Jamila's screams tore through the sky, travelling the deep lengths of haunting silence guarded by military men at River Neelum. She wanted to grab her son, Ali Ahmad, from the other side of the border and run. Instead, Jamila saw him being dragged away by Indian soldiers, away from the river, away from the border, away from her sight. The cross-border meeting time was over.

Ali Ahmad is 20 years old and was raised in the disputed territory of Jammu and Kashmir by one of his mother's relatives, who had looked after him since he was an infant. He was left or forgotten on the Indian side of the border when his mother was swept up in the mad rush to flee to Pakistan during the violence of the early 90s. He now lives and studies in New Delhi, and made the long journey to the border for the rare opportunity to see his mother. In fact, it was the rarest of opportunities, as she stood in front of him for the first time across the border at River Neelum -- also known as Kishanganga -- that splits the Kashmir region between India and Pakistan; the place where all the wars in his life began.

Jamila still lives in the beautiful, isolated valley of Pakistan-controlled Kashmir very near to the Line of Control (LoC) that divides the two countries and continues to be their single most threatening bone of contention.

"Return my son", she pleaded as people held her from trying to cross over the river. "Forgive me for leaving India. I was scared. Please return my son before I die."

Jamila uttered gibberish and let go of her last scream, before the sun slipped behind the dark green mountains splitting Kehran into what Pakistanis generally call ‘Azad [free] and Occupied Kashmir.'

For 20 years, Jamila had waited to meet her son, attempted to reach him, and since the recent initiation of cross border permits, has made dozens of visits to the permit office. All to no avail. Her application to cross the border has never been rejected, "they don't reject or give a reason for delay. They just don't grant us the permit," Jamila later told the AfPak Channel. "I have been trying for several years, and have spent hundreds of thousands of rupees just making incessant visits to the office, sometimes bribing officials who never really helped. Those who do get their permits must be really lucky, but I have never met anyone like that."

Jamila has no family on the Pakistani side of the border. Her father and husband were killed during the massacres of the 1990s in Indian-held Kashmir a few months after her marriage. The Indian army is accused of committing thousands of extra-judicial killings, and "stories of arrests, torture, killings, and secret burials were rife in Kashmir" at the time.

Jamila's town of Zachaldara, Handwara in North Kashmir's Kupwara district was infamous for such violence, and her "only hope was to escape." Her son was just a year old when she decided to go to Pakistan with a group from her village that was "fleeing to Azad Kashmir for freedom." "It sounded like a miraculous imagination, a dream, at that time to be able to live freely," Jamila said. "But freedom is pointless if it separates you from your own child." Today she is 45 but looks a decade older, perhaps aged by a lifelong desperation to live with her son again.

"I want to see him graduate from college and find a nice girl to marry. For years I have dressed him for school in my head and I have imagined tucking him to bed. But like the dreams we have had of freedom in Azad Kashmir, these dreams I have for him are not real and I fear they shall never become." She says she is "very tired" and fears dying from this wait.

What do Kashmiris want?
It seems for many Kashmiris that there is nothing more horrible than having a family and knowing that you will never meet them. Jamila is one of thousands of such Kashmiris in Pakistan, who are now speaking out about their issues through protests and demonstrations. On July 10th and August 5th of this year protesters gathered on both the Pakistan-controlled (Azad) and Indian-controlled sides of Kashmir bordering the Neelum Valley, and caught the attention of local and foreign media outlets. Chanting in demand for freedom from the armed forces of the two countries, they held banners that said "India, Pakistan, leave us alone." "Kashmir belongs to Kashmiris," and "Kashmir is burning, leave us alone."

Among the various difficulties that Azad Kashmiris face when trying to meet with their families on the other side of the border, the topmost include: (a) being unable to communicate with their relatives either via mobile phones or land lines; (b) being unable to send and receive mail, letters and packages, "It is also commonplace, that our mails and letter never really reach our families on the other side, and if they ever do, they are always open," pointed out Jamila; and (c) being unable to commute and meet their families across border.

The question is, why do these Kashmiris have to gather in dissent when India and Pakistan seem to be having rather healthy negotiations and agreeing on confidence building measures (CBMs) that often focus on relaxing regulations for Kashmiris? Kashmiris are now nominally permitted to meet their families as often as three times per year, for as long as 30 days per visit. And Kashmir now has five transit routes at the LoC for Kashmiri-born traders.

The most recent CBMs discussed by the two countries have resulted in landmark developments, including increasing the number of trading points along the Line of Control, increasing the number of days on which trading can occur, the launching of a new bus service to operate via new routes between northwestern Pakistan-occupied Kashmir and southern Indian-occupied Kashmir, and an increase in the frequency of the bus service between Muzaffarabad (the capital of Pakistan-controlled Kashmir) and Srinagar (the capital of Indian-controlled Kashmir). However, there is clearly a vast different between agreeing to a policy and implementing it on ground.

Local analyst and professor Khalil Sajjad, who works in the Peace Studies department at the University of Azad Jammu and Kashmir, believes that CBMs are merely a marketing tool to flaunt improving relations between India and Pakistan, and are not really delivering on the promises made to Kashmiris. "Even though new developments such as re-opening and regularizing of bus routes seems to provide unstinting opportunity to traders and people, if thousands of families have still been unable to meet their relatives for the past two decades, then in essence the impermeability is intact."

The core issue: Who gets the cross border permits?
Jamila is one of the approximately 10,000 applicants who have been seeking cross border permits since 2005. There are no exact numbers on how many applicants actually receive permits every year. The bus using the route between Chakoti in Pakistan-controlled Kashmir and Srinagar in Indian-controlled Kashmir carries around 40 passengers every Monday. Major Iftikhar from the Chakoti Military check post says, "90% of valid applicants get their permits. Only those declined by our verification procedure have to wait."

The verification procedure is long, and includes various levels of checks and double-checks. When applications are submitted, the individual's biographical details are initially verified by different government departments. "If their records are clean, we then give these details to about five agencies that are part of the Inter-Services Intelligence Directorate (ISI)," Major Iftikhar told the AfPak Channel. "We are very careful with who we are allowing to the other side of the border. This develops a feeling of neglect and hostility among many applicants who await permits, but we need to be fastidious since our relation with India is still very sensitive" he added.

Trade Facilitation Officer Mubarak Abass, who manages the Chakoti Crossing Point and looks after the Srinagar-Muzaffarabad bus service on the Pakistani side, says "40 percent of the total permits are currently pending. Many applications are held because they do not qualify the verification procedure. Some submissions are incomplete; others are marked red based on security concerns. For example, if we find the applicant to have suspicious links or the data submitted by candidates is unverifiable then we hold such applications. One needs to be chary of the risks involved."

Are these limitations violating civil rights? Broadcast journalist Aurangzeb Jarral, who works for the private national channel Dunya TV, says, "[the most] genuine and the most bland applicants with unblemished records don't get their permits. I have met and interviewed many people who have nothing to do with militancy or have the thinnest possibility of something mistrustful, but they don't get their permits for years if not decades. This is a clear-cut abuse of human rights, when the government has a system in place just for these people but they are still not able to avail it. Many of them die waiting."

According to Wadood Ahmed, who is currently conducting academic research on the Kashmir conflict, "It is tacit knowledge that India and Pakistan do not want to provide absolute cross-border access to Kashmiris on either side. And Kashmiris on both sides of the border are well aware of this. More than any militancy threats, the real fear has to do with a fair people's access." For India, the fear is that more Kashmiris coming from the Pakistani side may create pressure for freedom, and in the worst-case scenario, they may join liberation armies in Indian-held Kashmir. For Pakistan, the fear is of spies sent by the Indian government. "As long as India and Pakistan want to hold on to their sides of Kashmir, neither of them will provide fare permits freely, even to the most authentic families/candidates."

Indian journalist Jahangir Ali told the AfPak Channel, "An old lady died in July this year of cancer. She had communicated her last wish to the [Indian] government; it was to meet her son. Her daughter and family tried to urge the government to let her son come to meet her from Pakistan. The government refused to give him the cross border permit. It was heart breaking to watch her die without seeing him. What good are such CBMs if they can't be serviced for genuine cases like this?"

Does this mean that India and Pakistan are only nominally applying the CBMs? Is Kashmir just a convenient rallying point for both countries? And is there is a strong interest on both sides of the border in keeping Kashmir alive?

"Look, absolute peace is really not in the interest of either of the two countries," researcher Wadood Ahmed told this author. "Neither of them wants to see Kashmiris independent because that would mean [one] of them loses their territory." Both governments have failed to provide the populace with welfare, development or infrastructure. Visa permits are just one example of how the two states continue to put off the difficult task of giving Kashmiris' their right to self-determination while giving the world the impression that real progress is being made.

Kiran Nazish is a journalist based in Pakistan, currently covering the country's conflict areas to report on issues of human rights. She can be followed @kirannazish.

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Cross-border contagions

By Haider Warraich

Pakistan is in the midst of a massive outbreak of dengue fever. With tens of thousands of patients affected, mostly under the age of 15, dengue is arousing much chaos and paranoia. While dengue is fatal in few cases (less than 1%), it results in a severe bleeding disorder in about 20% of cases (due to a dramatic reduction in patients' platelets), and in many cases, symptoms such as fatigue and depression persist long after the acute infection has subsided. Therefore it is a source of severe debilitation and its rapid spread is a source of great public panic. Dengue has spread like wildfire throughout the country, with cases being reported in all four provinces. However, modern means of transportation (cars, trains, airplanes) mean that not only can an infectious disease spread easily within the borders of a given nation-state, pathogens can overcome both geography and nationality with much ease. Consider the H1N1/swine flu pandemic of 2009 which within a matter of three months spread to 214 countries and territories, affecting millions, and causing about 18,036 deaths. The flu pandemic spurred the recognition of the need for cross-border collaboration to curtail the spread of infectious diseases. However, these important lessons have not been recognized by the governments of India and Pakistan, which share a 2,308km long border.

While Pakistan's border with India is certainly not as open as the one it shares with Afghanistan or China, reflected by the transit of polio cases across these two fronts, it is certainly far from airtight. Research into the subtypes of the dengue virus has shown that the strains circulating recently in India and Pakistan are similar, and an epidemic caused by one strain is usually followed by an epidemic with a similar strain across the border. Such a relationship was clearly reported in the temporally linked epidemics of Delhi and Karachi in 2006. Therefore, there is substantial evidence indicating cross-border spread of dengue, and possibly indicating the spread of other infections as well. Modern means of transport, which have far more mileage than the tiny wings of a mosquito, have made it much easer for infections such as dengue to spread from one side of the border to the other. The threat of cross-border HIV infection has also been reported, and is an important one to keep in mind as the painful memory of the Mumbai attacks recedes, thawing diplomatic relations, thus reopening the door for more people-to-people contact. Furthermore, a case of polio was recently detected at the Attari-Wagah border, raising fears of the spread of polio to the Indian side of the border. 

In spite of the overwhelming need for collaboration in health and infectious diseases between India and Pakistan, no official channel is in place to conduct such an exchange. Currently, the Attari-Wagah border is used as a quarantine of sorts to vaccinate children crossing the border to prevent the spread of polio infection. During the H1N1/swine flu pandemic, the train that crosses the border - the Samjhauta Express - is frequently fumigated with insecticide. Custody was sought of animals being transported to India such as pigeons, donkeys and dogs for fear of spread of diseases ‘eradicated from India'. While the issue of cross-border infection has been used for rhetorical purposes, no constructive step to overcome this deficit has so far been taken from either side. While Pakistan has sought medication and insecticide from India to combat the dengue epidemic, there is no robust mechanism to ensure that such positive exchanges can occur on a regular basis.

Pakistan and India face similar public health challenges. Both are third world countries faced with similar geography, population demographics, and infectious diseases such as pneumonia, measles, malaria, and tuberculosis, accompanied by widespread malnutrition.  Pakistan and India are also two of only four countries in the world where polio remains endemic, though India has made substantial progress in eradicating polio within its borders this year. Importantly, dengue is also a challenge shared by both Pakistan and India, which in itself is reason enough for close cooperation to occur.

Pakistan's healthcare system is decrepit by any standard. Healthcare remains a luxury reserved for those who can afford expensive services provided by largely privatized providers. Furthermore, the formerly federal responsibilities of coordinating healthcare and health-related services have recently been devolved in both India and Pakistan. This devolution poses similar challenges to Pakistan and India, since the lack of internal systematization of health information precludes international collaboration. According to Dr. Sania Nishtar, president of the Pakistani NGO Heartfile and a leading authority on health systems in the developing world, "The inadvertent fragmentation of health information as a result of health devolution in Pakistan is further undermining the country's ability to share information with its neighbors." However, she suggested a way forward to overcome the disintegration of a central health in order to facilitate international collaboration. "Options are available, however, to cast an institutional construct that will enable Pakistan to step up its capacity so that the country is compliant with International Health Regulations, 2005", she added.

The lack of collaboration between Pakistan and India with regard to infectious diseases is only reflective of the thorny history shared by these two countries and the level of prevalent distrust on both sides of the border. The World Health Organization is a large platform with regional organizations that help countries collaborate in their neighborhood. However, in a move representing a snapshot of the bigger picture, Pakistan opted to be a member of the Eastern Mediterranean region as opposed to the more natural South-East Asia region, which is headquartered in New Delhi. This move away from the South-East Asia region was political and was made so that Pakistan does not have to compete with India, which dominates the regional organization. Therefore, composite dialogue carried out bilaterally by Pakistan and India is the only platform for a health partnership to be forged. A fresh start needs to be sought to elevate the relationship from quarantining birds and other animals on the border to sharing research, disease surveillance data, vector control strategies and health communication material with institutional support. However, this can only occur under the umbrella of wide ranging confidence-building measures. Not only will it be extremely difficult to initiate collaboration, but the sustainability of any initiative might be an even greater issue given that it will always remain hostage to politics.

Haider Warraich, MD, is a research fellow at Harvard Medical School. He is a graduate of the Aga Khan University in Karachi, Pakistan, and the author of the novel, Auras of the Jinn.

 

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Pakistan's war against polio

By Haider Warraich, January 25, 2011

This week, Pakistani President Asif Ali Zardari put the fight against polio at the forefront of his domestic agenda, announcing emergency measures to vaccinate 32 million children at risk of the disease. Pakistan is one of four countries in the world to continue to suffer serious incidences of the disease, and this new attention to polio eradication shows how far the world has come in battling the disease, while also showing the serious challenges standing in the way of eliminating it forever.

Read on

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