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Zardari in difficult straits
Many factors may hit his party’s poll prospects
by G. Parthasarathy President Asif Ali Zardari appears set to go down in Pakistan's history as the first head of a democratically elected government to complete its full term, without having been destabilised, dismissed or ousted by a military coup. President Zardari was under constant siege not only from his hawkish Army Chief, Gen Ashfaq Pervez Kayani, but also from the country's mercurial Chief Justice, Iftikhar Chaudhry. The Chief Justice bears a deep grudge against the President because of the latter's disinclination to restore him to office after he was summarily sacked by President Musharraf in 2007. The empathy between the Chief Justice and General Kayani goes back to the days when as DG (ISI), then Lt-General Kayani was the only army officer close to Musharraf who did not harangue the Chief Justice when Musharraf summoned and summarily sacked him in 2007. Moreover, while pretending to be a champion of democratic freedoms, Justice Iftikhar Chaudhry had the dubious distinction of being among the first judges to sanctify the military coup by General Musharraf in October 1999. He was then Chief Justice of the Baluchistan High Court. While haranguing the elected government and seeking the arrest of two prime ministers, the Chief Justice has treaded very warily in dealing with serving army officers. His decision to order the arrest of the present Prime Minister, Raja Pervaiz Ashraf, came even while he looked the other way at allegations of kickbacks and illegal cash transfers in shady property deals by his son Arsalan Iftikhar. Moreover, General Kayani himself now has a tainted reputation even within the ranks of the army because of serious allegations of corruption and irregularities on the transit of NATO supplies against his brother. President Zardari's troubles were compounded by the strange and unexpected return to Pakistan Maulana Tahir-ul-Qadri, a Barelvi cleric, who controls a vast network of charities, running hundreds of schools, colleges, libraries and medical facilities, primarily in the populous army-dominated Punjab province. A majority of Pakistanis are Barelvis and constitute a powerful, though leaderless and disorganised, vote bank. While Qadri supported the 1999 coup by General Musharraf and was elected to Parliament, he soon found that he was marginalised because of the close links the military had with Wahabi-oriented groups like the Lashkar-e-Jhangvi and the Jaish-e-Mohammed, which periodically target and kill Barelvis and Shias. He obtained political asylum in Canada, leading many to allege that with his strong views against terrorism, he enjoyed CIA and western backing. Collecting around 30,000 supporters, Qadri undertook a “Long March” to Islamabad, where he demanded that the present “corrupt” government be replaced by an interim government, appointed by the Army Chief and the Chief Justice. He also demanded removal of the highly respected Chief Election Commissioner Justice Fakhruddin Ebrahim. Interestingly, Chief Justice Chaudhry ordered the arrest of Raja Pervaiz Ashraf on charges of corruption on the same day that Qadri reached the capital, sparking off yet another constitutional crisis. Pakistan's squabbling political parties got together and rejected Qadri's demands while calling for early elections as mandated by the Constitution. The National Accountability Bureau, investigating the case against the Prime Minister, rejected the Supreme Court's order for his arrest, stating that investigations in the case were still ongoing. The Zardari government and Qadri reached an agreement on January 18, leading to the end of the agitation in Islamabad. While Qadri's demand for a national government appointed by General Kayani and Justice Chaudhry was rejected, the government agreed that the cleric would be “consulted” in the formation of an interim government. His other demands like the dismissal of the Chief Election Commissioner were also rejected. The government agreed that the National and Provincial Assemblies would be dissolved by March 16 and elections thereafter held within 90 days. It remains to be seen how a consensus would be reached on the formation of an interim government, though both major parties, the PPP and the PML (N), appear agreed that the army must not be allowed to intervene, using the Chief Justice and the likes of Maulana Qadri as proxies. Preparations for the forthcoming elections are now gathering momentum. The anti-incumbency factor, amidst rising inflation, endemic power shortages and allegations of corruption will weigh heavily against President Zardari's Pakistan Peoples' Party (PPP). This is, however, countered by growing anti-Punjabi sentiments in rural Sind, the bastion of the PPP, about the assassination of two Sindhi Prime Ministers, Zulfiqar Ali Bhutto and Benazir Bhutto, purportedly at the hands of the Punjabi military establishment. Bilawal Bhutto has already played on these sentiments. More importantly, an important card for the ruling PPP-PML (Q) Alliance is its support for a separate state of “Seraikistan,” to be carved out of the Bahawalpur, Dera Ghazi Khan and Multan regions of South Punjab. There is alienation in this Seraiki-speaking region against discrimination by Punjabi-speaking rulers, from the army-dominated North Punjab. Former Prime Minister Nawaz Sharif and his Pakistan Muslim League (N) have opposed this move and will find themselves at a disadvantage in South Punjab against a powerful array of politicians like Deputy Prime Minister Pervaiz Elahi and former Prime Minister Yousuf Raza Gilani. With 80 per cent of Punjab's development budget going to the army-dominated North, which also dominates the Police and civil services, Seraiki grievances run deep. Insensitivity of the Punjabi establishment towards the aspirations of others has contributed significantly to the alienation in other parts of the country. The PML (N) is seeking to forge alliances with sectarian Barelvi groups to counter the Muhajir-dominated MQM in urban centres like Karachi and Hyderabad and in Punjab. Imran Khan, the favourite of jihadi and Taliban-oriented outfits and the military establishment, has been losing momentum but is likely to eat into sections of the traditional vote base of the PML (N). The present scenario can change in the next five months in the run-up to the elections, given the propensity of the army to covertly influence the dynamics of politics. The army's traditional animosity towards the PPP runs deep as do its fears of what a strong leader from the Punjabi heartland like Nawaz Sharif can do to erode its domination of national life. Maulana Qadri's proposal for a caretaker government appointed by the army and the Chief Justice enjoyed tacit army support. Both Chief Justice Chaudhry and General Kayani are scheduled to retire this year. A handpicked caretaker government would perhaps not be adversely disposed to suitably “accommodating” them after their
superannuation! 
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Literary pilgrims of Jaipur
by Rajnish Wattas We're back — and from Jaipur’s Literature Festival. Having participated in the literary Kumbh, there is a halo around us after the pilgrimage. While it was fun to be there, it's even greater fun to talk about it.Just drop in a little, "Oh! I think William was so insightful. Prasoon such a bore, but I loved Pico ... and his global soul insights!" And see the jaws of your audience drop agape. Never mind, you never understood anything of the Afghanistan conundrums and 'Return of the King' theory propounded so painstakingly by William Dalrymple. It's enough you saw him, got photographed and even managed a hand-shake (rather snatched it). What's important is to see and be seen, and to be seen doing so on your social network. Keep mum about a shove and push there, scampering for seats, getting squashed by thousands of over-eager readers, authors, writers, wannabe intellectuals, playwrights, Page-3 celebs or out-of-work stars — the mother of all LitFests (there are 80 of them now and still counting ...) is a moveable feast. And literally so, as there is no place to sit and you're perpetually moving from one pandal to another. A lot of time also goes into ogling at the haute couture femme fatale audience with stylish scarves, hats and designer goggles. Nehru jackets are the unwritten dress code for desi intellectuals. The presence of real-life royalty at the venue was even more distracting. It made it difficult to concentrate on the cerebral crowns discoursing on subjects as diverse as “If you meet the Buddha on the road, laughing, weeping, writing,” “The origins of sex” or “007 Ian Fleeming and the making of James Bond” when we spotted the magnificent Raja Ram Pratap Singh of Diggi, owner of the festival premises, being given a royal musical salute by the tall, strapping, moustached traditional bagpipers of Rajputana. If your audience is still not shaken and stirred, then throw in the trump card about the Ashish Nandy controversy. "Of course, I was there!" It will get you all ears. "What really happened?" How would you poor know, you were so busy standing 34th in the serpentine queue for the famous kullarwali-chai, catching snatches of Tarun Tejpal's dialectics with the grand old man of sociology — described by Urvashi Butalia as the “resident psychiatrist of the nation”. Though post-festival, Nandy himself may be needing a bit of counselling. Between getting lost and sending desperate text messages to one another to relocate, we prided ourselves when our own city litterateur Nirupama Dutt steered the session “Punjabi by Nature” or when the famous art historian, Dr B N Goswami, held forth on the intricacies of miniature painting — and was described by Glenn Lowry, Director of the Museum of Modern Art ( MOMA) of New York, as a “national treasure”. Jaipur, now watch out for Chandigarh. We will paint the city pink with literary
ink. 
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A UN report says there are about 10 lakh registered users of heroin in India. However, with about 50 lakh estimated unregistered users, it is time to tackle the growing substance abuse among the youth
The white powder of death
Dr Rajeev Gupta
Thousands
of young boys from Punjab and neighbouring states have fallen victim to the onslaught of heroin, one of the most lethal intoxicants. It has become a serious public health hazard. Heroin was originally developed by Bayer Pharmaceuticals Company as a cough suppressant in 1895. Derived from opium poppy, it is light, white in colour and bitter powder. When adulterated with talcum powder, powdered milk, sugar, strychnine and other substances, it takes the form of brown powder and is sold as “smack” or “brown sugar” and is called poor-man’s heroin. According to a UN report, about one million heroin users are registered in India and about 5 million are estimated unregistered users in our country. Heroin was initially a casual pleasure provider among the affluent class in metros but now its use has percolated to all sections of Indian society. How it is used
Heroin is commonly sniffed (snorted in), smoked or injected. Heroin powder, kept on heated silver foil, emits fumes which are inhaled. These addicts gradually move from inhalation to injections, which is a highly potent agent. An addict keeps heroin powder in a spoon, mixes it with tap water and heats it, then injects the preparation intramuscularly or intravenously. Some addicts also prepare injections of brown sugar which may turn to be dangerous and even fatal at times. Clinical effects Heroin immediately induces a pleasurable feeling called ‘rush’. After the initial alertness, the user remains drowsy for several hours. Heroin slows the heart functioning and the respiratory rate which can cause sudden death. Since quality and the purity of street heroin can never be ensured, its use always carries a high mortality risk. If used a few times, it has great potential for dependence and addiction. In fact, more than half of the individuals who have even occasionally used heroin become dependent. It causes physical and psychological dependence. Once addicted to it, a heroin addict spends time only in seeking and procuring the drug. In a patient who is heroin addicted/dependent, once the use of heroin is reduced or withdrawn, he experiences severe and intolerable withdrawal symptoms: body ache, vomiting, diarrhoea, restlessness, lacrimation, sneezing, agitation, disturbed sleep, sweating and cold flushes, blood clots and unconsciousness. Symptoms generally appear 24 to 48 hours after the last dose. Heroin addicts are known to have craving for even weeks and months after the physical withdrawal is over. Even visual cues can arouse strong craving and flashback in a controlled addict. This is why relapses are common among them. Medical complications Heroin addicts are known to suffer from chest infections, liver and kidney diseases. Injection drug users have local skin abscesses, collapsed and blocked veins, infection of the blood vessels and heart valves, arthritis and loss of menstrual cycles. Contaminated street heroin causes serious health complications. Fatal infections like Hepatitis B, Hepatitis C, HIV are quite common among intravenous users of heroin. They can pass on these infections to others through the use of shared needles and syringes and can sexually transmit these to their partners. After five years of use, the average heroin addict has a 90 per cent chance of having contacted Hepatitis C. Hepatitis C is an important cause of liver cancer. Cases of Hepatitis C are showing a steep rise in many areas of Punjab. Opiates are known to suppress the immune system and make the users prone to skin and systemic infections. Personality breakdown Heroin addicts become indifferent to their surroundings, family and friends. They lose their sensitivities and sense of responsibility both towards themselves and towards others. Often they are not able to meet the demands made on them in their personal and professional life. Heroin habituation directly affects the mood, memory, eating habits, sexuality and aggression of users. The natural inhibition threshold is rapidly broken down. Most addicts lie to family members, relatives and acquaintances. Many addicts also develop the habit of stealing to feed their addiction. Due to this breakdown of their inhibitions, they are able to resort to criminal acts and prostitution in order to obtain money for drugs. Thus, the use of heroin destroys the personality of the addicts. It’s referred to as a breakdown of the personality. Cost of addiction In India, the street cost of smack is Rs 600-Rs 800/gm and that of heroin is Rs1,500-Rs2,000/gm. Addicts regularly use 1gm to 3gm of smack or heroin per day. The price depends upon the level of purity. As an addict regularly abuses drug, he develops tolerance towards it and needs a higher amount of the drug to reach the earlier high. Many addicts themselves become drug peddlers to support such a growing habit. The heroin addict must classically work in any or several of four occupations: “deal, steal, pimp or whore”. Road to crime Heroin is associated with crime for the simple reason that its manufacturing, use and distribution is illegal. Many people turn to a life of crime in order to help fuel their addiction for the illegal drug. Since, addicts do not ordinarily hold jobs, they often turn to theft, followed by drug sales, stealing, shoplifting, mugging, burglary, armed robbery, con games, and violent offences and so on. In India more than half of heroin/smack used is locally prepared. States like Punjab and Rajasthan have become the transit route for heroin coming from Afghanistan. Pakistan became a major transit route in the 1980s, when trafficking was officially sanctioned in Afghanistan as a way to fund the Mujahideen. Recent confiscation of huge quantities of heroin from Punjab clearly indicates the magnitude of heroin being smuggled across the India-Pakistan border.
Risks
Heroin users have a death
rate of 13-17 times that of their age-matched peers and a 14-fold risk
of suicide. Between 10 and 35 per cent of deaths of heroin addicts are
due to suicide.
Accidental overdose is a major cause of death among heroin addicts. Street heroin is often contaminated and its users can never determine its potency and purity.
If some addicts take heroin after stopping for few weeks, they risk an overdose, even with a smaller amount.
Most heroin addicts are multiple substance users and they may also use alcohol, cannabis, opium, spasmoproxyvon, sedatives or cocaine. The use of these substances also contributes to death due to overdose.
Under the influence of heroin, an addict may become deeply sedated and may inhale vomit and die.
Heroin injections may damage veins and can cause embolism and gangrene.
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Warning signs
Presence of needles and syringes not used for other medical reasons.
Spoons with burn marks.
Aluminium foil or gum wrapped with burn marks.
Straw with burn marks.
Small plastic pouches with white or brown residue.
Sign of burns on fingers, palm.
Loss of menstrual cycles in females.
Staining of teeth.
Missing shoe laces used as a tie for injection sites.
Wearing long sleeves or long pants to hide needle marks, even in warm weather.
Severe itching.
Fits of unconsciousness.
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Behavioural signs
Intolerance and sudden behaviour changes.
Frequent lying and deceptive
behaviour.
Loss of motivation for future goals.
Hostile behaviour towards loved ones.
Avoiding eye contact.
Spending extra time in toilet/bathroom.
Slurred or incoherent speech.
Worsening of school or college records.
Worsening of work record.
Poor personal care and hygiene.
Unprovoked anger and violence.
Loss of interest in life.
Repeated stealing and borrowing money.
Broken promises.
Sexual dysfunction.
Long and unexpected absences.
Drowsiness or lethargic behaviour.
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Management
 Heroin is a drug that is easy to take but difficult to leave.
Treatment and rehabilitation facilities are quite limited in our country.
Most addicts do not have access to even existing treatment facilities.
There is no registry being maintained for such cases.
There is no follow-up services in most of the places.
Drop out and relapses are quite common.
Punishment and confinement of heroin addicts are of no help.
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India and the world
India is the world’s largest producer of illicit opium in the world, which is used to make prescription drugs.
The UN recently declared India as South Asia’s biggest consumer of heroin in its comprehensive demographic report.
It is a transit point for countries like Afghanistan, Bangladesh, Nepal and Pakistan.
Out of 40 tonnes of heroin produced in South Asia, 17 tonnes are consumed in India with a trade value of $ 1.7 billion.
Of the 17 tonnes of heroin consumed in India, about eight are of Afghan origin and the other nine are indigenously manufactured.
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The writer is a Ludhiana-based psychiatrist and deaddiction specialist.
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