In 2013, two factions of the Pakistani Taliban fought for control of Karachi's water infrastructure

Pakistani policemen carry an injured colleague after a clash between two political parties during a by-election in Karachi last week. Image: Rizwan Tabassum/AFP/Getty

With a population of more than 23m, Karachi, PAkistan is one of the world’s largest cities. It's also a hotbed of crime, corruption and militancy.

Omar Hamid was a police officer there for 12 years, before leaving to become a security analyst in the UK. In an event in Washington DC last week for the Project for Study of the 21st Century (PS21), he explained where it all went wrong.

Being a police officer means you really get to see the whole gamut of issues in Karachi. There are issues of sectarian violence; there are issues that any mega-city has. There are issues of political parties with the militias. There are issues of the growing presence of the Pakistani Taliban. And, of course, you have all of the regular crime.

With Karachi the commercial centre of Pakistan, control and influence within it is just too lucrative. In effect, the story of the past 25-30 years of the city is the struggle between various groups to squeeze that pie as much as possible. What you can learn from Karachi's example is exactly what not to do in any mega-city.

With the expansion of megacities, you have a situation where the central government – and in many cases the local government – has very little control. As these cities grow organically, control over scarce resources often ends up in the hands of non-state groups, political parties or organised crime syndicates. The challenge for urban governance this century will be how the state is able to impose itself, or how it can prevent resources from being taken over.

Karachi has large representations of all the ethnicities and nationalities in Pakistan. All of these various groups feel that they have a vested interest in the city, all of them have competed for that. The complex political environment comes from the fact that, over the past 25 years, Karachi’s ethnicities have been essentially pitted against each other. They form the basis for political parties.

Most of these political parties have also represented themselves through criminal militias. Those militia come to the forefront of organised crime and corruption.

What you can learn is exactly what not to do in any mega-city

As these parties fight for control of the city, the infrastructure of government – whether it’s the municipal operation of the city, or the police force – has become almost hopelessly politicised. Civil servants or police officers go to one party or another to vie for lucrative postings. The objective is to get in the good books of a certain local party, to get a good posting and to be able to recoup your expenses by making that a poster revenue generating tool. 

Everything is for sale in Karachi. The way that it filters down to the micro level, for instance, is illegal land grabbing. Political parties and religious groups, like the Taliban, indulge in illegally occupying or squatting on pieces of land. They carve slices of land up to create new squatter colonies, then they subsequently sell it off.

There is a shortage of water in the city, so control of the city's water hydrants is a very key tool in corruption. In 2013 rival elements of the Pakistani Taliban fought over control of water supplies in parts of the city. At one point last year, as the Pakistani Taliban was splintering into various groups, two of them were fighting against each other, essentially for control of water. It had nothing to do with religious ideology. It had to do with the cash that could be gained through the water.

For some time now there has been, it seems to people in Pakistan, a kind of understanding that the west was all right with the excesses of political parties as long as they were secular and talking the right talk. The fact is that the presumption ever since 9/11 has been that it was important to back groups that were opposed to religious extremists. On paper that makes a lot of sense – but the problem in Karachi is that lots of those groups are equally involved in criminal activities. 

It runs part of the city as virtually a parallel state with an extensive armed wing

The MQM, the largest party in the city, is an extremely secular party, totally opposed to the spread of religious extremism. Yet the MQM operates the largest criminal-political Mafia nexus in the city. It runs part of the city as virtually a parallel state with an extensive armed wing that has regularly taken part in politically targeted killings murders of police officers and government officials.

Something that has really turned around over the last five or six years is the growth of civil society. When you're sitting in Pakistan it feels like civil society does not necessarily have a direction. It's putting its head everywhere. But the fact it has found its voice is very important. The other thing that's aided the growth is the expansion of the media in Pakistan. The media too, at times, seems like it's a lot of heads shouting at each other nonsensically – but it has meant that, unlike in the past, the media is no longer a creature that can be controlled by any particular political party, or the country's political or military establishment.

Pakistan remains a very violent place, and in Karachi there have been a number of cases of journalists being murdered by all parties. But if there is hope, it is in this: these things are no longer controllable. The crimes or misdeeds of various groups become very public, and the growth of civil society, the growth of social media, means that the contrarian view gets out more often.

Omar Hamid is head of Asia Pacific Risk at IHS, and the author of a novel, "The Prisoner". 

He is also a global fellow at PS21, the Project for the Study of the 21st Century.

 
 
 
 

What’s killing northerners?

The Angel of the North. Image: Getty.

There is a stark disparity in wealth and health between people in the north and south of England, commonly referred to as England’s “north-south divide”. The causes of this inequality are complex; it’s influenced by the environment, jobs, migration and lifestyle factors – as well as the long-term political power imbalances, which have concentrated resources and investment in the south, especially in and around London.

Life expectancy is also lower in the north, mainly because the region is more deprived. But new analysis of national mortality data highlights a shockingly large mortality gap between young adults, aged 25 to 44, living in the north and south of England. This gap first emerged in the late 1990s, and seems to have been growing ever since.

In 1995, there were 2% more deaths among northerners aged 25 to 34 than southerners (in other words, 2% “excess mortality”). But by 2015, northerners in this age group were 29% more likely to die than their southern counterparts. Likewise, in the 35 to 44 age group, there was 3% difference in mortality between northerners and southerners in 1995. But by 2015, there were 49% more deaths among northerners than southerners in this age group.

Excess mortality in the north compared with south of England by age groups, from 1965 to 2015. Follow the lines to see that people born around 1980 are the ones most affected around 2015.

While mortality increased among northerners aged 25 to 34, and plateaued among 35 to 44-year-olds, southern mortality mainly declined across both age groups. Overall, between 2014 and 2016, northerners aged 25 to 44 were 41% more likely to die than southerners in the same age group. In real terms, this means that between 2014 and 2016, 1,881 more women and 3,530 more men aged between 25 and 44 years died in the north, than in the south.

What’s killing northerners?

To understand what’s driving this mortality gap among young adults, our team of researchers looked at the causes of death from 2014 to 2016, and sorted them into eight groups: accidents, alcohol related, cardiovascular related (heart conditions, diabetes, obesity and so on), suicide, drug related, breast cancer, other cancers and other causes.

Controlling for the age and sex of the population in the north and the south, we found that it was mostly the deaths of northern men contributing to the difference in mortality – and these deaths were caused mainly by cardiovascular conditions, alcohol and drug misuse. Accidents (for men) and cancer (for women) also played important roles.

From 2014 to 2016, northerners were 47% more likely to die for cardiovascular reasons, 109% for alcohol misuse and 60% for drug misuse, across both men and women aged 25 to 44 years old. Although the national rate of death from cardiovascular reasons has dropped since 1981, the longstanding gap between north and south remains.

Death and deprivation

The gap in life expectancy between north and south is usually put down to socioeconomic deprivation. We considered further data for 2016, to find out if this held true for deaths among young people. We found that, while two thirds of the gap were explained by the fact that people lived in deprived areas, the remaining one third could be caused by some unmeasured form of deprivation, or by differences in culture, infrastructure, migration or extreme weather.

Mortality for people aged 25 to 44 years in 2016, at small area geographical level for the whole of England.

Northern men faced a higher risk of dying young than northern women – partly because overall mortality rates are higher for men than for women, pretty much at every age, but also because men tend to be more susceptible to socioeconomic pressures. Although anachronistic, the expectation to have a job and be able to sustain a family weighs more on men. Accidents, alcohol misuse, drug misuse and suicide are all strongly associated with low socioeconomic status.

Suicide risk is twice as high among the most deprived men, compared to the most affluent. Suicide risk has also been associated with unemployment, and substantial increases in suicide have been observed during periods of recession – especially among men. Further evidence tells us that unskilled men between ages 25 and 39 are between ten and 20 times more likely to die from alcohol-related causes, compared to professionals.

Alcohol underpins the steep increase in liver cirrhosis deaths in Britain from the 1990s – which is when the north-south divide in mortality between people aged 25 to 44 also started to emerge. Previous research has shown that men in this age group, who live in the most deprived areas, are five times more likely to die from alcohol-related diseases than those in the most affluent areas. For women in deprived areas, the risk is four times greater.


It’s also widely known that mortality rates for cancer are higher in more deprived areas, and people have worse survival rates in places where smoking and alcohol abuse is more prevalent. Heroin and crack cocaine addiction and deaths from drug overdoses are also strongly associated with deprivation.

The greater number of deaths from accidents in the north should be considered in the context of transport infrastructure investment, which is heavily skewed towards the south – especially London, which enjoys the lowest mortality in the country. What’s more, if reliable and affordable public transport is not available, people will drive more and expose themselves to higher risk of an accident.

Deaths for young adults in the north of England have been increasing compared to those in the south since the late 1990s, creating new health divides between England’s regions. It seems that persistent social, economic and health inequalities are responsible for a growing trend of psychological distress, despair and risk taking among young northerners. Without major changes, the extreme concentration of power, wealth and opportunity in the south will continue to damage people’s health, and worsen the north-south divide.

The Conversation

Evangelos Kontopantelis, Professor in Data Science and Health Services Research, University of Manchester

This article is republished from The Conversation under a Creative Commons license. Read the original article.