.

The group gathered on an early July day in the small town of Fox Creek had traveled nearly 10,000 miles (16,000 kilometers) to help fight the hundreds of devastating wildfires that have burned homes and wild lands in the region, destroying an area about the size of the U.S. state of Virginia. They chanted and worked through drills before signing a Canadian flag presented to them as a token of thanks.

In a record-breaking year for Canada's wildfires, with crews coming from all over the world to help out, the South Africans are a familiar and uplifting sight. This year's deployment is the fifth — and largest — for the men and women in Working on Fire, a public works program for young people that serves as South Africa's wildland fire agency.

The rich harmony and movement travel with them everywhere they go, said Trevor Abrahams, Working on Fire's managing director. It was on display in early June, when more than 200 firefighters were filmed singing and clapping in the Edmonton airport after arriving to help with the fires, drawing millions of views on TikTok.

“That part is part of our tradition,” Abrahams said. "At work they will be singing to a rhythm during the busy work. All the teams sing and make up songs as they go along.


The company has had as many as 428 firefighters in Canada this summer, when rampaging wildfires have sent dangerous levels of smoke pollution south through big swathes of the United States and as far as Europe. Their tours of duty run 35 days, hard work on different terrain and with different tools than those used at home.

“The fires in Canada are very different from fires in South Africa,” said Thuto Ganya, one of the firefighters. He said his crew was not familiar with smoldering peat fires that can burn below ground in the Canada woods, and they are still getting used to “all those diggings.”

Abrahams said the overseas deployments are a prestigious assignment for the crews.

“Coming to assistance on an international platform is certainly something they take with more than a pinch of pride,” he said.

They adjust to the differences fast. As their crews are divided into smaller teams for work in different areas, they try to team experienced firefighters with “newbies” to North America, Abrahams said. They learn how to load heavy equipment into a helicopter safely, and how to carry a shovel near the chopper — even when it's not running. They have to be vigilant for the danger of shallow-rooted trees toppling at any moment.


In South Africa, wildland fires are typically much smaller than those seen in Canada and without nearly as much fuel. They're usually fought by men and women carrying backpacks with 20 liters of water and tankers nearby to resupply them, Abrahams said.

Canada arms its firefighters with more advanced and detailed weather forecasts, and with information on moisture content in vegetation. Firefighters also use infrared scans to spot hot spots — technology not routinely used in South Africa. And South Africa firefighting doesn't rely on the massive water-carrying planes nor the “kilometers” of hose that are routinely laid to fires in Canada, Abrahams said.

The Canadian deployments have become routine enough that Working on Fire trains its firefighters in how to operate a particular pump that is a fixture in fighting Canadian fires, but little used back home.

Ganya, who has a girlfriend and 2-year-old back home, said his team had just come back from two days of rest, when they visited a mall and saw fireworks.

“I’d love to come here as often as I could because I love this place. It’s a very quiet place. I’m in love with it,” he said, smiling. “It’s just a lot of peace of mind.”


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Associated Press writers Barbara Ortutay in San Francisco and Doug Glass in Minneapolis contributed.

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Associated Press climate and environmental coverage receives support from several private foundations. See more about AP’s climate initiative here. The AP is solely responsible for all content.

1864 letter recounts Confederate soldier’s masturbation addiction

“It’s Johnny Reb, not Johnny Rub!”

By Jon Simkins
Jul 11, 2023

(Getty)

An 1864 letter sent by Confederate Lt. William Dandridge Pitts to assess the wellbeing of his brother Charles is up for auction — and its contents are brimming with remarkably different strokes.

In the handwritten note, Pitts, an officer who served in the 40th Virginia Infantry until his resignation in late 1862, asks the superintendent of the Staunton-based Western Lunatic Asylum, where Charles was being kept as an inmate, to keep him apprised of his brother’s condition.


Once a private in the same outfit as his brother, Charles was discharged from the Confederate Army shortly after the outset of the Civil War due to an unspecified “illness,” according to documentation reviewed by Live Auctioneers.

At least part of that affliction, based on the professional opinion of Charles’ pre-asylum physician and the accounts of numerous soldiers who served alongside him, was chronic masturbation.

“I have had some conversation with the physician who attended my brother previous to his going to the asylum,” Lt. Pitts wrote to the superintendent, “and he advises me to inform you of the fact, that he had learned from some of my brother’s associates, who were in [military] camp with him, that he was addicted to masturbation, while in camp. He (the physician) is also persuaded of this fact from the conversations he has had with my brother.”

“I missed this scene in Gettysburg,” tweeted historian James Taub, the associate curator at the Museum of the American Revolution who first shared the letter to Twitter.

“Director’s Cut,” another user responded.

The poor soldiers forced to bear witness to Charles’ ailment were no doubt scarred, their visages imprinted with thousand-yard stares well before ever being baptized in the fires of armed conflict.

To this day, desperate cries of “It’s Johnny Reb, not Johnny Rub!” echo throughout the South, particularly in Pitts’ home state of Virginia, which labels itself as “for lovers” instead of for onanism.

The condition of the letter, meanwhile, appropriately titled “[Civil War] Soldier Addicted to Masturbation,” is considered “very fine, with only very minor wear and original fold lines,” according to the item’s listing.

The auction, which includes the unusually paired tags of “Civil War” and “Erotica,” is slated to conclude in mid-August. The current bid is $125.

About Jon Simkins  is a writer and editor for Military Times, and a USMC veteran.

With antibiotics losing their punch, vaccines are Pakistan’s best bet against superbugs

Childhood vaccination, along with clean drinking water and improved hygiene practices, are the key to eradication of typhoid XDR, not indiscriminate use of antibiotics, say health experts.

Zofeen T. Ebrahim 

Published July 9, 2023 

DAWN


The first thing you notice about eight-month-old Manahil Zeeshan is how tiny she looks on the adult-size hospital bed at the government-run Sindh Institute of Child Health and Neonatology (SICHN) in Karachi’s Korangi district.

Experts encourage parents to vaccinate their children against typhoid and ensure that the child has access to clean drinking water. — Photo by Zofeen Ebrahim/IPS

Her right foot is taped with a cannula, and she whimpers incessantly. “I have been in and out of the hospital for the last seven days,” said Uzma Mohammad, Zeeshan’s mother, with worry lines on her forehead. “High fever that refused to come down, severe cough for days and breathlessness,” were some of the symptoms Mohammad described. She was convinced someone had “cast a spell” on her daughter.

The doctors, however, suspected she had typhoid.

Salmonella Typhi bacteria cause typhoid fever, and Salmonella Paratyphi bacteria cause paratyphoid fever. According to the US-based public health agency, Centers for Disease Control and Prevention, along with a fever that can be as high as 103-104°F (39-40°C), the sick person can suffer from weakness, stomach pain, headache, diarrhoea or constipation, cough, and loss of appetite. Some people have a rash of flat, rose-coloured spots. Internal bleeding and death can occur but are rare. It affects between 11 and 20 million people each year, leading to 128,000 to 161,000 deaths, according to the World Health Organisation (WHO). The highest fatality rates are reported in children under four years of age.

While Zeeshan’s blood culture report had yet to come to ascertain the cause of her sickness, she needed urgent medical care, said Dr Shabita Bai, who had admitted her.

“We could not wait for five days for the blood culture report as she was not doing well. And because she had already been given an antibiotic (a medicine used to kill bacteria) from outside, our chances of finding if the baby had typhoid for sure were slim, and we had to rely on the history,” justified Bai.

Decisions had to be made. Based on her condition, symptoms, and clinical diagnosis, the baby was given Ceftriaxone, an intravenous antibiotic, but she showed no improvement. The doctors then administered the stronger Meropeneme intravenously, a last-resort antibiotic.

Manahil Zeeshan’s foot has a drip in an effort to bring her temperature down and fight suspected typhoid. — Photo by Zofeen Ebrahim/IPS


Battling the superbug

But even if she had typhoid, the bacteria in her body had taken on the form of a superbug — the extensively drug-resistant (XDR) typhoid and the current antimicrobials had become ineffective, said paediatrician Dr Jamal Raza, the executive director of the SICHN.

According to a Lancet study published in 2022, multidrug-resistant (MDR) typhoid has been seen in Pakistan, while typhoid bacteria resistant to the widely-used antibiotic azithromycin have been found in Bangladesh, Nepal and India. “Our analysis revealed a declining trend of MDR typhoid in south Asia, except for Pakistan, where XDR S.Typhi emerged in 2016 and rapidly replaced less-resistant strains,” stated the study, which researchers claim is the largest ever examination of the S.Typhi bacterium.

The reason why antibiotics are losing their punch against some types of bacteria, said Raza, was the “indiscriminate use of antibiotics” that health practitioners prescribe to provide immediate relief. Another big problem was self-medication by people. “I know people often use an old prescription by a doctor to get the same medicine if they feel they have the same symptoms, thinking they do not need to visit the doctor.”

But he pointed out viruses, which are also small germs like bacteria, are causing bacteria-like infections, like a cold or the flu.

“Taking an antibiotic for the latter does not treat the disease; it only leads to antibiotic resistance,” said Raza.

A study conducted by researchers from three medical institutions, namely, the Aga Khan University (AKU) in Karachi, the Armed Forces Institute of Pathology (AFIP) in Rawalpindi, and the Shaukat Khanum Memorial Cancer Hospital & Research Centre (SKH) in Lahore in 2018, found indiscriminate use of antibiotics to be causing new drug-resistant “superbugs”.

It found a high prevalence of multidrug and fluoroquinolone resistance for both S.Typhi and S. Paratyphi strains of typhoid bacteria. From 20 per cent in 1992, the resistance was found to have increased to around 50pc in 2015. The stubborn bacteria were resistant to antibiotics like ampicillin, chloramphenicol (and co-trimoxazole), as well as fluoroquinolone (ciprofloxacin and/or ofloxacin).

“The situation is quite grim,” said Dr Mashal Khan, chairperson of the government-run paediatric medicine department at Karachi’s National Institute of Child Health, referring to the increase in the number of children developing resistance to typhoid drugs. His worry is not that the bacteria has spread; his concern is the bacteria has mutated and become resistant to the drug.

“We’re running out of new antibiotics to treat bacterial infections; Meropeneme is the last one, and a very expensive one too,” he said resignedly, adding: “Although the development of newer antibiotics is the need of the day, I must emphasise the rational use of the ones being used is more urgent.”

Developing new drugs is challenging, and antibiotics more so, as the science is tricky.

“Antibiotics are not the most lucrative drugs to develop for pharmaceuticals as their utility is limited in the future due to the bacteria developing the ability to resist them,” said Infectious Diseases specialist and epidemiologist Dr Faisal Mahmood at the Aga Khan University Hospital in Karachi. “A lot of money goes into developing new drugs, and since most of the funding is from the global north, they prefer to work on infections that concern them directly. Typhoid is unfortunately endemic in the low and middle-income countries in the South, which have poorer water quality and have warmer, more humid climates.”

And that is why the only sure-shot way of reducing the disease burden of typhoid is to vaccinate the children.

Eight-month-old Manahil Zeeshan is treated for typhoid at the government-run Sindh Institute of Child Health and Neonatology (SICHN) in Korangi, a neighbourhood in Karachi. — Photo by Zofeen Ebrahim/IPS

In 2019, Pakistan became the first country to get the World Health Organisation (WHO)-recommended single-dose typhoid conjugate vaccine (TCV) injected intramuscularly, added to its routine immunisation (RI) regime. This is given to babies at nine months, alongside measles-rubella vaccinations, without impacting either vaccine.

“Childhood vaccination complemented with clean drinking water and improved hygiene practices is the much more cost-effective way of eradicating typhoid than pumping antibiotics in a child,” said Raza. Meropenem costs as much as Rs30,000 ($105) for a 10-day course, and if hospitalisation is included, it can go up to Rs100,000 ($349), said the doctor. Being in a government hospital, Zeeshan is treated free of cost.
Typhoid vaccine launch hits a snag as Covid-19 surfaces

The 2019 TCV campaign was first launched in the two cities of Sindh — Karachi and Hyderabad (children up to 15 years of age were also given a shot), which reported the highest number of typhoid cases among children. There was a pause when Covid-19 hit the world. But by 2022, TCV had been launched across Pakistan, and 35.5m children were vaccinated, after which it was added to the government-run Expanded Programme on Immunisation (EPI) programme.

“Many parents do not know that the TCV is a more effective vaccine but only available at government vaccination centres, and not at private clinics and hospitals as Gavi has only given it to the government of Pakistan,” said paediatrician Dr D S Akram.

“There is another typhoid vaccine available in the private sector (typhoid polysaccharide vaccine), but it can only be given to children over two years of age, and it needs boosters every three years. My advice to parents is to vaccinate their kids against typhoid bacteria at nine months,” she said.

But it is still a drop in the ocean, and the fight against typhoid and other childhood diseases continues. The WHO places Pakistan among the ten countries that account for almost two-thirds of the world’s unimmunised children.

When Covid-19 hit the country’s already crumbling health system, it also brought the country’s immunisation programme to a halt. An estimated 1.5m children across Pakistan missed out on basic vaccines from March to May 2020, according to Gavi.

For Pakistan, which already has low immunisation coverage (the percentage of fully immunised children aged 12-23 months is just 66pc), it meant a further dip in coverage which in turn led to an unprecedented rise in the number of zero-dose children (those that have not received any routine vaccine). Add to these were the almost 19,000 new births every day. But when the lockdown eased and vaccinators returned to work, there was less demand for vaccination, having been replaced by fear of the new virus.

While Pakistan has yet to reach the optimal immunisation coverage of 90pc, during Covid-19, Pakistan’s EPI received plaudits internationally for taking both vaccine coverage and the number of zero-dose children close to pre-pandemic levels in 2021. “What Pakistan achieved needs to be celebrated. In fact, Pakistan and Chad are used as examples internationally of how to get it right in an emergency,” said Huma Khawar, an immunisation and child health advocate working closely with EPI.

“Despite a year’s delay due to Covid-19, which was unforeseen, I think it is the best thing that the government has done for its country’s children,” said Khawar. She credited the RI programme that bounced back to the pre-pandemic level in 2021.
Clean water, good hygiene key to preventing typhoid

While immunisation can protect children from getting infected, clean drinking water and improved hygiene practices can reduce the risk of catching the disease to a great extent.

“Vaccines provide immunity when there is exposure to the bacteria,” agreed Dr Jai Das, assistant director at the Institute for Global Health and Development at the Aga Khan University and one of the co-authors of the 2018 report on typhoid, but emphasised the need for improved water and sanitation, a situation that continues to remain dismal and compromised in Pakistan.

The same study not only found a strong correlation between water and sanitation but to literacy levels as well. In addition, it stressed improving the country’s food safety protocols and implementing regulations.

While Mohammad believes that her daughter is under a curse, one reason could be that the unpasteurised cow’s milk she gives her daughter may not be properly boiled at home. “I was unable to breastfeed her,” she said. Further, she confessed to diluting it with unboiled tap water to make it last longer.

Doctors say giving Pakistani babies a lease of life is simple and costs nothing. “Exclusive breastfeeding up to at least six months of age (right now it is only 43pc), attaining 90pc coverage of RI across Pakistan and improving water and sanitation quality,” according to Dr Akram.

Bacteria don’t respect geographic borders

The XDR typhoid bacteria propagating in Pakistan has crossed borders and reached as far as the UK, Canada and the US. Earlier this year, a team of Pakistani and US researchers published their findings in the American Journal of Tropical Medicine and Hygiene, stating that numerous typhoid bacteria variants circulating in Pakistan have also been identified in Southeast Asia and Eastern and Southern Africa and have been introduced into the United Kingdom, Canada, and the United States by travellers.

The Lancet study said strains from South Asia had spread 200 times to other countries since 1990. When these superbugs grow and spread, they can cause infections that are hard to treat. Sometimes they can even spread the resistance to other bacteria they meet.

The future looks frightening. While the need for improving water and sanitation cannot be overemphasised, along with the need for vaccinating children, newer and stronger antibiotics need to be developed and fast as typhoid may surface in deadlier ways than now since very few antibiotics remain effective against the bacteria.

This story was supported by the Sabin Vaccine Institute and Internews

This article was originally published in the Inter Press Service news agency and has been reproduced here with permission.

Header Image: Syringe vaccinates the globe, on a map of the Asia. — Elizaveta Galitckaia/Shutterstock

The danger ahead

Huma Yusuf 

Published July 10, 2023 

DAWN

OUT of control. That’s how the UN described the pace of climate change last week. The days leading up to last Wednesday were the hottest on record. July was the hottest day on Earth in 125,000 years, signalling that we’re now well on track for average temperatures to increase by three degrees Celsius by the end of the century. And this is just the beginning.

Pakistan is once again suffering the consequences of a rapidly heating planet. At least 50 people, including eight children, have died since June 25 in floods and landslides triggered by heavy monsoon rains. Lahore last week received record-breaking rainfall, and Karachi had only just finished breathing a sigh of relief at dodging Cyclone Biparjoy when it is forced to brace for rain. We talk about the 2010 and 2022 floods as freak, one-off disasters. But they are our new reality, reflecting the global 134 per cent increase in climate change-related flooding since the turn of this century.

As our planet approaches climate tipping points, Pakistan will find itself in alternating cycles of flooding and drought, worsening in frequency and intensity with each passing year. For that reason, whoever becomes the next prime minister must put climate change adaptation and mitigation at the centre of all policymaking.

The hype last year around loss and damage funding — announced at the 2022 UN climate change conference COP27 after gaining impetus from Pakistan’s experience with devastating floods — seems to have unleashed, counter-intuitively, complacency among our policymakers. They now dream of foreign funds flowing into climate finance projects. But discussions in the run-up to COP28 later this year should serve as a reality check that loss and damage fund disbursements will not be coming anytime soon.

Pakistan will find itself in cycles of flooding and drought.

Questions about such funding persist. Where will the money come from? We know that high-emitting, rich countries will be on the hook, but beyond that, details remain elusive. Will funds be generated through carbon taxes or other levies? Will states offer grants or partner with the private sector to mobilise capital? How will financing be structured and amplified? And most importantly, what counts as loss and damage? The last is a tricky question because it could encompass everything from immediate humanitarian assistance to more long-term investments into climate-adaptation projects aimed at minimising loss and damage. Will we fund the prevention or the cure?

In all scenarios, loss and damage funding is likely to be conditional. There are likely to be expectations that countries receiving loss and damage funding have good disaster management plans, emissions reductions strategies, green transition pathways, and relatively stable economies and governments. Recipients will also have to evidence some rule of law, transparency and accountability, to ensure that funding is properly deployed. Pakistan is sadly struggling on all these counts.

Ironically, this struggle itself is often cited as a reason why Pakistan is not tackling the climate challenge more aggressively. A common refrain is that we can’t afford to think about the green transition, that climate change adaptation and mitigation are luxuries for the developed world. Pakistanis, we counter, have to prioritise feeding themselves and powering their homes and factories.

But the fallacy of such thinking is increasingly being challenged. For example, there is no feeding ourselves without dealing with climate change. An article published last week in Nature Communications points to the risk that warming jet streams could lead to simultaneous harvest failures in major food-producing countries, presenting a severe threat to global food security. The article emphasises that such a phenomenon has not yet been properly modelled and so is poorly understood, but that basic global food security is certainly not guaranteed. Indeed, ‘breadbasket failures’ would take us back to the eras of mass famine and resulting social instability, even conflict.

Pakistan’s lack of planning in the face of such impending disaster is arguably its greatest political crisis. And that’s saying something, given how recent events have played out. A key danger of any technocratic, stitch-up government that may emerge is that rather than find meaningful routes to climate adaptation and resilience, it is swayed by the promise of climate tech, geo-engineering or fanciful carbon capture technologies. After all, it’s easier to plan for a future in which a problem is miraculously solved, rather than one in which the only way to avert state failure is to find an inclusive, equitable way to share increasingly meagre resources. Today’s ruling elite and their power brokers are not up to the task, and we’re now fast running out of time.

The writer is a political and integrity risk analyst.
Twitter: @humayusuf

Published in Dawn, July 10th, 2023

Population Day

Editorial 

Published July 11, 2023 

AS the global community observes World Population Day today, a strange dilemma confronts humanity. In many developed states, such as Japan, South Korea and many European countries, populations are declining as people age and birth rates are low. This ‘negative population growth’ throws up its own set of challenges, as a day may come when there will not be enough human resources to keep societies functioning efficiently, while pension bills shoot up. On the other hand, there are resource-strained developing states like Pakistan, where the population growth rate remains high, and feeding, educating and keeping such large masses healthy is a major challenge. The numbers of the recently concluded census suggest nearly 250m people live in the country; the 2017 head count showed a population of around 208m. The fertility rate is high, as are the number of unwanted pregnancies and abortions, estimated in the millions. Yet despite these alarming numbers, no one at the helm seems to have a coherent strategy to ensure a more sustainable population growth rate.

Rather than enforcing state efforts to ‘control’ the population, the centre and the provinces need to give families, particularly women, the information and tools required to help them plan the ideal number of children. This can help reduce unwanted pregnancies and improve maternal health. Providing women information and contraceptives through culturally appropriate methods can aid the goal of planned parenthood. Considering the mostly conservative milieu of our society, it is essential that the clergy and community leaders are brought on board to promote family planning. The notion that planned families are against religious norms can easily be disabused by pointing out that countries such as Iran, Saudi Arabia and Bangladesh — all Muslim states — have successfully reduced their respective population growth rates. The criteria of the National Finance Commission award, which, in effect, rewards high population, can also be revamped to give provinces incentives to achieve more sustainable numbers. Pakistan needs to stay away from both extremes: policies such as the one-child scheme that infringe on personal rights as well as letting the population grow unhindered. Instead, balanced and progressive community-led and state-supported initiatives are needed to encourage family planning. If this is not done, a dystopian future likely awaits us, where there are simply not enough resources to support a huge population.

Published in Dawn, July 11th, 2023

UN set to clash over motion on religious hatred

Reuters

Published July 11, 2023 

GENEVA: The Human Rights Council is set to debate a contentious draft proposal on religious hatred in the wake of burning of the Holy Quran in Sweden, an initiative that has highlighted rifts in the UN body and challenged practices in human rights protection.

In a draft resolution presented by Pakistan on behalf of the 57-nation Organisation of Islamic Cooperation (OIC), the group described the burning of Holy Quran in Stockholm last month as “offensive, disrespectful and a clear act of provocation” that incites hatred and constitutes a human rights violation.

The draft — which condemned “recurring acts of public burning of the Holy Quran in some European and other countries” — has stoked opposition from Western diplomats who argue it aims to safeguard religious symbols rather than human rights.

“We don’t like the text,” one Western diplomat said of the draft, which will be presented to the Human Rights Council in Geneva on Tuesday. “Human rights are supposed to be attached to individuals, not to religions.”

The OIC initiative also stokes tensions between Western states and the Islamic organisation at a time when the group has unprecedented clout in the council, the only body made up of governments to protect human rights worldwide.

Nineteen OIC countries are voting members of the 47-member council, and other states such as China have aligned with their draft resolution.

It remains to be seen whether Pakistan will succeed in rallying all OIC countries behind it. A Saudi-led effort to end a Yemen war crimes probe prevailed in 2021.

“If the resolution passes, as seems likely, it will strengthen the impression the council is flipping and the West is losing ground on key debates such as the boundary between free speech and hate speech, and whether religions have rights,” said Marc Limon, director of the Geneva-based Universal Rights Group.

“This could make the council explode in acrimony.”

The European Union has urged parties to reach a consensus on the issue. “Defamation of religions has been a difficult topic for decades within the UN,” an EU diplomat said in negotiations last week.

“The question where to draw the line between freedom of expression and incitement to hatred is indeed a very complicated one.”

Published in Dawn, July 11th, 2023

Forgotten histories

Arifa Noor 

DAWN

Published July 11, 2023

IT turns out this Eid, many people of Pakistan didn’t just have their hands full with animals and qurbani or other festive chores. A report in Dawn claimed that many also found the time to keep the police on their toes and ensure the ‘wrong’ kind of people did not celebrate Eid.

In at least two such complaints, the police were told to make sure the Ahmadi community did not sacrifice animals, which is a ritual for Muslims. Appare­ntly, FIRs were also registered against those who did not heed the warnings duly issued by the police.

This is a story which made it to the papers for usually our treatment of this community is so routine that it rarely makes it to the press. Indeed, stories of the desecration of their graves or other forms of harassment usually pass without remark.

Our success in othering our own countrymen, especially on the basis of religion or even sectarian differences, is an example of continuity in policy that perhaps is unmatched; even our obsession with real estate came much later. And proof of this can be found in the barrage of news stories which simply tell of events such as the kidnapping or conversion of Hindu girls or the targeted killings of Sikhs.

What life for anyone of our minorities is like, their day-to-day existence, we never really learn of. The ‘other’ simply exists. There is little else to be aspired to. Only perhaps in death or some extreme hardship are they worthy of some sympathy.

This is one area, where perhaps India has caught up with us, despite our completely different trajectories in other areas where our neighbour is seen as an economic powerhouse being courted by the world.

It seems that Pakistan and India are hurtling down the same path of religious intolerance.

The land which once celebrated Amar Akbar Anthony is now one where stories of minorities being mistreated have become common. Just recently, two such men were brutally beaten on the suspicion of carrying beef; while one of them has since died, the other was said to be in hospital with brain injury.

Our journey here has been rather different: with the Muslim faith providing the main ideological bulwark for this country, it is little wonder majoritarianism was pushed in one form or the other from the first day in Pakistan, the Aug 11 speech notwithstanding.

And then, of course, the arrival of Ziaul Haq was simply the cherry on top, in more ways than one. His reign also absolved the rest of us of any responsibility or blame for the state of affairs, for it was far easier to put all the horrors of religious intolerance at his door.

India, on the other hand, opted for a secular, more encompassing approach to unite a more diverse society. But that appears to be a lifetime ago now. Amar Akbar Anthony has given way to Padmavat. And while our Islamisation project was a top-down affair from day one, India has followed suit only recently — but the change has come, decisively, or so say some.

Now it seems, the two neighbours are hurtling down the same path.

From a distance, it doesn’t seem this journey has any roadblocks or turns which can take us in different directions. At home, there appears to be little in our politics to suggest any party or government can chart a different course; one simply has to examine the legislative record of the Punjab Assembly where every conservative and regressive law has garnered — across the aisle — consensus to understand this. And from the little I hear of our next-door neighbour, few feel that even if a different government were to be elected, it would lead to big changes on the issue of tolerance.

As an aside (it is called an ‘aside’ because little matters in comparison to the issue of citizens being in danger or facing humiliation simply for their faith into which they were born), this obsession with majoritarianism manifests in other ways as well. Consider that in Pakistan, while we are vocal about state-imposed censorship, we rarely speak of how much we self-censor when it comes to issues related to religion.

So much so that few are willing to speak up for cases such as Junaid Hafeez’s and the need for reform in our laws, which lead to the needless and cruel incarceration of people such as him. It is far easier and safer to keep silent than speak up.

However, personally what intrigues me is not how we got here but how significant this period may turn out to be in the history of the region. After all, the subcontinent has always appeared to be a region far too populous and far too diverse to be too homogenous in terms of language, culture or religion. None of its rulers were able to impose a specific religion on the area, and to date, some of the most admired monarchs tend to be the ones who celebrated the diversity of the land.

Not just that, this was also a land which became home to so many who came from afar (for different reasons) and settled here, never to return — or to push out the locals. This doesn’t only include those who came with raiding armies such as the Mughals.

Consider the Parsi community, which escaped persecution in their homeland of Iran to settle in the subcontinent. How generous and tolerant a culture or land it must have been for a persecuted community to settle here and call it home. It is a story that never fails to make me a wee teary-eyed, especially at present. Was it the only such example of the land providing refuge and a home to those who needed it? And what was it about the subcontinent that people looking for a new start as well as safety were willing to risk the journey here?

But today that is just history. History that we are not even proud of, for we would rather write or squabble over the wars and the invasions that comprise the official story of this land.

The writer is a journalist.

Published in Dawn, July 11th, 2023

Revisiting Article 370: Why India’s Supreme Court must undo the Modi govt’s move to usurp Kashmiris’ rights

The fateful orders of August 5, 2019, are a blot on the constitution, which threaten to destroy the basic structure of the union of India.

Syed Manzoor Gillani

DAWN

Published July 11, 2023 

The Supreme Court of India (SCI) is set to hear today a batch of nearly 23 petitions challenging the Modi government’s decision to abrogate Article 370 of the Constitution, which had given special status to Indian-occupied Jammu and Kashmir.

The petitions, to be taken up by a five-judge bench headed by Chief Justice of India DY Chandrachud, will be heard almost four years after the Indian government reconstituted the state of Jammu and Kashmir into the two ‘union territories’ of J&K and Ladakh in August 2019.

With this act, the Indian government unilaterally stripped Kashmiris of the special autonomy they had enjoyed for seven decades through a rushed presidential order.
A leaf from history

Though the SCI has delivered several judgements relating to Article 370, two leading cases — Prem Nath Koul vs State of Jammu & Kashmir (1959 SCJ 797) and Sampat Parkash vs State of J&K ( AIR-1970 1118) — each heard by five member constitution benches, have extensively deliberated the law and accorded permanency to it.

As per practice and the procedure of the SCI, it would require a larger bench to overrule the earlier views of the five judges benches. If, prima facie, the SCI feels that the earlier views require review, the number of judges hearing the current petitions would have to be increased.

Moreover, the present bunch of cases involves extraordinary points requiring an in-depth exploration of the constitutional history, relating to the accession of the ruler with the union, compared to that undertaken in the earlier cases.

In exploring the constitutional history, the court will have to ensure it brings on record and examines the following documents and anecdotes from history:Indian Independence Act 1947;
The Government of India Act, 1935, as adopted on August 15, 1947, by India;
Letter of the Maharaja of the state to the Governor-General of India dated Oct 26, accompanied by the instrument of accession and its response by the Governor-General dated Oct 27, 1947;
Parliamentary debates on Article 306 (re-numbered as Article 370);
Speeches of former prime minister Jawaharlal Nehru and former president Ramaswamy Venkataraman inside parliament and outside;
Speech of former J&K prime minister Sheikh Muhammad Abdullah in its constituent assembly;
Various provisions of the Indian and J&K constitution, besides an honest appraisal of the circumstances that lead to militancy and the collapse of democratic institutions in Kashmir

For that matter, the court also cannot ignore the overall circumstances and environment which created a dispute between India and Pakistan, landing the subcontinent into trouble.

Promises, promises

At the time of Independence, the Maharaja of the Jammu and Kashmir, Hari Singh, was the only ruler out of all the princely states, who faced a people’s movement for self-rule. He alone, to his credit, negotiated the terms and conditions of accession with the union of India, that too against the ground realities. In doing so, the Maharaja was lucky enough to gain the support of his arch-rival, Sheikh Muhammad Abdullah, to support his decision of accession to India against the latter’s own constituency.

Maharaja Hari Singh managed the Delhi agreement of 1952 (signed by Sheikh Abdullah on behalf of government of J&K) between two popular governments of Delhi and Srinagar. Thus, the official record of the state, the ruler and the political leader’s statements cannot be brushed aside.

At the same time, looking from a broader perspective, the court cannot lose sight of the fact that 45 per cent of the land mass of the state, with over 1.3 million state subjects in AJK, GB, as well as those settled out of state, equally await the day to decide their destiny in accordance with the Independence Act 1947, the Government of India Act 1935, the Governor-General of India’s conditional acceptance of the instrument of accession, as well commitments of Indian leaders and the UN resolutions.

It can also not ignore the fact that the people of the parts of the state administered by Pakistan (on which India also asserts its claim) had resolved through a declaration by its government on Oct 24, 1947, (much before the ruler of the state had conditionally acceded to India), requesting the governments of India and Pakistan to help them decide their fate through a free and fair plebiscite. Article 257 of the Constitution of Pakistan pledges its support for the resolution.





A similar pledge was given by the Governor-General of India on Oct 27, 1947, in his letter to the Maharaja, which reads: “… as soon as law and order have been restored in Kashmir and her soil cleared of the invaders, the question of state’s accession should be settled by reference to the people …” This was endorsed by Mahatma Ghandhi and Jawaharlal Nehru as well as other stalwarts of the Indian freedom movement.

The same pledge was also endorsed by the United Nations Commission for India and Pakistan (UNCIP) through its resolution on Jan 5, 1949, after India had itself moved the UN Security Council on Jan 1, 1948. The Simla agreement of 1972 equally endorses the spirit of all of the above.

The Government of India is bound under Article 51 of its constitution “ … to foster respect for international law and treaty obligations“ and Article 253 “… for implementing any treaty, agreement or convention … made at any international conference, association or other body”.

The conditional accession by the Maharaja and its acceptance by the governor-general, irrespective of its legitimacy and propriety, was accorded approval by the union of India in the spirit of Article 2 of its constitution ‘subject to terms and conditions’ proposed by the ruler, guaranteed by Article 370.



The court cannot also ignore the contents of Articles 371-A to 371-I of the constitution, relating to other Indian states and union territories that enjoy the special status with almost similar rights (some even more). Although the latter had unconditionally acceded to India, they were given the guarantees due to their ground realities.

There is nothing novel in Article 370 that does not find a place in the above-mentioned special articles. But they are sacred because they are not for Jammu & Kashmir.

The fateful orders of August 5, 2019, are a blot on the constitution, which threaten to destroy the basic structure of the union of India. Through the presidential order, the state assembly was dissolved, the state was placed under union bureaucracy, controlled by around a million soldiers under union rule.

An employee of the union government is governing the state as its governor, who has to be construed and read under the presidential order as the ‘government’ and ‘Sadr-e-Riasat’. The legislative assembly is to be construed as the constituent assembly. In other words, the union is consulted by the union and consented by the union.
Interpreting the law

Article 370 is a condensed constitution in itself with its own mechanism of legislative process without the need for intervention from parliament. The terminology used in it is self-explanatory and does not leave room for any ambiguity.

The unequivocal words used in Article 370 cannot be subjected to subjective and whimsical interpretations, added through Article 367 of the constitution to give leverage to executive interpretations over the judicial power of interpretation.

Interpretation involves understanding, explaining and applying the meaning of laws, texts, or other sources of information that may be susceptible to different meanings.

It is an essential aspect of legal process, which is the prerogative of courts, legal professionals, jurists and scholars of relevant fields, who apply and interpret the law, and not the legislature or executive that only provide the foundations of law. Its application may vary from time to time with the change of facts, circumstances or environment.

Through its actions in August 2019, the Government of India has preempted the authority of its supreme court.

The words used in Article 370 are very clear. They mean what they say. Even if any ambiguity arises or there are mitigating circumstances that necessitated the Article have changed, the Article can be interpreted to meet the eventuality, but it cannot be made redundant by any branch of the state.

Interpretation reflects the mind of framers of the constitution or law, as well as the circumstances under which it was framed. Its intents and meanings can be ascertained from India’s library records as well as the constituent assembly’s debates (India as well as Kashmir), if the court finds any ambiguity.

The final word on interpretation of the constitution and law rests with the Supreme Court of India, not with the Indian government or parliament to say what a particular Article, clause or any word used therein means or to be construed as was done through the order on August 5, 2019.

Header image: A demonstration against the Modi government’s move to abolish Article 370 outside the Indian embassy in London in 2019. — Abdul Shakoor/ Shutterstock