Wait for the endgame is long

The situation in Syria is turning from bad to worse. President Bashar al-Assad appears well and truly besieged, but he shows no signs of giving up. Will he triumph in the end or quit after leaving his country in a state of complete disrepair? No one seems to know for sure

On the morning of July 18, when a bomb went off in the same building where embattled Syrian President Bashar al-Assad was meeting with his national security council, for a brief second its deafening noise even silenced the sound of gunfire that crackled in the background. And then reality struck: Three of Mr Assad’s top security chiefs — Minister of Defence Daoud Rajiha, former military intelligence chief and his brother-in-law Assef Shawkat, and another former Defence Minister who had remained a power to reckon with across the country’s vast military establishment, Hassan Turkmani — had been killed. The President’s cousin, notorious as the chief interrogator of the state security agency, Hafez Makhlouf, had been grievously injured. The President himself had escaped unhurt, but only just. The regime had been hit. For the first time since the popular uprising began 17 months ago, the rebels had finally been able to wound the obstinate Assad Government, deeply and definitively.

The endgame was here; it was the beginning of the end, proclaimed many a newspaper editorial and security pundit. A general consensus had quickly formed that the attack — which came four days into a rebel onslaught on the Government-controlled cities of Damascus and Aleppo — had so crippled the Assad regime that it would now quickly unravel and at least some of the bloodshed would finally stop.

In fact, in one of the many “endgame-is-here” type articles that appeared since the blast, a reputed international news magazine theorised that in every revolution there comes a moment when the tide turns against the regime — Libya, it was rise of Tripoli against Colonel Muammar Gaddafi, and in Egypt, it was when protesters occupied Tahrir Square and torched the ruling party’s headquarters. In Syria, it goes on to add, that moment when the balance of power shifted away from the Assad regime could have well been on July 18.

Today, it has been exactly a week since the deadly blast ripped through the high security, military compound in Damascus, hitting the brutal Ba’athist regime closer to its heart than ever before and prompting talks of an endgame. And yet, there has been absolutely no sign of either Mr Assad getting away on a jet plane to seek refuge in some exotic foreign location or reports of a slew of high profile defections that would hollow out the regime from within or even instances of rebel surge that could finally topple the Government, as it had been predicted earlier.

If anything, it seems the bomb attack, which was definite proof of the rebels gaining more strength, seems to have convinced the regime to dig its heels in deeper. Overall, apart from the empty rhetoric, there is little proof that the ‘endgame’ has begun for the Assad regime, or for that matter the regime has any reason to back out at this moment. Sure, it has come under a lot of pressure and yes, it will eventually collapse, but the time for that has not yet come — not until a huge Pearl Harbour kind of incident totally shakes things up.

And, therefore, it should not come as any surprise that in this past week Government forces renewed their offensive and even lashed out from the skies at the people. On Tuesday, warplanes bombed Aleppo, Syria’s second largest city and the country’s commercial capital. Once an Assad stronghold, unrest has also spread to this city prompting the Government to launch a coordinated attack that included heavy artillery shelling and rockets launched from military helicopters.

The fact that the Government has now resorted to aerial bombing, along  with reports from Israel’s intelligence chief that the Syrian Army has removed all its soldiers from the Golan Heights border area and possibly redeployed them to Damascus and other cities, shows that the Assad administration is growing desperate. But it should also serve as a reminder that between the rebels and the regime, it is still the latter that is by far the more powerful player. Moreover, don’t forget that Mr Assad is yet to take out his big guns.

Let us also not forget that the Syrian President continues to have at his command one of the largest air forces in West Asia, and as he showed on Tuesday, he is yet to use it to full effect. Similarly, he is also sitting atop a huge stockpile of chemical weapons that includes sarin nerve agent, cyanide and mustard gas, and reports of them being moved out of their storage places, even if unconfirmed, remain a cause for worry. Will Mr Assad use chemical weapons against his own people and risk becoming an international pariah? There is no way one can tell for sure but given that the President has painted himself into a do-or-die situation, no options can be ruled out at this point. Besides, Mr Assad continues to enjoy the support of Russia and to a lesser extent, China. These two insulate him from international pressure and have emerged as his main source of external support.

Finally, one must also factor in the fierce loyalty of Syria’s elite security forces that belong almost entirely to the minority Alawite sect of Islam (an offshoot of the Shia faith), like Mr Assad himself. As this conflict, now officially tagged a civil war, draws out and takes on definite sectarian contours, pitting the country’s Sunni majority against the powerful Shia/Alawite minority, the President can trust upon the latter to defend him till his death and beyond. This, for instance, is in clear contrast to the case of Col Gadddafi, who had to depend largely on foreign mercenaries for his survival. But Mr Assad knows too well that, today more than ever before, the Alawites need him the most.

In the minds of the Alawite community, particularly those within the security forces and others closely associated with the Government, the fear of revenge and reprisals against them if Assad’s regime falls is a very real one — and perhaps, rightly so.

Nevertheless, the fact remains that Mr Assad’s days are numbered — and even the Alawites know it. And that is possibly why many of them are already moving out of their hometowns, mostly around Damascus and Homs, to the port cities of Tartus, Latakia, Baniyas and Jableh in the Sahel region that traditionally belong to the Alawites. It is here that the Alawites had lived throughout centuries of Mamluk and Ottoman rule, coming out to the mainland only occasionally to work as domestic labourers. After World War I, the French even created a sovereign Alawi state that extended from Latakia to Tartus in 1920. But the experiment failed due to the overwhelming Sunni desire for union with Damascus and by 1937, the coastal areas had been incorporated into present-day Syria. The Alawite community eventually entered the Syrian mainstream as well — and some like Mr Assad’s father even made it to the very top — but their integration was neither even nor ever complete. The religious fault-lines remained and this latest conflict has only served to crack them wide open.

Today, there is a huge possibility that as the battle for Syria continues between the regime and rebel forces, a de facto partition of the state will occur, with the Sunni rebels gaining control over Daraa, Deir al-Zour, the Homs-Idlib corridor and the rural areas around Damascus and Aleppo, while Government forces will shrink to the old Alawite state. But such a state will be as non-viable today as it was in 1920, and hence the Alawites can only be expected to fight until the very end for the whole of Syria.

(This article was published in the Op-ed section of The Pioneer on July 26.)

Quoting contempt, plotting coup

The ongoing power tussle in Pakistan between the judiciary and the executive is a losing battle for both sides. While neither of them is going to emerge unscathed, governance is already taking a beating

Less than a month after Pakistan’s Supreme Court in a dramatic move removed the country’s then Prime Minister Yousuf Raza Gilani after charging him with contempt of court and thereby disqualifying his membership to Parliament on June 19, the stage is now being set for a repeat performance. On July 12, Mr Gilani’s successor, Prime Minister Raja Pervez Ashraf, is scheduled to inform the Supreme Court whether or not he will follow its orders to reopen old corruption cases against President Asif Ali Zardari. In all probability, Mr Ashraf, like Mr Gilani, will choose to defy the apex court’s diktat, reiterating the Government’s argument that the President enjoys immunity from such cases for as long as he is in office.

On its part, the Supreme Court can choose to once again charge the Prime Minister with contempt of court, but it is unlikely those charges will stick. On Monday, Pakistan’s lower House of Parliament, known as the National Assembly, passed a key legislation that provides blanket protection to all Government functionaries holding high offices from contempt of charges with regard to the performance of their executive duties. The Contempt of Court Bill, 2012, is expected to be cleared by the upper house of Parliament or the Senate, and signed into law by the President before July 12.

Technically, that should provide the Prime Minister some cover from an over-zealous judiciary but the situation still remains fluid and largely unpredictable. There has been a marked escalation in the ongoing tussle between the judiciary and the executive in recent months, and this has thrown awry the delicate balance of power that lay at the crux of the relationship between these two key state institutions. Consequently, the Pakistani Parliament may pass a law but there is no guarantee that the Supreme Court will not throw it out of the window on grounds of being unconstitutional, for example. Indeed, only two days before the National Assembly passed the law protecting the executive from contempt of court charges, Chief Justice Iftikhar Chaudhry made statements expressing exactly this very sentiment.

Of course, the fact that the country’s highest court has the authority to nullify a law that it deems to be at odds with the Constitution is a basic judicial principle. However, it is the timing of Mr Chaudhry’s comments that make them highly suspect especially when viewed in conjunction with his other equally worrying statements. On Saturday, Mr Chaudhry went as far as to say that the supremacy of Parliament was indeed “out of place in the modern era”, that it was actually the Constitution that should enjoy pre-eminence. This, as an editorial in a leading Pakistani newspaper rightly pointed out, is indeed “explosive” not only because it strips the country’s democratically elected Government of its powers but more so because those powers are now reinstated with the judiciary — ultimately, an elected institution — which portrays itself as the high keeper of the Constitution.

Clearly, the judiciary is courting trouble. But if the judges want to play rough, the political class — no matter how emancipated — has proven that it can also pack a punch or two just as well. Therefore, a day after Mr Chaudhry fired his ‘Constitution is supreme’ salvo, Mr Gilani hit right back at him by stating that it was Parliament that had in effect created the Constitution. When viewed in consonance with the Contempt of Court Bill, it is wholly evident that the Government will not be taking any of this judicial bullying down. It will put up a fight, and a good one at that. Besides, given that its tenure expires in less than six month, the Government has little to lose, anyway.

For the judiciary, however, the game is far from over. Its strategy of attacking the Government head on has achieved mixed results at best, and even that has come at the very high cost of its own reputation. Between 2007, when the Mr Chaudhry became a Pakistani household hero for standing up to then President Pervez Musharraf who had illegally fired him at the time, and now, the Chief Justice’s stock has fallen greatly. Some of course still laud his campaign to cleanse Pakistani politics of widespread corruption, but most others can’t ignore the stench of personal vendetta that engulfs his actions. For instance, the Chief Justice’s June 19 decision to actually disqualify Mr Gilani as Prime Minister — earlier, he had left that decision to the Speaker of the National Assembly — came only after a real estate tycoon with close ties to the President charged Mr Chaudhry’s son of bribery. Some believe that Mr Gilani’s dismissal was indeed an act of revenge by a powerful father on behalf of his wronged son.

Either way, the larger picture is gloomy and hopeless. There is no end in sight even though this tug-of-war has been dragging on for several years now. At the core of the dispute still lies the National Reconciliation Ordinance, an amnesty law instituted in 2007 by then President Musharraf as part of a power-sharing deal with the PPP’s exiled leader Benazir Bhutto. According to the agreement, Mr Musharraf through the NRO would close the graft cases against Bhutto and her husband, Mr Zardari (as well as many other politicians) who had been accused of money laundering through Swiss bank accounts, in return for the PPP’s support for his re-election bid at the end of that year. Towards that extent, the then Chief Justice of Pakistan had even written to Swiss authorities to close the Bhutto-Zardari files and the latter had complied. But things didn’t go as planned. By 2009, Bhutto was dead, Mr Musharraf had resigned and left the country, and Mr Chaudhry was Chief Justice. He found himself an empty playing field and promptly, hit his first goal: He struck down the NRO.

Since then, he has been insisting that the Government write to Swiss authorities to disregard the earlier letter and by default reopen the graft cases. But as a Supreme Court lawyer has recently pointed out, Mr Chaudhry does not need the Prime Minister or any other Government official to write that letter. He can write it himself, and it would be just as valid. The problem for Mr Chaudhry actually lies in the fact that the Swiss, no matter what, will not reopen the graft cases against Mr Zardari while he is still President because of the immunity he enjoys under Pakistani law.

In effect then, this is a losing battle for both parties. While the judiciary has already lost much of its credibility with little to show in return, the Government also has suffered many battle scars with its own position within the establishment now significantly weakened. It is time for both to cut their losses and leave the battlefield.

(This article was published in the Op-ed section of The Pioneer on July 12.)

Not the care that India needs

Obamacare is one of the most progressive, pro-people legislations in recent time. The manner in which the White House pushed it shows the power of political will, which is a lesson for New Delhi. But India must look inward to find its own healthcare solution

The US Supreme Court’s endorsement of the Patient Protection and Affordable Care Act last Thursday is undoubtedly a defining moment in the Obama Administration’s efforts to provide healthcare coverage to all Americans. Popularly known as Obamacare, the legislation was the US President’s most important electoral promise back in 2008. It was signed into law in 2010 and aims to insure millions of Americans who live dangerous lives without any medical coverage.

In short, Obamacare makes it compulsory for almost all Americans to buy health insurance. If one can’t afford health insurance, the state shall provide for it. But anyone without insurance will have to pay a penalty. Termed ‘Individual Mandate’, this second clause was hotly contested and there were legitimate concerns if it would stand judicial scrutiny. The Supreme Court put those fears to rest last week when it ruled that the penalty was indeed a form of tax, and that the Government had the right to impose.

That apart, another salient feature of Obamacare is the manner in which it aims to rein in private health insurance providers. For instance, private insurers routinely refuse patients with prior health conditions. By making insurance mandatory for all, Obamacare has in effect blocked that loophole. Similarly, by extending the coverage available to the elderly under Medicare — which along with Medicaid forms the two main state-sponsored insurance schemes — it has also plugged the notorious ‘doughnut hole’ that compelled senior citizens to pay for their expensive medication.

But none of this comes for free. In fact, Obamacare lays the ground for enormous Government spending. Not only will the exchequer have to pay for the insurance of those who can’t afford it, it will also have to foot the bill for an extended Medicare and Medicaid coverage. Washington, DC hopes to pressure the States to eventually chip in but even that will not be before 2020, if at all.

Nevertheless, there is no denying that Obamacare is perhaps the most progressive, pro-people legislation that has been formulated in recent times. Yes, it will cost the federal Government an obscene amount of money and yes, it will drastically change things within the healthcare industry. But more importantly, Obamacare sends out the message that it is wholly unbecoming of a civilised country to not make basic healthcare available to all its citizens.

Expectedly, this is a message that has found resonance in India where political apathy, crumbling infrastructure and rising costs have deprived thousands of the healthcare they rightly deserve. One can only hope that the raucous over Obamacare will also generate debate on India’s healthcare systems and eventually push the topic of public health into the national mainstream.

Some have pointed to the Planning Commission’s stated goal of achieving Universal Health Care in the country by end of the 12th Plan period in 2017 as a positive step in that direction. Indeed, towards that end, an expert panel has even recommended a ‘National Health Plan’ which will, by law, make every citizen entitled to a basic healthcare package.

Unfortunately, this is where the comparisons with Obamacare become problematic. Not only is such a project far more ambitious than Obamacare, given its proposed scale and density but it is also a pointless exercise that will serve as a topic for academic discussion at best and an excuse for colossal money laundering at worst. An Obamacare-like plan will have little positive impact in India because it is not designed to address India’s problems. Instead, Obamacare is a tailor-made response to the American problem of sky-rocketing medical expenses wherein healthcare is so ridiculously expensive that insurance is an absolute necessity.

In India, however, medical services are relatively cheap and affordable. Government hospitals and healthcare centres across the country provide medical services at highly subsidised rates and often even free of cost to marginalised communities. The problem here is not so much the cost of the treatment but the quality of it. Abysmal infrastructure at many Government-run hospitals and healthcare centres means that even the best of doctors cannot effectively tend to all their patients.

If the Government is indeed considering pumping money into India’s healthcare system, it is in this aspect of improving infrastructure that the money should be invested. Or else, a hair-brained health plan that is really a cross between the wasteful populism of the Mahatma Gandhi National Rural Employment Guarantee Act and the wall flower-like idealism of the Right to Education Act will come to naught.

Ultimately, if the Government is really serious about achieving its UHC goal by 2017, it must leverage the country’s inherent potential to build a workable model that provides quality yet affordable healthcare to all.

Take for instance, the Aravind Eye Hospital network that is headquartered in Madurai and provides high level ophthalmic care to poor patients across south India. Here, cataract cases form the bulk of the patient body — only 30 per cent of which comprises paying patients who shell out anything between Rs 12,000 and Rs 15,000 for one surgery. But the revenue this section generates is enough to fund the treatment of the remaining 70 per cent of patients.

This financially self-sustaining model is based on the unique Indian innovation of the Small Incision Cataract Surgery. Instead of using modern phacoemulsification machines that are expensive, have high disposable costs and are not well-suited to cut out advanced and mature cataracts that are typical of developing world populations, doctors at Aravind perform a manual, sutureless, small incision extracapsular procedure with indigenously produced equipment on poor patients. The procedure is quick, cheap and safe and the results comparable to surgeries done on paying patients using the phacoemulsification machine.

There are several such examples wherein Indian doctors have come up with low cost but high efficiency technology that has revolutionised the way medicine is practised in this country —keeping it away from the debt trap of the West’s bloated healthcare system.

And if Aravind in south India has used technology as a game changer, across the country in the small towns and mofussils of Bengal, Disha Eye Hospital (another regional chain) has capitalised on India’s burgeoning population to build a financially sustainable model that provides world-class health facilities. Its hospital in Barrackpore alone caters to approximately 1,200 to 1,500 patients daily. Out-patient fee is a nominal Rs 60 but the tremendous bulk of the patient body renders this a profit-making institution that is able to provide quality medical services. Hospital chief Debasish Bhattacharya has his fingers on the pulse of his patient body when he says, “Whenever we think of eye care, we either picture a state-of-the-art hospital or a charitable organisation for the poor. The common man with his handful of money and heart full of pride fit nowhere.”

If only the Government would care to listen.

(This article was published in the op-ed section of The Pioneer on July 5)